For the last five years with no staff, the charity has been led and run 100% by people with lived experience voluntarily. We are proud to be service user led and driven at all levels. This includes a trustee board that is entirely governed by those who are service users. We offer peer support to anyone, over 18, who has experienced or is experiencing any level of mental health problem as well as being somewhere for people to come who want to give their well-being a boost or who are feeling isolated.
Please briefly describe your project, group, team or service, outlining what you do and why it makes a difference.
We are a charity that was formed in 1964. We have always been a mental health charity, originally independent and for a number of years a local Mind. With the real threat of closure, the service users took over the running of the charity, developing it further with a real focus on lived experience and peer support. For the last five years with no staff, the charity has been led and run 100% by people with lived experience voluntarily. We are proud to be service user led and driven at all levels. This includes a trustee board that is entirely governed by those who are service users. We offer peer support to anyone, over 18, who has experienced or is experiencing any level of mental health problem as well as being somewhere for people to come who want to give their well-being a boost or who are feeling isolated. We are regularly open every Monday from 10am till 8pm providing a breakfast club, a drop-in session, a cookery group and evening support group. There are two trained facilitators for each session, who have lived experience. Additional regular activities include a Tuesday guitar group, a gardening group on Wednesdays, also beginner’s guitar group and a men’s group on Fridays. Any activities are planned by and are at the direct request of the people who use our drop ins. We plan to now develop further groups including an art and craft group, walking group and a ‘Wellbeing Wednesday Group’. We also in the near future plan to send a volunteer on Mental Health First Aid train the trainer course, in order to deliver this training to all our volunteers and group members. All our activities are free to those who come, including food & drinks. Our annual running costs are approximately equivalent to the cost of one average inpatient stay. For more about what we do and to see some of our members and hear their stories you can watch our film here: https://www.youtube.com/watch?v=SYEr0Q8lnvw
What makes your service stand out from others?
Our group is open to anyone over 18 who would like support with their mental health and physical wellbeing. This can encompass those who are experiencing or under threat of homelessness; people who have addictions; people who have co morbid conditions and those whose needs have not been met by statutory services and/or experienced social inequalities. We are unique in that we are entirely run and led by those with lived experience with no staff, we do all of this on a voluntary basis thus enabling all funds to go straight to service provision. We help around 50 people a week and over 200 people per year, for a lot of our members we are life changing and for some we are life saving (their words): “I was a service user for 22 years. I have a duel diagnosis but my mental health was misdiagnosed due to alcohol and other substances. When this was separated from the substance misuse I was then able to come to terms with my mental health. I never felt that organisations or services met my needs in the past and I felt discriminated against. When I came to Chester PLUS and was able to speak about my own personal experience to others who had experience of their own mental wellbeing. When I explained how I had overcome my mental wellbeing I felt that there was an understanding and empathy from two members who had their own individual approach to recovery, but also acknowledged and appreciated mine, which has never happened before. I began to use the drop in service regularly and input my own ideas and experiences which were embraced by the trustees and group.
The peer support helped me to continue my wellbeing and as it was run by volunteer people who had common experiences to me I felt they did not enforce their own agendas on me but rather embraced my agenda and needs. This led me to becoming a trustee and through gaining skill including; communication; team working and understanding the broader picture this has enabled me to now gain employment as a support worker” “I think peer support, for me, is mainly socialising with people who have had mental health issues themselves in the past or currently have mental health issues. It’s slightly different from socialising with just your friends or random people, because they understand some of the stuff you’ve been through. I enjoy sitting around maybe playing a board game because it’s a social activity, but sometimes I get slight anxiety, so it’s nice to have to have an activity that you’re doing whilst talking, it helps to focus on the board game then you can talk more easily. Without the group I would have found that really difficult. It has given me those few people who were supporting me so I could get my self confidence back” “I get support when I need it, 99 times out of 100 I go through my daily life happy as Larry, but now and again I need that extra bit of support. I enjoy most definitely the guitar group, it’s a laugh and it’s nice to see people getting more and more relaxed when they’re losing their self-consciousness” “I enjoy the Monday night healthy eating group, partly because I very much enjoy consuming whatever we make” “You can be around people through coming here there’s a lot of us who live on our own we will probably just be in staring at the four walls” “ I’ve met some interesting people who have similar problems and different problems. It’s a good place to meet people and somewhere to relax, if I didn’t have it I would miss it most certainly, I’m glad it’s here. The garden is been fun, I’m not one for gardening, but it’s been fun being with all the people doing it having conversations and things like that, so something I didn’t like and now I quite like” “I’ve gained confidence, get up and go, will power drive, mental stamina. The healthy eating and cookery is the main thing I enjoy because I enjoy cooking for people, it’s what I used to do in past jobs.
