There are strong and diverse examples of support for carers within Mental Health Trusts although as yet this practice is not generally being brought together under a ‘Carer Passport’ scheme. The elements of a Passport scheme however do exist.
Mental Health Trusts in general are not currently offering ‘Carer Passport’ schemes and are not connected with other Passport schemes that may be operating in their local area. There are however many carer friendly initiatives taking place within mental health trusts which although not recognised as ‘Carer Passports’, do constitute important elements of Passport scheme. Across the country at present however these lack uniformity.
Creating the Triangle of Care
The Carers Trust’s Triangle of Care model that many trusts are operating in England, sets out a framework of standards and ways of working that would provide a strong foundation for a Carer Passport scheme within a mental health trust. The model follows six key standards, as follows: Carers and the essential role they play are identified at first contact or as soon as possible thereafter; Staff are ‘carer aware’ and trained in carer engagement strategies; Policy and practice protocols regarding confidentiality and sharing information are in place; Defined post(s) responsible for carers are in place; A carer introduction to the service and staff is available, with a relevant range of information across the care pathway; A range of carer support services are available.
In total, 32 mental health trusts operate the Triangle of Care model in England, and are part of the Triangle of Care Membership Scheme. In addition, the Triangle of Care for Dementia, developed in partnership with The Royal College of Nursing, provides an added resource to community hospitals through a framework to better identify and support carers of people with dementia across the care pathway. [Suggest cut and include TOC for Dementia in resources]
Where a trust operates the Triangle of Care model, a Carer Passport would build on this foundation, translating the core aspects of the model into an offer for a carer. A Passport would then have the potential to offer additional and specific provision to carers.
Surrey & Borders Mental Health Trust
Surrey & Borders Mental Health Trust have made a serious commitment to recognise and support carers through their application of the Triangle of Care model which involves including carers in all workstreams of the service delivery.
Two organisational Carers’ Leads drive forward the agenda which includes implementing their organisational carers’ action plan. This includes such initiatives as their ‘Carers Charter’. Surrey and Borders were the top performing Surrey NHS provider for referring carers to support using the Surrey Carers Prescription service during 2016-17.
A total of 367 carers received support. The trust employs 13 Carer Practice Advisors who work across the system to ensure carers friendly practice and this includes a specific offer to young carers.
The Greater Manchester Mental Health NHS Foundation Trust
The Greater Manchester Mental Health NHS Foundation operates the Triangle of Care model and support carers through several key provisions that would be expected to be found within a Carer Passport offer. A Carer Lead manages the provision for carers and coordinates training for its Carer Champions, however it is recognised that the responsibility for supporting carers rests with all staff.
Carer Information Packs are given to carers within defined timescales according to the service. Each pack provides carers with vital information including; a guide to accessing health records, admissions information, information on care planning, customer care, confidentiality, discharge planning and information about what can be brought on to a ward.
An introductory letter accompanies the packs which introduces the service and the staff team to the carer and informs the carer about parking, visiting and staff shift times and details of local carer support groups.
Young carers and whole family approach
A Carer Passport scheme must also respond to the needs of young carers and should therefore accommodate a ‘whole family approach’ to how a young carer is engaged and supported.
Mersey Care NHS Trust in partnership with Barnardo’s Keeping the Family in Mind (KFIM) provide ‘Family Rooms’ to provide a safe, comfortable and homely environment for all families with children under the age of 18 who have a family member staying in a specialist mental health service. The 16 rooms designed by young carers are located at Mersey Care NHS Trust specialist mental health, learning disability and substance misuse inpatient services and are promoted to young carers and families by ward staff, clear signage and posters designed by young carers. The Jelly Baby Logo, designed by a young carer, is the kite mark awarded by young carers to Family Rooms which have met their standards.
In order to put in place a whole family approach for supporting young carers, 2gether NHS Foundation Trust have developed a Young Carers Charter and an audit system to record patients with dependent children in a consistent way. The hospital Discharge Policy includes specific reference of any children to ensure that that support is in place at discharge and a child does not become the principle carer.