Enter and View visit South Hackney Recovery Team CMHT February 2020 Service South Hackney Recovery Team Service address Donald Winnicott Centre, Coate Road London, E2 9AG Provider name East London Foundation Trust (ELFT) Date/Time of visit 20 February 2020 E&V representative/s Kanariya Yuseinova Emma Cooke Rachel Klem Healthwatch staff contact Kanariya Yuseinova Service contact Adesoji Ogungbola 020 7275 1000 About Healthwatch enter and view visits The Local Government and Public Involvement Act 2007, as amended by the 2012 Health and Social Care Act and directed by Local Healthwatch Regulations 013, imposes a duty on health and social care providers (including the private sector) to allow authorised representatives of Local Healthwatch to enter premises they own or control to observe the services being provided. These are legally binding directions and are often referred to as ‘the right to enter and view’. Purpose of the visit 1 One in six adults has a common mental disorder such as anxiety and depression Mental health services are of increasing concern to the public. In Hackney, mental health is consistently raised with us by the public as a key issue. Healthwatch Hackney decided that for 2020, one of our Enter and View priorities would be to review mental health services provision in the borough and report on the care quality. The purpose of Enter and View is to collect feedback from people who use the services, staff who provide the services, and others with an interest e.g. carers, where possible. We visited the Community Mental Health Team (CMHT) known as the South Hackney Recovery Team to: ● Get patients’ feedback on the care and support they receive from the CMHT ● Talk to staff members about their experience of working at the CMHT ● Observe the physical environment of the service ● Compile a report highlighting good practice and recommendations for improvement Our decision to visit was influenced by the following factors: ● Routine comments and feedback from patients to Healthwatch Hackney ● Healthwatch Hackney priority to review mental health service provision within the borough 1 Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2014 Acknowledgements Healthwatch Hackney would like to thank Team Manager Adesoji Ogungbola and the staff for accommodating our visit, as well as the patients and carers for participating in our interviews. We are also grateful to our volunteer authorised representative for conducting the visit. Important Information for management/provider ● We asked South Hackney Recovery Team to provide an action plan and response to issues raised in this report’s recommendations. The impact of the Covid pandemic on the service has meant that they have been unable to respond to date. ● Copies of this report will be circulated to the Care Quality Commission, the East London Foundation Trust, City and Hackney Clinical Commissioning Group and Healthwatch England, and will be posted on the Healthwatch Hackney website Disclaimer ● Observations made in this report relate only to the visit carried out at South London Recovery Team on 20th February 2020which lasted for a total of 3 hours and 15 minutes, and one patient feedback received via email. ● We notified the service five days prior to the visit and sent them leaflets to notify the patients about our arrival. The leaflets were available to patients in the waiting area. ● We did a call-out through our website and social media to anyone who wanted to share their views on these services. ● This report is not representative of all CMHT patients on the day of the visit. It only represents the views of ten patients who were interviewed on the day of our visit, one patient’s feedback received via email, and the members of staff who were able to contribute within the time available. Recommendations All recommendations are based on patients’ feedback and our observations Recommendation 1 Improving appointment system. The service should - make it easier for patients to schedule and reschedule appointments - ensure administration is up to date and provides clear information to patients / eg. a patient received 3 different appointment dates for their first appointment Recommendation 2 Customer service training for the receptionist and all other support staff For receptionists to better understand the patients’ needs and the environment provided, receptionists should receive training on how to assist patients with their health visit. Recommendation 3 Improve signage to access the building Accessing the waiting area through the two double doors is not clear due to the multiple signs and buttons/intercoms. Recommendation 4 Improve wheelchair accessibility Accessibility to the waiting and consultation rooms for wheelchair users and mobility scooters to be reviewed. Wheelchair accessibility should also be reviewed for the lift. Recommendation 5 Improve the physical environment for patients and visitors Review processes to ensure the physical environment is regularly checked and ensuring amenities, such as the toilets and water dispenser, are fully stocked for the