Mental Health Services in Wrexham
This chapter of the Social Care Plan has been written by the Wrexham Mental
Health Planning Group. This consists of representation from Social Services
Department (Lead Manager and Team Managers CMHTs’), North East Wales NHS
Trust (Directorate Managers), Service Users, Brighter Futures, Local Health Group,
Unllais, Wrexham Mind, Consultant Psychiatrist (Directorate Manager), NSF Cymru,
and Officers from Planning & Development.
National / Local Strategies
There are a number of strategy developments that will shape the future development
of mental health services in Wrexham. These are: 
Adult Mental Health Services for Wales

North Wales Strategy for Adult Mental Health

National Service Framework for Mental Health in Wales

Health Act 1999 (Flexibilities)

Health Improvement Programme

Best Value and Clinical Governance
Copies of these documents can be obtained from Planning & Development Team,
Personal Services Directorate, Lambpit Street, Wrexham 01978 292966
Strategic Vision
The Planning Group has agreed the following strategic vision for mental health
services in Wrexham that recognises the values that underpin the strategies above:
(a)
To ensure good mental health promotion is at the heart of our approach to
services.
(b)
To educate the public about the effects and treatment of mental illness in
order to develop positive attitudes, reduce stigma and incorporate mental
health into the wider health, well being and social agenda.
(c)
To provide equitable access to mental health services for people of Wrexham
in need of mental health services, irrespective of gender, sexuality, disability,
race, or social, cultural and religious background.
(d)
To actively involve service users and carers in the planning, commissioning,
monitoring and delivery of services.
(e)
To ensure joint working & good communication between Social Services,
Health Authorities and the voluntary and private sectors in order to
commission an effective, comprehensive and co-ordinated mental health
service which will enable us to provide an efficient, responsive and seamless
care package.
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(f)
To support service users, and their carers in ways which enhance their ability
to cope & remain in control of their lives and to promote the integration of
service users into all aspects of community life.
(g)
To assess the medical, psychological and social needs of service users and
carers at appropriate times with reviews at regular intervals.
(h)
To provide effective and high quality care based on the best evidence and to
include provision for medical, psychological and social needs of service users
and carers of people with mental health problems
(i)
To protect service users, carers and the public from avoidable harm whilst
respecting the rights of users and their carers.
(j)
To recruit and retain highly trained staff of all disciplines who are confident in
their skills and who have high morale.
(k)
To review all aspects of service to ensure best value in clinical governance
and such a process should include all relevant stakeholders.
The above highlights the objectives we are striving to achieve both broadly and
specifically and will be measured against the principles and aims laid down in the
Adult Mental Health Services for Wales in terms of equity, empowerment,
effectiveness and efficiency.
Person Centred Planning
Members of the Mental Health Planning Group in 2001/02 undertook a “gap
analysis” of mental health services in Wrexham. Because of the multi-disciplinary
approach within mental health services, this analysis aimed to identify both social
and health issues. This person-centred approach to needs analysis revealed the
following: -
1. A Place To Live
There is active partnerships with Local Authority Housing Department, Housing
Associations and voluntary Organisations (e.g.: Womens Aid and MIND) to provide a
range of housing / tenancy support services. Supported living arrangements are in
the early stages of being developed with a new scheme commencing in May 2002.
A further scheme is to be set up in September 2002. It is anticipated that the new
appointment of a Special Needs Housing Co-ordinator in June 2002, through
Flexibility funding, will promote further positive developments.
The Social Services Department and Housing Department are working together to
ensure that the “Supporting People” legislation is used to maximise applications for
Transitional Housing Benefit to enable people to be supported independently in the
future. More information on the ‘Supporting People’ scheme is included in Section
8.4 of the General Information chapter of this Social Care Plan
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2. Having a Voice
A number of voluntary organisations working in Wrexham provide support and
advocacy for service users. However it is acknowledged that information is often not
user friendly or available in a wide enough range of styles and formats. There is a
need for more user and carer involvement and consultation including the views of
people who may be socially isolated such as children with parents who have a
mental health problem. It is also acknowledged that further development needs to be
done in gaining user and carers views of services.
3. Jobs / Occupation
The Local Authority and North East Wales NHS Trust should act as role models with
regard to the employment of people with mental health problems. There are
currently Work Opportunities schemes provided by Social Services Department but
options for people to move on from these are limited & better links are needed
between the Social Services Department and Employment Services. It must be
recognised that both flexible & meaningful employment options are needed such as
job sharing. The provision of a Support Worker to encourage people with mental
health problems to participate in voluntary work is acknowledged as being a valued
but limited service.
The Work Opportunities Service for people with a learning disability are undertaking
a management review of their services in 2002 and this will include reviewing access
to Work Opportunities for people with mental health problems.
4. Learning
Day Services provide a range of learning opportunities and NEWI have a Disability
Liaison Officer to facilitate access courses, however it is noted that often support is
needed to enable and encourage people to attend, for example, Project Workers.
5. Carers
A range of voluntary organisations in Wrexham provides support for carers.
