Your Care and Support from the Crisis Resolution/Home Treatment Team
Welcome to the Crisis Resolution and Home Treatment Team. We are a 24 hour a day, 7 days a week, 365 days a year service which provides specialist services including:
- Information, advice, guidance and signposting
- Detailed assessments of mental health and social care needs
- Detailed risk assessment
- Care and support planning compiled, wherever possible jointly with people who use our services and other people such as carers/advocates (subject to certain rules and consent)
- Treatment, care and support
- 24 hour contact details
- We will provide you with a copy of your Care and Support Plan
We provide these services to people (and carers of people) that have an identified mental health need that cannot be met by their General Practitioner (GP) or other services within the Primary Care setting. People accepted for support by the Crisis Resolution and Home Treatment Team have assessed mental health and/or social care needs which are having an adverse impact on their life, significantly affecting how they feel, live and/or function.
The teams work within either hospital based or community-based settings and are made up of a number of mental health and social care professionals and their support staff.
The team consists of qualified mental health nurses, social workers, a psychologist, occupational therapists, a consultant psychiatrist, community support workers and administrative staff who provide support for the Crisis Resolution and Home Treatment Team.
Making a referral and hours of operation
Referrals come from a variety of sources such as your GP, including out of hours GP service, A&E/Minor Injuries Departments, Police, Housing, Schools/Colleges etc..
All referrals are made direct to the Access team on the following number:0808 1964501 which is a 24 hour service.
The Crisis Resolution and Home Treatment Team operates 24 hours a day, 365 days a year. The service is never closed.
Helping us to help you
Our expectations are that we will work together to improve your mental health and well-being with the aim of enabling you to live your life independently and free from services.
The Trust works to a set of core values and encourages a positive behaviours approach to provide everyone with a safe place for us to deliver services. This means that whilst we will actively work with you to support you through your difficulties, abusive behaviour is not acceptable and the Trust reserves the right to refuse treatment to anyone who acts in an abusive, violent or unlawful manner.
To help you participate fully, in your care you will be encouraged and supported to be involved in meetings and the planning for your treatment. As part of reasonable adjustments, we can provide access to interpreting services or other specialist services such as sign language to help you participate fully.
You will be informed about advocacy services which are free, confidential and independent from the team. An advocate can provide support and information and help you to get your views and choices heard. Advocacy services can be contacted in the ways outlined at the end of this leaflet. Contact can be made by you or on your behalf by a member of staff, a carer, a relative or a friend.
Please note, where certain sections of the Mental Health Act apply, you will always be provided with an independent Mental Health Advocate unless you do not wish to receive this support. Shropshire Advocacy Services – VoiceAbility
Telephone: 0300 303 1660
Assessing your Mental and Physical Health and Wellbeing Needs
The assessment is about working with you to determine what your current mental, physical and social wellbeing needs are. This is the opportunity for you to ask questions and for us to talk with you in detail about how our services can help you towards your recovery. Sometimes this can mean that we signpost you to another service or team (either within or outside of the Trust), that may be more appropriate to help meet your current needs. This will be discussed with you at the time of the assessment.
Your physical health and well-being is important too. With your consent, the team doctor or nurses may arrange for some routine checks such as blood and urine tests. You will be asked about your general physical health, (with your blood pressure, height and weight being recorded) as it is well recognised that this can impact upon your mental health.
We also recognise your cultural and spiritual needs are very important to your overall well-being, and we can arrange access to Pastoral Care. Please be aware that staff will discuss this with you to assist us to ascertain your needs and to provide a more personalised service for you.
Planning your Personalised Care and Support
Following assessment, we begin the process of care and support planning. Once your current needs have been assessed with you, we will work with you to see how best these needs can be met and will develop with you your personalised ‘Care and Support Plan’. This may involve support from health and social care staff and/or signposting to other services.
Where we can allocate the same team members to work with you we do, but this is not always possible because the team work around the 24 hour cycle with different shift patterns. There is always a ‘Shift Coordinator’ on duty and they can always be called if you have any questions or if you need anything we can help with.
Care and support is the term used to describe the help which adults of any age might need at any point in their lives. This may include support such as help with washing, dressing, eating, getting out and about and keeping in touch with friends or family.
