A positive and proactive workforce
Thursday 26th June 2014, Birmingham
Jim Thomas
Marie Lovell
Positive and proactive care, &
A positive and proactive
workforce
All of social care and health
A positive and proactive workforce – SFC &
SFH, part of the picture
Skills for Care
– NHS Protect
– Mental Health Crisis Care
Concordat
– NHS England and LGA Core
Principles Commissioning
Tool (for services for people
who display behaviour that
challenges)
– NICE
– Mental Health Act Code of
Practice
Page 8
Current on-going work, allied projects and
future products
Deaths in
The Positive and
Safe programme
Ministry of Justice
Safer custody: NHS
care in prison
Care Bill 2014
Everyone
RCN
members’
forum
Care Quality
Commission
Restraint Free
Futures
NICE Guideline due 2014 / 15
Violence & Aggression
Custody
High level
principles
People in secure
settings
Health
Education
England
A place I call home.
Winterbourne View
Joint Improvement
Programme
People with
mental health
problems
Royal
College of
Psychiatrists
NHS England
1. Physical restraint as a patient safety incident
2. Reporting NRLS Safety Board
3. Mental Health Expert Working group to consider whether physical
restraint will be a priority
Children and
young people
Independent
restraint advisory
panel
People who
have a learning
disability /
autism
NICE Guideline due 2014 /
People with
dementia
People in acute
health crisis
DH (due 14 / 15) Positive and
Proactive: guidance on support and
care of children and young people
Safewards;
making
psychiatric
wards more
peaceful
places
15, Challenging Behaviour
& Learning Disability
Review of the Mental
Health Act 1983 / 2008
Code of Practice.
Mental Health
Crisis Care
Concordat
More than just ‘restraint’
Page 12
Key Questions
Is there a real risk
of serious harm to
the individual or
someone else?
Does the person
have the mental
capacity to make
this decision
themselves?
Is the person
detained under the
mental health act?
Is this a planned
restriction as part
of a care plan?
has every effort
been make to help
them decide ?
Is the restriction
necessary for their
treatment?
Is a restriction in
their best
interests?
does the
restriction need to
be carried out
now?
Is this the least
restrictive option?
Pages 15 and 16
A positive and proactive workforce
Developing workers to minimise all restrictive
practices.
 Who is ‘the workforce?
 What do they do? where?
When?
 What skills knowledge,
attitudes do they need? And
what do they already have?
 When and how can we develop
the skills that are needed?
Restrictions
difficulties
Five steps to Mental Wellbeing
1.
2.
Connect with family, friends, colleagues and neighbours.
Be active – Take a walk, go cycling. Find the activity that you
enjoy and make it a part of your life.
3. Keep learning – learning new skills can give you a sense of
achievement and a new confidence. So why not a cooking
course, learning to play a musical instrument, or to fix your bike?
4. Give to others – even the smallest act can count; a thank you
or a kind word. Or volunteering at a community centre.
5. Take notice – be more aware of the present moment; feelings
and thoughts, your body and the world around you; "mindfulness"
How well do our services support people to follow this advice?
“people” who use the service and those who work there!
http://www.nhs.uk/conditions/stress-anxietydepression/pages/improve-mental-wellbeing.aspx
Evidence
 Risk what is a MICROMORT!
http://understandinguncertainty.org/
Professor David Spiegelhalter FRS. Winton Professor
of the Public Understanding of Risk. Statistical
Laboratory in the University of Cambridge.
 Clown Target
 Obviously safer
“Let me be by myself in the evenin' breeze,
and listen to the murmur of the cottonwood
trees,
Send me off forever but I ask you please,
“Don't fence me in”
“Just turn me loose”
“I want to ride to the ridge where the west
commences, and gaze at the moon till I
lose my senses”
“I can't look at hobbles and
fences”
I can't stand
Risk
“Physical health and safety can sometimes be bought at too
high a price in happiness and emotional welfare. What good
is it making someone safer if it merely makes them
miserable? . . And if this is where safeguarding takes us,
then is it not, in truth, another form of abuse?”
Lord Justice Munby
MICROMORT!
http://understandinguncertainty.org/
Professor David Spiegelhalter FRS. Winton
Professor of the Public
Understanding of Risk. Statistical
Laboratory in the University of Cambridge.
“I felt sick at the thought of sedating him. The staff made it clear
that giving him ‘something to help with the behaviour’ would
speed up the condition and he would deteriorate quickly.
They said that if I didn’t agree, he would have to be moved to
another home, if I did agree he would die sooner!
Even now, I still feel I killed him. As the eldest it was
my responsibility to make the decision. I know we
discussed it as a family, I know we all agreed it was
for the best for him and those around him………but I
still feel I killed him.”
Sister of a man with dementia
Please
Questions
www.skillsforcare.org.uk
www.skillsforhealth.org.uk
Jim.Thomas@skillsforcare.org.uk
Marie.Lovell@skillsforcare.org.uk