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Tagged In:  Mental health, Nursing

An innovative review system and a 'wellbeing planning tool' are helping improve care for older people with mental health issues.




Since the Equality Act 2010, the emphasis in mental health has been on person-centred care models that put the patient's needs and preferences first. However, this has proved more of a challenge in long-term care settings where patients' wellbeing has traditionally been assessed from a medical perspective.

In 2011 a research paper by Dr Jonathan Webster, Assistant Director, Quality & Clinical Performance, Bexley Care NHS Trust, called for dementia care in acute hospitals to be more patient-centred: "Patients who are understood, listened to, and responded to tend to display lower levels of challenging behaviour, are calmer, more receptive to accepting treatment and have higher levels of well being."

A more holistic approach has helped drive service transformation at a continuing care mental health unit at Birmingham and Solihull Mental Health NHS Foundation Trust. Trainee clinical psychologist Nicola Wheeler and occupational therapist Rachael Gardner worked with the unit's multi-disciplinary team to introduce a system of wellbeing reviews focusing on a different resident each week. They've also developed a 'Person-centred Wellbeing Care Planning Tool' which helps staff identify priorities for improvement.

With over 4000 staff, Birmingham and Solihull Mental Health NHS Foundation Trust is one of the largest in the UK, serving over a million people spread over an area of 172 square miles. The continuing care mental health unit provides residential care for up to 19 older people with a range of long-term mental health issues, including psychotic episodes, severe depression, complex trauma and dementia.

Led by psychologists and occupational therapists, the wellbeing reviews ensure nurses, healthcare assistants and other relevant staff have time to focus on an individual patient's needs. The objective is to embed person-centred care into the unit's culture, empowering staff to learn more about indicators of wellbeing or ill-being and encouraging them to reflect on how a patient's behaviour may be influenced by factors such as life history and physical environment.

Nicola, who has now graduated from the University of Plymouth, is hoping that the wellbeing planning tool will be of use in variety of settings, including care homes. She also thinks it could be adapted for use by relatives and home-based care staff. "Staff who have used the Tool have commented on finding it has increased their knowledge and understanding of clients, and as a consequence it has enhanced their job satisfaction," she said. "We are very pleased to have the opportunity to share it with other organisations and care settings in the hope it will enhance their care planning too.”

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