Partnership Matters - June 2009 - Kent and Medway NHS and ...

Kent and MedwayNHS and Social Care Partnership TrustmatterspartnershipThe newsletter for staff of Kent and Medway NHS and Social Care Partnership TrustmattersMeet your Staff GovernorsThe elections are over, the results are in and now it’s time to meet your Staff Governors! There was auniversal sentiment from each of them in saying thank you to everyone who voted and that they willdo their utmost in making your views known.Looking forward torepresenting staff in EastKent is Terence Huckstep acommunity psychiatric nursebased at The Beacon,Ramsgate. Terry has alwayshad a keen interest in thegovernance and managementof the Trust and has beeninvolved as a staff siderepresentative within theOPMH. “I feel ready for thechallenges this demandingrole will bring and amconfident that experiencegained from other roles willserve me well as a Governor.Previously, I was secondedPhil AnscombeTerry Huckstepfor the implementation ofagenda for change and theknowledge and skillsframework, challengingpieces of work. I have servedas an elected board memberfor The Royal College ofNursing, have experience ofgovernance within a largeorganisation and have alsorun my own business.Concerns already raised bycolleagues range from ‘arewe to become a postcodelottery provider’ to the safetyof jobs within therestructuring of the Trust aswe move to a businessJeannette PhillipsSarah Hodgesetting.” Contact Terry atterry.huckstep@kmpt.nhs.ukIn West Kent staff arerepresented by Dr PhilAnscombe who said, “As astaff Governor, I aim torepresent all care groups andprofessions in a strong andcoherent manner which willensure that staff are listenedto as services develop. As afrontline worker in a CMHTand on an acute ward I amwell aware of the pressuresfacing both frontline andadministrative staff.Amidst the changes of thelast ten years, it has beenenormously frustrating forstaff to feel ‘out the loop.’Initiatives have beenproposed but the views ofpeople implementingchanges have seldom beensought and sound ideas havegot lost in impracticalimplementation. I realise Iwould not be able to changethis on my own but there isan opportunity to championinitiatives in which the viewsof staff are sought andvalued. I am passionate inbelieving that this would leadto improved services forservice users and morerewarding work for staff.” Philcan be contacted atphil.anscombe@kmpt.nhs.ukJUNE 2009INSIDE THIS ISSUESpace UtilisationHidden Talents ArtExhibitionBe our Guest Editor!AND MUCH MORE…Jeannette Phillips is aConsultant Child andAdolescent Psychiatrist,Clinical Director for WestKent and Medway CAMHSand is the staff representativefor Medway. Jeannettewanted to become aGovernor to improve anddevelop the services the Trustoffers to really meet theneeds of users. “I amespecially interested inpreventing severe mentalillness and reducing the riskof relapse using the principlesof the recovery model andstrongly feel the Trust needsto adapt it's provision so thatusers are able to receive helpin the most respectful mannerand with dignity. I would liketo see more joined up workwith Social Care andVoluntary Agencies togetherwith User groups so thatresources can be used mosteffectively and that morepeople benefit from theCONTINUED ON PAGE 3

Contents:PAGE 3NewsPAGE 5Ethnicity MonitoringPAGE 8Dementia Care MappingPAGE 9Hidden Talents ArtExhibitionPAGE 10Supporting PeoplePAGE 13National NewsPAGE 14Patient FeedbackPAGE 15Research & DevelopmentPAGE 16Major ProjectsPAGE 17Learning & DevelopmentPAGE 18IM&TPAGE 19ePEXPAGE 20Dates for yourDiary/Lottery/Take a BreakWorld of the WebFor information about ourservices, visit our website:www.kmpt.nhs.ukKMPT Headquarters35 Kings Hill Avenue,Kings Hill, West Malling,Kent ME19 4AXTelephone: 01732 520400Fax: 01732 520401Designed by Baines.The views and opinions in thispublication do not necessarily reflectthe policies of Kent and Medway NHSand Social Care Partnership Trust.Editor’s introductionI hope that this is the last editorial introduction I have to write for a few months. Not because Iwon’t be working, or because we won’t be publishing a staff newsletter, but because one of ourreaders will be editing the next edition of Partnership Matters. We have decided to allow amember of staff this opportunity and you can read more about how YOU can become the Editorfor the August edition on page 7.We welcome our new staff Governors on the front cover and inside feature articles on DementiaCare Mapping, Supporting People and Ethnicity Monitoring. As always, please keep the stories,good news, areas of best practice and key information flowing to my team viacommunications@kmpt.nhs.ukAdrian Lowther, Head of Communications and MarketingContact the Editorial TeamIf you wish to contact the Editor of Partnership Matters, you can do so by writing to Trust HQ,35 Kings Hill Avenue, Kings Hill, West Malling, Kent ME19 4AX, by emailingcommunications@kmpt.nhs.uk or calling 01732 520441.About the TrustKent and Medway PartnershipTrust was established on 1April 2006. It provides mentalhealth, learning disability,substance misuse and otherspecialist services and wasformed as a result of a mergerbetween two predecessorNHS trusts in East and WestKent. Service provision ismainly organised throughthree geographical servicedirectorates which arecoterminous with the threePrimary Care Trusts: WestKent, Eastern and Coastal, andRequests for informationPlease remember that allrequests for Information,including those from serviceusers, carers, police, solicitorsetc, must be sent immediatelyto the Information Rights Teamat 35 Kings Hill Avenue, WestMalling, for response.The Information Rights Teamdeal with all requests forcorporate information under theFreedom of Information Act, andrequests for personalMedway. In addition, the Trustoperates a range of specialistservices across Kent andMedway, including theForensic Mental HealthService.The Trust boundaries are inline with those of Kent CountyCouncil and Medway Council.Serving a population ofapproximately 1.6 millionpeople, the boundariesincorporate areas of affluenceand severe deprivation andinclude both rural areas andlarge conurbations.information about service usersand staff under the DataProtection Act and the Accessto Health Records Act.As you may know there aremany instances wheninformation MUST or MUSTNOT be released to thoseoutside the Trust. TheInformation Rights Team willensure that all legalrequirements are met in order toensure that safety andThe Trust works inpartnership to provideresponsive and dependableservices to the communitieswe serve in Kent and Medway.It aims to provide hope,recovery, well-being and socialinclusion, individual choice andindependence through highquality care and environments;services that are safe,sustainable and stigma-freeand a culture of developmentand continuous improvement,taking account of ethnicity,culture and gender.confidentiality of staff andservice users is preserved. Theteam can provide advice to staffwho are unsure whetherinformation should be disclosedand to service users who wishto access information. Ad hoctraining to teams is availableon request.For further informationplease contact the teamon 01732 520447.2 Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009

NewsMeet your Staff Governors Continued from page 1expertise of highly trainedprofessionals.” ContactJeannette onjeannette.phillips@kmpt.nhs.ukThe Trust-wide staffrepresentative is SarahHodge, Service Manager forthe Eating Disorder Servicewho said, “I wanted tobecome a Governor because ISpace – the final frontier…?Latest stats show thisTrust runs 172 buildingson 115 sites!To make KMPT a morestreamlined, cost-effective,efficient organisation we needto look at the buildings wehave and how to make thebest possible use of thespace available. It was widelyacknowledged that there waswasted space and after an indepthstudy, the resultsshowed that overall, theorganisation could afford tofeel that it is a greatopportunity to represent'frontline' workers and makesure their views are heard andthat they are really treated asmembers of the FoundationTrust. On a personal level, Ialso experience Trust servicesin my role as a carer, whichhas given me an invaluableshrink by 20% if the utilisationof space available was put tobest use.The process has alreadybegun; for example, theRecruitment team formerlybased at our headquarters inKings Hill has now relocatedto Canterbury. This in turn hasfreed up space at Kings Hillwhere we currently have asplit site. The medium to longterm aim is to have all staff atheadquarters based in onebuilding which requirescareful planning and logisticsinsight into this perspective.Trying to navigate your waythrough the system to ensureyou get the correct care canbe very difficult and I wouldlike to see a clearer pathwayfor carers and service usersso they know how to accessour services. Although I am aService Manager, I retain ato enable this to happen.Across the region there will besimilar drives to ensure all theobjectives are achieved.This will, in turn, helpreduce our carbon footprint asubject on which we will soonbe canvassing your views andencouraging you to shareyour ideas via aquestionnaire. For instance, in2008 the Trust printed astaggering 15 million sheetsof paper using our printersand photocopiers – anamount that might begreat deal of passion for myprofession (nursing) and thecontribution it makes to theworkings of the Trust, andthink it's vital to represent thisworkforce on the council.”Sarah is based in Maidstoneand colleagues can contacther atsarah.hodge@kmpt.nhs.ukreduced with a bit of thought(for example, whenphotocopying make sure youuse both sides of the paper!)and nationally, the NHS hasincreased its CO2 emissionsby 40% since 1990 so wereally do need to makechanges. When you receiveyour questionnaire(electronically of course!) wereally would appreciate youtaking the small amount oftime it takes to complete andreturn it as we really do valueyour input.Making Experiences CountThe Department of Healthreformed the NHS and AdultSocial Care Complaintsarrangements at thebeginning of April. The newprocess encourages NHSand Social Careorganisations to ask peopleabout their experience ofcare and to use thisinformation to help improvestandards. There is agreater emphasis upon thequick resolution of straightforwardcases by managersand commissioners, as wellas greater use of optionssuch as mediation toresolve complex caseslocally.Complainants and NHS andSocial Care organisationsshould agree upon anindividual timescale andapproach to resolving a caseand Complainants will havethe option to go directly tothe Commissioner rather thanto the provider of the service.The HealthcareCommission is no longer thefirst point of review for NHScomplaints that cannot beresolved locally. A single localresolution stage for AdultSocial Care has beenintroduced replacing thetiered stages prescribed bythe old Local Authority SocialCare Complaint Regulations.A Complainant who isunhappy with the way theircase has been handled canstill ask the Health ServiceOmbudsman or the LocalGovernment Ombudsman toreview their case.The Trust now has an evengreater commitment inconsulting and listening topeople who wish to offerfeedback or raise concernsabout the service they haveexperienced. Furtherdevelopment and training arenow on the cards for Truststaff, to ensure that theprogramme for complainthandling is first-rate.This is part of the ‘customercare’ approach to complainthandling, which sees thecomplaints team workingalongside PALS within thePatient, Public andCommunity InvolvementDepartment so no voice isunheard.To see the ReformedComplaint Regulations visitwww.opsi.gov.uk/stat.htm‘Listening RespondingImproving – A Guide to BetterCustomer Care’ offersguidance on good complainthandling and is available onthe Department of Health’swebsite www.dh.gov.ukSwine FluPreparationJanet Smith,Administrator at PracticeDevelopment Centre andLee Busher, LeadResuscitation Officer arepictured in the process ofsending the first lineresponse kits forPandemic Flu to thein-patient areas afterspending two daysputting the kits together.Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009 3