From 1st April 2015, the law governing care and support in England changed. The new Care Act replaced previous laws with a simpler, single method to access personalised care and support to help meet your needs, and the support needs of your Carer. The Trust works in partnership with Shropshire County Council, and if you require any further information about the Care Act, and how this may benefit you in improving your well-being outcomes, the following websites explain this process further. These websites also provide a range of care and support information, advice and guidance for people of all ages and care needs:
Visit the Shropshire Council website
OR telephone Shropshire Council on 0345 678 9000
OR contact the Mental Health Services in your local area (contact details are at the end of this leaflet).
What happens next?
Following the assessment and the formulation of your Care and Support plan, a range of interventions/treatments will be discussed with you and your carer/family. This may also involve any other support network you may use. It is well recognised that people who are seen and treated within their own homes and community make a much quicker recovery.
The Crisis Resolution/Home Treatment team can offer intensive support and interventions to people in their own home. The team will arrange to meet you as often as is required and will work in partnership with you to help you to resolve your issues.
During this time, by identifying relapse signs and symptoms we will look at plans of action to help prevent such crisis’s re-occurring in the future. If at that time it is agreed that you require an admission to hospital, then the team can arrange this and will always try to do so without the need to use the Mental Health Act. If you are assessed as too unwell to understand or accept an admission in this way, then the team will act in your best interests and may make a request for a Mental Health Act Assessment. Where necessary and to help provide continuity of care, the team will often remain involved and will, when necessary, allocate a bed. The ward you may be admitted to will usually be the closest to your usual place of residence, however please note, this is not always possible. Sometimes hospital beds become available sooner at a different location, and to meet your immediate mental health needs you may be admitted there. If this is the case, then as soon as we are able to provide a bed closer to home, you may be transferred there.
Your Personalised Recovery, Care and Support Options
Everyone’s recovery is an individual, complex and diverse process. During the time you are supported by the team, a number of professionals may be included in your Care and Support Team. This will be discussed with you, and determined jointly with you (and where appropriate, your carer). Options include (but are not limited to):
- Link with your GP and/or other professionals supporting you
- Psychotherapeutic interventions i.e. Cognitive Behavioural Therapy (CBT)
- Physical well-being advice and support
- Relapse and risk management/prevention
- Sign posting for information, advice and guidance including local community services, social care services, financial support and housing.
- Support towards recovery e.g. accessing employment
- Support with daily living skills
- Day opportunities
- Skill retention and development
- Medication management, including prescribing and adjustments
Your medication, if required, is a unique part of your treatment plan. Please try not to be concerned by comparing your care and/or medication with other people regarding what medication they are prescribed.
You will be offered a copy of your care and support plan when it has been agreed with you to remind you what has been agreed.
Consent to Treatment
There are some circumstances where people can be treated without their consent. However, these are exceptional, carefully regulated and safeguards are in place including the duty we have to inform people of their rights, including your rights to specialist advocacy services. For example, if you are assessed as too unwell to look after yourself or others, then the team will act in your best interests, and this may include a request for a Mental Health Act Assessment.
If you would like to know more about this, please ask a member of your care team.
Giving and Receiving Information, including your Personal Information
As well as giving you information, we will also need to collect some personal details from you at this time. Whatever health and social care you are receiving requires staff to know certain information about you such as your name, where you live, who your relatives or carers are, if there are children living in the home and whether you are receiving other healthcare services. Also, more personal information about your health difficulties, medicines, social situation and life history are needed so that we can try to help you in the right way.
We respect your right to confidentiality and only under specific circumstances do we share your personal information with anyone involved in your care. We will only share your information (including about your current mental health) with carers, family or friends if you give us permission to do so, but please bear in mind that this information may help them to continue to support you. However certain information cannot be kept confidential which, if not shared, could result in serious harm to yourself or others. We will always try to discuss these circumstances with you first.
Further leaflets explaining more about how you can access your health and social care record and about information sharing can be provided to you. If you have any further questions about how we record and share your information, please speak to a member of staff.
We can also provide access to a range of leaflets that cover a lot of topics giving you the information to help you make choices and decisions. We know that you are given lots of information when using Trust services so please do not hesitate to ask any questions you may have.
The Trust also has a website which tells people more about many of the topics covered in this leaflet, and about services and mental health problems and medication. Visit the Trust website.