However, there is a gap in the range and choice of respite care available within
Wrexham, particularly emergency respite. It is acknowledged that statutory bodies
need to actively involve carers in the planning of care and support and to offer
Carers Assessments to all carers.
6. Health
Primary Care (First Access Team) and Secondary Care (Community Mental Health
Team) services link to other professionals who support health care needs. People
who suffer mental health problems also suffer from poor physical health and are
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more prone to life threatening illnesses due to poor diet, lifestyle and long term
effects of psychiatric medication. To address this, the Local Health Board initiative,
“Hearts and Minds”, enables people with mental health problems to have a full
medical screening through their General Practitioner. However gaps exist in
providing a person-centred approach for specialist outreach work in a number of
areas, including the ability to support vulnerable and high-risk people in the
community at times of crisis.
There is no appropriate in-patient unit for seriously disturbed adolescents or for
those adolescents requiring compulsory assessment/treatment under the Mental
Health Act 1983.
There are difficulties for people with Learning Disabilities to access mental health
services and vice versa.
7. Planning for Life
An assessment of need is central to any person centred approach. Assessments
must be completed for each service user and it is essential that each user of the
service feel "heard” and has good advocacy to enable them to do so.
It is felt that sound foundations are in place to enable users to be at the centre of
care planning and this will be enhanced by the adoption of the Care Programme
Approach within Community Mental Health Teams. However, more work is needed
to enable a seamless transition from children’s to adult services. It is important to
continue to involve and consult with users and carers in relation to planning,
monitoring and delivery of services.
To assist with planning for life, an integrated Community Mental Health Team for
people with mental health problems is needed to enable people to access services
easily. As the Care Programme Approach is about multi-disciplinary working within
Teams, any training on the role of team members is facilitated in the same way. The
Social Services Department and North East Wales NHS Trust have accessed
‘Flexibilities’ funding to provide joint training and aid the process of integrated team
working.
8. Money / Income
The specialist service provided by the Social Services Department’s Welfare Rights
Unit has enabled users to access a range of entitled benefits. Voluntary
Organisations in Wrexham supplement this work (see ‘Summary of services
available for people with mental illness in Wrexham’) by offering benefit support and
advice.
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9. Support In Daily Living
There is a range of services available to support and assist people to remain in their
own homes. However there are no local respite residential care for people with
mental health problems. Although the Social Services Department has an Out of
Hours Emergency Duty Team, there is no joint Social Services Department and
North East Wales NHS Trust 24 hours Crisis Service.
10.
Leisure & Social Activities
The Social Services Department, Independent and Voluntary Sector provide Day
Services to support and encourage people to take up new leisure interests.
11.
Information
It is agreed that there are pockets of good practice across Wrexham with regard to
information but this would benefit from being better co-ordinated, more accessible
and targeted. The Social Services Department is working in partnership with others
to develop a Communications Strategy for the people of Wrexham.
The Community Mental Health Teams and Primary Care First Access Team in
Wrexham have an outmoded data information system. This will be addressed during
2002 – 2003 through the proposed replacement of the Adult Services Management
Information System and the development of unified Referral and Assessment
documentation for all adult services.
12.
Keeping Safe
Community Mental Health Teams in Wrexham have formal arrangements in place
with North Wales Police around protecting vulnerable adults with mental health
problems.
The Social Services Department has a responsibility to provide support and care to
people most vulnerable in the community. The Department has in place procedures
to respond to adult abuse effectively, in conjunction with other relevant agencies.
The Council is committed to raising awareness of abuse and protecting vulnerable
adults.
Statistical and Budgetary Information
The following graphs illustrate the allocation from within the Mental Health Services
budgets for 2001 – 02 and 2002 - 03 to particular service areas. It will be noted that
for 2002 – 03, the total budget has been increased by £131,237 from £1,494,733 to
£1,625,970. This represents an increase of nearly 9%.
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Within this overall increase, the ‘Community Care’ budget heading has increased by
over £64,000. This is an increase on the previous year’s budget for Community
Care of almost 32%. The amounts included in all of the other budget headings for
2002 – 03 have increased. Some of the increases have been relatively low (less
than 1%), whereas others have increased by almost 10%. However, the division of
the overall budget has remained fairly constant.
Within Mental Health Services budget Professional Services comprise a much larger
element than is found with other service user groups. This reflects the pattern of
service delivery, that is, through social workers providing on-going support to service
users.
Budget Allocations 2001 - 2002
(Total Budget £1,494,733)
4%
8%
10%
45%
14%
19%
Budget Allocation 2002 - 2003
(Total budget £1,625,970)
4%
8%
9%
45%
16%
18%
Professional Support
Day Services
Community Care
Project Workers Pay
Supported Living
Drugs & Alcohol
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Priority Areas For Development
From the over arching strategic objectives outlined above, the Planning group have
identified and agreed the following key objectives as priority areas for development
to ensure that the strategic objectives within the vision statement are achieved. For
each of these key priorities, objectives have been developed
Objectives

