Friday 05 July 2019 Welcome Twitter: @AdultPSWNetwork - - PowerPoint PPT Presentation

Friday 05 July 2019

Welcome

Twitter: @AdultPSWNetwork @PCFSWNetwor #PSWJointConference19 Facebook: Adults PSW network Children’s PSW network

Child and family PSW Network Update

Cla laudia ia Megele le and Carol l Sib Sible ley Child and family PSW Network Chair and Vice Chair

PCFSW

Achievements

• Publication of e-Book on Relationship Based

Practice: first e-book for PCFSW and it was downloaded and read 1326 times.

• Social Work England Consultation: Response from

PCFSW network via the chair on new procedures. Championed inclusion of digital skills.

• PCFSW in partnership with the WWC examined SW

attitudes and behaviours: Surveys and polls have gone out to all LAs in the UK. Initial findings will be presented at our national network meeting Sep. 2019.

PCFSW Achievements

• Workstreams: Creation of the social media, technology and

innovation workstream.

• Day of Action: for DeafBlind Awareness Week via social media.
• Contributions to advisory groups: (SWE, NICE, WWC, Children’s

Commissioner Research Group, DfE research in recruitment and retention).

• Developing the Health Check into an evidence based tool: PCFSW,

SCIE and the WWC are working with the LGA to update the Social Work Health Check and develop it as an evidence-based tool for measuring social worker health and wellbeing in the workplace.

• Evidencing SW and Practice Complexity: Presented Practice

Complexity to Ofsted Inspectors at their national conference this inspired the current call for our new e-book.

• Contributed to the NAAS DfE Practice Endorsement: provides

valuable support to the sector.

PCFSW Achievements

• Publication of NAAS Workbook: Published today

and every PCFSW social worker will receive a free copy of the workbook. Just email siobhan@kirwinmaclean.co.uk for your free copy.

• There are 12 Chapters and 320 pages, interactive

exercises to support practitioners to enhance their Knowledge and Skills in preparation for their

• NAAS. The book was co-produced by PSW and

experts by experience.

Regional PCFSW Networks Achievements

• Overall number of PCFSW’s in our network stand at approximately 162.
• PSW regional groups well embedded with workplans.
• PSW leading in NAAS work in their LA and supporting SW to achieve accreditation.
• PSW shared excellent practice in teaching partnerships, new apprentice schemes, social

work development and learning, workforce retention and recruitment and QA processes.

• Raising the profile of Social Work and PSW across various settings especially regarding

raising the profile of e-professionalism, digital skills and online safeguarding in social work.

Future Plans

• Social Media, Technology and Innovation Workstream:
• Two distinct research projects; one on digital professionalism and the other on online safeguarding:
• These projects will produce relevant guidance and evidence and recommendations for practice and

policy to support and develop social workers digital capabilities and digital professionalism at all

• levels. They will also promote and enable holistic safeguarding of children and young people both
• nline and offline.
• MRC are one of our partners in these projects and we will be having a research Conference in

partnership with MRC on the 18 Nov. 2019 to examine initial findings and allow for focused discussion on these themes.

• Outputs: 2 e-Books, National Guidance, evidence-informed approach and best practice examples

with toolkits and resources for Digital Professionalism and online safeguarding for the sector.

• e-Book on practice complexity and practice wisdom: contact

Claudia.Megele@hertfordshire.gov.uk for more details.

• Leadership and Communication Training for PSW: in partnership with Community Care. If you

are able to host a workshop, contact Claudia.Megele@hertfordshire.gov.uk

• Training on Systemic Leadership: In partnership with SfC, details to follow.

Adult PSW Network Update

Trici ricia Pereri ria, Fran an Le Leddra an and Be Bev v Latania ia Adults PSW Network Co-chairs Reflecting on the last year and future plans

Our collective achievements

• ADASS voted to include PSW role in its membership
• ADASS endorsed and distributed our APSW Roles and

Responsibilities Document

• Social Work England Consultation: Response from APSW network and

ADASS

• Strength Based Social Work Practice Framework and Handbook (DHSC)
• Social Work in Disasters Working Group – CPD guidance is in draft

conference planned for November

• LD capabilities statement in partnership with BASW
• Chief Social Worker advisory group various work streams
• Two days of Action : Carers and Deafblind Week

– e-books produced

• Parliamentary advisory groups future of adult social

care

Regional APSW Networks Together Everyone Achieves More

• PSW regional groups are well embedded with

focussed work plans

• They have hosted numerous conferences with

strong focus on leadership and strength based practice

• They have shared excellent practice in teaching

partnerships, the new apprentice schemes, social work development, and safeguarding

• Over 40 PSW’s have completed the Leadership

programme.