Advance Directives/Decisions and Other Mental Capacity Act Authorities
For example, Lasting Power of Attorney, Court Appointed Deputy
Before they become too unwell, or whilst they are unwell, some people write down how they want to be treated or helped in case they become too ill to express this at a later time. Sometimes this may also involve telling us additional information about (for example) any dependents or pets you may have. If you have completed any of the above, please make sure our staff are aware that you have done so and we will update your records. If you would like to make your wishes known for future reference, please speak to a member of the Crisis Team who will be pleased to outline the options for you.
Carer Needs
If you have someone who provides you with help, assistance, care and/or support they will be entitled to an assessment of their own needs. Where both you and your carer agree, this assessment may be a joint assessment. The options will be discussed with you, and we will explain about information sharing with you and your carer. Further information, guidance and advice can be provided to your Carer about this and a range of Carer Support Services. Carers can request a carers assessment via Shropshire Council First Point of Contact to help with their needs and support. Telephone: 0345 678 9044 Email: firstpointofcontact
Self Help
Self-help does not mean managing on your own. You may still need a great deal of support as you start to recover, so don't be afraid to ask. Remember, friends or relatives may want to help but may also be unsure of what to do. The more open you can be about your difficulties and what seems to help or hinder you, the easier it can be for others to offer you appropriate support.
Self-help tips
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Take things one step at a time.
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Find ways to express your feelings such as talking to someone you trust or writing them down.
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Accept that it is all right to make mistakes.
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Calm yourself by using a relaxation technique.
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Be prepared for progress to be up and down – some days you will feel worse than others.
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Sometimes a form of training, education or some other meaningful support may also help. We can explore all these options with you.
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Please don't feel ashamed or afraid to ask for some help.
Structuring your day
Most of us find it easier to cope if we have some structure to the day. This is even more important if you have a mental health problem and are feeling tired and unmotivated. There is no point in struggling while you are very distressed, but as you start to feel better try to set yourself one or two small tasks to complete each day. This can give you a sense of achievement and help build your confidence. Don't tackle too much at first: tidying a drawer may be quite enough; turning out a room may be too much.
Include some activities that break up your day and give you something to look forward to, such as walking in the park or having a cup of tea with a friend. As you find things to do that you enjoy, you may start to feel more optimistic.
Sleep
Getting a restful sleep can help your mental state. Relaxation is one method than can help to aid restful sleep but there are other things you might be able to try that will help you. Avoiding stimulants last thing at night such as coffee and other caffeine drinks can also be helpful in ensuring to get a good night’s sleep.
Diet
Make sure you eat regular, well-balanced meals with plenty of fruit and vegetables. Missing meals or eating a diet lacking essential nutrients can make you feel more anxious or depressed and reduce your ability to cope.
Caffeine is a stimulant and large amounts can have unpleasant side-effects such as restlessness, palpitations and anxiety. If you are drinking a lot of caffeine-containing drinks such as tea, coffee and cola, try to cut down and substitute other liquids instead.
If you are taking medication for your mental health problem, you may not be able to drink alcohol. Check with your doctor. If you are able to drink, it is better for your physical and mental health to do so in moderation. Heavy drinking can increase anxiety and depression and make it more difficult for you to cope.
Support, Social Contact and Wellbeing
Just meeting and chatting with people on a casual basis can lift your mood without making any emotional demands on you. It can also help you feel less alone. You might meet people in this way through a shared activity such as a sport or a club. Of course, this does require some effort on your behalf, but it's a good way of getting back in touch with the outside world. Support groups enable people who have the same kinds of problem to overcome their isolation and share their experiences. It can help people come to terms with their problems and find ways to cope.
You may also find that offering support to others, based on your own experience, helps you make sense of what you have been through yourself and gives you a feeling of strength. We can put you in touch with other services that can help and support you with this.
Visit the Hub of Hope: online support service website.
Choice and Medication
Whilst under the care and support of the Crisis Resolution/Home treatment Team you may be prescribed medication to help improve your mental health problems. We are continuing to improve the patient experience by ensuring that all patients cared for by the Trust understand:
- What their mental health medicines are for
- Any potential side effects your medication might have
Nursing staff have a lot of knowledge about the medications you will be given and are supported by team psychiatrists to make sure that you have the best medication for your personal needs. Staff will discuss the medication prescribed with you, the effects and any potential side effects. If you have any questions about the medication that you are taking please ask a member of staff who can provide you with additional information and leaflets if required.
There is an allocated Pharmacist based at The Redwoods Centre, staff members can liaise with the pharmacy team to gain any advice or information for patients regarding their medication, and request involvement from the pharmacy team. If you would like to speak or have advice from a pharmacist, please speak to a member of the team and this will be progressed.