NewsHolding the Fort!A project of social inclusiondeveloped by theCommunity ResourcesTeam in Medway inconjunction with the FortAmherst Trust Chatham,integrates service usersinto existing communityprojects as volunteers.Senior Resource CentreWorker Chris Cursonexplained, ‘We were lookingat ways to motivate peopleand also provide them witha positive and meaningfulexperience and the idea ofintroducing service users asvolunteers meant it couldbe beneficial not only to theBest Practice Eventsindividual but to theorganisation as well.’After some discussion andnegotiation with the FortAmherst Trust it was agreedthat service users would workalongside volunteers and helprun the café and maintain thegrounds.Community ResourcesManager Gill Holmeschampioned the project fromthe word go and is delightedwith how it has progressed.‘At Fort Amherst there is nodistinction between serviceusers and volunteers – onceyou are here everyone is avolunteer and treated theTwo very successful BP events were held recently in Dartfordand Canterbury to show case some of the excellent practice &service improvements which are taking place across the Trust.The aim of the event was to promote awareness of this work &create opportunities to share learning:The Dementia Primary Care Pilot is an initiative developed toimprove access to diagnosis and support for people with dementia inprimary care. It is a partnership arrangement between the Trust and‘For Dementia’ and will be delivered by Admiral Nurses working inGP’s surgeries.Amberwood is a 16 bedded acute admissions ward providinginpatient care for women with mental health problems and aims toprovide a gender sensitive service environment.Recovery highlighted the work being done on 5 acute care inpatientwards relating to medication and choice as part of the recoveryprocess.Creating Capable Teams Approach has five clear steps to promoteservice change and modernisation involving service users, carersand staff.Psychosocial Interventions (PSI) with individuals who experiencepsychosis and their families are available within KMPT. The Lead Nurseshighlighted training opportunities and a network of those practising PSI.Key themes include psycho education, improving communication,problem solving strategies and relapse preventionThe Forensic Mental Health Directorate theme was minimising therisk of illicit substances being smuggled into secure units and beingused by patients.The CAMHS service presented information on two pieces of work;“Tree of Change” where service users provide feedback by writing ona leaf which is then added to the tree and an audit collecting viewsof service users.Brenchley Unit Personality Disorders had a presentation devisedand assembled by former service users and included details of theservice, suitable referrals criteria and a description of the elementsand effects of the therapeutic communities model of work.Volunteers at the Fort Amherst cafésame. There’s no doubtexisting volunteers at the Forthad worries about workingalongside people with mentalhealth issues but once theygot to know them you couldliterally see the barrierscoming down. It’s been aneducational process on bothsides and a fantastic projectin terms of social inclusionand reducing stigma. It alsooffers service users theopportunity to gain workexperience and training andmotivates them to achieveboth short and long termgoals. It’s been such asuccess that we have nowstarted another similar projectat Capstone Farm CountryPark in Gillingham.’Fort Amherst is a worldheritage site and funding isself-raised through eventsmany of which are volunteerled.To find out more aboutthe Fort and all its activitiesvisit www.fortamherst.com orcall 01634 847747.Wheelchair Repair Service provides cleaning, re-conditioning,painting, welding, modifications, collections and delivery service,Portable Appliance Testing, Mobile Workshops to carry out repairs inthe patient’s homes and a full Electronic Programming andDiagnostic Service.Thanet Horizon is a unique multi-agency service aimed at providinggood quality affordable housing with intensive support through thelocal CMHT to those with severe and enduring mental healthproblems.Home Treatment Service – HTS aims to reduce hospital admissionsto acute mental health inpatient beds and minimises the risks ofpremature or avoidable dependence on long term care and workswith individuals with dementia and their carers.NICE Implementation Team distributed leaflets about the team andits functions and information on published guidelines for clinicianand service users.Canterbury College of Art Studio provides a venue for an arttherapy group and meets Government criteria in that it is a project ofsocial inclusion held in a venue outside of statutory arenas such ashospitals or clinic.Well-being displayed a board exhibiting examples of work that hasbeen achieved with inpatients, including wake and shake gentleexercise sessions, healthy lunch club, walk and talk and variousexamples of how health is promoted on the wards.Other stands at the Best Practice events included the EIS SportingGroup; Carers Service; Drop-in at Priority house and TLC carersgroup; Nursing; R Place; Layered Care; PICU and the Limb Service.We want to hold future events & your feedback will be vital toensure we reach the right target audience, cover topics ofinterest & improve on practical arrangements.Please thereforeuse the link at the end of this article to provide us with feedbackto shape future events.Another Best Practice event is scheduled to take place on Friday, 9thOctober but before then we would like to harness your views, pleasego to http://staffzone.kmpt.nhs.uk/bestpractice4 Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009

NewsProtecting privacy and dignityThe drive to eliminate mixed sexaccommodation and protect theprivacy and dignity of service usershas moved forward substantively withthe announcement that the Trust hasbeen successful in securing 5 bids forfunding. These bids were madeagainst the £100m announced byHealth Secretary Alan Johnson, totackle Mixed Sex Accommodationnationally and will be used to cover:-• The development of a female onlyward at the Arundel Unit• Improved Sanitary and ShowerFacilities at Priority House• Better toilet and sanitary facilities atthe Arundel Unit• The introduction of real-time patientsurveys focusing on privacy and dignity,and Mixed Sex Accommodation• A programme of learning anddevelopment for staff to improve theirawareness and understanding ofMixed Sex Accommodation issues• Further work to establish thewomen’s only ward at A BlockEthnicity MonitoringEthnicity monitoring is linked to the legalobligations under the Race RelationsAmendment Act (2000). This places astatutory general duty on publicauthorities to promote race equality andprovide services without discrimination.Keeping ethnic records of service usersand staff is also a requirement to establishwhether services are meeting the needsof different ethnic groups in thecommunities.A survey of hospital admissions forattempted suicide and self harm showedthat young Asian women’s rates ofadmission were three times those ofWhite British women (Bhui, 2002).A counselling service is a key resourceto the Black and Minority Ethnic (BME)community and specifically to BMEwomen.Describing your ethnic group is differentfrom nationality, eg you may have a Britishnationality but belong to a different ethnicgroup such as Indian, Irish, Chinese,Polish, African or Caribbean.Collecting this data is vital. We live in aculturally diverse society and before wedevelop and improve services we need toknow who is using them. It is important forus to understand the needs of serviceusers from different groups and so providebetter and more appropriate services.Relatively small black and minority ethnicpopulations can be the most isolated anddisadvantaged in terms of access to healthcare, therefore collection and use shouldoccur nationally, and not only in thoseareas with large black and minority ethnicpopulations. All information collected istreated with the highest degree ofconfidentiality and service users need to bemade aware that it will only be used as partof their confidential NHS or care notes andwill not be shared with any other person ororganisation.The collection of ethnic data must besupported and led by senior managementin order to address healthcare inequalitiesamong service users and tosustain/improve local practice. Thefollowing approaches are advised tocollect ethnicity, either:•on the ward after the initialassessment, or• at subsequent assessments, or•at some other time, possibly when arelative or advocate can help theservice user or• at assessment prior to dischargeInterpreters should be used as neededin ensuring that service users understandthe importance of collecting ethnicity data(see Interpretation Policy). However thereis no obligation on individuals to respondand no pressure applied to answer. “Notstated” should be recorded only if serviceusers do not give a response after beingThe money must be spent by the endasked. Should the service user not haveof June, which means benefits will bethe capacity to respond due to emotional,realised quickly. The surveys will start tomeasure these benefits and will takemental or physical stress, data onplace first in the above areas that haveethnicity could be collected later in theimprovement programmes underway.admission.This funding announcement is theFor a service user with dementia,latest example of ongoing work by locallearning disability, etc., experienceTrusts with NHS partners, patients andsuggests that ethnic group should bestaff to improve and protect the privacyand dignity of people wherever theygathered from a relative or an advocate.receive care. From a sample of 4000A parent may be asked to respond for apatients questioned across Kent, Surreychild under the age of 9; for those aged 9-and Sussex in the 2006 national inpatient13 the individual capacity to understandsurvey, 25 per cent who stayed in onethe request should be determined andward, said they shared accommodationwith the opposite sex. This fell to 17 perage 13+ should be able to respond forcent the following year and KMPT isthemselves unless they do not have thecommitted to reducing this even further.capacity to do so, eg learning disability.The Trust uses the 16 + 1 code national standard as a minimum for collecting and reporting on the ethnic group of serviceusers, these codes may be further sub-divided.A : WhiteBritishIrishAny other White background (please write in)B : MixedWhite and Black CaribbeanWhite and Black AfricanWhite and AsianAny other mixed background (please write in)C : Asian or Asian BritishIndianPakistaniBangladeshiAny other Asian background (please write in)D : Black or Black BritishCaribbeanAfricanAny other Black background (please write in)• Do you find it challenging to ask service users their ethnic origin?• Are you aware of the Trust Collection and Recording of Ethnicity policy?• Would you and your team benefit from/need some training on collection of ethnicityrecording?If your answer is YES to even one question please contact the Equality and DiversityTeam by emailing equalities@kmpt.nhs.ukE : Chinese or other ethnic groupChineseAny other (please write in)Not statedNot statedKent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009 5

NewsCBIT – Making a differenceThe Community Brain Injury Team (CBIT) based at theDisablement Services Centre at Medway MaritimeHospital was established in 1996 and seeks to addressthe physical, emotional and social consequences ofbrain injury experienced by adults living in thecommunity throughout Medway and Swale.The team includes a secretary, a manager/clinicalpsychologist, a physiotherapist, an occupational therapist,a speech and language therapist, a clinicalneuropsychologist and a rehabilitation assistant. Referralsare accepted from adults aged 16 and over who havesuffered a single incident brain injury, are living in acommunity setting within the Medway/Swale area andrequire the intervention of at least two of the disciplines inthe team. CBIT aims to facilitate adjustment to theirchange in circumstances, help them find new ways ofparticipating in everyday life and works alongside theirfamily and carers to achieve this. After an initialassessment goals are set, agreed upon and reviewed atappropriate times during the rehabilitation process.Last summer, a patient and carer group meeting washeld at the King Charles Hotel in Gillingham. The focus ofthe day was on the role of Social Services’ and benefitsprovision as well as giving everyone a chance to meet upwith people in a similar situation. It was so well attendedthat another is currently being planned for this year.CBIT also helps facilitate a Brain Injury Support Groupset up 4 years ago which meets every 6 to 8 weeks andgives past and present CBIT clients and relatives anopportunity to meet socially.More recently, a young persons group has begun whichmeets on a monthly basis and uses Facebook to maintaincontact and organise its activities.In addition, CBIT runs a series of patient and carereducation groups. The patient education group consistsof eight sessions over four weeks (twice a week for 1hour) and topics include:• Overview of brain function• The nature of brain injury• Memory after brain injuryRelatives and carers attend three sessions and learn about:• Brain anatomy and brain injury• Cognitive, emotional and behavioural changes after braininjury• Coping and adjustmentConsidering that all the CBIT staff work on a part-timebasis, an impressive amount of work and new initiativeshave been achieved not to mention the successfulrehabilitation of clients and the support offered to familiesand carers. For more information on CBIT contactSamantha Prior, team Secretary on 01634 833937.Kent County ShowWe’ll be there so if you wantto man the stand pleasevolunteer!The show takes place overthe weekend of 17-19th Julyat the County Showground inDetling and we are looking foroutgoing, engaging staff whoare happy to promote mentalAs most staff and serviceusers of the Trust are nowaware, we are workingtowards the implementationof a refocused CPA. Thismeans that CPA will nowfocus on those who havemore complex needs andrequire the support of carecoordination. The keydifference between thosewho will be subject to CPAand those who will not, isthe level of support requiredto access services.Refocusing the CareProgramme Approach (DOH,2008) states that ‘It is clearthat all service users shouldhave access to high quality,evidence based mental healthservices….the rights thatservices users have to anassessment of their needs,the development of a careplan and a review of that careby the professional involved,will continue to be goodpractice for all.’Those receiving theadditional support of CPAand those who will not, willstill have the same rights toassessment of riskand need and thedevelopment of acare plan. Thisprocess will be ledby the professionalinvolved andthough the serviceuser and carer areintegral to this, it ishealth well being services andanti-stigma messages to awide audience. If you wouldlike to volunteer to man thestand for half a day pleasecontact Katie Watkinson byemailingkatie.watkinson@kmpt.nhs.ukor call 01732 520461.CPA: A New Focus butsame Care Standards for allthe responsibility of your staffto ensure that thisassessment and careplanning process takes place.Those who are carecoordinated under CPA will,wherever possible, take alead role in the care planningprocess and move towardsmore self directed care.It is important for all as welook toward implementing aRefocus of CPA that we alsoaddress the needs of thosewho do not require theadditional support of CPA,through the same thoroughassessment process,including the potential needfor the support of CPA.CPA Webpage & Mailboxis LaunchedAs part of the refocus ofCPA a webpage has been setup and can be accessed bygoing towww.kmpt.nhs.uk/cpa pleasecheck here for informationand updates. If you would liketo comment on the webpageor share ideas please emailCPA@kmpt.nhs.ukThe CBIT6 Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009

