A positive and proactive workforce

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A positive and proactive workforce
Thursday 26th June 2014, Birmingham
Jim Thomas Marie Lovell
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Positive and proactive care, A positive and
proactive workforce
All of social care and health
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A positive and proactive workforce SFC SFH,
part of the picture

• 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

• Skills for Care

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Page 8
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Current on-going work, allied projects and
future products
DH (due 14 / 15) Positive and Proactive guidance
on support and care of children and young people
Deaths in Custody High level principles
The Positive and Safe programme
Ministry of Justice Safer custody NHS care in
prison
Independent restraint advisory panel
Children and young people
Care Bill 2014
People in secure settings
Everyone
A place I call home. Winterbourne View Joint
Improvement Programme
People who have a learning disability / autism
People with dementia
RCN members forum
Care Quality Commission
NICE Guideline due 2014 / 15, Challenging
Behaviour Learning Disability 
People with mental health problems
People in acute health crisis
Restraint Free Futures
Review of the Mental Health Act 1983 / 2008 Code
of Practice.
Health Education England
NICE Guideline due 2014 / 15 Violence Aggression
Safewards making psychiatric wards more peaceful
places
Royal College of Psychiatrists
Mental Health Crisis Care Concordat
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
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More than just restraint
Page 12
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Key Questions
Are you considering restricting someone?
have you tried all reasonable non-restrictive
alternatives?
Is there a real risk of serious harm to the
individual or someone else?
Is the person detained under the mental health
act?
Is this a planned restriction as part of a care
plan?
Does the person have the mental capacity to make
this decision themselves?
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
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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?

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Restrictions
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difficulties
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Five steps to Mental Wellbeing

1. Connect with family, friends, colleagues and
   neighbours.
2. 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-anxiety-depres
sion/pages/improve-mental-wellbeing.aspx
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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

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and listen to the murmur of the cottonwood
trees, Send me off forever but I ask you please,
Don't fence me in
Let me be by myself in the evenin' breeze,
Just turn me loose
Dont fence me in
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 I can't
stand fences
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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.

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• 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 didnt 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 himbut I still feel I killed
  him.
• Sister of a man with dementia

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Please
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Questions
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www.skillsforcare.org.uk www.skillsforhealth.org.
uk Jim.Thomas_at_skillsforcare.org.uk Marie.Lovell_at_
skillsforcare.org.uk