• Overall coverage now PSW’s stand at 170
• Raising the profile of Social Work and PSW

across various settings

Mental health recovery and the changing context and significance of communities

Dr r Peter Buzzi i Research and Management Consultancy Centre

After the break…

Hawkhirst Rooms 2 & 3 Assembly Hall 11:45 – 12:45 Developing Open Dialogue in the NHS Yasmin Ishaq - Kent and Medway NHS and Social Care Partnership Trust New competencies for Approved Mental Health Professionals Mark Trewin - Department of Health and Social Care Robert Lewis - Devon Partnership NHS Trust

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The AMHP Workforce Plan, Standards and Competencies

Positive development of the Future AMHP workforce

Mark Trewin

Mental Health Social Work Lead DHSC Mental Health Social Work advisor NHSE MHA Review working group

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The AMHP Workforce Plan

• AMHP Workforce Plan
• National guidance on the

development, support and workforce requirements of AMHPs

• Includes draft AMHP Standards
• Includes draft AMHP competencies
• Guidance for LAs, NHS Trusts and

Social Work England on the employment, support, recruit and retention of AMHPs

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Expanding the AMHP workforce

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HEE New Roles in Mental Health group

• Social Work one of 8 key professions in MH. Recommendations:
• Guidance supporting SWs employed in the NHS
• New leadership and development recommendations
• Cross agency support for the AMHP workforce
• Cross agency support for the Forensic SW workforce
• Roles:

❖ Named SW role ❖ Specialist community SW role ❖ Development of forensic social supervisor role ❖ Development of approved clinician role

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Developments supporting the AMHP role

• New Guidance for NHS Trusts employing Social Workers
• Social Work for Better Mental Health is working with over 60

areas to support MHSW exploring new models of integration

• DHSC MH workforce planning now includes social work
• Green Paper for Prevention and Social Care
• NHS Long Term Plan:
• Community MH Framework
• New models of Crisis and Urgent Care
• Forensic, secure care and prisons

PSW Network Conference

AMHP Workforce Plan – National AMHP Service Standards

5th July 2019

Robert Lewis - AMHP Service Manager, Devon County Council and member of AMHP Leads Steering Group Karen Linde - Lead for Social Work for Better Mental Health (SWfBMH)

AMHP service context

• 152 LAs in England, 22 LAs in Wales with responsibility to provide

AMHPs

• Estimated 3,900 AMHPs, no national register, no full-time equivalency

figure (65% have combined roles)

• 142,000 MHA assessments per year and climbing (2016/17)
• 64,000 detentions and climbing (2015/16)
• Useful workforce and demand surveys in recent years, there are no

minimum data sets. Demand and activity is hidden nationally

• Diversification of AMHP service arrangements/ways of organising social

work service

What is an AMHP service?

• The CQC review (2018) noted that there was no single definition of an

AMHP service and the lack of over-arching AMHP service standards

• There had been some recent guidance to DASSs and Trusts around

what supports they should be offering AMHPs, but generalised to the AMHP rather than the development of AMHP ‘service’.

• AMHP literature focussed on role and stress. Minimal (but growing)

research into AMHPs and AMHP services and organisational factors in effectiveness

• Diversity of AMHP service delivery models in a wide range of
• rganisational structures developed in response to a variety of

pressures/influences – rather than proactively to achieve effectiveness

Models of AMHP Service Delivery

Three main forms 1) Traditional

(or “disparate AMHP rota” - the Masked AMHP)

AMHPs providing a duty cover service, while primarily holding other roles. AMHPs based in different diagnostic/service-user teams, potentially picking up the ‘off-duty’ AMHP work. AMHP Leads. Local AMHP forums

Decreasing as a form Strengths AMHP cohort will likely come from a broad base of current experience, often sat directly with MDT colleagues. Provides workers with an additional specialism/role

• n top of case carrying

Weaknesses Professional isolation. Inflexible at times of peak demand role conflict/resource

• demands. Leads are not managers

Models of AMHP Service Delivery

2) Hybrid

Might be a ‘hub and spoke’ arrangement – a small dedicated group of AMHPs providing triage, referral management and back-up to a locality rota or rotas. AMHP manager, plus AMHP Leads

Significant shift towards this model and positive reports Strengths Provides clear oversight of day-to-day operations. Improves capacity and

• prioritisation. Promotes peer discussion/problem solving and knowledge building.