NewsTriathlon training - and a name change!In the April issue of PartnershipMatters we reported on our team ofintrepid athletes from the East KentNeuropsychology Service at BucklandHospital who are training to take partin the relay section of the South CoastTriathlon on Saturday 15th August. Theteam, Dr Chris Strydom, Dr JenniferDean and assistant psychologist IzzyBiggin, decided to test their sportingprowess and at the same time raisemoney for their chosen charityHacked off??Have you ever wonderedwhat it would be like to be ajournalist or even the editorof a publication? Perhapsyou’ve never given a secondthought into how a magazineis put together but would beinterested in finding out? Isthere someone within theTrust that you would like tointerview or a feature thatyou would like to see inprint? Well, here’s yourchance!We are inviting everyoneinterested in being the GuestEditor of the August issue ofPartnership Matters to get intouch. This is your opportunityto decide which stories go in,which page they should be onor whether they should justtake the quickest route to thenearest dustbin!Now, we appreciate that youall have your day jobs tocontend with so we won’t beMind the GapMind the Gap is an artist ledfestival celebratingcreativity, individuality anddiversity in arts for mentalhealth and the theme for2009 is “A place at theTable”. All are welcome totake part whatever yourconnection with mentalhealth, be it service user,carer, service provider,group or individual.Make a Video - make a 3minute video on the theme‘A Place at the Table’.Make a Tablecloth –decorate a small tablecloth‘Headway’. It seems the teaminadvertently caused offence to somewith their choice of team name ‘TheNeuro Nutters’ and would like toapologise unreservedly. They neverintended to be insensitive or causeoffence and have therefore changedtheir name to Neurotri-ers whichrefers to participating in a relaytriathlon as well as including the factthat they all work withinNEUROpsychologyexpecting you to go it alone.Our dedicated team will be inthe wings to offer as much oras little help as you want butremember, as Editor, you candecide on a story or interviewand tell one of us to go and doit…just think of the power! Itmay come as a surprise tosome of you but we doforward plan and will alreadyhave built up a surplus ofarticles that you can choosewhether to use or start theAugust issue from scratch.And who knows, PartnershipMatters today - Voguemagazine tomorrow?So, if we’ve whetted yourappetite for being a hackplease tell us in no more than35 words why we should pickyou as Guest Editor and emailit to us atcommunications@kmpt.nhs.ukor call 01732 520441 byFriday 26th June.(free packs of fabric and ideassheet available to order) on thetheme ‘A Place at the Table’.Join a Choir- Workshopswill take place during the yearculminating in a Big Singperformance on Saturday17th October at CanterburyChrist Church Universitydirected by ProfessorGrenville Hancox.For more information emailinfo@canterburymindthegap.comor call Sandra Pearson Tel:07870 320479 alternatively,visitwww.canterburymindthegap.comNeurotri-ers can be sponsored bygoing towww.justgiving.com/neurotri-ersAn appeal for a cyclist and swimmer tojoin runner Adrian Lowther (Head ofMarketing & Communications) in creatinganother triathlon relay team to challengeNeurotri-ers has so far fallen on deafears but it’s still not too late! If you wouldlike to take part call Adrian on 01732520441 or emailcommunications@kmpt.nhs.ukThe Memory Clinic TeamThe new ‘Memory Clinic’ has beenlaunched at Gregory Day Hospital, everyTuesday by appointment only.Gregory House, St Martin’s Hospital,Littlebourne Road,Canterbury, Kent,CT1 1TDTel: (01227) 812054 Fax: (01227) 812018Crisis Team Says FarewellThe Eastern and CoastalCrisis Team said farewell toMike Brazzill upon hisretirement following over 30years in mental healthnursing. After surprising Mikewith a cake and refreshmentsat the end of his final shift, theCrisis Team joined him later athis local pub, ‘The Hope’, fora farewell party andpresented him with an ipod.Mike trained in 1975 and hisfirst job was at West CheshireHospital. He moved to Kent in1979, met his wife Sue andworked at Oak House in StAugustine’s as a staff nursebefore moving on to RadnorMike and his Crisis Team colleaguesFrom left to right:Heidi Outrim (SeniorOT), Dr Elizabeth Field(Clinical Psychologist),Ian Oliver (OT SeniorPractitioner),Dr Deborah Connolly(Consultant Psychiatristfor Older Persons),Dr Mary Aston (SASDoctor), Sue Day(Senior Staff Nurse).Not photographed -Dr Bastiaan Veugelers(Consultant Psychiatrist)Park as a CPN. He then wentto MIST before joining theCrisis Team in 2004.So far, Mike’s plans forretirement includedownloading Bob Dylanmusic, catching up with oldfriends, going to local cricketmatches, doing some DIY andgenerally chilling out!He was well-known in theteam for his calmness -especially on a Fridayafternoon when referrals weremany - and also for his whizkid IT skills! Mike will begreatly missed by the CrisisTeam who wish him a veryhappy and healthy retirement.Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009 7

NewsDetailed assessments lead to better careDemetnia Care Mapping ishaving a positive impact onthe way services areworking with clients.Adrian Lowther went to findout what it is and what ithopes to achieve.Staff working in dementiaservices across Eastern andCoastal Kent are increasinglyusing Dementia CareMapping to assess patientsand it is enabling moretailored care to be given topatients.Dementia Care Mapping(DCM) is a method designedto evaluate quality of carefrom the perspective of theperson with dementia. It isbased on the philosophy ofperson centered care, whichpromotes a holistic approachto care that upholds thepersonhood of the personwith dementia.The process of using DCMinvolves observing peoplewith dementia over a periodof time and recordinginformation about theirexperience of care, analysingand interpreting the data andthen feeding it back to staff.This information is then usedto draw up an action plan tobring about change andimprovements in the patient’scare.It is used to get staff torecognise that they need towork in certain ways withcertain people. The course isnot about new learning butinstead gives staff the chanceto reflect on what they knowand do already.There are several two weekblocks planned for the activityto take place on each wardand ideally it will beundertaken 2-3 times a year.The actual planning of whichis not easy as the staffundertaking the mapping aresuper-numery (but still boundby ethical codes). It is notjust nursing staff that aretrained in the mappingprocess, Associate Directorsand Healthcare Assistants arealso taking part. The Trustnow has about 60 peopletrained in the mappingprocess and a further 30 areundertaking training thismonth. There is an advancedcourse also planned forNovember.Although the programmeuses a laptop to record theinformation as the mappingtakes place, there is no fancyor expensive softwareinvolved, a Microsoft Excelprogramme used underlicense captures data andproduces graphs ready foranalysis.The mapping is usuallyundertaken shortly afterarrival on a ward or as part ofdischarge planning. Theapproach is now only usefulto those on in-patient wards.It can also be effective inplanning care for those underHome Treatment Teams andthose in longer stayresidential wards. There isalso a growing use of thistechnique in learningdisability services, but thetechnique does not workwhen assessing functionalmental illness. It has beensaid to be most effectivewhen assessing ‘thosewithout a voice’.All carers and relatives areinformed the technique istaking place and whereappropriate the results can beused as a positive feedbacktool for carers.If you have any questionsabout mapping pleasecontact the lead mapper –Tanya Clover on 0771 18598163 or email:t.clover@btinternet.com+5+3+1-1-3-5U U U A U F U K K A U F U U P U A P U A U U ABEHAVIOUR CATEGORIESThe MethodEvery 5 minutes a mapper writes down a BehaviourCategory Code (BCC) which represents what eachperson was mainly doing for that five minute period.This is chosen from a list of 23 codes which aredenoted by a letter e.g. F = eating and drinking, L =leisure, fun and recreational activities). In each fiveminutes the mapper also records a Mood andEngagement (ME) Value which represents howengaged the person is and whether their mood ispositive or negative. This is represented on a sixpoint scale ( +5, +3, +1, -1, -3, -5). This generates aclear graph for analysis (see left).DCM – The Facts!Do I need to do anything‘special’ when mapping istaking place?No – mapping aims to capturewhat life is like for the person withdementia on a typical day. Carestaff carry out their work asnormal and DCM should notinterfere with this.Who is being observed?The focus of mapping is on theperson with dementia and theirexperience rather than care staffor visitors. DCM tries to highlightthe experience from their point ofview. What is recorded is howpeople with dementia areresponding and reacting to theenvironment in which they findthemselves.Will names be mentioned infeedback?No – DCM tries to capture thesocial environment that surroundsthe person with dementia. Namesof care staff are not included atany time during the process.Names of service users areremoved from any report that isseen by anyone other than thedirect care team.Who sees the results?The results of any mapping areowned jointly between themappers and those directlyresponsible for care staff in theplace being mapped. No-one elseis allowed to see the resultsunless this is agreed by the staffteam.Can I talk to the mappers whilethey are mapping?Yes – absolutely. You areencouraged to discuss whatmappers are doing and if youhave time it is sometimes good tosit and observe with the mappers.Mappers may find it difficult todiscuss things at length while theyare in the middle of anobservation period. It may bebetter to discuss things with themduring their breaks.What about toilets, bedroomsand bathrooms?Mapping is only carried out inpublic areas. Mapping in areaswhere sensitive care practice isundertaken is strictly forbidden.Some of the DCM trained staff atFrank Lloyd Unit, Sittingbourne8 Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009

