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Simon Bradstreet: SRNAllison Alexander: NHS Education for Scotland/SRN

Scottish Recovery Indicator

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SRI workshop

• Introduce SRN and NES work around Mental Health Nursing Review

• Introduce the Scottish Recovery Indicator tool

• Consider how to use SRI to help achieve improved outcomes

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The National Programme

Improving the mental health and well-being for everyone living in Scotland and improving the quality of life and social inclusion of people experiencing mental health problems.

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What we aim to do

• SRN aims to– Raise awareness of recovery– Develop our understanding of

recovery – Build capacity by sharing information

and by supporting efforts to promote recovery

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Why develop a practice tool

• To assess the extent to which practice is focussed around recovery

• To help people realise principles of recovery in practice

• To make recovery more tangible• Are we really ‘doing this already’?

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“[A] The recovery approach should be adopted as the model for mental health nursing care and intervention, particularly in supporting people with long-standing mental health problems.”

Values base for mental health nursing

RelationshipsRights

RespectRecovery

Reaching outResponsibility

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“The recovery approach should be adopted as the model for mental health nursing care and intervention, particularly in supporting people with long-standing mental health problems.”

Some relevant actions

1. All mental health nurse will undertake values based training

2. National framework for training in recovery-based practice to support the dissemination of recovery-focussed frameworks into practice

3. Mental health nurses will use recovery environment audit tools to gauge their current practice and to inform the development of recovery based approaches

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NHS Education for Scotland / SRN Joint project

• To produce a framework for mental health nurses outlining the knowledge, skills and values needed to work in a recovery focussed way

• Underpinned by the lived experience of service users, SRN Narrative Research and training currently available

• Literature review

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Commitment 1: We will develop a tool to assess the degree to which organisations and programmes meet our expectations in respect of equality, social inclusion, recovery and rights. The tool will be piloted in 2007 and be in general use by 2010.

Delivering for mental health

Improve the patient and carer experience of

mental health services

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Development of SRI

• Assessed existing tools and approaches

• Identified Recovery Oriented Practices Index* as viable option

• How ROPI was developed• Adaptation process• From stick to carrot• Piloting SRI and evaluating impact

*Mancini, A.D., and Finnerty, M.T. (2005). Recovery-Oriented Practices Index, unpublished manuscript, New York State Office of Mental Health

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SRI headings

1. Meeting basic needs 2. Personalisation and choice3. Strengths-based approach4. Comprehensive services5. Service user involvement/participation6. Involving support networks and promoting

social inclusion and community integration7. Service user in control and active participant

even when subject to compulsion8. Recovery focus

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Using SRI

1. Preparing to use SRI– Training– Gathering information and people

2. Answering the questions– Sampled service user records (Assessment

forms and Care Plans) – Project information/documentation– Practitioner and service user interviews

3. Acting on the findings

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Example 1: Assessment information

3. Strengths-based approach

Indicating that service delivery and planning should be focussed on service user’s strengths.

1 2 3 4 5

3a. Assessment addresses service user strengths in multiple areas.

Assessment does not address service user strengths

Assessment Includes one aspect relating to strengths

Assessment addresses strengths in multiple areas of functioning

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Example 2: Care plan information

2. Personalisation and choice

Indicating that the planning and delivery of all services be designed to address the unique circumstances, history, expressed preferences and capabilities of each service user.

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2b. Care planning should reflect personalised self-set service user goals, with substantial variation across care plans.

Care plans are standardised, with minimal to no variation

Care plans show minimal variation in goals, with 90% of plans having at least 1 similar or identical goal (e.g. psychiatric stabilisation, medication compliance)

Care plans show moderate degree of variation in goals, with 50-89% of plans having at least 1 similar or identical goal

Care plans show high degree of variation in goals, with 20-49% of plans having at least 1 similar or identical goal

Care plans show substantial variation in treatment goals, with < 20% of plans having at least 1 similar or identical goal in most recent care plan

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Example 3: Project information5. Service user involvement/participation

Indicating service user involvement as integral to the planning and delivery of all services and to the determination of policies and procedures for service operations. Service should also actively recruit service users who are hired with equality in pay, benefits, and responsibilities to other employees.

1 2 3 4 5

5a. Service has policy and formal mechanism for involving a diversity of service user input that has resulted in demonstrable changes in policies, procedures, or provision.

Policies do not specifically address diverse service user involvement in activities or operations and there is no formal mechanism for promoting involvement

Policies exist regarding diverse service user involvement but no formal mechanism for promoting involvement

Policy and formal mechanism for promoting diverse service user involvement exist but mechanism is cursory (e.g. yearly satisfaction survey) and has not significantly informed development

Policy and formal mechanism exist for promoting diverse service user involvement that has resulted in at least one significant change (must identify this change)

(In addition to 4) There is service user advisory board and/ or service user(s) on governing body. Service users also contribute to staff appointment process and training

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Example questions

1. Do these criteria make sense to you?

2. What evidence or examples could your service produce to meet the criteria?

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Key issues

• Who to involve in gathering and assessing information?

• Who to involve in answering questions?

• Maintaining morale • Confidentiality and ethics• Defining parameters of questions• How best to involve service users• How to act on findings

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Contacting us

• info@scottishrecovery.net• Join SRN mailing list and access

SRI draft www.scottishrecovery.net• 0141 240 7790