Within the overall context of improving access to urgent mental health services,
the SUNDERLAND UNIVERSAL CRISIS TEAM provides assessment, care and treatment
across all ages groups for individuals experiencing a mental health crisis, including
those with a learning disability.
Within the overall context of improving access to urgent mental health services, the SUNDERLAND UNIVERSAL CRISIS TEAM provides assessment, care and treatment across all ages groups for individuals experiencing a mental health crisis, including those with a learning disability.
Traditionally, crisis services were only open to service users of working age (typically 18-65 years), who were already known to mental health services and often excluded those with learning disabilities. Following engagement sessions with service users and carers, it was agreed that with the support of Specialist Nurses from learning disability, older persons and children’s services that crisis assessments would be offered universally. We also removed barriers to referral, improving access to assessment, care and treatment.
Service users and carers – in line with the National Think Family agenda, we have developed the expertise within our Home Treatment team by the provision of bespoke Family Interventions training to our clinicians. This is to enable any service user and their families on our caseload to be offered Family Interventions as part of their Home Treatment care plan. We have developed strong links with the Family Therapists within Community Treatment Team to support a smooth transition into longer term Family Therapy at an appropriate time for the family. This has made a real difference to service users and their families, as at time of mental health crisis a considerable strain can be placed upon relationships and dynamics within a family unit.
The service interacts regularly with Community Treatment teams and the Psychological Wellbeing Service within the locality to promote a smooth transition from crisis home treatment intervention into longer term planned interventions that are appropriate to them and their recovery.
We regularly meet with local housing groups, local carer centres and support groups to build relationships, develop understanding of service provision and improve the advice given to service users and carers.
The patient experience is of paramount importance and as part of our recovery focussed approach we actively involve service users and their carers in every aspect of their care and treatment. Following consultation with service user groups, a recovery focused tool “My discharge recovery plan” was developed within the Sunderland team and is used across all crisis services within NTW. This supports the patient to identify wellness tools, coping strategies and triggers to empower them to be an active participant in their future care.
We encourage every service user and carer to complete a satisfaction questionnaire (Points of You) to provide the opportunity for constructive feedback to be given to the team to ensure continuous improvement. We hold daily multi-disciplinary team meetings to review appropriateness of care and treatment and all care plans are developed collaboratively with the service user and carer.
This has been an ongoing process which has been developed based upon continuous improvement. During recent years there has been a shift towards more community based treatments and less of an emphasis on inpatient care. This has resulted in the typical patient profile on our caseload has becoming more complex in terms of need and levels of risk. As a service we have overcome this by utilising NICE guidance, national body of evidence and continued evaluation of our skillset. The clinical team have been extremely flexible in their approach and a learning culture exists within the team to encourage further professional development which supports the changing needs of our service.
In terms of sustainability, we have developed a culture of shared accountability for the home treatment model. This includes regular group supervision sessions which encourage innovation within the team and encourages a shared sense of responsibility. Each member of the team is experienced within their role and the processes of the service provision; they regularly support new starters or student nurses with a comprehensive induction programme ensuring that the positive service continues. We also encourage staff development, enabling those interested in leadership to have the opportunity to experience elements of the role to support their personal and professional development in preparation for applying for more senior posts. The current clinical lead team have been developed through this process and have demonstrated a strong succession plan within the team.
The service is regularly evaluated including monthly collation of patient and carer feedback (each service user and carer is encouraged to complete a satisfaction questionnaire) – this is reviewed within the team by the Clinical lead and also discussed within the Trust Crisis Clinical Standards Group to enable this to be shared across all crisis services within NTW.
Patient safety is a focus of the monthly Lessons Learned forum, of which our team is part, and any clinical examples or themes are fully explored highlighted areas of clinical improvement or clinical good practice. Every member of crisis services across NTW are invited to attend the Lessons Learned forum to encourage openness, transparency and candour within our service.
Staff engagement is a high priority agenda item for our team, therefore weekly group supervision is arranged to support the team with any issues they wish to raise, There are also regular engagement sessions arranged with the Senior Management team to again encourage a culture of “speaking easy”, enabling the decisions makers to be aware of staff viewpoints and priorities.
Staff engagement is a high priority agenda item for our team, therefore weekly group supervision is arranged to support the team with any issues they wish to raise, There are also regular engagement sessions arranged with the Senior Management team to again encourage a culture of “speaking easy”, enabling the decisions makers to be aware of staff viewpoints and priorities.
We regularly support other teams within our own organisation to understand our processes and approach to crisis care. On a regular basis, visitors from outside the organisation visit our team and we are happy to share examples of our practice with them.