It’s giving me a bit of a passion for food again, so now I can cook for people and it gives me a sense of fulfilment. Before coming to the group I couldn’t leave the house because I was too paranoid and anxious it’s enabled me to be able to walk down the street to group now; I can go out places further in the car, I can go shopping. It’s given me a great deal of confidence also I don’t think it’s a coincidence when I say it’s kept me out of hospital, I haven’t been admitted for nearly 2 years now either” “I have a bit more understanding of mental health because I always used to think it was just me who was suffering with mental illness, but I found out it isn’t, I’m not alone like I always thought I was. Because of my mental illness I found it difficult to form relationships in social groups. I was always a loner I never used to go out. But since I’ve joined this group I’ve got more confidence in myself being able to talk to people” “Before coming to Chester PLUS I had tried to end my life, been admitted to hospital and as a direct result lost my job. I am now back in full time employment. I still have difficulties with my mental wellbeing but now have more positive ways of coping and I don’t say it lightly when I say that they have saved my life and given me hope for the future”
How do you ensure an effective, safe, compassionate and sustainable workforce?
Coproduction with those who use our services, the local community and other services is at the heart of everything we do. We take time to get to know people well and identify what skills they bring, further developing their skills through gentle encouragement, role modelling, alongside using positive and constructive feedback. All of our volunteers have been empowered to take on roles and develop their leadership skills within groups and on our trustee board. In addition to this many have gone on to represent ourselves and the ‘service user voice’ at local, regional and national levels. For example – locally: the planning and implementation of a crisis cafe; a mental health forum and a mental health partnership board. Many of our members undertake work such as Regionally: Rethink Mental Illness regional committee; crisis care concordat and social prescribing planning group; Nationally: Positive Practice Collaborative third sector special interest group and Peer Support SIG; Rethink lived experience advisory board; Physical activity project in partnership with Sport England and Time to Change. All of this contributes to developing skills for paid employment, challenging stigma associated with mental illness, changing perceptions and highlighting the value of lived experience at all levels. Those with ‘lived experience’ can get involved at all levels.
That can range from sitting chatting to someone who drops in for support; to putting the kettle on to opening up and facilitating the drop in; to fundraising; to raising the profile of mental health and campaigning; to being a member of the trustee board. We believe that everyone has something to offer and the ability to achieve. These achievements can be the big things such as getting a job etc to the softer but just as important things like getting to meaningful activities we provide and inspiring others to also achieve. Alongside this developing real world skills which are transferable into personal life. As well as our Chester PLUS hub we have helped others with lived experience start their own groups throughout Cheshire West and Chester by providing a blue print and practical support. Now operating on a hub and spoke model of delivery. We have developed a training package that enhances these and creates sustainability. We are starting work with Rethink Mental Illness’s (England’s largest voluntary sector provider of mental health services) and Mental Health UK’s fundraising teams on a cohesive strategy that will address increased individual giving, corporate partnerships, professional bid writing support and high-quality evaluation reports. We are going to be featured as a best practise example in the upcoming NHS England Framework for Community Mental Health Support guide published later in the year, we aim to have a campaign to build on the attention this will generate.
Who is in your team?
We have 6 trustees and 10 peer support coordinators and 4 peer support helpers who facilitate the groups in partnership – all on a voluntary basis
How do you work with the wider system?