NewsJoyce Armstrong,Art PsychotherapistHidden Talents on DisplayAn Art Therapy group who meet on a weekly basis atCanterbury College as part of a joint venture betweenKMPT’s Psychological Services and the College held anexhibition of their work at the Neville Pundole Gallery inFolkestone at the beginning of April.The ‘Hidden Talents’ exhibition was deemed a great successby all involved and many of the pieces were sold as a result.Art Psychotherapist Joyce Armstrong explained, ‘This is apioneering project which not only fulfils the College’s equalityand diversity programme by offering us studio space one day aweek for our mental health service users and college studentsbut also meets Government criteria in that it is a project ofsocial inclusion held in a venue outside of statutory arenassuch as hospitals or clinics. Being able to extend the project inholding an exhibition in a public gallery also gave greatcredence to the work the artists produced.’The Art Therapy group has approximately 13 regularparticipants and has amassed an impressive amount of worksince its inception and the standard of work achieved isremarkable. Mark Howland, Section Manager Art & Design atCanterbury College who curated the exhibition said: ‘We arethe only college in the country working on this kind ofprogramme and offering these opportunities and are thrilled tobe involved. The project not only allows people to enter atotally unique environment to explore art, therapy andeducation, but it also helps us showcase to our students whatcareers are available in today’s art world.’Gallery owner Neville Pundole was delighted to offer space athis gallery for the exhibition and commented that it brought tofruition a partnership between the education sector, healthsector and private sector which was always to be welcomedand championed.Many of the artists wrote personal statements which weremoving accounts of how the group enabled them to expresstheir feelings and be part of the community. Group memberDavid Lines wrote in his statement that ‘Art has always been agreat interest to me and that is what has led me to be a part ofthe group. Many years ago I studied for a HND in Fine Art andafter successfully completingthat I enrolled for a fine artdegree. Halfway through this Iwas suffering from severedepression and unfortunatelyI could not complete thecourse. Then last year I was offered the chance to do some arttherapy and I found this very rewarding, and it sparked off myinterest in creating art again… The group has offered me thechance to create art in a non-pressured atmosphere and also tobe with people again.’Spurred on by the success of this exhibition, Joyce’s nextaim is to find sponsorship for framing and a Canterbury venuefor the next show and would welcome any offers of help. Joycealso wants to promote a wider use of the service by building upa body of work and/or accepting commissions from anyone inthe Trust that needs art work. This could, for example, followthe redecoration of an office or to simply liven up a corridor soif you want to ditch the posters and have some original artworkon your walls contact Joyce by email atjoyce.armstrong@kmpt.nhs.ukGallery owner Neville Pundole and Joyce ArmstrongHorticulturalProject Blooms!A fundraising group, to support thework of an innovative horticulturalproject for people with dementia, hasbeen launched. The Friends of theYoung Onset Dementia HorticulturalProject has been established toimprove voluntary fund raising andpromote wider support and knowledgeof the group’s aims.The Horticultural Project for youngerpeople with dementia was set up in 2003and is based at the Robert Bean Lodge inPattens Lane, Rochester. Members meetweekly and enjoy a mixture of gardening,craft work and outings and everyone isinvolved in the decision making. Critically, itserves anyone who has been given adiagnosis of dementia before the age of 65.The Friends’ first piece of work was tocommemorate the life of former memberChristine Prothero by planting herfavourite flowering shrub as a memorial.Christine’s husband and principal carerDavid is now Chairman of the Friends’and he attended the planting session withmembers of the horticultural project.The horticultural project supportersFurther information on the project andthe Friends’ Support Group can beobtained by contacting Reinhard Guss orFrances Cook at NHS Elisabeth House,Holding Street, Rainham, Kent or call01634 382080.Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009 9

NewsRaising the Standards of CommunityMental HealthThe Support, Time and Recovery teams flag up their achievements on St Georges DayThe Support, Time &Recovery (STR) MentalHealth teams across Eastand West Kent have beenworking together with theSupporting PeopleProgramme to raise thestandards of the FloatingSupport scheme to ourclients within the community.They have combined theirskills and practises with aclear vision of what theywanted to achieve and raisedthe quality bar from a D gradeto a High B! The team havehad regular in-depth auditsand made consistent progressdespite the complexity ofbringing 6 areas together tooperate a quality of care to beproud of.Christine Cason, the areacoordinator for STR andSupporting People, meets withthe leads monthly to sharepractise and improvestandards. “The upgrading isan encouraging achievementand the leads are determined toimprove their performancefurther until they reach thehighest possible standards ofSupporting People and becomeleaders in this field,” said Chris.Associate Social CareDirector Jean Evans attendeda celebratory lunch on the23rd April which combined aprogramme of practise andvisitor speakers. DaveWebster, InvolvementManager from Porchlightspoke to the group about hisorganisation’s participationwith the Supporting Peopleprogramme and the benefits ithad brought. Other guestspeakers were the HIV /AidsCare Manager for East Kent(name protected requested)and their Supporting PeopleLead Carole. They talkedabout their work and how theSupporting People initiativehad strengthened links withthe Community Mental HealthTeams. Jean said that thegrading is thoroughly welldeservedand all involved areto be congratulated with aspecial mention to ChristineCason for keeping theprogramme on track, andensuring the annual audits bythe Supporting Peoplemonitoring and review officerswere all delivered on time.The Supporting Peopleprogramme offers vulnerablepeople the opportunity toimprove their quality of life byproviding a stableenvironment which enablesgreater independence. Itdelivers high quality andstrategically planned housingrelatedservices which arecost-effective and reliable andcompliment existing careservices. The planning anddevelopment of services isneeds-led and SupportingPeople is a workingpartnership of localArea leads for the Supporting People programme(l to r) Peter Cordrey West KentSP Lead, Tony Knight ShepwaySP Lead and Rachel BeachAshford SP Lead in discussiongovernment, clients andsupport agencies.The leads continue toimprove the standards bysupporting the recoveryjourney model within the localcommunity. Christine wouldlike to thank Chris Fay, LocalityManager in Coleman Housewho hosted the day and DerekSeymour, Assistant SocialCare Director, who managedthe progress of the teams.For further informationcontact Christine Cason, AreaCoordinator for STR &Supporting People by emailingchristine.cason@kent.gov.ukor call 01304 216666 ext 6649.A Special Brand of BuddyJo Brand and Buddy SchemeCoordinator Colin MitchellJo in the recording studioThe award-winning Buddy Scheme which enables serviceusers to become mentors of university students hasproduced a training pack so other Trusts can replicate thescheme. The pack includes DVDs with a voiceover bycomedian Jo Brand, a former psychiatric nurse, whodonated her services for free.Belinda Garnett, part of the management team for the BuddyScheme, said, ‘Jo was an absolute delight to work with and hadus all in stitches. She is really enthusiastic about the schemeand we are very grateful that she made time within her busyschedule to help us put the DVD together.’The Buddy Scheme is validated by Canterbury Christ ChurchUniversity and the NMC as part of the new mental health nursingcurriculum. Mental health nursing students are offered theopportunity to take part in the Buddy Scheme during theirpractice placements in the recovery and wellbeing module as partof Canterbury Christchurch University’s curriculum. Currently, thescheme is managing to accommodate all of the students withBuddies from Laurel House Canterbury CMHT, Gillingham andChatham CMHTs and the Rehabilitation Service Eastern andCoastal Directorate. It is hoped the scheme will expand to includeother CMHTs and the Early Intervention Service.If your team is interested in being part of the Buddy Scheme,as both an intervention in a service user's recovery and as aneducational tool for students on practice placements, theBuddy Scheme team will provide inductions, training andongoing support for service users, staff and students as well asthe training package containing all the documentation neededto start the Buddy Scheme. We also provide the necessaryfunding to pay your service user as Buddies! For moreinformation please email belinda.garnett@kmpt.nhs.uk or visitthe website www.thebuddyscheme.co.uk10 Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009

Kent and MedwayNHS and Social Care Partnership TrustNursing FocusI would like to welcome you to our first nursingfocus newsletter and for those of you that I havenot met, to introduce myself. As the Head ofNursing and Director of Infection Prevention andControl I would like to establish a very clearcommunication network to all nurses within theTrust. With the huge geographical area coveredby the Trust, we are going to have to beinnovative to maintain really good two-waylines of communication. Nurses are the largestgroup of staff within the Trust and make a vitalcontribution to providing care to service users ofall age groups and in all settings and it isrecognised that this is always as part of a widermulti-disciplinary and multi-agency network.The idea behind this newsletter is to encouragenurses to promote all the good initiatives they aredoing, not just within the Corporate Nursing Teambut within all Trust services.I am keen to hear from all nurses and to inviteparticipation on a regular basis for this newsletter. Soif you have some really great nursing news thenplease contact me and we will publish it in thenewsletter.I hope you enjoy the news that we are providing andyour feedback would be greatly appreciated.Donna EldridgeHead of Nursing/DIPCInfection Prevention and Control NewsletterInfection Prevention and Control is everyone’sresponsibility. We can all play a valuable role in ensuringthat all of our service users are cared for in a clean andsafe environment.How clean are your hands?Improving the hand hygiene of healthcare staff atthe point of patient care will reduce healthcareassociated infection (HCAI). The point of carerepresents the time and place at which there isthe highest likelihood of transmission ofinfection via healthcare staff whose hands act asmediators in the transfer of microbes.Why don’t you play the National Patient Safety Agency’s(NPSA) cleanyourhands campaign online Wi-Five handhygiene game? The game is based on the World HealthOrganisation (WHO) five moments and there is a choice ofdifferent healthcare settings, either a ward or the community.Try to achieve the highest score. You can find this game on theNPSA website by typing the following link into your webbrowser:http://www.npsa.nhs.uk/cleanyourhands/resource-area/wi-five-game/The UV light boxes used during hand hygiene techniquedemonstrations are available for IP & C trainers, infectioncontrol link nurses, hand hygiene champions and any othermember of staff that would like to use it for training purposes.Please contact the Infection Control Team for further details.MRSA screening PolicyWe have a new Trust Methicillin Resistant StaphylococcusAureus (MRSA) screening policy which can be found in theclinical policies section on the staff intranet. This policygives useful guidance on MRSA screening in Mental HealthTrusts, screening of service users, skin decolonisation,nasal decolonisation, throat decolonisation, skinlesions/wounds, urinary catheter management, screeningpost treatment, specimens/swabbing sites protocol andstaff screening.Infection Prevention and Control Train the TrainerThe Infection Prevention & Control Team has now trained72 Modern Matrons/Service Managers and Link InfectionControl Nurses throughout the Trust, holding sessions inCanterbury, Kings Hill and Maidstone. The aim is for thetrained trainers to provide staff training within their ownwork environment, which is ideal for Team training days.Future ‘train the trainer’ sessions will be arranged.If you have any questions or suggestions in relation toinfection prevention and control, please emailinfectioncontrol@kmpt.nhs.uk or visitwww.kmpt.nhs.uk/infectioncontrol

Nursing FocusThe Productive MentalHealth WardThe Productive Mental Health Ward is an exciting andproactive initiative which adopts a practical andcommon sense approach to improving and increasingthe safety, reliability and dignity in care provision. Thisongoing programme of improvement, works with abottom up approach, empowering wards to redesigntheir ward processes. The programme utilises practicalimprovement tools to remove or adapt workingpractices identified as ineffective or inefficient. Thepractical and time saving solutions to these commonproblems are all within the Productive Mental HealthWard toolkit, which makes visual and high impactchanges achievable by following the straight talking,step-by-step improvement activities.Following the success of the Productive Ward initiativewithin the acute hospitals, the Trust has committed to thedevelopment of our inpatient wards using the same tool,now tailored for Mental Health and produced by the Institutefor Innovation and Improvement. Ultimately, by decreasingthe time spent on ineffective processes and releasing thattime to care for patients, we aim to increase patientsatisfaction, reduce complaints, reduce staff sickness,reduce length of stay and cut down on costs. This initiativecertainly has a different feel about it. The main markeddifference is the huge enthusiasm held by the front lineworkers of the existing productive wards and the eagernessof wards within our Trust who would like to be involved.The Strategic Health Authority supported the Trust infunding a small team to take this forward. GemmaMcSweeney - Project Facilitator, Antonia Boorman - ProjectAssistant and Mike Curtin - Project Lead are eagerlyawaiting the commencement of the showcase wardsjourney and are confident in the success of the innovateprogramme of improvement.Basic Physical Observations of PatientsThe regular practice of undertaking basic physicalobservations on our patients by registered mentalhealth nurses is an area that has been raised andrequires some clarification.Through the introduction of the well being servicesacross the Trust the need for staff to have the competenceto undertake basic physical observations is an essentialrequirement.What we mean by basic physical observations is bloodpressure, temperature. respirations and pulse. Theseobservations are part of basic nursing skills and should notbe forgotten as they are the means of identifying physicalchanges in the patient that are not always reportableverbally by the patient or through observing the patient .As a basic standard, all wards and residential servicesAntonia Boorman, Mike Curtin and Gemma McSweeneyThe first three wards to take on the exciting initiative areBrocklehurst Ward in Maidstone, Dudley Venables Ward inCanterbury and Groombridge Ward at the Trevor GibbensUnit in Maidstone. The team is getting ready to roll out thefirst of the wards to embark on this project alreadyinternationally labelled a phenomenon.A planned conference will be held in October 2009,allowing the wards to present their changes in practiceusing the Productive Mental Health Ward and the resultingimprovements in patient and staff experience. This willcoincide with the next planned phase of ward roll outs.We do not hesitate in stating that this initiative has thepotential to transform our working lives in a short period oftime and for the foreseeable future.For more information on the Productive Mental HealthWard,please visithttp://staffzone.kmpt.nhs.uk/productivewardshould be offering basic physical observations on patients /residents in our care on a weekly basis. Observations mayalso be necessary more often if the patient has changes inmedication, has undergone rapid tranquilization, suspectedillness or infection and if they have sustained an injury orfallen.Modern Matrons along with Wards Managers andmanagers of residential homes must ensure that a systemis in place to regularly monitor the physical observations ofpatients (such as a weekly round) and for patients whorequire more frequent monitoring, it must be care planned.Staff requiring further information should contact theirDirectorate Lead Nurse through the Practice DevelopmentCentre.