patients’ and visitors’ needs. In addition, ensure all equipment within the service is in working condition. Recommendation 6 Better placement of the water dispenser The water dispenser to be serviced and moved away from the toilet door improve health and safety of patients and visitors. Also ensure that there are cups available at the water dispenser. Recommendation 7 Provide patients and other visitors with better information The service should make sure that racks are stocked with up-to date information on: Accessible Information Standard, Dementia, Special Educational Needs, Carers Support, Mental Health support groups, Healthwatch Hackney, Hackney’s Complaints Charter and other relevant information that patients and carers may benefit from. This includes providing more and appropriate reading materials, ensuring that they are free of offensive content. Recommendation 8 The defibrillator should be moved to an area accessible to the public. The defibrillator is currently in the duty doctor’s room, inaccessible to the public for use in an emergency. The equipment is designed to be used without specialist knowledge and training and should be located in an area accessible to everyone. Key information about the provider ● The South Hackney Recovery Community Mental Health Team (CMHT) provides a specialist service for adults aged 18-65 years who require a period of support to maintain their mental wellbeing. ● The service is run by the East London Foundation Trust (ELFT). ELFT Provides a wide range of community and inpatient services to children, young people, adults of working age and older adults, as well as forensic services to the city of London, Hackney, Newham, Tower Hamlets, Bedfordshire and Luton. ● The CMHT offers a range of interventions or treatments including: ● Joint assessment and care planning ● Talking therapies ● Medication ● Support for family or friends who are helping the service user ● Support to recognise possible early warning signs of distress and developing techniques to manage this and staying well. ● Support finding training, employment, and meaningful activities. ● There are approx. 1,097 service users registered with the service of whom 201 are on the Care Programme Approach (CPA). Location and transport ● South Hackney Recovery Team CMHT is based at the Donald Winnicott Centre, Coate St, London E2 9AG and shares the entrance with other mental health services. ● The services are open from Monday to Friday 9am-5pm. ● The main entrance is off the main Hackney road, near the 26, 48, and 55 bus stops. The conversation with the Team Manager The team South Hackney recovery team has been fully staffed for the past year and used no agency staff. The team comprises 35 clinical staff divided into two teams – Recovery Team 1 and Recovery Team 2. The core team consists of 1 operational lead, 2 senior practitioners, 6 social workers, 6 community psychiatric nurses, 2 occupational therapists, 4 support workers, 2 psychologists, 2 assistant psychologists, 2 psycho- social intervention workers, 1 homeless specialist, 2 consultant psychiatrists, 2 staff- grade psychiatrists, 1 employment specialist, 1 carer support worker, 1 benefits advisor. Each social worker has a caseload of maximum 25 patients per month, and each consultant sees approximately 548 patients per month. The service also has 8 non-clinical staff comprising administrators and a receptionist. The full-time receptionist is supported by an apprentice or one of the administrators, so the reception is covered by two people at all times. Clinical and administration staff receive yearly mandatory training and undertake other annual courses for the various professional disciplines to remain registered with their respective regulatory bodies. Other services available Depot clinic – The clinic runs twice a week on Tuesday morning and Wednesday afternoon to provide flexibility for service users of whom there are currently 186. Open House - This is a fortnightly forum for patients to express their views on their experiences of engaging with the mental health services. Attendance is open to anyone who is known to South Hackney CMHT. Personal Health Budget (PHB) - This scheme was created to give NHS services users more choice and control over their own health and wellbeing. PHB can be used to purchase a range of services, activities or support that the service users require to achieve their recovery goals. Duty worker - The CMHT has a “walk-in” clinic every day from 9am–5pm for anyone in need of a prescription or in crisis. The service is run by a different professional every day. Referrals Referrals are received mainly by the City and Hackney Adult Mental Health Referral and Assessment service (CHAMHRAS), and directly from inpatient settings including eg the City and Hackney Centre for Mental Health. CHAMHRAS acts as a single point of entry to the services and is responsible for conducting the initial assessment. Referrals to CHAMHRAS can be made by a GP, or by housing or social services. Over the last six months the service has received around 257 referrals.