A lot has changed over the last five years. When we first started with Peer Support, we faced a number of barriers, dead-ends and closed doors, often within the NHS itself. Things have changed and over the last five years we have managed to build up a number of connections. We positively encourage involvement and dozens of our users have participated in Involvement opportunities and volunteering within both Cheshire and Wirral NHS Partnership Trust and Rethink. We have good links with the Police, Chester University, other charities, both Mental Health and other areas. We have a good working relationship with Fallen Angels addiction dance group, Outside In homeless service, Soul Kitchen vulnerable persons drop in, P3, Dial West Cheshire and Chapter mental health charity. We have helped with the recent Poverty Truth Commission. We have a good relationship with the council with a number of our group sitting on the newly formed West Cheshire Mental Health Partnership Board. We have great relationships with a number of professionals working within places such as the Job centre, The Probation Service and a number of surgeries as well as the primary mental health team. We aim to turn these individual relationships into organisational ones and help set up processes to inform and signpost potential beneficiaries of our offerings.
We are the third sector partner with West Cheshire CCG and have worked intensively with them redesigning crisis care pathways and have been heavily involved in the development of a CRISIS cafe due to open in Chester August 2019. We have also worked as part of group redesigning Recovery led services locally with West Cheshire CCG. We very much operate within the wider systems of stepped down and stepped up care to statutory services; providing signposting and support to engage with these. We do not differentiate where anyone is in their recovery and provide an open walk in service to those people who are either in crisis, maintaining their recovery or to promote their wellbeing. As the voluntary sector lead on the local ‘crisis café’ project we hope that our network will be a place people can move onto after initial crisis support and that this network can continue to grow so everyone can access peer support in a timely manner, right on their doorsteps. We want to continue what we do and build on it, we provide early and immediate interventions focused upon prevention, recovery and maintaining mental wellbeing. We support improvement of both physical and mental health – peer support/ cookery group/ Gardening Activity/Healthy living information available. We are involved with Active Minds Cheshire’s Mental Health sub-group and Equally Well UK. We give support to family/carers of those with dementia due to the impact upon their mental wellbeing of caring for someone with dementia, which then boosts their ability to provide care. We offer support to many post diagnosis, in particular we give support with the mental wellbeing impact of diagnosis and living with ASD and ADHD.
Do you use co-production approaches?
Chester PLUS works in partnership with the four Rethink Mental Illness peer support groups across West Cheshire using a hub and spoke model with Chester PLUS as the hub. We are also linked to other support groups across wider footprints (CWP, STP, North West and nationally), we have the resources of Rethinks’ Involvement team at our fingertips as well as the services of their Regional Group Development Officer and their support team based in Taunton. The four spokes run a mixture of weekly and monthly groups, we want community support right on people’s doorstep’s where we can then guide people to our hub once they feel confident, secure and supported. All activities are fully complaint with Rethink’s procedures, everything new is risk assessed and both parties have comprehensive insurance policies. We offer peer support for any level of mental health problem to anyone aged 18 or over. We also offer help with general well-being and try to reduce levels of isolation in the community.
Therefore we can offer on average 25 -35 hours of peer support a week spread across four or five days. As mentioned earlier very group or part of our service is based on co-production using a ‘you said, we did’ model. We have a suggestion box, open discussions and more formal feedback sessions. Every persons input is valued and considered. We also have an open door policy for carers and appreciate any suggestions they have. Coproduction is at the heart of everything we do. Participants will regularly complete assessment forms on the activities to monitor quality and to constantly improve our offerings. We have a number of films that the film group has made to capture people’s stories about how useful coming to Chester PLUS has been. For some of our classes such as the Mindfulness and Tai Chi where we received specific funding to pay for outside instructors we used rating scales to monitor the effectiveness and value for the courses. We have a working relationship with Edge Hill University to monitor future funded activities and members of the group have been involved with some of their research. We are keen to maximise the funding and will react to reported effectiveness. We put a hold on the Tai-chi as whilst it helped some people it wasn’t reaching the intended number of people for a variety of reasons. With the partnership with Rethink it means we have regular help from their Regional Groups Development Officer, National Participation Manager and Head of Involvement. They regularly monitor the groups and are a way for us to escalate concerns or queries. They also facilitate regular training for new and existing group facilitators and ensure we have regular co-ordinators meetings and group development days. For 19/20 The Stone Family Foundation are working with Rethink to produce impact assessment reports for the collaboration for future funding bids.