South West Kent YoungPersons GroupFor the past four years within South West Kent, wehave been delivering family work for psychosis tofamilies in this area. The family work identified thatsome clients with psychosis were having considerabledifficulty going out in public, and either avoided goingout at all or needed to be accompanied by their familyor friends. As a result of this, most of them were unableto fulfil some of their goals for the future, eg going tocollege, getting a job, meeting people and makingfriends. The common theme was that they all felt verydifferent to other people and thought they were the onlypeople with these difficulties. There were considerableconfidence issues, with people feeling very anxious anda dependency on family and friends, which contributedto low self esteem.The young person's group was set up in response tothese needs and is open to clients who have a psychosisand are aged between 16 and 40 years.Prior to the group starting, a considerable amount of timewas spent by the care co-coordinator with each client,preparing clients for the course, explaining about thecourse content and preparing clients for the commitmentinvolved. The “group” set-up was chosen in preference toindividual psychosocial interventions (PSI) work so thatthese clients would be in an environment with other peoplewith similar experiences and needs. It was also thoughtthat meeting new people would go towards helping theclients deal with meeting new people in the community. Allof the clients already had individual PSI work and/or familywork so this group was designed to build on the workcarried out previously. We purposely designed the group toinclude various facilitators, again, to enable the clients toget used to different people and cope with change.The group takes part in a 21 week course held weekly inthe local community. Each session lasts for an hour and ahalf and is organised by two facilitators with at least oneskilled in PSI work. Initially, the ground rules and format forthe group were established and clients were encouraged toidentify personal objectives and goals. Comprehensivepsycho-education is used over many weeks and builds onthe clients own knowledge and strengths. The StressVulnerability Model of psychosis is introduced at this earlystage. Each week there is some overlap of previoussessions to enable learning to take place as some clientshave difficulty retaining information. Small and large groupexercises are used and clients are encouraged to givefeedback. Problem solving techniques are used and groupmembers are encouraged to share their ideas andsuggestions. We spend some sessions focusing onphysical health, how to make improvements and the impactthis has on psychological health. The latter stages of thisgroup focus more on skills development using theknowledge and expertise already covered in the earlystages of the group and focusing on the group member’sstrengths. We have allocated several sessions toThe young persons groupin actioncommunication; these are practical sessions for membersto explore how they interact and how they can improvetheir experience.Each member of the group has their own portfolio ofpersonal development with their own identified problemsand goals and problem solving strategies. To empower thegroup members, they write up their own progress in theirportfolios. They also write their own clinical notes aftereach session on how it went for them, and the facilitatorsalso write in these notes after each session to demonstrateopenness and clarity. Their portfolio also has baselinemeasures taken when the client first started the group sowe can evaluate their progress.At the end of each session we have a relaxation sessionbetween 15-30 minutes so by the end of the course theclients will have some practical experience and skill inmanaging stress. We have encouraged our clients tocontribute to this by suggesting or running the session andso far, they have chosen some relaxation strategies that theylike and one person brought in a relaxation CD he uses.For further information please contact Heidi Coburn,Lead Nurse, SWKThe Well Being Support ServiceThe well being support service continues to gofrom strength to strength. Currently, over 250staff are trained and over 900 services registeredon the audit tool.Thank you to all you who responded regarding thechange of name for the service. As you may knowAlison Gambrill from the Dudley Venables Unit askedher service users what they would like to call theservice. The choices that they came up with are“Happy Health and Well Being”“Healthy Choices”“Better Living”“Better lifestyle”“Lifestyle Choices”“Live life”“Healthy Engagement Lifestyle Promotion “(HELP)!The overwhelming response was to change thename to the Healthy Choices Programme, so thankyou to all who responded.If you would like any further information on theservice then please contact Nicky Dawber, LeadNurse through the Practice Development Service.

NMC Code ChampionsThe NMC wants you to be a Champion – a Code Champion.They are calling for volunteers throughout the UK to promotethe new Code of Conduct for the 674,000 nurses and midwiveson the register. And you can be involved.Support toolThe new Code, which came into effect on 1 May 2008, aims toclarify expectations; setting out for nurses and midwives what isrequired of them as professionals and showing members of thepublic what standard of care they can expect to receive.“Healthcare services are continually changing, as are theneeds of patients. Developments in practice mean that nursesare increasingly faced with situations that challenge theiraccountability. The Code is a support tool to help nurses inpractice so if they are faced with an ethical, moral orprofessional dilemma, they can refer to the Code for guidanceand advice.Feedback from the review of the Code was that nurses needto be encouraged to engage more actively with the Code on aEssence Of CareIntroductionThe NHS Plan (2000) reinforced the importance of 'gettingthe basics right' and of improving the patient experience. TheEssence of Care, launched in February 2001, provides a tool tohelp health and social care professionals, as well as wholeorganisations, take a patient-focused and structured approachto sharing and comparing practice. It has enabled health andsocial care professionals to work with patients to identify bestpractice and to develop action plans to improve care.The Essence of Care Benchmarks include Communication,Privacy and Dignity, Record Keeping and Nutrition. As well ascontributing to patient focused service improvements Essenceof Care can also inform other quality initiatives such as AIMSaccreditation and the current work being completed on Privacyand Dignity, eliminating the need for single sex accomodation.Lastly, Essence of Care has been developed in line with theDepartment of Health’s core standards, eg Privacy and Dignityrelates to C13a, Nutrition relates to C15a and C15b. DuringHealthcare Commision inspections there is an expectation thatevidence from the Essence of Care Benchmarking is submittedagainst the relevant core standard.Essence of Care activity in Kent and MedwayCurrently, a Trust-wide Essence of Care audit is beingcompleted and analysed by the audit department as you readthis article, the results of which are eagerly anticipated. One ofthe the purposes of the audit is to identify areas of goodpractice and to share them across the Trust. Premliminaryfindings are looking very promising with approximatley 30inpatient areas completing over 200 separate pieces of work onthe various benchmarks within Essence of Care.Historically, the implementation of Essence of Care has beenled by the MHSOP. This was partially due to the original version ofbenchmarks being biased towards physical care which fittedbetter within these particular services. Now Essence of Care hasbeen developed further to encapsulate specific practices relatedday-to-day basis. It also highlighted the importance ofemployers understanding their responsibilities in relation to theCode and the need for them to be involved in promoting it.ChampionsThis is where Code Champions come into play. The NMCwants you to be involved in raising awareness of the Code. Yourrole could include ensuring the new Code is easily accessible inyour workplace and supported throughout the organisation -out with the old and in with the new! You may also like to runinformation sessions on the Code or incorporate it into events inyour workplace or local community. There are plenty of ways toget involved.The more Code Champions we have, the further awareness ofthe Code will spread. The Code is for everyone; it helps promotehigh standards of care and gives staff pride in their professions.If you would like to be a Code Champion, please emailcommunications@nmc-uk.orgto mental health, the nursing directorate has encouraged otherservices to engage and work collaboratively with Essence of CareEach team now has a nominated Essence of Care lead whoattend the various comparison groups across the Trust.Some significant outcomes include the following:Safety• A risk assessment record document has been developed sostaff can confirm that a risk assessment has beencompleted for clients prior to departing on temporary leavefrom hospital.• The need for a defibrillator to be available in a stand aloneunit was identified by one team.Record keeping• Teams are implementing regular monthly monitoring andaudit of patient’s clinical notes for use in supervision. Thishas also been identified as part of the new managerialsupervision policy.Communication• Teams have acknowledged the need to make variouspieces of patient information available in different formats.Also, new pieces of information are to be developed andadded to patient information packs.• Work is progressing on developing a policy on the use ofthe internet for service users.Privacy and Dignity• There is now a Trust-wide commitment to have nominateddignity champions within all clinical areas.• Wards now manage their beds according to the male andfemale patient mix, zoning single sex areas accordinglyrather than by level of dependency.It is clear that this process does have an impact on highquality outcomes this is in no small part to the dedicated teamsand individuals, therefore, a very big thank you to all staff whocontinue to support this worthwhile process.For further information please contact Mike Curtin, LeadNurse at the Practice Development Centre.

NewsBeing MindfulFollowing the successfulreview of the Trust’scommitment to the Charterfor Employers who arePositive about MentalHealth, we are now able tocontinue to use the MindfulEmployer logo and displaythe Charter for a further twoyears. The Trust isresponsible for the KentMindful Employer initiativewhich has led to successfulemployer networks andsupport for employers byemployers around the issuesof mental wellbeing,sickness and absence dueto mental health issues,retention and recruitment.However, to retain our ownstatus as a Mindful Employerwe have to fulfil the samecriteria and it is awarded bythe Devon Partnership NHSTrust who founded theinitiative in 2004.Courses are run byWorkWays, part of the DevonPartnership NHS Trust, forstaff and employers to helpachieve a more mindfulworkplace. Details of all thecourses can be seen atwww.mindfulemployer.net orwww.workways.org.ukFor more information on theKent Mindful Employer pleasevisitwww.kentmindfulemployer.netNew Developments in Specialist Mental HealthNHS Eastern and CoastalKent has announced newdevelopments which theTrust will deliver. Firstly, aMother and Infant MentalHealth Service will bedeveloped across thelocalities. The clinical teamwill be recruited over thenext few months and bebased within the community.A range of specialistinterventions and treatmentpackages to mums withmental health problems willbe available and the servicewill provide close links withmaternity services, primarycare and other agencies. APerinatal Locality ClinicalNetwork will be establishedto oversee the introductionof the new service and itsmembers will include clinicalstaff, mums and their carersand the Voluntary Sector. Inaddition, a Mums and CarersGroup will be set-up.Finally, there will be anexpansion to the EatingDisorder Service with therecruitment of two ClinicalNurse Specialists in PrimaryCare and a Family Therapist.The service will provideeducation in primary care toensure prompt access,intervention and support forpeople with eating disordersand their families and a Userand Carer Group will beestablished.OT Presentation to SchoolsTwo schools in Gravesend -St Johns RC ComprehensiveSchool and Northfleet Schoolfor Girls are in the process oftrying to develop a newHealth and Social CareDiploma course. After liaisonwith Occupational TherapistsHelen Thackery and DanielleGear, it was agreed that thetwo therapists would deliver apresentation to the students.Helen explained, “There wasa group of about 16 studentsfrom both schools and theteacher felt that ourpresentation would be a greatway of getting the schools tointeract. We incorporated asocial skills activity previouslyused in a mental healthinpatient unit to use with thestudents. This helpeddemonstrate the value ofactivity in treatment andassessment but in thisattempt to unite the twoschools it meant that theactivity was also usedtherapeutically.”The content of thepresentation includedinformation on OT as aprofession and the field ofmental health and also lookedat stigma, discrimination,social inclusion, the careprogramme approach, theTime to Change campaignand the importance ofemployment for people withmental illness. Students alsohad the opportunity to trysome of the equipment usedby Occupational Therapists.The presentation was verywell received and feedbackfrom the students showed that88% felt it changed their viewof mental illness. ‘The dayOT Helen Thackery engages the pupils in an outdoor activitywent really well and the schoolhas already asked if we can goback and do another which isgreat!’ said Danielle.For information on the Timeto Change campaign visitwww.time-to-change.org.ukKent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009 11

