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Community support for mental health
The Mental Welfare Commission(Scotland) carried out a 2016 survey of the opinions of people with mental health problems being supported in the community. People were in general satisfied with the care and support they received. However, the Commission found some areas for improvement of services. Their report stated that people valued:
“...having consistent relations with staff and not having frequent changes, being listened to, and having flexible support which can increase when this is needed. Some people also mentioned difficulties they had experienced negotiating the system and accessing services at the beginning, although almost all of this group were happy with the care and treatment they received after they accessed services.
A few people spoke about recovery focussed ideas when we met them. This included people who had clear personal goals and hopes, and also a very small number of people who had their own wellness recovery action plan (WRAP)... We would have hoped to see more evidence though that services are developing a stronger focus on recovery in the way care and treatment is provided, and that this is reflected in care plans.”
One step mentioned in the report was for the Mental Welfare Commission to work closely with the Care Inspectorate to ensure that inspections focussed on how services could be improved, in the light of the report which had been published.
The Inspection tool
The Care Inspectorate then worked on an inspection tool, to be used in some relevant services to identify and promote any further improvements which could be made.
The tool forms a useful document for pointing to aspects of best practice in these services, and in mental health support services in general. Four main areas are covered: Care planning , physical activity and support, a recovery focus, and staff skills and knowledge.
One of the most important areas, in my opinion, is the emphasis given to recovery. The WRAP tool was a system for self-help recovery, devised by Mary Ellen Copeland in 1997, and both the Care Inspectorate and the Mental Welfare Commission recommended its wider use.
Another vital area was the need for clear and specific policies, including on care planning, working with other agencies and having discharge planning in place. These issues were some of the shortcomings in the Winterbourne View scandal, where patients in a long-term hospital for mental health appeared to lack consistent care outcome and discharge planning.
This tool is useful for all services wishing to improve their practice further. It is available on the Care Inspectorate HUB website. Using it should help services to develop their services to people, as well as being in line with the best practice indicated by the Care Inspectorate.
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