Agenda item

The panel was taken through the presentation by Jackie Liveras, Assistant Director, Crisis and Emergency.

Key points included:

Home Treatment Teams (HTTs)

·        HTTs have been running for 12 years across the country.

·        HTTs are a meanigful alternative to hospitals.

·        The National Service Framwork some years ago laid out what the role of HTTs is.

·        People prefer to be treated in the own homes.

·        There is a target of 727 treatment episodes, MHT is currently at 700 and therefore expecting to exceed the target by quite a lot.

Issues include a slight drifting from the National Service Framework and so work is currently being done to re-focus the service.

·        HTTs are a vital component of enabling the re-profiling of beds.

Future plans include:

·        Work to improve service users experience and quality of services, for example ensuring that service users do not have to complete multiple assessments, GPs being able to refer to HTTs directly for assessment.

·        The intake service was reviewed at the end of 2011, this work is now being re-looked at.

Recovery Houses

·        The partnership with Rethink is working very well.

Issues include:

·        Services are not always in place to enable people to move on.

·        Recovery Houses are usually full, with an expected increased demand this will increase pressure.

·        90 admissions across the Trust.

Comments from Rethink included:

·        The success of Recovery Houses is due to the partnership between Rethink and the MHT.

·        Recovery Houses are a hub within the community.

·        Feedback from service users is positive.

·        Peer support groups are being formed and ex service users are being developed in the skills needed to run these groups.

The following discussion points were noted:

·        All staff that are displaced from the closure of Haringey Ward will be redeployed, including an increase in staff numbers on HTTs.

·        The ability for GPs to refer to HTTs is positive.

·        If a person goes into a pharmacy with mental health queries then it would be helpful for the pharmacies to know where to signpost to and which services were open when etc.  The MHT agreed to speak to the Local Pharmaceutical Committee to share this information.

·        The language used on the information sheets about HTTs and Recovery Houses will be shared with service user peer groups to gain their input on how they can be improved, particularly in relation to the language used.

·        Strong relationships with carers and their families is an integral part of the services.

·        HTTs are moving towards a positition where all assessments are done in the home, apart from in exceptional circumstances.  By conducting these at home family members and carers are often automatically involved.

·        Social workers are a part of all HTTs and will conduct carers assessment where the carer says that they wish one to be undertaken.

·        The MHT have a target on carers assessment and report to the Local Authority.  They also have their own records.

·        It is ensured that carers are spoken to and listened to as part of the pathway.

·        Care Coordinators based in HTTs are responsible for the Care Plans for service users in both HTT services and in Recovery Houses.  They then liase with the relevant staff member if the service user moves to acute care.

·        The monitoring of a service user depends upon their risk assessment, when in primary care this is the GP.

·        It was noted that the smallest Recovery House is in Haringey, and in the West of the borough away from the area of highest need.  The MHT stated that there is not a limit on the number of Recovery Houses an area could have and that if they were offered a house in the area of most need then they would be very keen to take this on. 

o   It was noted that larger houses, for example with over 15 rooms is more economically efficient and cost effective.

o   It was noted that a property review is currently taking place which may identify suitable properties which could be used for this.

·        Noted that the RIO IT system is being rolled out to the Haringey Recovery House this month, and that this will make it easier for assessments to be done 24hrs a day without disturbing resting staff on night shifts.

·        All information leaflets, and service users care pack include information on how to complain.  If a person wishing to complain wasn’t aware of a direct route they would be able to call the St Ann’s helpline and be put through to the relevant department.

The Panel asked for an update on the Foundation Trust application status and were informed that the current process and next steps are unclear.  The Foundation Trust application had been through NHS London and was with the Department of Health when the Trust Development Agency (TDA) was formed.  The TDA have said they would like to go through some of the stages again and there is therefore a 3 – 4 month delay expected, before it goes to Monitor.

The current process and lines of responsibility are currently unclear.

The forthcoming Francis report on Mid Staffs may have implications on the process.

A recent CQC inspection resulted in some moderate concerns which othe Trust intend to put right in the immediate future.

The MHT are doing some Peer Review work with a high performing neighbouring Trust.

The Mental Health Support Association stated that the interest of the Panel in HTTs and Recovery Houses has been positive and useful and requested that Panel revist the area in future.  The Mental Health Trust stated that they would be happy to bring further information to the Panel, particular as input would be useful as the care pathway changes.

It was noted that Nick Bishop, Mental Health Support Association, was stepping down.  The Panel wished their thanks to be noted for Nick’s valuable support and input over the years.

Agreed:

·        The Panel would write to the Cabinet Member for Housing about any available property in the East of the Borough which could be used as a Recovery Houses.

·        The MHT and LPC would discuss sharing information on mental health services in the borough to enable pharmacists to signpost.

·        The Panel would write to the TDA and the CCG to ask for clarification on the next steps and affirm the CCG’s support of the Foundation Trust application.

·        The Panel would revisit HTTs and Recovery Houses at a later date for further input.