All the activities we run are chosen by the current users as a collective in a democratic manner. When someone visits for the first time they are informed of the activities on offer and informed that if there is anything else they’d like to do we will help facilitate/arrange it if possible. Many of our current mainstays have been formulated in this way. We feel that operating in such a fluid responsive manner it gives people increased choice and enables people to be more invested in the activities, ultimately enabling more people to become involved in helping run the activities rather than just participating in them, creating better outcomes for everyone involved. When people get in touch, come along but don’t return we also reach out to see if they feel like giving us any feedback and see if we can reduce any barriers to aid in their return.
Do you share your work with others?
We have a strong social media and web based presence. Each Sunday between us we decide what we can offer and communicate that on a weekly basis to our members via text messaging, email and social media. With a new range of flyers, we are hoping to build relationships to embrace social prescribing by linking into GP surgeries that are close to all the groups, a strategy. One local health centre has already asked for our flyers on every practice reception desks of all GP practices in the medial centre. We have posters throughout he local area and promoted by the local nhs trusts, CCG and wider social care next work. As given earlier we have a link to an online peer support film. We are well networked in the local area and have a positive reputation both nationally an locally. Our cookery group has transitioned to a fully plant-based menu and are working with are starting to work with a Consultant Psychiatrist from Lancashire Care Trust to start looking at encouraging people to switch to a plant-based diet to mitigate weight gain whilst on anti-psychotics. We’re looking to help roll this out to their wards. This piece of work is part of the National Mental Health Safety Improvement Programme as featured in the recent NHS Long Term Plan.
Outcomes and evaluation
What outcome measures are collected, how do you use them and how do they demonstrate improvement?
Rethink also provides a complaints and feedback procedure open to anyone participating in any of our offerings; as formal evaluation questionnaires can often be a barrier or over bearing to some we prefer to use more person centred ways to collate feedback in many cases. There is no them and us, everyone is a ‘service user’ a proportion of those are carers, approximately a quarter of those who attend volunteer in some way for part of the time and attend activities the rest of the time. We have regular open meetings to assess what is working and what could be improved. Our evaluations for our group offerings has mainly been qualitative and for our activities is a mix of qualitative and quantative.
Has your service been evaluated (by peer or academic review)?
Development and sustainability
How will you ensure that your service continues to deliver good mental health care?
We have continued grant funding with West Cheshire CCG this year, which was increased following our open and honest dialogue with them regarding the impact of this ending. We have now formulated a robust action plan to secure future funding and to develop our services and governance structure. We are currently in discussions with a national third sector charity with the view to enhance our partnership working. A number of those helping run the charity have moved on to education, employment, peer mentoring, training or job searches. Whilst we have experienced an increase in numbers of people attending, we are finding more people are coming to us either in crisis or closer to crisis than ever before and the flow through rate from attending to helping run hasn’t been as timely as in recent years. We have addressed this and have found seven new volunteers with lived experience from outside the group who wish to help, we have their induction underway and devised an enhanced training.
What aspects of your service would you share with people who want to learn from you?
One thing we initially did not completely ‘get right’ was the original name of our charity, when MIND withdrew their services from Chester a few of the service users from their services wanted to continue to meet and initially we were called ‘Chester Community Mental Health Support’. This did not truly represent the peer led nature of our support; served to confuse people that we were perhaps a statutory service alongside community mental health teams. Also it did not reflect the association between mental wellbeing and physical health, giving the wrong impression that we were only there for those with a mental illness diagnosis rather than supporting any one with concerns about their mental wellbeing (which is very common and more applicable to all). We therefore re-branded to Chester PLUS (Peer Led User Support) with the strap line of: for positive health and mental wellbeing. We also may have advertised our services better but also were mindful that we wanted to get things totally right in house before we spread our reach. We have faced many challenges or hurdles along the way. One was that we initially had three drop in sessions per week but soon found that we did not have the capacity to have two people opening and closing plus ensuring safety. We therefore reduced our drop in sessions to one per week so we could ensure what we were offering was quality and safe. In order to still keep up the peer support hours on offer we then set up group activities which are offered to known members hence reducing risks and set up spoke groups in the wider community in public venues which only require 1 coordinator in many instances. We have now recruited more service user trustees and hope to increase our drop in sessions soon. Another challenge was convincing professionals of our credibility and safe practice. We have done this through building a positive reputation via people who use our services; through professional visits; being open and transparent in all we do; having policies and procedures that are adhered to including group ground rules and through highlighting the evidence base of peer support at open days, during presentations and at community forums.
