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Nta recovery presentation 22/10/10 leeds/ CVH1 Recovery in North Lincs. Presented by Charlotte Harrison & Helen Kirk from the Junction. Supported by Ben.

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Presentation on theme: "Nta recovery presentation 22/10/10 leeds/ CVH1 Recovery in North Lincs. Presented by Charlotte Harrison & Helen Kirk from the Junction. Supported by Ben."— Presentation transcript:

1 Nta recovery presentation 22/10/10 leeds/ CVH1 Recovery in North Lincs. Presented by Charlotte Harrison & Helen Kirk from the Junction. Supported by Ben Gow and Stephen Storrs

2 Nta recovery presentation 22/10/10 leeds/ CVH2 The Junction North Lincolnshire Legal partnership between RDASH and ADS. Employ 24 staff of mixed disciplines Nurses, councillors, structured day programme workers, social worker. Links to DIP, MH, BBV nurses, midwife, housing, probation, Provide services for Core specialist drug treatments. Shared care within 9 satellite bases or GP surgeries Support Multi disciplinary multi agency working within the locality

3 Nta recovery presentation 22/10/10 leeds/ CVH3 Background to pilot Largest shared care practice supported by experienced GPs supported by practice and Junction. Locality and commissioners refocusing on throughput. Staff energised by ITEP/ recovery training. Prime opportunity to respond to several drivers for progress and change form strategic, local and staff level Proposal put to commissioners using the flexibility of the smaller team at shared care – pilot agreed, naturally the next step for stable service users Ongoing consideration to larger team, a service redesign was running concurrently in the core service.

4 Nta recovery presentation 22/10/10 leeds/ CVH4 What was the pilot? Weekly clinic 1;1 work Key worker led To motivate service users to support teir aspirations and capabilities Small start planned to not be to resource intensive. Opportunity to trial ITEP mapping tools Specific recovery care plan for individualised needs Criteria used to identified clients initially. Contract devised in conjunction with service user panel

5 Nta recovery presentation 22/10/10 leeds/ CVH5 What did we offer? Individualised care plans and named key working- one size does not fit all Initial recovery capital assessment Flexible negotiated reductions for planned detoxification from medication. Agreed plan for unmet needs. Sign posting, onward referral, advocacy, accompany, peer mentoring. Involvement of significant others and family in planning, and appointments and support.

6 Nta recovery presentation 22/10/10 leeds/ CVH6 What are the outcomes? Completed treatments month. Initial target for project 8 completed discharges Attendance figures 100% in q1 95% in q2 Numbers on pilot 20 at start now 50 Completed treatments Planned discharges Quarter 1 3 Quarter 2 1 Quarter 3 4+3 OCT

7 Nta recovery presentation 22/10/10 leeds/ CVH7 Service user feed back the worker really believed in me. the dentist referral is so important- your smile is your face and everyone knows your past when your teeth are bad please come to my house to meet my family- you have only seen me in your clinic and I am proud of what I have achieved

8 Nta recovery presentation 22/10/10 leeds/ CVH8 Key findings – so far. Therapeutic relationship is crucial to role- service users need to feel supported and empowered by worker. Everyone has some recovery capital but the treatment approach needs to recognise where the service user is and adapt the intervention Recovery is infectious- use successes to motivate other in to believing they can do it too Recovery champions Peer mentoring Recovery needs to be introduced at the start of the treatment journey

9 Nta recovery presentation 22/10/10 leeds/ CVH9 Activity. The next slide will be a model many people will be familiar with that explains how people develop, learn and achieve their own potential. It also suggests that this process will not the completed if there are deficits. This model can be considered for service users journey and shows recovery is supported be research in many formats

10 Nta recovery presentation 22/10/10 leeds/ CVH10 Maslow model What needs to be In place for recovery

11 Nta recovery presentation 22/10/10 leeds/ CVH11 Do flip chart exercise What needs to be in place for recovery?

12 Nta recovery presentation 22/10/10 leeds/ CVH12 Maslow model What needs to be In place for recovery Becoming a recovery champion Hope. Self belief, acceptance, hope. detoxification Support, family, NA, AA Honesty. Daily activity with purpose Script / abstinence from illicit Housing, prescribing, benefits.

13 Nta recovery presentation 22/10/10 leeds/ CVH13 Inclusion in treatment model Concurrent review of service model allowed inclusion of 3 addition staff with relevant training in to the programme delivery Staff with recovery experience have been linked to other disciplines as new model developed Senior Recovery practitioner to support all staff through MDT process in locality for consistency. Work in progress with commissioners to develop this further in other shared care clinics

14 Nta recovery presentation 22/10/10 leeds/ CVH14 Our Model JUNCTION NEW CLIENT (see pathways induction and script initiation completed recovery concept is introduced and discussed throughout the treatment journey ) MDT Process Used to Design Holistic Care/ Recovery Plan for Phase of Treatment (Stabilisation, maintenance, recovery) Care/recovery plan to support progress to next phase e.g. Stabilisation to maintenance or recovery, incorporating where appropriate multi agency work, family and carers etc RELAPSE (re assess) Care co-ordinator ensures individual is linked in with Counselling / Prescribing/ Recovery Leads partner agencies etc as appropriate to their needs to enhance recovery capital and support progress to the next treatment phase focus of care planning to increase recovery capital Ready for Recovery Highest recovery Capital reduced risk, may have progressed through treatment phases or short history of substance misuse Maintenance Service user has a significant level of stability states wants to be maintained at this point in time. Those in maintenance will have recovery re-discussed 6 monthly Stabilisation Highest risk, most complex needs, lower recovery capital needs intensive support to build confidence and recovery capital Intensive recovery support Planned reduction regime If suitable for subutex or symptomatic detox support with this Outcomes Good client experience Improves family, and social networking Growth to community benefit Lowering or stigma and increasing integration Change in attitudes and outlook Enhanced Aspirations Planned Treatment Exit Referral to Shared Care Recovery

15 Nta recovery presentation 22/10/10 leeds/ CVH15 Most complex needs Most complex. Dual needs Multi agency working Highest risk life style Ongoing chaotic drug use Limited capacity for recovery at this point Workers need to Aim to achieve stability and increase recovery capacity. Assertive engagement Interagency working. Outreach, home visits Maintaining script whilst addressing deficits in recovery capacity

16 Nta recovery presentation 22/10/10 leeds/ CVH16 Previously maintenance Considered maintenance Some evidence of stability, client may considers progress adequate. Unwilling to consider prescription change Fearful of change Entrenched behaviours that prevent progress. Some unmet needs Change achieved by Care plan for unmet needs as specific goals. Engage in alternative context to challenge perception, ie. motivational interviewing. ITEP Recognise and build on success, ie, family support. Use of recovery champion, peer mentoring, group support.

17 Nta recovery presentation 22/10/10 leeds/ CVH17 New in to treatment / detoxing New entry clients- short drug using histories or detoxing currently Low level use Not in treatment previously Previous successful treatment exits Planned reductions Consider subutex, or symptomatic detox, Introduce recovery from inductions 1.1 support Family support programme Plan time limited prescribing by negotiation Maximise recovery potential Relapse prevention

18 Nta recovery presentation 22/10/10 leeds/ CVH18 Future development Staff training Development of the recovery champion role Visioning with commissioners for future planning Measuring outcomes Celebrating successes Raising the profile of success – Promoting the development of recovery champions in to recovery groups.

19 Nta recovery presentation 22/10/10 leeds/ CVH19 Thanks for your time… Any Questions??


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