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Being Human togetherWorking together to reduce restrictive interventions.Iris Benson and Nick Horne
• To provide an insight to our journey to support perspective taking of all involved
• To share successes and our learning• To discuss challenges and fears.• To generate conversation to support National
guidelines• To support a change in culture• To give Hope that all of this is absolutely possible.
A time for reflection !
Aims and Purpose
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• For all of us to see beyond the illness and behaviour and see the person in a different way.
• For all of us to have an understanding that behaviour is a way of communicating that someone-a person ,a fellow human being is distressed and looking at how together we can provide support and high quality person centred care that meets their individual needs.
• Puts people using services at the centre of care
• Meaningful involvement of those with lived experience of services and that their views and concerns are LISTENED TO
Vision
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Nicks JourneyUs and them
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Nicks journeyCONTROL AND RESTRAINT TRAINER
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Meritorious MAPA Instructor
Advisory capacity to CPI and help us shape new initiatives .Has demonstrated an unwavering enthusiasm and dedication in supporting the vulnerable people in his care and supporting his colleagues and fellow MAPA® Instructors
I am that little girl again…
Copyright © April 2018 ExE Consultant Services & Iris Benson MBE
Broughton Towers Special School, Barrow-in-Furness.
Copyright © April 2018 ExE Consultant Services & Iris Benson MBE
I am that little girl again
TRAUMA
• Some staff think its just about the trauma story• -”I'm more than my trauma”• Seeing me as a person and has got to know me as a person• Support• Involved in all aspects of planning , consultation and decision making• “In-built Sensor system”-”That’s trauma”• Getting to know me• Awareness of triggers e.g. my advanced statement• Developed insight of living with trauma 24 hours a day impacts on every
aspect of life• Mutual respect and learning• And BELIEVES IN ME• True Vision and Passionate• Thinking about the perspective of other service users
Iris PerspectiveBeing Human Together
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Copyright © April 2018 ExE Consultant Services & Iris Benson MBE
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• Working together within Mersey care• Learning and Sharing
-Positive and Safe-Launch of no force first-Day in Mersey care with No Force team
• Invited to support development and implementation of Cygnets Reducing Restrictive Practice Strategy
Coming together
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• Interview Panels• Development of Patient
Engagement strategy and structures
• Expert by experience lead• Peoples councils• RRP Project Board• Regional RRP Delivery Board• Safewards Masterclass,
,support days and Celebration days
• Ward RRP engagement work • Recovery College• RRP Leadership /RRP
Preceptee Event• RRP Awareness Training• Delivering on the impact of
and living with trauma• RRP University sessions• Policy review e.g. seclusion
and LTS
Expert by Experience roles and development
Internal
• Consultancy Awareness • National Conferences• Prevention focused
working • Other organisations e.g.
Cygnet• Restraint Reduction
Network• BILD-Training standards• Universities • Hospitals• Multi disciplinary,
Working with AHPs ,psychology, Doctors
• Research• Public speaking• Awareness and training
films
External
Expert by Experience InvolvementCo-produced & Co-delivered staff training
RRP Leadership day
Co-produced RRP Events
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• Only staff interviewed new recruits.• Only staff trained new staff.• Very limited consultation with young people about changes to the ward.• Staff led.
The Picture now• I read my ward round reports from each staff member ahead of the meeting
Write my views into the report.• I go to my MDT from the start • I am involved in all decision making. • I lead the risk assessment and care planning. Sometimes the team and I
disagree, but we talk about it in the meeting. • I write my own report for the CPA and I chair it. I say my opinion if I don’t
agree with things. I have a say over who is invited and how I want it to run.• I am Working with staff to improve the ward.Helps with my personal recovery. • My Doctor gives me leaflets and talks to me about different options.
Cygnet Sheffield - Acute Adolescent WardThe Picture 3 years ago
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We chair community meetings and at the meetings every Monday morning we bring our ideas for how the ward could be improved. These can be small things or big things. Staff and patients attend and each week the actions from last week are reviewed to make sure we are making progress.
We vote on where we want to go out as a group. We have a system so everyone gets a say.
We generate ideas for the activities on the timetable. In summer we came up with all the ideas for the whole 6 week timetable. We are asked to come up with the ideas for evenings and weekend activities and asked what we want on the timetable when it is reviewed.
