1. Rehabilitation and Recovery in Mental Health
Community Voices Briefing
Tuesday 28th August 2018

2. About the engagement
Topic: Mental Health (MH) Rehabilitation and Recovery Services in Kirklees What do we mean? ‘Rehabilitation and Recovery services are services to support people with complex mental health needs to gain or regain their skills and abilities to function as independently as they can in the community, as symptom free as possible.’

3. About the engagement We want you to help us engage on two areas:
What accommodation should be provided in Kirklees
What community services should be available
We need to ensure we consider the needs of our diverse local population when planning services.

4. Who do we want to involve
People who use services now – patients and carers
Staff who work in mental health services
Children and young people who may need services in the future
The community so we can ensure services support everyone who may need them
Providers – to gather ideas on what could work well

5. Rehabilitation and Recovery Services
28 August 2018

6. Review of services undertaken during 2016/17.
Background :
Review of services undertaken during 2016/17.
Review outcome resulting in this project – which is for people who have a primary diagnosis of psychosis, many of whom are being cared for under the Mental Health Act.
This is being overseen by NHS England and the Council Overview and Scrutiny Committee in line with the NHS England Assurance process.
Return to Overview and Scrutiny Committee in December 2018
There was a review of mental health rehabilitation and recovery services undertaken during 2016/17 which identified that there were a lot of people receiving care out of area in locked rehabilitation units and that it appeared there was a need for more local community based services to ensure that people have the best chance of recovering from mental ill health.
The project we now have relates to people who have a primary diagnosis of psychosis. Many of these people will be subject to the Mental Health Act, either through sections or community treatment orders; however people who are not sectioned referred to as “informal” inpatients will also be able to access the services.
To clarify there is work in NHS England and in SWYPFT on services for people with a diagnosis of personality disorder and the CCG is also fully involved in this. But this is not part of this project. This is just about rehabilitation services for people with psychosis.
The project is being monitored by NHS England in line with the NHS England Assurance process and the Council Overview and Scrutiny Committee are being consulted at each key stage.
The plan is to go back to Overview and Scrutiny Committee in December with the outcome of the engagement and proposals for service development. At that point the Overview and Scrutiny Committee may consider that further engagement or consultation is required or that some or all of the elements included in the project can move forward.

7. Background: Joint Commissioning Panel – MH Guidance:
The Joint Commissioning Panel – MH – Guidance on Rehabilitation and Recovery Services.
Referrals made by:
Regional Forensic Services
Regional Low Secure
Local Acute inpatient and PICU
Local Inpatient Rehabilitation Services:
Hospital rehab unit
Longer term complex support
Community services that support rehabilitation and recovery:
Primary Care
Community Mental Health Teams (Generic Secondary Care Mental Health Trust)
Health and Social Care
Community Rehabilitation Team
Supported Accommodation – nursing/residential care, supported tenancies (onsite/floating support)/ independent tenancies
Support to work/education/volunteering
Advocacy
Peer support
The Project takes into account the latest good practice guidance provided by the Joint Commissioning Panel. The Panel Guidance identifies a range of services for people at different points in the rehabilitation and recovery pathway.
This diagram shows the types of service from forensic services which are commissioned by NHS England to our local acute inpatient services which will refer into rehabilitation and recovery services.
These services could be provided in inpatient services like Enfield Down. Or increasingly it is hoped more people will receive rehabilitation services in the community, either in nursing home provision, supported accommodation or in their own home.
It is clear that we have a lot of the recommended services in Kirklees, however, more close working is required and there are some gaps and some services that need further development.

8. Inpatient rehabilitation services (SWYPFT, Enfield Down)
What do we have in place now:
Inpatient rehabilitation services (SWYPFT, Enfield Down)
Services for people with longer term complex needs (SWYPFT, Enfield Down, Out of area placements)
Community rehabilitation services in a nurse led residential home (Richmond Fellowship)
From looking at the current services and reviewing the people currently receiving those services it was clear that we needed to look at Enfield Down provision which is currently working with people who have rehabilitation needs but also those who have complex long term care needs. These groups of people shouldn’t be receiving care in the same setting. In addition, a significant number of people are receiving care out of area because their needs can’t currently be met at Enfield Down. Some of these placements will be appropriate if people require specialist treatment or there are specific reasons why people are not living in Kirklees, but other people could be cared for and supported locally if they were placed in the right setting or type of service.
It is also clear that we need to support more people in the community with a community rehabilitation team working intensively with people coming out of hospital. We need nursing home provision that supports people for a shorter period of time and we need good quality supported housing.

9. Enfield Down – rehabilitation/complex care
What we need to do:
Need for re-provision of inpatient rehabilitation and recovery services
Enfield Down – rehabilitation/complex care
Develop a community led model of care
Community Rehabilitation Team
Nursing Home Provision
Supported Housing
From looking at the current services and reviewing the people currently receiving those services it was clear that we needed to look at Enfield Down provision which is currently working with people who have rehabilitation needs but also those who have complex long term care needs. These groups of people shouldn’t be receiving care in the same setting. In addition, a significant number of people are receiving care out of area because their needs can’t currently be met at Enfield Down. Some of these placements will be appropriate if people require specialist treatment or there are specific reasons why people are not living in Kirklees, but other people could be cared for and supported locally if they were placed in the right setting or type of service.
It is also clear that we need to support more people in the community with a community rehabilitation team working intensively with people coming out of hospital. We need nursing home provision that supports people for a shorter period of time and we need good quality supported housing.

10. We want to find out how we can achieve:
Aims and Objectives of the Engagement:
We want to find out how we can achieve:
Good quality services in Kirklees
Integrated services – NHS/Health and Social Care/Voluntary Sector
Clear pathways and processes to ensure more people receive timely rehabilitation and recovery services
Through the engagement we want to find out how we get good quality services in Kirklees that are in line with the guidance but reflect what patients and carers are telling us they need in different parts of Kirklees. We want more integrated care where appropriate with all the providers involved and we want it to be clear how services work so that people access services according to their individuals needs.

11. Details of the task Dawn Pearson Senior Engagement Manager
Calderdale and Greater Huddersfield CCGs

12. We need your help!
We need local people to get the community model right
We need service users, carers and stakeholders to help us improve what we have in place
You can help us understand
what good accommodation looks like
what a community service looks like
What else we need to do

13. Tools we have available
Presentation we have used today
A hard copy survey
A form to capture conversations with equality monitoring for focus group use
An online survey with equality monitoring
QR code so people can upload to mobile phones
Any other approaches will be considered on an individual basis.

14. Any questions

15. Alan Duncan Engagement Lead VAC
Community Voices
Alan Duncan
Engagement Lead
VAC

16. How to get involved
Register your interest with VAC and describe your approach
The CCG will need to consider how they target particular protected groups – VAC will allocate the work based on the funding available and the reach
Alan Duncan will be the lead contact for Community Voices

17. Payment
Hard copy responses are at the standard rate of £5 per individual response
Online responses are £2 per online response (please ensure your member adds the code – we cannot pay for responses that have no code added)
Approved provider event/focus group will be £25 per half day rate and £10 for refreshments
Other responses will be considered on an individual basis
We are interested in anyone who can support data input at 50p per unit – please liaise with Zubair Mayet or Dawn Pearson on or

18. Any questions