Builds sense of being a distinctive service as well as a role Weaknesses Capacity generally focussed on the day-to-day and covering shortfalls (sufficiency), rather than more preventative work. Does not address the issues that lead to burn

• ut for the majority of duty AMHPs providing the rota cover

Models of AMHP Service Delivery

3) Dedicated

Centralised, dedicated AMHP service and/or collection of ‘virtual’ team(s) across an

• authority. Single referral point. AMHP Managers, rather than AMHP Leads. Can include

responsibility for other roles/related tasks – social supervision, etc. Focus is non-case carrying AMHP-led practice

Increasing but small numbers Strengths Greater control of the AMHP workforce capacity, their training, and operational

• governance. Ability to promote consistent peer-led practice and professional

support with AMHPs. Reduces isolation, as AMHPs work in identified teams with an AMHP manager Weaknesses Risks being inward looking and reactive AMHP role less embedded in CMHT AMHP establishment numbers reduced – knowledge and skills concentrated in a smaller number of colleagues. Risks being overly focussed on the AMHP role at the expense of other professional skills

Barriers to sustainable and effective AMHP service provision

• Previous lack of national service

focus/standards/framework

• Well documented issues related to work place

stress, pay, and key resourcing issues (beds, doctors, police availability, courts, and ambulances, reduction in community resources)

• Lack of systems thinking. AMHPs and AMHP

services sometimes lost in partnerships and local authorities

• Acute care culture - splitting off from community
• rientated care
• Recruitment and retention
• Aging AMHP population (1 in 3 over 55)

Leadership in AMHP Practice

• Strong professional identity and clarity of role

for AMHPs

• Well led, peer-led, highly-skilled, educated and

experienced workforce (57% have 10+ years’ AMHP experience)

• National AMHP Leads Network – success of self-
• rganised support, primarily web-

based/supportive/problem solving, with a non- funded AMHP Leads Network Steering Group

• In recent years, the profile of AMHPs nationally

has improved and the influence increasing with greater organisation ownership

• Significant achievements in embedding

CPD/refresher training

Development of the AMHP Service Standards

• In response to the identified lack of National

Service Standards, in conjunction with the Leads Network, SWfBMH and contributions from across a number of organisations

• The aim of the Standards is to begin to develop a

shared language across AMHP service providers, AMHPs and those who receive services, promoting service development, building a knowledge base of good practice and provide a framework against which to begin to measure the effectiveness of AMHP services in supporting the work of AMHPs

• Links to local and national quality improvement

leadership especially Social Work England, PSW

Draft AMHP Service Standards

• Not prescriptive about service model
• To be used as a reflective tool to promote local

dialogue across stakeholders with support resources.

• Six headings:
• Local Authority governance and connection to national and

regional AMHP networks

• Governance within 24-hour AMHP Services
• AMHP Service scope
• AMHPs’ personal, professional, physical and psychological

safety

• Service and professional development
• Improving the experience of people who come into contact

with AMHP services

• 1. Local Authority governance and connection to national

and regional AMHP networks

• Direct line of sight between DASS and frontline AMHP service

and CEOs of Mental Health Trusts, where Partnerships exist

• Ensuring clear approval, re-approval and authorisation

processes.

• Ensuring connection and development of local, regional and

national AMHP Lead networks

• Responsibility placed upon the DASS to ensure that a Lead

AMHP/AMHP Manager is connected to the AMHP Leads Network.

• 2. Governance within 24 hour AMHP

Services

• Clear operational responsibilities set out across the 24 hour

time period – access to peer, managerial, legal supports and so on

• Referral management and data collection processes clear and
• robust. Reporting into multi-agency forums and systems to

ensure the support of strategic planning

• Clear contingencies around accessing capacity at times of high

demand

• Clear escalation and reporting mechanisms in place.

• 3. AMHP Service scope
• AMHP services to be viewed as integral to mental health

services, active in system development – particularly, prevention, safeguarding and crisis care.

• AMHP should promote localism and be able to have

connection to all teams (not just adult mental health), with clear access points.

• The AMHP workforce should reflect the diversity of their

communities and targets should be set to reflect this ambition.

• 4. AMHPs’ personal, professional, physical and

psychological safety

• AMHP services should be configured to ensure that AMHPs’

safety and well-being is at the forefront of operational considerations

• Lone working in non-contained environments should be

removed

• Clear arrangements for supporting AMHPs who work passed

their contracted hours

• AMHP independence should be supported through access to

individual and peer support and supervision

• 5. Service and Professional development
• AMHP services should be considered ‘open learning

environments’. AMHP s should be supported to promote human rights and rights-based agendas, safeguarding, the social model of mental health and access to social care

• As system leaders, AMHPs should be empowered to

contribute to the learning of others.

