1
Simon Bradstreet: SRN
Allison Alexander: NHS Education for Scotland/SRN
Scottish Recovery Indicator
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SRI workshop
• Introduce SRN and NES work around
Mental Health Nursing Review
• Introduce the Scottish Recovery
Indicator tool
• Consider how to use SRI to help
achieve improved outcomes
3
The National Programme
Improving the mental health and wellbeing for everyone living in Scotland and
improving the quality of life and social
inclusion of people experiencing mental
health problems.
4
What we aim to do
• SRN aims to
– Raise awareness of recovery
– Develop our understanding of recovery
– Build capacity by sharing information and
by supporting efforts to promote recovery
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Why develop a practice tool
• To assess the extent to which practice is
focussed around recovery
• To help people realise principles of
recovery in practice
• To make recovery more tangible
• Are we really ‘doing this already’?
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Values base for mental health nursing
Relationships
Rights
Respect
Recovery
Reaching out
Responsibility
“[A] The recovery approach should be adopted as the
model for mental health nursing care and intervention,
particularly in supporting people with long-standing mental
health problems.”
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Some relevant actions
1.
All mental health nurse will undertake values
based training
2.
National framework for training in recoverybased practice to support the dissemination of
recovery-focussed frameworks into practice
3.
Mental health nurses will use recovery
environment audit tools to gauge their current
practice and to inform the development of
recovery based approaches
“The recovery approach should be adopted as the model
for mental health nursing care and intervention, particularly
in supporting people with long-standing mental health
problems.”
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NHS Education for Scotland / SRN Joint project
• To produce a framework for mental health
nurses outlining the knowledge, skills and
values needed to work in a recovery
focussed way
• Underpinned by the lived experience of
service users, SRN Narrative Research
and training currently available
• Literature review
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Delivering for mental health
Improve the patient and
carer experience of
mental health services
Commitment 1: We will develop a tool to
assess the degree to which organisations
and programmes meet our expectations in
respect of equality, social inclusion, recovery
and rights. The tool will be piloted in 2007
and be in general use by 2010.
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Development of SRI
• Assessed existing tools and approaches
• Identified Recovery Oriented Practices
Index* as viable option
• How ROPI was developed
• Adaptation process
• From stick to carrot
• Piloting SRI and evaluating impact
*Mancini, A.D., and Finnerty, M.T. (2005). Recovery-Oriented Practices Index,
unpublished manuscript, New York State Office of Mental Health
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SRI headings
1.
2.
3.
4.
5.
6.
Meeting basic needs
Personalisation and choice
Strengths-based approach
Comprehensive services
Service user involvement/participation
Involving support networks and promoting social
inclusion and community integration
7. Service user in control and active participant
even when subject to compulsion
8. Recovery focus
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Using SRI
1. Preparing to use SRI
– Training
– Gathering information and people
2. Answering the questions
– Sampled service user records (Assessment
forms and Care Plans)
– Project information/documentation
– Practitioner and service user interviews
3. Acting on the findings
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Example 1: Assessment information
3. Strengths-based approach
Indicating that service delivery and planning should be focussed on service user’s strengths.
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3a. Assessment
addresses
service user
strengths in
multiple areas.
Assessment
does not
address service
user strengths
2
3
Assessment
Includes one
aspect relating
to strengths
4
5
Assessment
addresses
strengths in
multiple areas
of functioning
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Example 2: Care plan information
2. Personalisation and choice
Indicating that the planning and delivery of all services be designed to address the unique
circumstances, history, expressed preferences and capabilities of each service user.
1
2b. Care
planning should
reflect
personalised
self-set service
user goals, with
substantial
variation across
care plans.
Care plans are
standardised,
with minimal to
no variation
2
3
4
5
Care plans
show minimal
variation in
goals, with 90%
of plans having
at least 1 similar
or identical goal
(e.g. psychiatric
stabilisation,
medication
compliance)
Care plans
show moderate
degree of
variation in
goals, with 5089% of plans
having at least 1
similar or
identical goal
Care plans
show high
degree of
variation in
goals, with 2049% of plans
having at least 1
similar or
identical goal
Care plans
show
substantial
variation in
treatment goals,
with < 20% of
plans having at
least 1 similar or
identical goal in
most recent
care plan
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Example 3: Project information
5. Service user involvement/participation
Indicating service user involvement as integral to the planning and delivery of all services and to
the determination of policies and procedures for service operations. Service should also actively
recruit service users who are hired with equality in pay, benefits, and responsibilities to other
employees.
5a. Service has
policy and
formal
mechanism for
involving a
diversity of
service user
input that has
resulted in
demonstrable
changes in
policies,
procedures, or
provision.
1
2
3
4
5
Policies do not
specifically
address diverse
service user
involvement in
activities or
operations and
there is no
formal
mechanism for
promoting
involvement
Policies exist
regarding
diverse service
user
involvement but
no formal
mechanism for
promoting
involvement
Policy and
formal
mechanism for
promoting
diverse service
user
involvement
exist but
mechanism is
cursory (e.g.
yearly
satisfaction
survey) and has
not significantly
informed
development
Policy and
formal
mechanism
exist for
promoting
diverse service
user
involvement that
has resulted in
at least one
significant
change (must
identify this
change)
(In addition to 4)
There is service
user advisory
board and/ or
service user(s)
on governing
body. Service
users also
contribute to
staff
appointment
process and
training
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Example questions
1. Do these criteria make sense to you?
2. What evidence or examples could
your service produce to meet the
criteria?
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Key issues
• Who to involve in gathering and
assessing information?
• Who to involve in answering questions?
• Maintaining morale
• Confidentiality and ethics
• Defining parameters of questions
• How best to involve service users
• How to act on findings
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Contacting us
• info@scottishrecovery.net
• Join SRN mailing list and access SRI
draft www.scottishrecovery.net
• 0141 240 7790