Adult secondary mental health services - quality standards: consultation

Standards for Adult Secondary Mental Health Services

In this part of the document you can find a full version of the standards we have drafted for secondary mental health services. The final document will also contain background information to introduce the standards. You can find the background information contained in the overview of the consultation. Questions about the standards overall can be found on page 23.

We know that currently not everyone has the same experiences or outcomes when they engage with mental health services. We want these standards to help make sure that services meet your needs whoever you are and whatever your background.

However, we know that we need to do more to listen to and learn from people and organisations as we work to improve the standards.

1. Access

What I can expect:

1.1 I will be able to easily access and understand information on who services are for, what is provided, and how I can be referred to these.

1.2 If I seek support, I will be supported to get the help that is right for me regardless of where I first made contact.

1.3 After I am referred to a service, I will be contacted with an estimate of the time I will have to wait to be seen. I will receive regular updates if the time I have to wait is longer than this.

1.4 I will be provided with information on other available support such as online resources and community resources which will support me while I wait.

1.5 I will be treated with kindness, compassion, dignity and respect when accessing services and my personal circumstances and requirements will be considered.

1.6 I will receive care and support in a timescale that reflects my needs.

How services will support me:

1.7 Services will prioritise the referrals of those in most need and detail the criteria used to assess need and to prioritise.

1.8 Services will publish information in a clear and accessible format on who services are for, what is provided, and who can refer to these services. Information will include contact information, location of services, opening hours and how to contact out of hours/emergency care.

1.9 This information should be widely available and easily found. Information should be available in people's preferred languages and in formats which are culturally sensitive and understands the possible impact of trauma on people accessing services.

1.10 Services will provide information on how mental services work together and with other agencies and organisations. Services will work with people to ensure this is easy to understand. This could be through ensuring information is available in an accessible format, for example, a visual representation.

1.11 Services will provide information on other sources of support such as online resources and community resources which will support people waiting. This will include consideration of third sector or member led organisations which support people from different social, economic, cultural and ethnic backgrounds.

1.12 Services must have systems to accurately measure waiting times for assessment and treatment, this information should be accessible to everyone. It must be recorded and regularly reported through Clinical and Care Governance structures.

2. Assessment, Care Planning, Treatment and Support

What I can expect:

2.1 I will be supported by a team which includes a range of professionals who can meet my assessed needs.

2.2 Alongside consideration of my needs, I will be asked what is important to me and this will inform my mental health assessment, care planning, treatment and support. If I want them to be, and it is appropriate, my carer and/or family should be involved.

2.3 I will have a copy of my care plan which will be regularly reviewed to ensure it reflects my needs.

2.4 The care and support I receive will be centred around my personal circumstances. This care and support will take into account my cultural and social needs, and will be trauma-informed.

2.5 Based on my needs and safety, my mental health care and support will be delivered in the community whenever possible.

2.6 I will have a choice in how I prefer to access care and support and whether I engage digitally or face to face. However I access support, the environment will be safe and will enable effective treatment.

2.7 If I need support from multiple professionals and agencies, I will have a designated named person who will offer support in coordinating these.

2.8 If I am experiencing crisis, I will be able to access information, care and support at a time I need it, in an accessible and available space. I will be shown compassion by the people who provide my support.

How Services will support me:

2.9 Services will ensure that teams have an adequate staffing skill mix to provide a wide range of assessments and therapeutic interventions based on needs in their community. This team should include psychiatry, nursing, psychology, social work and Allied Health Professionals as well as opportunity for peer support and other expertise as needed.

2.10 Services will ensure that people's preferences inform how they access services and that services are delivered in an environment which is accessible, safe, and conducive to enabling assessment, care and treatment.

2.11 Services will ensure that the mental health care and support is provided in a community setting wherever possible. If people need in-patient care, this will be for the shortest necessary time and planning for returning to the community will begin as soon as they are admitted with an estimated date for discharge.

2.12 When planning and delivering services, consideration of the wider determinants of health which can increase the risk of inequality will be addressed so that care and support can be person-centred and responsive. This will include consideration of inequalities related to cultural, ethnic and other protected characteristics.

2.13 Services will routinely measure and report care and treatment outcomes. This should include understanding both responsiveness of interventions and service users and carer experience. This should routinely be reported through clinical and care governance.

2.14 Services will use demographic data, engagement intelligence, national prevalence rates and data on wider determinants of health to identify groups with poorer mental health and direct resources accordingly.

3. Moving between and out of services

What I can expect:

3.1 I will have one written care plan which is jointly created by me and the professionals supporting me. If I move between different services, this will include clear information which supports my move.

3.2 With my permission, this plan will be shared as I move between services so that I have to tell my story as few times as possible.

3.3 If I need to move between or out of services, I will be supported to prepare for this move. If I need someone to help me, that support will be available to me at a time and pace I need, for example, advocacy.

3.4 If I am discharged from mental health services, I will understand how to get care and support if I need this again, this will be easy for me.

How Services will support me:

3.5 All mental health and care services will work together to reduce delays in transitions of care, whether from inpatient to community or between services, there must be joint processes in place to enable seamless transitions.

3.6 Services will ensure that if people's move out of inpatient care or between services are delayed, this will be recorded with the reason for the delay made clear. Services will report this through Clinical and Care Governance processes.

3.7 Services will provide co-produced written care plans for transitions between services or discharge from services, detailing how to reengage.

4. Workforce

What I can expect:

4.1 I will be confident that the staff who work with me have the right skills and experience to care for and support me.

4.2 I will be confident that the staff who work with me are well supported to do their job and their wellbeing is protected.

How Services will support me:

4.3 Services will support the wellbeing of the workforce.

4.4 Services will ensure that all staff who work with me will be trained in trauma informed practice and approaches and will have completed equalities and diversity awareness training.

4.5 Services will ensure that any assessments or interventions are delivered by staff who have the appropriate skills, training, capability and capacity to fulfil their roles. Where workload tools exist these must be utilised.

4.6 Services will ensure that staffing levels are safe and adequate and are compliant with the health and care staffing legislation.

4.7 All workforce will have access to continuous professional developmental that meets their needs and have protected time to undertake this.

4.8 Clinical supervision and reflective practice will be incorporated into all services as routine practice.

4.9 Leadership of services will create a collaborative culture which empowers and enables the workforce to support the implementation of these standards.

5. Governance and accountability

What I can expect:

5.1 I will be asked about my experiences and this feedback will be used to improve services.

5.2 I will be able to easily find accessible information on what actions I can take if these standards are not being met or I do not feel satisfied with my experience.^[1]

5.3 I will be signposted to independent advocacy services for support, and given the opportunity to share my experience confidentially and or be supported to make a formal complaint.

How Services will support me:

5.4 Services will ensure that information on compliments, feedback and complaints processes will be easily available and in a clear, easy to understand format regarding the performance of services against these standards.

5.5 Services will ensure that processes are in place to learn from feedback and complaints and will use this to improve services.

5.6 Senior leaders of services will work collaboratively to ensure a whole-system approach in supporting people who need mental health support.

5.7 Services will monitor and report on the standards and this will be embedded in the core Clinical and Care Governance business of Boards.

5.8 Services will work together with scrutiny bodies to provide assurance that standards are met and improve quality of care where necessary.