• Routes to AMHP training should be clear for all eligible

professions

• Emphasis should be given to service user experience and the

understanding of social trauma.

• 6. Improving the experience of people who come into

contact with AMHP services.

• AMHP services should promote the dignity and human and civil rights of those they come into

contact with. Social models and perspectives should be reflected in how AMHPs record and the systems they utilise.

• AMHPs should help address racial and cultural disparity through the development of competence,

awareness, staff capability and behavioural change.

• AMHPs should embed the principles of co-production and should explore ways to capture the

experience of those they come into contact with; with those people having routes into influencing and developing AMHP services locally.

• AMHP services should ensure the availability of clear information; which should be co-produced and

culturally appropriate.

Testing the standards

• The standards will be tested in a range of organisational settings

identified through the SWfBMH sites and the AMHP network

• A self-assessment workbook and guide with online resources
• Aim to encourage ownership of the exercise by quality networks, such

as PSW and AMHP network, CCGs and Trust and Council QA

• Encourage local service user involvement in assisting review
• Encouragement of use as regional benchmarking tool
• Establish a practice network to support feedback and data support
• Promote service-user direct feedback as a resource for service

improvement

Questions?

robertlewis2@nhs.net 01392 208948

Lunch

The big picture; policy directions in mental health

Mark rk Trewin in and Lyn Romeo Department of Health and Social Care Isa Isabell lle Trowle ler Department for Education

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Mental Health: Policy directions for Adults and Children/Family services

Mark Trewin - Mental Health Social Work Lead DHSC

Lyn Romeo – Chief Social Worker for Adults Isabelle Trowler – Chief Social Worker for Children and Families

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Where does social work fit in to this?

• Social work is part of a positive solution for the Cross Governmental

MH issues:

• Prevention and Community MH support
• Housing
• Integrated Workforce planning
• Models of integration
• Care at Home: Reducing OOA placements & locked rehab
• issues around detaining CYP with MH LD and Autism
• Transition
• Delivering the Long Term Plan

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PSW leadership role in delivering improved MH services

• A key leadership role in ensuring

consistency of service delivery and social work quality.

• A key role in supporting social work values

across health and social care and to ensure effective models of integration

• A key role in linking children’s and Adult

services together

• A key role in linking with other agencies eg

police, A and E, VCS

• A key role in developing workforce

planning across adults, children, health, social care and VCS

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Mental Health issues shared across adults & CYP

• Specialist AMHP support for childrens services and EDT teams
• Systemic Family work + Family group Conferences
• Motivational interviewing
• Open Dialogue
• Connecting People – building circles of support
• Multi Disciplinary approaches to shared issues:
• Crisis services and ‘safe spaces’ for CYP and adults
• Parental MH issues
• Child and Adolescent services
• Transitions to adult MH services
• Substances abuse
• Domestic Abuse
• Safeguarding

Afternoon workshops

Assembly Hall Hawkhirst Rooms 2 & 3 Hawkhirst Room 1 14:15 – 15:15 Liberty Protection Safeguards: New legislation for Children’s & Adult Services Andy Butler - Surrey County Council Louise Jordan – Department for Education Nurturing Emotional Resilience and Wellbeing in Your Organisation Louise Grant - University of Bedfordshire Mentalising through the lifespan Dr Peter Buzzi - Research and Management Consultancy Centre

The Liberty Protection Safeguards

Andy Butler – Principal Social Worker (Adults) – Surrey County Council E-mail: andy.butler@surreycc.gov.uk Louise Jordan - Team Leader, Mental Capacity and Deprivation of Liberty; SEND, Alternative Provision and Attendance Unit E-mail: Louise.Jordan@education.gov.uk

National PSW Joint Conference London – Friday 5 July 2019

What are Th The Lib iberty Protection Safeguards? (LP (LPS)

• They will replace The Deprivation of Liberty Safeguards (DOLS)

provisions under The Mental Capacity Act

• A new legal provision to authorise arrangements that amount to a

deprivation of liberty of people age 16+ in specified circumstances

• They apply where the person lacks mental capacity to consent to

their care or treatment and

• It is necessary to deprive them of their liberty in order to provide

them with that care or treatment

What constitutes a Deprivation of f Lib iberty (D (DOL)?

Not defined in the Act … however the ‘Acid Test’ …

• The person lacks the mental capacity to consent to the

arrangements

• They are subject to continuous supervision and control
• They are not free to leave
• The arrangements are ‘imputable to the state’

What ar arrangements can be authorised?

