1. The Triangle of Care: Carers included

2. Why do we work with carers and families?

3. Standards and Priorities
Quality Priorities: 5. Think! Family – working with the whole family and co-ordinating all aspects of support to address their full needs
Core Care Standards: We will work with families and carers
Care Act 2014: a duty to meet the eligible needs of carers and promote their wellbeing
CQC: the sustained and supported involvement of families and carers in the care of their loved ones
Trust Values: we work in partnership with service receivers and stakeholders
Triangle of Care, Carers included 2010: gives 6 standards for carers engagement and support
It’s the right thing to do

4. Becoming a Carer

5. Becoming a Carer
“At the time, when my relative joined the service I felt completely lost. Here was a set of new experiences I could not have imagined. I needed to know the ropes, who was there to help and what was going on. I especially needed to believe in the professionals – that they understood my connection to this precious person now in their care. I needed to have confidence they knew how to help him recover and that they saw me as part of that recovery.”
Carer speaking about when the person they care for had their first episode

6. The Triangle of Care is a therapeutic alliance between service user, staff member and carer that promotes safety, supports recovery and sustains wellbeing.

7. TOC for different groups
Carers of adults with mental health problems
Carers of people with dementia
Young Carers of adults
Being extended to other services including services to support people with a learning disability

8. 6 Key Elements
Carers and the essential role they play are identified at first contact or as soon as possible thereafter
Staff are carer aware and trained in carer engagement strategies
Policy and practice protocols re confidentiality and sharing information are in place.
Defined posts responsible for carers are in place
A carer introduction to the service is available with a relevant range of information across the care pathway
A range of carer support services is available

9. 1. Carers and the essential role they play are identified
“Nearly a third of care records (30%) did not record whether or not the service user had a carer. ”
Healthcare Commission 2008
Carers’ views and knowledge are sought, shared, used and regularly updated as overall care plans and strategies to support treatment and recovery take shape.
Record Carers

10. How do we identify carers?

11. 2. Staff are carer aware and trained in carer engagement strategies
“The Healthcare Commission review found that only 32% of front line ward staff had been trained in supporting carers and families, although this ranged from all ward staff having been trained to none.”
Triangle of Care 2nd edition
Staff need to be aware of and welcome the valuable contribution carers can make and be mindful of carers’ own needs.
Staff need knowledge, training and support to become carer aware.

12. How do we engage with carers? Discuss in pairs

13. Engaging carers Being listened to feels great
Structuring conversations: story, feelings, options
Checking meaning
Sensitive issues
Apologising
Body language, voice
Praise and compliments
Wrapping up
Talkwell Star Wards 2009

14. 3. Policy and practice protocols re: confidentiality and sharing information are in place
“For me it was hard at the beginning ... they didn’t want to talk to me. They just said: ‘I won’t talk to you without your son being present.’ They didn’t understand my son’s illness, but he used to tell me every single thing ... eventually they came to the understanding that we are partners in this, working together.”
Carer (Source: National Audit Office Carer Focus Group)
Guidelines on confidentiality and for sharing information
Information release forms and protocols.
Advance statement forms and protocols.

15. Carers Experience
"Without having friends and family to provide support and enable me to leave hospital within a week I may still be there now, rather than where I am - working, looking after my family and with hope for the future.” Service User

16. 4. Defined posts responsible for carers are in place
“only two fifths of wards (40%) had a dedicated member of staff responsible for leading on carer issues.”
Healthcare Commission 2008
Carers lead or champion for all wards and teams irrespective of which service.
Carers links delegated for each shift/team.

17. 5. A carer introduction to the service is available with a relevant range of information
“One in five wards (21%) did not have an information pack for carers containing any of the information we asked about”
Healthcare Commission 2008
An introductory letter from the team or ward explaining the nature of the service provided and who to contact, including out of hours.
An appointment with a named member of the team to discuss their views and involvement.
Team/Ward orientation/induction procedure and leaflet.
Carer information packs.
Discharge planning and aftercare support.

18. 6. A range of carer support services is available
“Carers want prompt access to help when the person they care for is becoming ill. They want information, practical advice, emotional support and occasional respite. Most of all they want decent care for their loved one.”
Professor Louis Appleby, The NSF for Mental Health: Five years On (Department of Health, 2004)
Support for carers including:
Carer support
Carer needs assessment
Family interventions

19. Triangle of Care Self-assessment
Self-assessments must:
Include carers (and service users where possible)
Involve all staff
Traffic light system: green=80%+, amber =50%+
Give good evidence for any ‘green’ areas
Include an action plan which is implemented and updated
Be counter-signed by a senior member of staff

20. What if? – A carer’s journey through care services
When asking for help, what if ...
both my relative and I had a phone number to call if an acute situation was to develop
as a carer I could call the staff, tell them the need was urgent and I would get a quick response
when assessing my relative, the worker(s) talked to me as well, so as to get a clear picture of how to help
the worker(s) tried to get a good picture of what my son was like when he was well and aspired to help him to return to this.
... then our caring duties would diminish to a point when we could look towards our own recovery
Alan Worthington, Carer