To receive the report.
The Committee considered the report into Adult Social Care (ASC) – Mental Health. The report set out the current position following the transition of services back to the local authority from Somerset Partnership Trust. The ASC services that supports people with Mental Health is continuing to develop in line with promoting independence strategy. The second phase of the transformation of these services has recently begun. As in all ASC services the vision is to ‘Promote Independence in Mental Health this is often translated into the Recovery Model. A strengths-based approach that
focuses on the strengths of individuals, families, social networks and
communities. Also, central to the approach, is what matters to individuals and
their families. Somerset ASC continues to empower people to take control of their lives and their care and support, work with people and their communities to identify and provide sustainable local solutions to help them stay as well as possible and as independent as possible, for as long as possible.
The new in-house service is led by the Strategic Manager Mental Health and Safeguarding who reports to the Assistant Director for Adults. There are two locality service managers covering the East and West of the county, a service manager for the Approved Mental; Health Professionals (AMHP) service and out of hours service, and an AMHP professional lead.
The AMHP is authorised by the local authority and practice for them, although they are fundamentally an autonomous practitioner. They provide a broad range of tasks under the Mental Health Act. Their work involves nearest relatives and carers, making sure service users are properly interviewed in an appropriate manner and ensuring they know what their rights are if they are detained under the Mental Health Act 1983. The Approved Mental Health Professional has the responsibility to co-ordinate an assessment under the Mental Health Act ensuring the least restrictive principle is applied. They need to ensure the person is appropriately interviewed and if admitted to hospital that they are conveyed there in the most humane and dignified manner.
The transition of services back to the Local Authority has enabled the ASC
Mental Health teams to focus on its vision of Promoting Independence and
Recovery, the significant change management processes required have been
complex and multi-faceted. Since that return to SCC Mental Health Social
Care service has been able to work earlier and more holistically with people,
with more flexible and varied support. The service is now in a position where
this change process can be escalated to develop the provision of Mental
Health Social Care to further meet the needs of the people of Somerset and
focus on prevention as well as direct care.
The Key tasks being undertaken include:
· Review the provision of Data
· Analyse the demand profile
· Scope any workforce implications
· Review structure options
· Develop AMHP workforce sustainability
· Consider the Digital strategy
· Increase opportunities to consider alternatives to maintain independence
The Committee were informed that there has been an issue at a national level since the legislation on Deprivation of Liberty as the legislation as first written led to more deprivations of liberty being recorded. The prioritising matrix led to the mechanically recording of some cases that was not appropriate; for example someone unconscious in hospital or someone in a safe place who has an expected gradual decline in their health. This will be replaced by the Liberty Protection Safeguards which should give a more accurate mechanism and better more appropriate recording.
The Committee discussed the report and welcomed the detailed presentation which conveyed a passionate commitment to delivering the best mental health support for Somerset residents. The Committee were keen to recognise the pressures on those working in the mental health field and the training demands on these professional to keep their skills up to date. It was recognised the training need to become an AMHP and the shortage of qualified people in this area. Recruitment and retention remains a challenge across many services in Somerset and mental health is no exception. To address this recruitment methods have been broadened to include social media and looking to get Department of Health approval to widen the range of people who can qualify as an AMHP (for example look to retrain paramedics).
By bringing the service in house it has been possible to make the Social Workers feel more valued and give them greater autonomy over their work. There has been some work with schools to capitalise on the emerging interest in psychology at A ‘Level and to translate that into an interest in working in the mental health field.
The Committee asked about the upward trend in residential and nursing placements. The committee were informed that there was some work in h and to understand this. Early indications were that it reflected an increase in the number of elderly people with dementia being place into this care. The policy of the mental health service was to put alternative support in place at the earliest opportunity to help people stay away from restrictive care and move towards greater independence for longer.
The Scrutiny for Policies, Adults and Health: -
Welcomed the report and asked for a further update in six months time.