Being involved in audits where possible such as for blanket rules and infection control.
Inducting new starters or visitors to the ward. Lead on some groups- ‘what do you know?’ and DBT group Deciding on and reviewing mutual expectations.
Co-production on a ward level
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• Designing the new ward• Voting for the new wards name• Our ideas put forward for the new ward setting• Designing and being allocated funding for a sensory garden• Developing/ improving tools for things like debriefs/ audits• Interviewing staff- MHSW’s, OT’s, MAPA trainers, Education
including head teacher• Training new and existing staff in the recovery approach,
trauma informed care, education, safeguarding, using soft words.
• Organising events such as fundraising for charity.
Co-production on a Hospital level
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Empowerment Gives us control Hope for the future Makes our voices heard Gives opportunities to test new things Educates others Occupies our minds with something meaningful Boosts our confidence and self esteem Feel valued Helps us reach future goals and opens new doors, gives us
new skills
How working together improves our Mental Health
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Cygnet Sheffield Peak View
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144
194
111
78
110
131117
176
157
115125
105
26
8695
75
23 23
104
40 46
70
0
50
100
150
200
250
JAN MAR APRIL MAY JUNE JULY AUG SEPT OCT NOV DEC
Incidents
2017 2018
Cygnet Sheffield Peak View
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17
23
61
21
4
13 15
21
6865
30 3127
1 0
1217
27
7
0
19
9 9
17
0
10
20
30
40
50
60
70
80
JAN FEB MAR APRIL MAY JUNE JULY AUG SEPT OCT NOV DEC
Restraint
2017 2018
Safewards Celebration
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• Initial resistance of staff to this work• Lifelong symptoms or diagnosis• Awareness of staff and their understanding of the individual needs of
a person• Stigma and Discrimination• Understanding trauma• Development of Patient Engagement strategy-Cygnet• Organisational change• Lack of frameworks and structures • Corporate “buy in”• Investment of time • Meeting support and supervision needs• Effective line and risk management
Challenges
Organisational• Expert by Experience work developed beyond anything we envisaged• At a greater pace than what we predicted• Autonomy of role and resources to support
Individual factors(Service user/staff relationship)• Time to;
- Relationship build,-Get to know each other-Support and supervise -Care and risk manage-Understand
• Can this be sustained?
• Impact on Vulnerable people
Reflections
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• Mutual respect and understanding• Mutual support• Investment of time is vital• Developing relationship• Supervision• BEING A PERSON• Seeing beyond the person using services• Seeing beyond the persons behaviour• We all have behaviours• Positive and Safe• Use of language and soft words
Being Human Together-ReflectionWhat has enabled this to happen
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• Changing the organisational culture
• Harnessing lived experience to plan, deliver, support and improve services
• Learning to share power, recognising all contributions
• Advocacy
• A critical friend
• Reduced stigma
• Prevention of challenging behaviour
• Reducing restrictive practice
• Improved outcomes
• Recovery
ReflectionsThis isn't easy
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• BILD committed to support the Expert by Experience role, developing resources, delivering training programmes and facilitating events that serve to make vital improvements to people’s lives.
• BILD are facilitating a consultation to shape their practice in this area
• BILD would welcome your feedback
BILD Guidelines to inform good practice
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• This work needs to be taken seriously- To keep people safe• Need to be clear about role, role expectations, impact and
outcomes, and support for experts by experience and staff• Need to develop guidance for working alongside vulnerable
people• Need to consider work to date, what has been developed so
far, research and outcomes to date• Organisations need strategy for Patient EngagementNeeds to be robust and updated with structures to support service user involvement and ensure that it addresses individuals support needs.• Need to be clear about our vision• Need to share and learn from good practice• Celebrate our learning and success
Conclusion
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How working together
– Would help others see and learn that dreams and
aspirations are available to us all
– We are all human beings and deserve to dream
– Staff dreamed for me.-guided me ,supported me and saw
things in me ,that I couldn't
– MAKING DREAMS REALITY
– I have watched people grow
– Staff made my dreams reality
Conclusion
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Contact details
• Nick HorneRegional Nurse DirectorNorth
• Iris BensonExpert by Experience
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