Creating the Culture
Implementing Recovery
09.30 – 16.30
Rachel Dadswell, Lesley Herbert,
Steve Parker, Sarah Richmond
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
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)
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)
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, selfdetermination, 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)
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)
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”
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”
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
SERVICE
PROVIDER
ANXIETY MANAGEMENT
SHFT
HCC
VOLUNTARY
SECTOR
MIND GROUPS
SERVICE USER
CARE PACKAGES
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
OTHER
Personalised model:
SERVICE USER AT THE
CENTRE MAKING CHOICES
OWN
STRENGTHS/
RESOURCES
CARER
HCC
FRIENDS
SERVICE USER
CHOOSES FROM
SHFT
FAMILY
VOLUNTARY
sector
EMPLOYMENT
EDUCATION
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
•
•
•
•
•
•
•
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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
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)
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
Themes
In practice
Person at the centre
Choice
Recovery focused
Individualised
Personal responsibility
Life course approach to care
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
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
ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust.
The ImROC identity was created by service users.
IMROC
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
• Outcome Measures
• Spiritual Care Pathway
• Recovery Interventions Toolkit
Ensuring organisational commitment,
creating the culture
• This training!
• Medical staff and board
•
development programmes
Review of policies and procedures
Transforming the Workforce
Development of Peer Support
Changing the way we approach risk
assessment and management
Building on the practice development
work undertaken by Steve Morgan
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
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.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
To provide environments and experiences that inspire hope
To believe that a meaningful life is possible for everyone
To acknowledge that people are experts in their own experience
To make information accessible and relatable
To challenge stigma
To teach as well as treat
To work collaboratively
To provide living proof of recovery
To listen and to learn
To be creative
To take positive risks
To work purposefully
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…
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)
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
Traditional practice
recovery
I’ve got aSupporting
great new assessment
form here
Supporting recovery
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 problems
What 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 skills
Why 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 nurse
I wonder if we gave you training and support if
you would like to work in this team?
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
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
ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust.
The ImROC identity was created by service users.
In summary
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
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
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….
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•
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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…..
ImROC is the Implementing Recovery (Organisational Change) programme within Southern Health NHS Foundation Trust.
The ImROC identity was created by service users.