MH13.2012 Work with families, carers and individuals during times of relapse or crisis

Overview

This standard covers working with individuals and their carers and families in times of relapse or crisis to assess the urgency of requests for action, take and review the effectiveness of actions to meet needs and agree risk management strategies. The term `carers and families' is used to mean any persons who have an active and on-going informal role in caring for the individual with mental health needs, including those with a familial relationship to the individual. Partners, where they exist, would be considered as family members. Individuals with mental health needs may be adults of working age, children or adolescents or older people. This standard applies to those who respond to and work with individuals with mental health needs and their carers and families during times of relapse or crisis. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 2

Knowledge and Understanding

You will need to know and understand:

1. legal and organisational requirements and policy requirements relevant to the functions being carried out
2. the types of support available to individuals, carers and families in the event of a relapse or crisis
3. the relevant methods and models of intervention that may be appropriate
4. what the purpose and priorities are of the service provider and how these influence the kinds of support offered
5. the range of factors that need to be taken into account when determining the urgency of a request for action and how best to respond to it, including economic and social factors, any illnesses which the individual may have, risk assessment, and restrictions which may apply under legislation
6. the details which need to be specified in risk assessments and risk management strategies
7. different methods of enabling carers and families to participate in the agreement and review of actions taken in times of relapse or crisis and in the development of risk management strategies
8. the importance of ensuring that individuals, carers and families are actively involved in the process of agreeing and reviewing actions taken and in developing risk management strategies
9. how to communicate clearly and effectively
10. how to make a valid assessment of the urgency of a request for action
11. how to facilitate individual, carer and family participation
12. how to conduct valid, reliable and comprehensive reviews
13. how to write reports, including statutory documentation
14. the agency's policy and procedures regarding confidentiality of information and the disclosure of information to third parties, and the specific circumstances under which disclosure may be made

Performance Criteria

You must be able to do the following:

1. carry out your agreed role in ways that promote active participation and minimise risks
2. assess the risk of relapse or crisis situations occurring with individuals, families and carers
3. obtain current, accurate and complete information about the circumstances in which needs have arisen and may arise
4. work with individuals, carers and families to:
1. take account of information on the effectiveness of different actions taken in response to the needs arising
2. identify and evaluate actions that could be taken to avoid or minimise risk to individuals, families, carers and others
3. review the care plan in light of changes in the needs and vulnerabilities of individuals, carers and families
5. enable individuals, carers and families to contribute actively and openly to the process of identifying and agreeing appropriate risk management strategies
6. use your assessments to formulate risk management strategies in which you take account of:
1. concerns raised by individuals, families, carers, communities, colleagues and other professionals
2. individuals' right to take risks balanced against the likelihood of harm to themselves and/or others
3. the situation and circumstances associated with the risk
7. negotiate agreement to the risk management strategies with the individuals, carers, families, service providers, other agencies and practitioners
8. enable all those who will contribute to the risk management strategies to clarify and confirm their understanding of the strategies and their roles and responsibilities within them
9. detail and record the agreed risk management strategies and ensure that they are communicated clearly to those who need to receive them
10. obtain as much accurate information as possible on the nature of, and reasons for, the requests for action
11. evaluate the information and form a valid judgement as to the seriousness and urgency of the requests for action
12. follow the guidelines of the service provider in making an assessment as to the urgency of requests for action
13. obtain accurate, relevant, reliable and current information on the strengths, vulnerabilities, needs and circumstances of the individual, carers and family
14. identify any conflicts of interest arising from the requests for action in relation to the needs of the individual with mental health needs and their carers/families
15. record and justify your assessment of the urgency of requests for action and make it available to those who need to receive it
16. work with families, carers and individuals to assess the situation, including risks to individuals, carers, families and others, and identify the actions required to meet immediate needs
17. enable individuals, carers and families to participate in the decision making process as actively as time and circumstances permit
18. offer views and suggestions in a way which is non-threatening to individuals, carers and families and which is sensitive to your own power and authority
19. build on the preferences of individuals, carers and families when working with them to agree actions
20. ensure compliance with legislative requirements and the policy, practices and procedures of your organisation
21. clearly specify the actions to be taken and who will undertake them
22. negotiate agreement on the information which will need to be shared, and with whom, in accordance with agency and legislative requirements
23. ensure that the details of the actions to be taken are communicated clearly to all those who need to know them
24. ensure that the agreed actions are implemented as promptly as possible in accordance with the assessed urgency of the need
25. keep accurate, complete and up to date records of the actions agreed and implemented
26. review the outcomes of actions taken to address immediate needs at the earliest possible opportunity
27. ensure that all parties are aware of and have the opportunity to contribute to the review process
28. enable individuals, carers and families to express their views on the effectiveness of the actions taken in a frank, honest and constructive manner
29. ensure that the review process is conducted in an environment that facilitates active participation by individuals, carers and families
30. clearly summarise the outcomes of the review and enable all those who have contributed to it to comment on the summary
31. keep an accurate, complete and up to date record of the review and decisions taken and ensure that it is stored securely
32. use the results of the review to inform the service provided to the individual, family and carers and to inform future actions taken in response to relapse or crisis situation
33. ensure that the results of the review are communicated clearly to all those who need to receive them

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004): Dimension: HWB3 Protection of health and wellbeing