For this to be recognised and developed as a key role of the First Access
team

To link with the health promotion responsibilities of the Local Health Boards
when they are formed

To strengthen links with Primary Health Care Teams through Hearts & Minds
and First Access Team

To work closely with voluntary organisations to ensure a high level of public
information is available in Wrexham

Establish a baseline of current access to services

Develop an action plan to address issues arising from baseline assessment

Work closely with Primary Health Care Teams to ensure appropriate referrals
to the range of mental health services

Explore, through use of Health Act Flexibilities, integrated provision of
Community Mental Health Teams (CMHTs)

Adopt Care Programme Approach within CMHTs' to ensure that users and
carers are at the heart of the care planning process

Ensure close links across service areas / planning forums to facilitate
seamless service provision e.g. learning disability, transition

Explore, through use of Health Act Flexibilities, integrated provision of
Community Mental Health Teams (CMHTs')

Adopt Care Programme Approach within CMHTs' to ensure that users and
carers are at the heart of the care planning process

Ensure close links across service areas / planning forums to facilitate
seamless service provision e.g. learning disability, transition

Undertake a full review of work opportunities / day services in consultation
with all stakeholders

Continue to develop supported housing options / tenancy support for service
users

Explore ways of extending services / developing new services which will
enable service users to be supported in the community