HeadingStaff Stress SurveyAction PlanIn the April issue of Partnership Matters weinformed you that the results of the 2008 StaffStress Survey had not improved as much as wehad anticipated since the 2006 survey. Anaction plan has now been drawn up to addressthe areas which are currently cause forconcern in both the National Staff SurveyResults AND the Staff Stress Survey.Information Management EMT is to considerinformation demand management as part ofStrategic and Operational Objectives and evidencerequirements for QCC etc so that front line staff arenot inundated with requests. The EMT is tocommunicate priorities for action in a timely manner.Management Stress Survey Conduct furthersurveys in 2010 and 2012 as confirmed to H&SExecutive.Establish links between Pulse Surveys andManagement (Stress) Survey to avoid duplication ofeffort on the part of staff and managers and achievethis by September 09.Publish the availability of the ManagementIndicator Tool for teams/individuals and identifyresources to manage by June 09.The detailed action plan can be viewed athttp://www.kmpt.nhs.uk/StaffSurveyBand on the RunCongratulations to Adrian Lowther, MikeWarner, Linda Hardy and Sandi Drewett who allsuccessfully completed the Flora LondonMarathon on Sunday 26 April. Each ran their ownindividual race and either achieved a personalbest (and we think Adrian deserves a specialmention in dispatches with his very impressivetime of 2hours 34minutes) or raised money fortheir chosen charities. Certainly a marathonachievement by all!CorrectionThe Trust really does champion andsupport the concept of lifelonglearning and applauds all membersof staff who juggle their workinglife/home life alongside theirstudies to achieve their goals,whatever they may be. As those ofus who have trod this path (or arestill treading!) know, it is notsomething that is undertakenlightly and demands much hardwork and discipline so we wouldlike to correct a few oversightsfrom the April issue of PartnershipMatters. We celebrated theachievements of all our adultlearners at the 2009 Learning &Development Awards Ceremoniesand printed in good faith the namesgiven to us of the attendees andtheir awards but unfortunately,Leah Scott was acknowledged ashaving gained a Diploma in MentalHealth Nursing when, in fact, it wasa First Class Honours Degree.Sincere apologies Leah! Also, MollyStevens, Pauline Hemsley andGanga McCarthy gained their BScHons in Occupational Therapy thenwent on to become state registeredand each now has a qualifiedposition within the Trust thatsupported them through theirtraining for four years. A perfectsynergy – well done to all!The following students have alsocompleted their training sinceSeptember 2007. Congratulationsand thank you to Amy Draper and LynSutton-Jones for supplying theinformation.Dip HE MH NursingAmina Mwanga, Amanda Wetherill,Sharon Howe, Julie White, GillianMiddleditch, Diane Jaques, Lee Walker,Chris Cutmore, Nicola Atherton, AbigailDenman, Andrew O’Brien, JaimieMungar, Andrea Hurlestone, Jean-PaulGeorge, Ben McAvoy, Katrina Valler,Rajen Murthoo, Sophie Makambu, LizaSmith, Debra PopeBSc MH NursingJin Skelding (1st class), Leah Scott(1st class), Lloyd Ramsey, RogerHughes, Benita ClaytonManaging in Health & Social CareProgrammeClaire Slade, Rebecca Lowe, PennyLamb, Jane Weir, Sarah Hodge,Kathryn Ayles, Claire Harvie, SelinaWillis, Kathryn ThomLevel 3 Award in First LineManagementSarah Fage, Christine Gordon, PortiaWhittingham, Sandy Vale, TeresaGilbert,Alison Sparkes, Jennifer Sentongo,Rebecca James, Hamed Al-Sinawi,Betty Bishop,Vanessa Jeffery, Leanne Manley,Sharon Plumridge, Vanessa Rank,Barbara Shepherd, Maria Wingrove,Clare Hallett, Cecilia TobalMarathon man Mike Warner is presented with acheque for £1,000 by the Town of Bridges Lodgefor the charity ‘for dementia’OTs Molly Stevens, Pauline Hemsley andGanga McCarthy with CEO Erville MillarLeah Scott12 Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009

Staff Pulse SurveysTrust staff are, without doubt, the Trust’s biggest assetso it is vital that the opinions of staff are heard so wecan respond to the views more quickly. We also want tobe able to get the views of ALL staff, not just those whoare randomly selected in the NHS’ annual staff survey.To this end a series of quarterly Staff Pulse Surveys aregetting underway across the whole Trust and the firstwill shortly be distributed. Each quarter will see adifferent 25% of staff receive an independent survey soover the course of the year every member of staff willhave received a survey.The staff response rate to the annual survey is excellentso please continue this trend and complete the survey – itshould only take 5 or 10 minutes of your time! We areworking with an external partner to obtain your views anddevelop resulting actions and your responses will be entirelyconfidential and not seen by anyone within the Trust.Your views matter to us and we are committed to actingupon the results so we hope you will use this opportunity tomake your voice heard.A LEAN Approach inKMPTLEAN is a service improvement approach to improve theflow of individuals through care pathways and eliminatewaste.LEAN is basically about getting the right people andinformation to the right place at the right time in the rightquantities while minimising waste and being flexible andopen to change.There are a number of initiatives across the Trust in whichthe LEAN methodology is being applied. These include:• The redesign programmes in the East and West• Work in CAMHS to develop a demands led approach to themanagement of services and to improve access and reduceDNAs• The implementation of the creating capable teams approachwhich featured in April’s Partnership Matters.On 24th March KMPT held a LEAN workshop facilitated bythe Salomons Centre. During the event there was anoverview of LEAN thinking and its potential benefits to KMPT.There were also presentations of some of the serviceimprovement initiatives within the Trust which have adopteda LEAN approach.Work is now underway to collate feedback from theworkshop and consider how best to support staff andpartners to apply approaches of this kind, with the aim of:• Driving up quality• Improving our understanding of what adds value for ourcustomers along the care pathway• Supporting clinical leaders in understanding, monitoring anddriving up performanceNew strategy for a 21stcentury social care workforceFifty thousand long-term unemployed young people will behelped into social care traineeships thanks to new planspublished by the Government. Backed by £75 million from theDepartment for Work and Pensions, employers will receive a£1,500 subsidy to take on social care trainees aged between18 and 24. In a new Adult Social Care Workforce Strategy,Care Services Minister Phil Hope will also aim to lureexperienced graduates, managers and leaders from theprivate sector into the social care sector.The strategy will boost the status of social care so that thesector can attract and retain the best and brightest candidates.Working in social care, helping others get more out of life can bevery rewarding. The aim is to make sure that the sector has ahigh quality workforce in place to deliver personalised servicesfor years to come.Initiatives in the strategy include:• CareFirst, a scheme which will get 50,000 long term unemployedworking in social care, giving them the skills and experience theyneed for a permanent career in this sector;• increasing the number of apprenticeships in social care byaround 1,300 targeting groups which have not traditionally takenup careers in social care;• establishing a new National Management Trainee Scheme toencourage graduates and top quality executives to move into thesocial care sector;• a new voluntary registration scheme for home care workers from2010 to help safeguard people who use services and improvequality;• developing more Social Care Awards to raise the status ofworking in the sector and recognise the hard work the 1.5 millionpeople working in social care are already doing; and• more support for newly qualified social workers in their first year,backed by £4 million.Speaking at the Association of Directors of Adult Social Services(ADASS) Spring Seminar, Phil Hope said:"We want to encourage a new generation into social care -helping more of them make a difference in their communities, bytaking on rewarding roles. This will bring new talent and skills tosocial care and fill the vacancies that have grown as the sectorhas expanded."This new Strategy will help to raise the status of social carecareers, enable workers to provide more person centred care, liftstandards and encourage more people to consider work in thissector."Once we recruit people, we must do everything we can tokeep and grow new talent. I hope the new apprenticeships will goa long way to doing this."This strategy only sets the framework. We will work withemployers, local authorities, professional social care bodies andskills agencies to make it a reality and create a workforce thathas pride in itself, is respected by the public and supported todeliver high quality, personalised services well into the future."For more information about working in social care go to:www.socialcarecareers.co.uk or to talk to an advisercall 0300 123 1055.Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009 13

Patient FeedbackService users, their carers, friends ofour Trust and the public arecontinually helping us to improve ourservices. In the April edition ofPartnership Matters, we undertook tokeep you informed by having a regularfeature on this kind of participationand involvement activity. This time,our spotlight focuses on threeexamples in East Kent, wherevolunteers - some of whom may wellhave had poor mental health in thepast - contribute in a very special wayto touch and affect the lives of certainindividuals.Steph Wickenden, Recreational SpaceCoordinator based at St MartinsHospital, Canterbury, reports that a verysuccessful Karaoke evening was held onFriday 8th May at R (Recreational) Placeat St Martins. Steph described theevening as a real hit with a good turn outand everyone enjoyed themselves.Left to right: volunteers, James Bradley andMark Holland, Steph Wickenden and volunteer,Karly Vickers at the Karaoke evening.Special thanks to Penny Alabone-Battye, Recreational Space Coordinatorat the Arundel Unit, Ashford, formanaging to bring so many service usersfrom her unit. Also, sincere thanks toKerry for providing the Karaokeentertainment and for the understandingand kindness he showed. All in all, agreat time was had by everyone in whatwas a very entertaining evening.Steph also reports that an artworkshop takes place every Thursdayafternoon at R Place. The workshop isparticularly fortunate to have the supportof a local professional artist Mr JamesBradley (BA). James is happy for us tomention that he was a former patient atSt Martins and so enjoyed the facilities inR Place, that he later decided to sign upThree examples ofthe cartoon artas a volunteer and share his expertisewith existing patients. Everyone isespecially grateful that he did!The cartoon art illustrated in thephotos and prepared in the workshop, isfor the Friends for Mental Health 1950Themed Summer Fair, to be held onSaturday 13th June ’09 at St Martins.The cartoons have not got faces as fairgoerswill be invited put their facesthrough a cartoon for a photo souvenir tobe taken on the day. Put the date in yourdiary, come along and bring all yourfamily and friends for a fun day out!Elsewhere, Jakki Caldwell-Barr, DeputyPPCI Manager at the The Beacon,Ramsgate shared some details aboutThe Comfort Zone with us.About 18 months ago the Pals &Volunteer Department at the Beacon,under Jakki’s direction, set up a coffeemorning on Tuesdays from 10am to12noon run by volunteers. Some havehad mental health issues themselves andbecause of their past experiences, areable to understand some of the problemsthe visitors have and offer a listening ear.It is a very popular group and Jakkitells us that they often have 30 to 40people attending. It is open to anyonewith a mental health issue, including theirfamily or carer. Volunteers are on hand towelcome visitors, sit and chat with themand generally put them at ease. The Pals& Volunteer Department provides the tea,coffee, biscuits and cake - and a bit ofTLC when needed!The Comfort Zone continues to be a hitand visitors often say it is a real lifelineafter a lonely weekend. They particularlylike the coffee mornings because theyprovide a safe place where everyonetries to understand their mental healthneeds. Over time, a lot of friendshipshave been forged and it is generallyagreed that everyone is very welcomingand friendly. Referrals are often made bythe staff at the Beacon but visitors donot need to be referred, they can justturn up on the morning.The PPCI Department is always on thelook out for examples of patientinvolvement and feedback that haveinfluenced services. How about theCommunity Mental Health Teams in theWest telling us about their activities inthis area in the next edition of PartnershipMatters? Contact Tony Peploe, PALSCoordinator, on 01622 723207.14 Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009