Brief description of population
inner city and urban via hub and spoke model implemented for groups. Chester and Cheshire have areas of affluence, however many areas have pockets of high levels of deprivation and this is where all of our groups take place. Importantly affluent areas are not an indicator of positive mental well-being therefore we also support an inner city group. We provide peer support for anyone 18+ and people travel in from local areas across Cheshire and North Wales.
Size of population and localities covered:
Cheshire West and Cheshire 77,040 (2001)
Commissioner and providers
Commissioned by (e.g. name of local authority, CCG, NHS England): Grant funding from West Cheshire CCG
Provided by (e.g. name of NHS trust) or your organisation: Independent mental health charity
The following questions are an opportunity for you to provide further details on how you implement positive practice in your service delivery and how you ensure your service is advancing access and equalities. Answers to these questions will not influence how your PPiMH awards application is assessed, however any responses received may contribute to the potential inclusion of your service/team as a positive practice example within published guidance developed by NCCMH and NHS England.
How many people do you see?
We offer support for approximately 50 people per week and over 200 per year.We endeavour to provide a safe space, free from stigma, discrimination and judgment, this is the cornerstone of how we operate but also forms the backbone of our ground rules and expected behaviours. We have a zero-tolerance policy for discrimination. ‘Not being judged’ and being ‘made feel welcome’ rate most highly in recent surveys among group members. Our current attendees age from 24 – 79, we are putting in work on the 18 – 25 age bracket. This year more males have attended during the day and more females have attended in the evenings. One of our group is now an Equality Leader for Mind and we will be taking the learnings from national work and from local Minds and embedding in our future offerings. We regularly attend Chester Pride. The majority of our attendees are white, we are working with the Time to Change group in Wirral to share learnings as they have a more representative membership. We are also linking in with Rethink’s North West regional diversity and equality working group, so our approach isn’t seen as colonialist. We think that less than 1% of people in the area know we are here and as our awareness increases, we want to ensure that all of our community find out about us not just certain groups and will seek help and advice from local faith leaders and community elders to seek ways to engage.
How do people access the service?
Open drop in access for all. We regularly have contact with those finding it difficult to access us via social media chats etc We do not operate a referral process, as we want to break down as many barriers as possible.
How long do people wait to start receiving care?
No waits at all !! as its open access with spoke groups and activity groups throughout the week and on weekends.
How do you ensure you provide timely access?
Always have open door policy
Advancing mental health equalities
What is your service doing to identify mental health inequalities that exist in your local area?
We endeavour to provide a safe space, free from stigma, discrimination and judgment, this is the cornerstone of how we operate but also forms the backbone of our ground rules and expected behaviours. We have a zero-tolerance policy for discrimination. ‘Not being judged’ and being ‘made feel welcome’ rate most highly in recent surveys among group members. Our current attendees age from 24 – 79, we are putting in work on the 18 – 25 age bracket. This year more males have attended during the day and more females have attended in the evenings. One of our group is now an Equality Leader for Mind and we will be taking the learnings from national work and from local Minds and embedding in our future offerings. We regularly attend Chester Pride. The majority of our attendees are white, we are working with the Time to Change group in Wirral to share learnings as they have a more representative membership. We are also linking in with Rethink’s North West regional diversity and equality working group, so our approach isn’t seen as colonialist. We think that less than 1% of people in the area know we are here and as our awareness increases, we want to ensure that all of our community find out about us not just certain groups and will seek help and advice from local faith leaders and community elders to seek ways to engage.
Assessing needs and providing care
How do you identify the needs of a person using the service?
We use a person centred approach and enter an immediate dialogue regarding needs and adjustments required.