Explore resource implications and identify funding sources / options
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Annexe A
Summary of services available for people with mental illness in
Wrexham
Service mapping has shown the following services to be available for people with
mental health problems, and their carers, in Wrexham County Borough:
Service
Description
Contact
Advance
Provides appropriate formal advocacy for
anyone who is affected by mental health
problems. Aims to promote the rights of
individuals and raise awareness of the
needs of people affected by mental health
problems. Service is based at 3 Belmont
Road in Wrexham.
01978 354737
Advance Brighter
Futures
Voluntary organisation providing a wide
range of support services including
advocacy; outreach and drop in & resource
centres; special interest support groups;
information service; a Patients Council and
co-ordinates User representation in the
planning implementation and monitoring of
mental health services.
Advance Brighter
Futures - Belmont
Road Partnership
House
Belmont Road offers support, information
and recreational facilities to people who are
affected by mental health problems in
Wrexham. The House is open during the
weekday, weekends and during holiday
periods.
Bridges
A Local Authority Work Scheme, providing
01978 366858
work-related activities for people with mental
health problems.
Brighter Futures
Is a user led organisation for people whose
lives are affected by mental health
problems.
01978 313560
01978 356789
Centre 67
A day centre operated by social services
providing a range of activities for people
with mental health problems. It is open 7
days a week plus 2 evenings.
01978 264344
9
01978 310247
Service
Description
Contact
Coed Celyn
Rehabilitation Unit
An NHS North East Wales Trust in patient
facility for people suffering serious mental
illness which provides support to help
rehabilitate clients to fulfil their potential to
live in a community setting.
01978 313105
Community Advice
and Listening Line
(C.A.L.L)
An advice and listening line covering the
whole of Wales for people.
0800 132737.
(Helpline)
01978 132737
(Office)
Community Mental
Health Teams
A multi-disciplinary team who provide
support to people with enduring mental
health problems. The teams comprise of
professionals and direct support staff from
social services and health who work in close
liaison with other agencies.
01978 355783
Elmbridge
A Local Authority Work Scheme, providing
01978 366858
work-related activities for people with mental
health problems.
First Access Team
A new team set up in November 2001. Staff
from Social Services and the NHS NEW
Trust health working together to support the
health of people with mild to moderate
mental health problems. The team works
closely with Primary Care.
Focus
A Local Authority Work Scheme, providing
01978 366858
work-related activities for people with mental
health problems.
Housing – Aids
and Adaptations
Wrexham CBC Development Services
Directorate can provide advice and
assistance on renovation and disabled
facilities grants
01978 292566
Llwyn-y-Groes
An NHS North East Wales Trust in patient
facility providing 24 hour care and treatment
for adults suffering from serious mental
illness.
01978 291100
Masquerade
A Local Authority Work Scheme, providing
01978 366858
work-related activities for people with mental
health problems.
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01978 356703
Service
Description
Contact
National
Schizophrenia
Fellowship Cymru
- Break-a-way
Provision of a range of choices &
opportunities for short breaks in response to
the expressed needs of carers & families
coping with the everyday effects of enduring
mental health problems
01978 310936
National
Schizophrenia
Fellowship Cymru
- Dolen
Provides support to families and carers
through a family Support Worker based with
CMHT Wrexham.
01978 355783
National
Schizophrenia
Fellowship Cymru
- Wrexham
Outreach Tenancy
Support
A pilot project that provides support to
tenants with mental health problems.
01978 310936
Stepping Stones
Offers group work and individual counselling 01978 354759
to adult survivors of childhood sexual abuse.
Unllais
A development, information & training
agency which provides support to the
voluntary sector, service users & cover
organisations working in the field of mental
health.
01352 718058
Wrexham Mind
Provision of information, health promotion,
counselling & support. Also operates a
supported housing project.
01978 366155
Wrexham Relate
Counselling agency specialising in
relationships. Provides services to adults,
either as couples or individuals.
01978 265028
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Action Plan For People With Mental Health Problems
Ref
Actions
Performance
Indicators
Target Date
Responsible
Officer
Priority 1: Extend the range of provision for supported living for people with enduring mental health in Wrexham
1.1
1.2
1.3