Research and DevelopmentOne of the key objectives in the recently approved 3-year R&D strategy is to grow research within KMPT and wewould like to share with you information on two current projects written by the researchers. For more information onR&D visit http://www.kmpt.nhs.uk/researchdevelopment or to view the strategy in more detailhttp://staffzone.kmpt.nhs.uk/Policies_and_Procedures/Strategies_and_plans/index.htmlOxford Community Treatment Order Evaluation Trial (OCTET)KMPT has agreed to collaborate withOxford University and Oxfordshire &Buckinghamshire MH NHS FoundationTrust in conducting a randomisedcontrolled trial of the new CommunityTreatment Orders (CTO) which tookeffect in England and Wales fromNovember 2008. Led locally byProfessor Tom Burns, and ProfessorTony Hale the trial aims to:• Close the gap in evidence regardingCTO outcomes and effectiveness• Learn from service users, their familiesand mental health teams• Inform mental health policy and practiceWhy is this study necessary?CTOs aim to help the so called‘revolving door’ patients who have longhistories of involuntary hospital treatmentfollowed by repeated relapse andreadmission soon after discharge.Patients on CTOs need to agree tocomply with compulsory treatment in thecommunity and can be recalled tohospital should they fail to do so.CTOs have been controversial for arange of reasons – legal, ethical andempirical. Many clinicians were critical tothe introduction of CTOs withoutconvincing scientific evidence of theirefficacy; in particular no convincingrandom controlled trial. OCTET aims toremedy this through rigorous research.Who is eligible?The study will randomly allocatepatients (who are CTO candidates) eitherto CTO or management without CTO for aperiod of 12 months. Eligible patients arethose currently detained in hospital onsection 3 (or unrestricted, non-forensic,section 37) with a primary diagnosis ofpsychosis. Learning from American CTOresearch, we will restrict patients to thosewho are likely to need sustained CTOs (iemonths not weeks) and to services thatcan offer weekly contact.What does the study mean for clinicalpractice?We have explored the ethical and legalimplications of our trial at great lengthand confirmed that it is both lawful andpractical. The study is supported by theDepartment of Health. Clinicians willinitially identify patients and ask them ifthey will meet the researcher. Ourresearchers will explain the study to thepatients, obtain written, informed consentand conduct interviews at baseline, 6 and12 months. If randomised to non-CTOthen clinicians would manage the patientas before November (initially on section17). If randomised to CTO then theclinician would proceed with that. Otherthan that, clinical practice is entirelyunconstrained. We anticipate that aproportion of patients in both arms will bedischarged to voluntary care (either byclinicians or the Mental Health ReviewTribunal).This is a vital trial for UK mental healthservices and may inform practiceinternationally. The window of opportunityto conduct it is narrow (the first 18months after introduction) so pleaseconsider taking part. More information isavailable on the OCTET website,http://www.psychiatry.ox.ac.uk/research/researchunits/socpsych/research/octet/ oremail jorun.rugkasa@psych.ox.ac.ukby Jorun Rugkasa, Research Fellow.Carers Support within Forensic Mental Health ServicesKelly Reynolds (Research Assistant,Trevor Gibbens Unit), Dr CatherineKinane (Consultant Forensic Psychiatrist,Clinical Director, Trevor Gibbens Unit), DrDouglas MacInnes (Reader in MentalHealth, Centre for Health and Social CareResearch, Canterbury Christ ChurchUniversity), Kathryn Ayles (Head ofOccupational Therapy, Trevor GibbensUnit), Alan Stewart (Community ServicesManager, Trevor Gibbens Unit).Families are still the main caringresource for service users with severemental health problems which can have adirect effect on many areas of family life.This effect has been described as ‘familyburden’ and can place considerablepractical, physical, psychological andemotional demands on carers resulting inhigh levels of distress. For example, itwas noted that 75% of individuals caringfor a family member with schizophreniahad high levels of psychological distress.The clinical impression is that the additionof criminal justice to mental health serviceinvolvement increases the stress within thefamily unit through having to cope with thepolice, courts, and the judicial system.Because caregivers often face increasedstress they have special psychological,spiritual, social and financial needs thathave to be addressed. Guidelines indicatethat the needs of carers of service userswith severe mental health problemsusually centre around three main areas;support, information and reassurance.A project team is developing a supportservice for carers of patients at the TrevorGibbens Unit and the Bracton Centre. Carerrepresentatives are on the project teamcontributing to the development of theproject and ultimately a support service.By spring 2009 a questionnaire will be sentto all carers of patients at both units to findout what their support needs are and whatthey want from a support service. The mainaims of the project are to find out:• If carers service would be a usefulresource.• What carers would like from a supportservices (ie types of support,information and reassurance).• What would be the best way oforganising and conducting carerssupport services.The project is currently in theconsultation/data collection stage andthe aim is for the initial research stage tobe complete by September 2009, intime for the development of asupport service.Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009 15

Major ProjectsCare pathway design is focus in Medwayand SwaleThe ongoing work to review the acute mental health services for Medway and Swale is currently attempting to understandthe needs of the local population and then look carefully at the facilities for in-patient care with a view to making sure thatwe have the right services, as well as the right number and type of beds in the right place to meet the needs of people inMedway and Swale. Redesign means working out how we should use our resources to provide the best possible treatmentand care at the best cost to the public purse. The Trust and PCT remain committed that the current inpatient services areimproved and that in the future services are provided in a modern and fit for purpose environment. Below you will find aprogress report…..Acute Care PathwayDementia Care PathwayOver the past few months a series of workshops, involvingstaff, commissioners and services users and carers havetaken place in Medway to design the ideal integrated acutecare pathway for people in Medway and Swale who areexperiencing, at risk of or recovering from a mental healthcrisis.The term acute care pathway refers to the journey a serviceuser makes from initial referral to discharge from acuteservices. An integrated acute care pathway refers to theinterlinked services and agencies working together to supportservice users’ and carers’ needs and achieve the desiredoutcomes. An ideal integrated acute care pathway is one whereeveryone involved shares aims, values, priorities andoperational policies.Work has taken place to map current services against theideal model that has been proposed and commissioners, atNHS Medway, are now able to consider this work and decidewhat needs to be done to put the ideal model into practice.The second of these workshops considered three keyquestions:1.What is already working well in the ideal pathway?2.What can be improved by managerial/operational action?3.What can only be improved by redesign?The discussions on these issues led to a clear set ofchallenges for the redesign of services to serve Medway andSwale. In summary the challenge for review and redesign is to:1.Ensure that both primary and secondary services are foundedon a clear understanding of the changing needs and wants ofthe population.2.Ensure that bed management and alternatives to admissionoperate consistently well around the clock.3.Ensure that home treatment services are as robust as possible4.Make sure that relationships between CMHT, home treatmentand in-patient services are clearly specified and well managed.As well as the work the on acute care pathway, parallelwork is taking place on the development of a dementiacare pathway. This pathway has been developed by theOlder Peoples’ Mental Health Needs Implementation Teamand Dementia Urgent Care Project. This work is nothappening in a silo and the work on acute and dementiapathways is being joined up.West Kent and East KentRedesignUpdates on progress on the East Kent and West Kentredesign programmes were published in April’s PartnershipMatters. You can also visit:www.kmpt.nhs.uk/wkmhredesignwww.kmpt.nhs.uk/ekmhredesignMedway redesignAs well as agreeing the ideal care pathway, the comingmonths will see the Trust work with NHS Medway and otherpartners to plan for a consultation that will let the people ofMedway and Swale share their views about how they wish tosee mental health services delivered in the future. At present itis anticipated that this consultation would get underway in theAutumn.16 Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009

Learning News & DevelopmentLearning and Development ProspectusThe new learning and development prospectus will beavailable to staff in July 2009.The prospectus will be available online and printed. If yourequire a printed version please contacttraining@kmpt.nhs.uk with your address and how manycopies you need so we can build a database. If you havealready requested a prospectus in the last year a copy will besent to you once they are available.For the online version please visithttp://staffzone.kmpt.nhs.uk/learningdevelopmentPlease check our training bulletin sent out regularly viae-mail and our internet site for prospectus updates andadditional courses running through out the year.Working with Personality DisorderA one-year programme of shared experience and learningSeptember 2009 – June 2010Entry RequirementsStaff in all services who work with Personality Disorderedclients including; All Mental Health Professionals; Psychiatrists;Social Workers; Criminal Justice Workers; The Police; VoluntarySector staff; Housing Sector staff; Addictions workers;Psychotherapists and counsellors etc.AimsThis course aims to facilitate a better understanding ofpersonality development and disorder and the relationaldifficulties inherent in working with personality disorderedclients. Participants are encouraged to explore their ownexperiences with colleagues and service users from otheragencies in the field and to promote improved serviceresponses to this client group back at the work place.Intended Learning Outcomes• To sharpen participants’ skills in the recognition andassessment of severe personality disorder• To facilitate an integrated inter-professional, inter-agencyapproach to the care and treatments of clients with SPDaccording to CPA principles• To encourage the setting of realistic treatment goals basedupon an increased knowledge of the aetiology andsymptomatology of SPD• To foster awareness of the impact of this client group on frontline professionals and their need for ongoing supervision andsupport• To enable appropriate referral on this client group to specialisedservices where appropriate• To enable participants to develop reflective practice within themulti-disciplinary context through understanding others roles andthe exploration and resolution of conflict in the clinical setting• Ability to communicate effectively with professional colleaguesfrom a variety of disciplines• Ability to provide and receive support in a multi-disciplinaryteam environmentGeneral InformationThe Brenchley Unit Personality Disorders Service in partnershipwith colleagues in the field and under guidance of the South EastDevelopment Centre (SEDC) has developed this trainingprogramme for professionals working with this client group.This course will comprise 18 fortnightly sessions of threehours duration each Thursday at 13.30 – 16.30. The sessionswill run over three “terms”.The cost per applicant is £600. Funding is assured foraccepted internal applicants.Application ProcedureFor further details and an application form, please contact:Roger Davies at the Brenchley Unit, The Courtyard, PuddingLane, Maidstone, ME5 1EL. Telephone: 01622 776330, Fax:01622 776339 or e-mail: roger.davies@icc.wkentmht.nhs.ukInterested in Management Courses?If you are interested in undertaking a management developmentprogramme we have three internally run courses that might besuitable:• Award in First Line Management – a 6 day course introducingthe fundamentals of management.• Accredited Managers Programme – a six month programme forfirst line managers developing your skills as a manager inKMPT• Managing Health & Social Care Certificate – a year long coursefor middle and senior managers wanting to explore further theskills and theories of management and leadership.Please contact amy.draper@kmpt.nhs.uk for further informationon any of the above.Have you updated your Infection ControlTraining?The Trust needs to achieve a minimum of 95% compliance inrelation to Infection Control training.This means that 95% of all staff (including non clinical staff)must be trained on Infection Control, there is no margin for failure,and the Trust must achieve this target.We are currently providing dates, these can be found on ourCourse Timetable at:http://staffzone.kmpt.nhs.uk/NetsiteCMS/pageid/405/index.html,please complete an Internal Application Form to attend.Alternatively you can complete this course online athttp://kmpt.nhslearn.com, if you have not already registered youwill need to ‘create a new account’.Training Needs AnalysisRecently we have asked managers to contribute to the trainingneeds analysis, thank you to all of those who completed these.We are in process of compiling the results which will help guideus to provide training over the coming years.We are your Learning & Development Department and weappreciate you comments, suggestions and ideas, pleasecontact us on training@kmpt.nhs.uk.Induction Co-ordinatorWe have a new Induction Co-ordinator starting with thedepartment in June. Dan Murphy will be responsible for coordinatingand facilitating the induction across the Trust and weare very much looking forward to him working with us.Further information will be available once Dan starts,including his email and contact details.Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009 17