• Arrangements can be authorised which enable care or treatment of a

person (aged 16+) that give rise to a deprivation of liberty

• Can be in any setting or multiple settings
• Can include arrangements for transport
• Cannot be used to authorise restricted contact with friends/family
• Cannot be used to authorise the delivery of the care or treatment

What arr rrangements can be authorised? DOLS v LPS!

DOLS only applies in Care Homes & Hospitals

• LPS applies in any setting (or multiple) including; people’s own homes, residential

and non residential schools, foster care, Shared Lives, supported living DOLS can cover the return of someone to a particular place

• LPS also covers the initial conveyance to that place

DOLS applies to 18+

• LPS applies to 16+

DOLS can be authorised for 12 months

• LPS can be authorised for up to 3 years

What are th the (L

(Liberty Protection) Safeguards?

• Must be authorised before DOL begins – except for life sustaining

treatment or vital acts

• Independent Professional Assessment
• Appropriate Persons and Independent Mental Capacity Advocates

(IMCAs) to support the person

• Consultation with the individual and third parties
• Right of Appeal to Court of Protection
• Built in Reviews
• Variable length of authorisation
• Additional scrutiny by Approved Mental Capacity Professional (AMCP)

in some situations

What Conditions have to be met?

Capacity assessment

• person lacks capacity to consent to the arrangements

Medical assessment

• person has a mental disorder

Necessary & proportionate assessment

• necessary to prevent harm to person, & proportionate to likelihood &

seriousness of such harm N.B. Must have regard to person’s wishes and feelings

Who can Authorise – Who is the ‘Responsible Body’

• if the arrangements are in an NHS hospital, the “Hospital

Manager” (i.e. the Trust)

• if the arrangements are mainly via NHS Continuing

Healthcare (Adults) the CCG (or LHB in Wales)

• if the arrangements are in an independent hospital , the

local authority (or LHB in Wales)

• ……….. In all other situations, the local authority (usually

based on Ordinary Residence or EHCP or S20/S37 CA)

16 & 17 yea ear old lds – What's new? What's 's different?

Why are 16-17 yea ear old lds in included in in th the LPS system?

According to the Law Commission:

• consistency with the rest of the Mental Capacity Act
• legal framework was failing to deliver Article 5

safeguards

• professionals understand the law better
• Mental Health Act and section 25 of the Children

Act used inappropriately

• assist with the young person’s transition from

children’s to adult services

Who will ill need an LPS authorisation?

• Young people lacking mental capacity who can’t consent to

decisions about their care and treatment

• Likely to have EHC plans – planning from Year 9 to get

assessments in place for 16

• Critical that children’s social workers identify when a DOL is

taking place – it is illegal to deprive someone of their liberty without the right processes in place

• Understanding who the Responsible Body is (usually the LA)
• Understanding the settings where LPS authorisations are

nneeded

What’s different about LPS authorisations for 16-17 17 yea ear old lds?

• Existing structures and supports – EHC plans, care plans, etc.
• Likely to have shorter review periods – life moving quickly
• Interrelationship between EHC plans and LPS authorisations
• The role of parents…

Parents as part of f th the LPS process

• We expect parents to be closely involved: through

consultation, as Appropriate Person (parents can request an IMCA – the difference between advocating for, and being an advocate)

• The Appropriate Person for a LAC
• What happens when parent objects? (including s.20 of the

Children Act)

• A word on Re D

A few more th thoughts on 16-17 yea ear old lds and LPS process

• Young people in care homes
• Yet another reason why well-planned transitions into

adult services are so important (hold a review)

• Monitoring and accountability – role of Ofsted and

CQC

Ti Timeframe and steps towards im implementation

• Target date (not before) October 2020, with transition

period

• Statutory Code of Practice – draft finished by end July
• Expert group feeding into chapter on 16-17 year olds – who

wants to join?!

• Need to ‘proof-read’ rest of Code for references to 16-17

year olds

• Consultation, Code laid before Parliament, Importance of

implementation planning

• Critical need for training (NB children’s social workers – less

familiar with MCA / LPS)

Next xt Steps for PSWs – (A (Adults & Children)

Lets talk! Work Collaboratively –

• with DCS & DASS to establish a one council / cross service LPS

service (management, processes, training)

• Know, support and work with your current DOLS / MCA lead
• to ensure workforce are ready for LPS implementation – training
• n MCA & LPS
• identify staff in Children's Services to train as Approved Mental

Capacity Professionals (? & BIAs)

• Scope numbers of people likely to be affected in each category

The End! Thank you for listening and for your engagement!

Thank you