A strategy is developed on a multi-agency
basis to plan for providing supported living
arrangements
A Special Needs Housing Officer is
appointed to facilitate the development of
these schemes
To explore range of options in developing
new schemes through “Supporting People”
legislation
Production of Strategy Document by MHPG
Sept 2002
Service Manager
Special Needs Housing Officer joins MHPG
June 2002
Service Manager
& Housing Officer
Number of new schemes introduced
March 2003
Service Manager
Priority 2: Establish multi-agency links in planning for meeting the needs of adolescents and people with dual diagnosis of
mental illness and learning disability
2.1
Representation on Transition Groups for
Children, Young People and Adults with
Learning Disability
Planning and Development Officer to be on
CAMHS Meetings
12
July 2002
Planning &
Development
Ref
Actions
Performance
Indicators
Target Date
Responsible
Officer
Number of assessments given to users in a
year
Number of assessments offered to carers
April 2003
Service Manager
April 2003
Service Manager
Number of users with a copy of their written
care plan
Number of users who have an annual review
April 2003
Service Manager
April 2003
Service Manager
Number of users and carers regularly
consulted about services
Number of people accessing Advance
Advocacy Service
April 2003
Service Manager
April 2003
Service Manager
Priority 3: Ensure users and their carers are at the centre of assessment and care planning
3.1
3.2
3.3.
3.4
3.5
3.6
All Users of services have a copy of their
assessment
All Carers are offered an assessment of
need
All users of CMHT’s have a care plan
Ensure users of services have their needs
reviewed
Establish a customer focus satisfaction
approach for users and their carers
Ensure good advocacy services are offered
to users of services
13
Ref
Actions
Performance
Indicators
Target Date
Responsible
Officer
Priority 4: Adopt Care Programme Approach (CPA) for within CMHT’s in Wrexham
4.1
Working Group to produce multi-agency
CPA policy for Wrexham and NEW NHS
Trust
Pilot CPA and evaluate its effectiveness in
working with users of CMHTs’
Task group to produce document and consult Sept 2002
with key partners
4.3
Provide Jojnt Training/Awareness of CPA
Care Co-ordinator's role
All staff offered awareness training of Care
Co-ordinator’s role in CPA
Sept 2002
4.4
Amendments to CPA from Pilot and launch
CPA for all users of CMHT services
Consult all staff involved in CPA & MHPG
Feb 2003
4.5
Launch CPA for all users of CMHT services Implementation of CPA in Wrexham
4.2
Nov 2002
April 2003
Jointly by Service
Manager & NEW
NHS Trust
Jointly by Service
Manager & NEW
NHS Trust
Jointly by Service
Manager & NEW
NHS Trust
Jointly by Service
Manager & NEW
NHS Trust
Jointly by Service
Manager & NEW
NHS Trust
Priority 5: Wrexham & North East Wales Trust move towards fully integrated mental health teams
5.1
5.2
Establish a pooled budget arrangement to
facilitate development of CMHTs
Consult with CMHT staff & partnership
Agencies in developing fully integrated
CMHT.
Signed pooled budget agreement
April 2003
ACSSO
Number of Meetings for consultation
April 2004
Jointly by Service
Manager & NEW
NHS Trust
14
Ref
Actions
Performance
Indicators
Target Date
Responsible
Officer
Jointly by Service
Manager & NEW
NHS Trust
Jointly by Service
Manager & NEW
NHS Trust
Jointly by Service
Manager & NEW
NHS Trust
Priority 6: Joint training with Social Services Staff and Trust in Mental Health Teams
6.1
Team |Managers Training & Development.
Funded by Flexibilities Bid
Number of staff involved in training
May 2002
6.2
Multi-Agency Training for CMHT on roles
within Teams
Number of Staff involved in Training
Nov 2002
6.3
Awareness training for introduction of CPA
Pilot
Number of Staff involved in training
Sept 2002
Priority7: Undertake a full Best Value Review of Work Opportunities/Day services in consultation with all stakeholders
7.1
Carry out a Best Value Review of current
Work Opportunities, Work Schemes &
Mental Health Day Services
Consultation with all stakeholders
April 2003
ACSSO
Priority 8: Improve quality and range of information to current and potential users of mental health services
8.1
8.2
Users and carers are aware of the services
offered in mental health services
CMHTs' in Wrexham have access to an
integrated Information System
Production of a Directory of Mental health
services n Wrexham
New Data Base System is in place to provide
accurate and upto date information
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Sept 2002
MHPG
April 2003
MIS Officer
Planning &
Development &
MIS Officer Trust
Welsh Assembly Government Performance Indicators
Of soecific reference to this service user group are Performance Indicators 3.3; 3.6; 3.6(a); 3.6(b); 3.8; 3.9; 3.11; 3.14(c).
These can be found in Appendix Six, which is included in the General Information Chapter of the Social Care Plan.
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