IM&TTHINKGREEN!Duplicate episodesReports produced from ePEX have highlighted a number ofrecords where particular clinicians have more than one openepisode that relates to the same service-user. Many of theseduplicated episodes were created in the process of migratingdata from PiMS to ePEX. This has created difficulties and workis being carried out behind the scenes to remove thesuperfluous episodes.Duplicate patientsHaving now consolidated on a single information system weare finding an increasing number of duplicated service-userrecords on the system. Unlike the duplicated episode issuedescribed above, where many of the issues were createdduring the migration, these duplicate registrations are the resultof staff creating additional records. A more thorough searchwill significantly overcome this issue. Before registering a newservice-user, staff should conduct further searches on the NHSnumber or the date-of-birth. Again, work is being carried outto identify and merge duplicated records but these can eachtake several hours to resolve.CPA levelePEX uses “pathways” to identify if service-users are on aCPA pathway and at which level. After migrating from PiMS toePEX (or from the old version of ePEX to the new version) itmay be necessary for care co-ordinators to ensure theirservice-users have a CPA pathway. There is a Quick ReferenceGuide for this on the trust intranet:http://staffzone.kmpt.nhs.uk/download.php?id=2762The same process also needs to be followed for leadprofessionals looking after service-users on non-CPApathways.Social exclusionAs part of efforts to reduce social exclusion, information Isnow collected on accommodation and employment as part ofthe CPA review. You will find a Quick Reference Guide relatingto the recording of social exclusion data on the trust intranet:http://staffzone.kmpt.nhs.uk/download.php?id=2809 Pleasealso remember to record ICD-10 diagnosis information at CPAreviews.EthnicityOver the last couple of years steady progress has been madein improving ethnicity information collected from service-users- currently, ethnicity information has been collected on 83% ofour service-users. You will probably know this information isimportant to ensure services provided are meeting the needs ofthe population and to monitor take up of services by thoseminority groups that may otherwise be excluded. Please dowhatever you can to reduce the remaining 17% - acombination of “not asked” and “not stated” responses. Youmay find the trust policy on collecting and reporting ethnicityhelpful, available from the trust intranet:http://staffzone.kmpt.nhs.uk/download.php?id=1710Purchase your copy of Windows Office Enterprise for £8.95If you are an NHS employee and have a current NHS e-mail address you can purchaseMicrosoft Office Enterprise- the full suite of Microsoft products - for just £8.95.Simply go to the Trust’s Intranet and click on Working for the Trust in the left hand menu bar.From there click on Staff Benefits followed by NHS Discounts Website; use the search box to locate Microsoft- and just follow the instructions.18 Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009

ePEXNewsWell, we’ve reached yet another milestone in the life of theePEX Project. Not only is it complete and ready to be formallyclosed (final reports are due to be submitted to the next IM&TSteering Group) this will be the last ePEX page that appears inPartnership Matters. After this, any information or news aroundthe system will be delivered either by global e-mail, the StaffBriefing or within the IM&T page of this newsletter. Anyimportant messages for system users will appear as a“message of the day” on ePEX itself.So, what news is there to tell in this final newsletterinstalment?Reporting ePEX helpdesk callsOne issue that’s become a topic of conversation for thelast month or so is how ePEX problems are now loggedand resolved.When the temporary Command Centre closed its doorsthe logging of your calls transferred to the Kent & MedwayHealth Informatics Service (HIS). People now ring 01227866399 and log an IT service-desk call. Or they can e-mailservicedesk@nhs.netIt is, perhaps, important to immediately point out that thiswas always going to be the case. In fact the serviceprovided through the Command Centre was only evermeant to be additional to HIS support. It was the Project’sway of helping HIS technicians out during the initial highvolumecall period. But the most important reason for theCommand Centre fielding the calls was because the peopleproviding the service wanted to use their knowledge andexperience of ePEX to help staff as they adjusted toworking with the system; it was, however, never intended tobe a permanent service.How it works now. Once a call is logged with the HISservice-desk it is immediately entered it into a call loggingsystem specifically for ePEX - it’s called Touchpaper. Fromhere the call is placed into a queue. That queue is accessedby the ePEX Back Office Support Team, who happen to bethe very same team who handled your calls into theCommand Centre during Go-Live. As soon as a call isflagged on Touchpaper a member of this team picks it upand deals with it.This system has only been in operation since 5 May 2009so it’s early days yet, but if you do have any commentsabout how you think it’s working we’d like to know whatthey are, so please e-mail them into epex@kmpt.nhs.ukFrom here they will be collated and forwarded on to theDirector of IM&T, the ePEX System Manager and theDirector of HIS.Duplicate episodesIt has only recently become possible for reports to beproduced on duplicate, open records; by this we meanrecords where a particular clinician has more than oneopen episode that relates to the same patient.Difficulties around duplicate records occurred during theprocess of transferring data from PiMS to ePEX when themigrated historic appointments presented as actualappointments. Unfortunately the automated process then usedin ePEX to generate contacts from the appointments createdfurther episodes for each appointment and contact. Once thiswas known the process was changed, but not before manyduplicate records had been produced. The impact of this withinthe east has been particularly bad.We recognise that this has created difficulties for somepeople more than others and apologise for the effect this hashad on some caseloads. We also want you to know that muchwork is being done to reduce the effects of this and help rectifythe situation.Duplicate patientsThere is an unacceptably high level of duplicate patients onthe system. These are mainly being created by aninadequate search of the system before entering patientdetails. It would help enormously if, in instances where apatient’s name cannot be found on the system, beforeregistering that person as a new patient in ePEX furthersearches on the NHS number or the date-of-birth are doneas well. If these steps are taken before a new record iscreated it will help reduce the number of duplicate recordsbeing created on the system.NHS NumbersNinety-eight per cent of patients with active referrals have averified NHS number. However, there are several hundred whocannot be uniquely matched with patients on the NHS Spine.For those who may not know, the Spine is a national, centraldatabase where summary patient records are stored. If fullyimplemented local records will automatically upload importantinformation to a summary patient record on the Spine. If youhave a patient without an NHS number please either ask them,or their GP, to provide it for you. It is this sort of information thatwill help improve the quality of data on our system.Kent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009 19

World of WebWelcome to the World of Web! This column will aim tobring you all the latest news about what’s going on withthe KMPT website (www.kmpt.nhs.uk) and StaffZone(http://staffzone.kmpt.nhs.uk).Did you know that we have recently updated the Eating DisorderService website? The new site features information more focusedtowards clients, families, friends and carers, and promotes the EatingDisorders Carers’ Group. Find out more atwww.kmpt.nhs.uk/eatingdisorders.We also now have a Care Programme Approach page in place whichwill be the central hub for all information about the refocused CPA:www.kmpt.nhs.uk/cpa.We are pleased to announce that the website now providesinformation in ten languages: Hindi; Gujarati; Urdu; Bengali; Punjabi;Mandarin; Polish; Turkish and Russian. Links to the pages can befound on the homepage: www.kmpt.nhs.uk.There have been some recent developments on the StaffZone also,including information about support services for doctors working forthe Trust who would like support for a mental health difficulty they maybe experiencing: http://staffzone.kmpt.nhs.uk/doctorsupportservices.Don’t forget that you can find a number of useful documents onStaffZone such as HR forms, Payroll contact details, Policies andProcedures and Patient Medication leaflets.You may also like to take advantage of the online Trust NoticeBoard, where you can advertise items for sale, wanted items, socialnotices such as retirements and unwanted Trust equipment.We always welcome your input so if there is something you wouldlike to see on Staffzone that we don’t currently cover, please emailyour ideas to Alison Grimsey, E-Communications Manager atalison.grimsey@kmpt.nhs.ukLottery winnersMarch Lottery Winners£500 1007 QEQM Hospital£250 2762 St Martins Hospital£100 3970 Greenacres, Swanley£100 2479 Medway Maritime Hospital£100 1626 Buckland Hospital£50 4172 QEQM Hospital£50 4188 Folkestone Health Centre£50 4052 QVM HospitalApril Lottery Winners£1000 2514 William Harvey Hospital£500 2889 The Grove£250 2809 QEQM£100 3314 Templar House£100 2744 Trevor Gibbens Unit£100 1104 Laurel House£50 4314 Kent & Canterbury Hospital£50 4250 William Harvey Hospital£50 3389 St Martins HospitalThe staff lottery is open to all staffacross the Kent and MedwayPartnership Trust. The minimumcontribution is £1 per month,which is deducted directly fromyour salary. Each month a draw ismade and randomly selectedwinners can win cash prizes. Thetop prize alternates between£1000 and £500 each month.Smaller cash prizes are won eachmonth ranging from £250 to £50.The lottery also improves patientcare with money raised goingtowards making patients' livesmore pleasant. If you wish to buysome numbers or purchase morenumbers, please contact yourlottery representative:Gill Dearing, Lottery Promoter,Kent and Medway NHS & SocialCare Partnership Trust, Easternand Coastal Area Offices,Littlebourne Road, Canterbury,Kent CT1 1AZThinking abouttrees and money?Are you able to read your copyof Partnership Matters online?Do you really need a hard copyof the newsletter? If you wishto save the planet and theTrust some money, you canrequest that in future youaccess your copy ofPartnership Matterselectronically via the KMPTwebsite. You will also get yourcopy quicker!You can notify us that youwould prefer to access yourcopy in this way by emailingcommunications@kmpt.nhs.ukTake a BreakDates foryour DiaryJune24 June 2009 –Trust Board meeting10.00am, The Boardroom,Trust HeadquartersJuly22 July 2009 –Trust Board meeting10.00am, The Boardroom,Trust HeadquartersNB There is no Trust Boardmeeting in August231 694 562 38 96 97 25 17 19 4 17 4 5 2 3Ideas inboxThere are two new ways that Executive on any issue. Youstaff can make their voicecan contact Erville at:heard as part of our ongoing chiefexecutive@kmpt.nhs.ukStaff Involvement Strategy. We Staff have also expressed acannot unfortunately publish all wish to be able to submit theirof your ideas and suggestions, ideas for improving services,but please keep them coming working practices or anyin as they are extremely valued matter concerned with theby the Chief Executive and the Trust. You can deliver yourexecutive team.ideas direct to the Trust'sAll staff are encouraged to use Directors at:the inbox to contact the Chief ideas@kmpt.nhs.uk.Want to know more?Why not log on to www.kmpt.nhs.uk or visit the Trust intranetat nww.kmpt.nhs.uk Also you might find more usefulinformation online at: www.healthcarecommission.org.ukwww.dh.gov.uk www.mhac.org.ukKent & Medway NHS and Social Care Partnership Trust Partnership Matters June 2009 20