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Placement Monitoring Team: Interventions & Observations of a Lambeth Case Study Heidi Emery MHLD Placement Coordinator Placement Monitoring Team (PMT)

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Presentation on theme: "Placement Monitoring Team: Interventions & Observations of a Lambeth Case Study Heidi Emery MHLD Placement Coordinator Placement Monitoring Team (PMT)"— Presentation transcript:

1 Placement Monitoring Team: Interventions & Observations of a Lambeth Case Study Heidi Emery MHLD Placement Coordinator Placement Monitoring Team (PMT) MHLD Services South London and Maudsley NHS Foundation Trust NHS Foundation Trust

2 Background for Out of Area Service Users Service Users – Learning Disabilities, Mental Health/Complex/Forensic needs. Majority subject to Mental Health Act (2007)or complex MCA issues.In Medium, Low Secure Units / Specialist Community placements > £100,000 per year but < £ 200,000 in most cases Long term input required due to complex needs and requirement for creative and complex rehabilitation programmes

3 Case Study: Female. 45 years old. Diagnosis: Mild LD, Bi-Polar Affective Disorder, Autism and Epilepsy. 11 Years placed out of area. 11 Years held under MHA 1983 Section 3. No forensic History, though high level of care staff assaults.

4 Initial Assessment – a picture of some issues :  No display of picture easy-read service user information on the ward  Copies others' behaviour and wants attention approximately 4 times an hour  Unsettled since Christmas when her mother went away on holiday and was subsequently unable to come and see her due to bad weather in the winter.  Misses out on activities due to aggressive and unpredictable behaviour  No relationships with her peers and only the qualified staff.  No interaction with community-based projects only going out for walks and meals with two escorts.

5 Example Concerns from Initial Assessment:  Care plans had remained the same since early in the admission except for seizures plan which was discontinued.  No up-to-date assessments of her psychological presentation and assessment of her IQ.  Little change in ward round monthly records.  No clear planned evidence of discharge planning.  Living skills and lifestyle management/rehabilitation not a focus of the admission.  Minimal Occupational Therapy input and when activities stopped they were not readily replaced.

6 12 months later, PMT take on the case:  Placement was very inflexible with organising dates for meetings so all parties could attend.  Little change from previous assessment 12 months ago.  Lack of recognition that suitable treatment options were not available.  MHRT directions not adhered to with subsequent ruling to move to an alternative placement.

7 Placement Reported to CQC on the following concerns:  Family not invited to S117 discharge planning meeting.  Placement ignored recommendations of transition plan.  Belief that having 3 patients on the ward with learning disability equated to providing an LD service.  No appropriately trained staff to provide such LD service.  Poor and defensive communication with external parties when rationales questioned.

8 Future for the Service User:  She has moved to a hospital where her LD and Autism needs can be met with appropriate treatment options available.( Placement is now in London)  Family are engaged.  Care pathway being considered as an ongoing issue, and opportunities for rehabilitation into the community being planned for  Some incidents but less in severity and patient appears much happier.  High level of Psychology input.

9 Further Information: Please feel free to contact me to discuss any issues in this presentation: Tel:


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