1. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Creating the Culture Implementing Recovery 09.30 – 16.30 Rachel Dadswell, Lesley Herbert, Steve Parker, Sarah Richmond

2. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Focusing Exercise Introduce yourself to someone you don’t know well Describe to them all of the things that you did between waking up and arriving at training today Be prepared to introduce your partner and their morning to the rest of the group

3. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. What is recovery? A person with mental illness can recover even though the illness is not ‘cured.’ Recovery is a way of living a satisfying, hopeful, and contributing life even with the limitations caused by illness. Recovery involves the development of new meaning and purpose in one’s life as one grows beyond the catastrophic effects of mental illness.” (Anthony, 1993)

4. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. What is recovery? “We define recovery as achieving the life we want in the presence or absence of mental distress” (Mental Health Foundation of New Zealand 2008)

5. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Elements of recovery Hope is a central aspect of Recovery as Recovery is probably impossible without hope. It is essential to sustaining motivation and supporting expectations of an individually fulfilled life. Agency refers to people gaining a sense of control. Recovery means service users taking control over their own problems, the services they receive, and their lives. It is concerned with self-management, self- determination, choice and responsibility. Opportunity links Recovery with social inclusion and thus peoples’ participation in a wider society. People with mental health problems wish to be part of communities; to be a valued member of and contribute to those communities; and have access to the opportunities that exist within those communities. (Recovery is for All – Hope, Agency & Opportunity on Psychiatry)

6. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Recovery oriented services “Like an individual journey of recovery is tumultuous, is up and down….. so is the journey of a recovery oriented service. It too must be allowed to struggle and learn from its struggles. And so we must challenge ourselves about allowing ourselves to sometimes get it wrong” (Helen Glover, 2004)

7. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. What is personalisation? “…..a key underpinning principle of reform whereby “individuals not institutions take control of their care”” ( A Vision for Adult Social Care: Capable Communities and Active Citizens) “Every person receiving support, in any care or support setting, will have choice and control in the type of support that they receive”

8. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Themes of Personalisation A focus on outcomes for the individual Effectiveness, quality of experience, safety, efficiency Transparency - “no decision about me, without me”

9. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. The power of personalisation Current service model : WE PROVIDE TO THE SERVICE USER

10. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. The power of personalisation Personalised model: SERVICE USER AT THE CENTRE MAKING CHOICES

11. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Key Drivers – health & social care No Health without Mental Health Making Recovery a Reality Recovery is for All – Hope, Agency & Opportunity in Psychiatry Implementing Recovery – a new framework for organisational change Liberating the NHS: Equity & Excellence Liberating the NHS: Greater Choice & Control A Vision for Adult Social Care: Capable Communities and Active Citizens Think Local, Act Personal

12. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Key drivers - Service user narratives “Recovery ideas have been largely formulated by, and for, service users to describe their own life experiences.” “....the recovery approach has emerged from the writings of people who used services…..many wrote about coping with symptoms, getting better, and regaining a sense of personal identity that was not defined by illness experience….the accumulated wisdom and witness from such personal accounts in many ways form the foundation of a recovery approach” ( From Making Recovery a Reality / A common purpose: Recovery in future mental health services)

13. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Commonalities of approaches Person at the centre Choice Recovery focused Individualised Personal responsibility Life course approach to care Themes In practice

14. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Within Southern Health – the Local picture

15. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Implementing Recovery – Organisational Change (IMROC) A 3 year programme funded by the DH and delivered through a partnership between the Centre for Mental Health & the Mental health Network of the NHS Confederation SHFT one of only six sites selected to pilot methodology Based on ‘Implementing Recovery – A methodology for organisational change’ – 10 key organisational challenges Changing the culture to support the structural changes

16. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. IMROC

17. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. IMROC challenges and progress Changing the nature of day to day interactions and the quality of experience Ensuring organisational commitment, creating the culture Transforming the Workforce Changing the way we approach risk assessment and management Outcome Measures Spiritual Care Pathway Recovery Interventions Toolkit This training! Medical staff and board development programmes Review of policies and procedures Development of Peer Support Building on the practice development work undertaken by Steve Morgan

18. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. IMROC challenges and progress Delivering a comprehensive, user-led education and training programme Establishing a Recovery Education Centre to drive the programme forward Building on Recovery Training already in place Training provided to both staff and service users Training developed through service user and staff partnership Recruitment of a full time Recovery Training Facilitator with lived experience Curriculum development Establishing of Recovery Learning Hub

19. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Common pledge (DRAFT) 1. To provide environments and experiences that inspire hope 2. To believe that a meaningful life is possible for everyone 3. To acknowledge that people are experts in their own experience 4. To make information accessible and relatable 5. To challenge stigma 6. To teach as well as treat 7. To work collaboratively 8. To provide living proof of recovery 9. To listen and to learn 10. To be creative 11. To take positive risks 12. To work purposefully

20. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Your knowledge and experience… How will we know we are working in a recovery oriented way? Describe what behaviours we would expect to see in the individual practitioner / the team / the organisation if we were working in this way…

21. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Working in a recovery oriented way requires.. Changing staff attitudes and behaviour Creating organisational support and leadership to ‘cement’ these changes Reviewing key policies and procedures (e.g. Risk assessment and management) Transforming the workforce (Shepherd 2010, Reform and Recovery in Mental Heath)

22. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Traditional and recovery oriented practice Traditional practice Supporting recover y Traditional practice Supporting recover y I’ve got a great new assessment form here which we’ve just designed. Let’s fill it in. Why don’t you tell me your story and what you want out of life? If you want, we can then write it down Tell me your main problemsWhat are your main strengths? I’ve just done a new training course in ‘mindfulness CBT’. I think it could help you I wonder if there is anything which I’ve been trained to do which would be useful to you? I can explain what has gone wrong with your brain How have you made sense of what has happened to you? Let me teach you some coping skillsWhy don’t you teach me how you have learned to cope? I don’t think you are ready for work yet, why not try being a volunteer at the charity shop? If you feel you are ready for work, then I’ll try to help you I think we need to employ another nurseI wonder if we gave you training and support if you would like to work in this team?

23. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Working in a recovery oriented way Undertake a SWOT analysis of working in a recovery oriented way: Strengths Weaknesses Opportunities Threats

24. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Problem solving Choose either a team weakness, opportunity or threat Consider ideas of how to bring about change Start to develop a plan that can be translated back into action in the work place

25. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. In summary

26. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. In summary Recovery, personalisation and self management ALL emphasise: A shift in power and control The importance of partnership working and individual strengths That HOPE is essential for things to be different That staff and service users need to learn and move together for the benefit of all

27. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. In summary Recovery – is the overarching philosophy and attitude in which we work Personalisation – is how (the approach) we work with an individual, in a ‘personal’ way Personal budgets, WRAP and employment as a peer worker are just some of the personal ‘vehicles’ an individual may choose to facilitate his or her recovery

28. ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust. The ImROC identity was created by service users. Further training Based in the Recovery Hub – our first step towards developing our Recovery College…. Recovery Training parts 1, 2 & 3* WRAP* Train the trainer and peer support Building a recovery story Presentation skills (* Watch the LEaD website for details) Personalisation Training also coming soon…..