What:-The Triangle of care is a therapeutic alliance between patient, staff and carer that promotes recovery and sustains wellbeing. The programme was launched by the Carer’s Trust, the UK’s largest carer charity, in 2010. RDaSH joined the programme in August 2013 and has conducted significant work to increase carer support and engagement.

What did we do? The Triangle of Care approach in RDaSH was initially developed by carer’s and staff seeking to improve carer engagement in acute mental health in patient areas. It has now been extended to cover all the services provided by the Trust whether they are an inpatient, community team or specialist service, each linking into the Trust overarching “Listen to Learn” and Triangle of Care Forums.

What difference we have made? Our whole trust has worked upon lots of actions including:

• Created Carers Charter

• Improved our carers communications strategy

• Submitted our pledge supporting John’s Campaign, which includes 24 hour ‘open door’ visiting on 2 of our wards.

• Developed bespoke individual ward/service action plans

• Completed unannounced visits to wards/community areas by Triangle of Care Steering Group members

• Increased carer involvement in all aspects of service planning and evaluation via Big Conversations, targeted events and also specific consultation sessions.

• Production of ward/community carer information packs

Expanded actions:

1) Enhanced Trust Induction – A carer story was introduced at Trust Induction as part of the Patient Experience session for staff. A number of carers have volunteered and are supported to participate. The stories are very powerful, thought provoking and insightful.

2) Carer Awareness Training Resource for Staff – The carer story at Trust Induction forms part of the carer awareness training resource for staff, which has been co-produced with carers. Carer awareness is also promoted and delivered locally through a network of designated Carer Champions, allocated to each team.

3) Carer Champion Network – Network events have been organised so that carer champions from all RDASH sites can come together and share best practice and work on consistent approaches to carer engagement– enabling us to reduce unwarranted variation in approach and also gain views from patients and carer to know what we need to do more of or less of.

4) Strengthening Links with Local Groups and Partner Organisations – Work continues to strengthen links and develop relationships with local groups and partner organisations with the aim of working collaboratively in relation to patient and public engagement.

5) Patient Story to Board – Feedback from our service users, carers and staff is always targeted, meaningful and pivotal in improving the delivery of quality care. We therefore invite a patient, carer, family member or a staff representative to attend the Trust Board on a monthly basis and gain an understanding from the patient or family’s perspective of what good care looks like and what we can improve to make a patient’s experience more positive.

6) Helping Carer’s find “Me Time” – The project called “Time for You” is for carers who have loved ones using the services at St Johns Hospice offering carers the chance to take part in group relaxation and other activities including arts and crafts, visit a hairdresser and support on other services.

Conclusion – We are so excited that we are one of only two Trusts in the country to have received a three star award from Triangle of Care and so proud of the patients, carers and staff who have helped us to achieve this.

We would like to share our story to promote not only the amazing work for our carers and carer champions and support other Trusts in their journey!

If you want to know more please contact:- Cheryl Watkinson (Membership & Engagement Facilitator) Chris Prewett (Head of Patient Engagement & Experience) 01302798135 or Jude -FAB Ambassador @Jude_Graham_ #rdashisfab

About the Author:

Judith Graham
I am proud to be a Fab Ambassador! I am a Registered Mental Health Nurse, Independent Prescriber, and a Registered Specialist Practitioner (Mental Health) with the Nursing and Midwifery Council (NMC). I was awarded the title of Queens Nurse in 2015, and work actively with this national organisation,. I have been qualified for 12 years and have worked in the NHS throughout my career. I am also a Registered Psychotherapist with the British Association of Behavioural and Cognitive Psychotherapy, and a registered Independent Assessor for Autistic Spectrum Conditions. I currently have a divided role; I am the Listening into Action (LiA) Lead for the NHS Trust I work for. This means that I work with various clinical teams including: mental health, neurorehabilitation, forensic services, drug and alcohol services, learning disabilities services, child and young people’s services and also school nurses. I also work in a clinical practice role for 1-2 days per week as an Advanced Nurse Consultant and Psychotherapy Consultant, in specialist mental health care services. I work at a senior clinical level, with adults across the age range who have functional and organic mental health problems, clients with mental health and learning disabilities, and also clients with substance misuse problems. I provide specific diagnostic assessment and work with patients and their relatives to develop psychotherapeutic formulations which act as guides for future treatment. Additional to my clinical practice, I have a role in regards to policy and practice development on a local, regional, and national basis. I am an elected Board Member of the NHS Confederation Mental Health Network.

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