You may be advised not to drive due to the effects of certain medications. Staff will discuss this with you in more detail and further information about this can be found at the MIND website here.
The Choice and Medication website has been designed to give patients, carers and health professional’s comprehensive information about mental health medication. The information is set out in a user-friendly understandable style with a strong evidence base for the information. The site contains information on specific mental health medicines and conditions; printable material can be accessed by clicking ‘Printable Leaflets’ on the left hand side menu.
On the Choice and Medication website you can find:
- Handy charts comparing medicines for each condition
- Printable patient information leaflets
- Quick information leaflets
- One-page, large print leaflets with information for those who just want the basic information.
Community Treatment
If you are admitted to hospital, sometimes your care and treatment will continue after you are discharged from a hospital stay and/or if you are discharged from the Crisis Resolution/Home Treatment Team. This will be discussed with you at your predischarge and discharge planning meetings.
Each local area has a Community Mental Health Team. If the decision is made that you require further support after being discharged from hospital or the Team, you will be given a point of contact within the Community teams, as well as the arrangements for future appointments if they have been agreed with you. If you were involved with the Community Mental Health Team prior to coming into hospital, this can continue after you are discharged.
Please ask a member of the team for public transport and taxi information.
Discharge
From the time of your admission to the Crisis Resolution/Home Treatment Team we will work with you to see what goals need to be achieved to enable you to be discharged from our services and will involve you, any carers, relatives and the multidisciplinary team. This process will also include members of Community Mental Health Teams if applicable. You will be offered a discharge care and support plan. This may contain details about relapse plans and future crisis intervention plans as well as any other on-going support. The detail very much depends on your personal needs.
Involvement and 'Having your Say'
You will be actively involved throughout your care and we look forward to working with you towards your recovery. Wherever possible choices exist, these will be discussed with you.
Whenever you are in contact with our services you will be made aware of some independent services that can provide you with advocacy advice and support, should you need it. These can include Service User Representation Forums.
The Service User Reference Forum, Patient Public Involvement and the Service User Network are examples of some arenas to also ‘have your say’ about the quality of services provided during your time with us, and beyond if you wish to stay involved.
People and their carers are encouraged to feedback on their experiences of Trust services through the Mental Health Meridian Feedback Survey. You can complete this on-line or in writing. This is to help us learn from your feedback and improve our services.
Please ask staff about how to access feedback methods and surveys electronically via the Trust web site. You can provide feedback on your experience of using any of our Trust services through our website, and we will be pleased to show you how to do this. If you prefer this in paper format, please just ask a member of staff.
Compliments, Complaints and Comments
We would appreciate your feedback on the service you have received from the Shropshire Crisis Resolution and Home Treatment Team, you can complete our survey online.
If using a mobile, you can use scan our QR code.
OR approach any member of the Team or a Senior Lead within the Team.
Operational Lead: Catherine Ellery
Quality Lead: Holly Williams
OR speak with our Customer Services Team on our Freephone number 0800 783 2865.
OR you can also make a formal complaint under the NHS Complaints procedure by writing to:
Neil Carr OBE
Chief Executive
FREEPOST WV2103
Midlands Partnership NHS Foundation Trust
St. Georges Hospital
Corporation Street
Stafford
ST16 3AG
Freephone: 0800 783 2865
Service contact details:
Your care is being delivered by Shropshire Crisis Resolution Home Treatment Team.
The Redwoods Centre,
Somerby Drive,
Bicton Heath,
Shrewsbury,
SY3 8DS
Tel: 01743 210100
Shropshire Community Mental Health Services
West Shropshire (Oswestry, Shrewsbury, Ludlow)
Severn Fields Health Village,
Sundorne Road,
Shrewsbury,
SY1 4RQ
Tel: 0300 303 3426
Spoke Addresses
71 Salop Road,
Oswestry
SY11 2NQ
25 Corve Street,
Ludlow
SY8 1DA
East Shropshire (Market Drayton, Telford, Bridgnorth)
Fuller House,
Hall Court,
Hall Park Way,
Telford,
TF3 4NF
Tel: 0300 303 1601
Spoke Addresses
Cottage Hospital,
Market Drayton
TF9 3DQ
Northgate Health,
Old Smithfield,
Bridgnorth,
WV16 4EN