1. Assessment Treatment Unit - Sheffield Health and Social Care NHS Foundation Trust. Benchmark of Best Practice for: ASSESSMENT AND TREATMENT UNITS

2. Presentation at Yorkshire and Humber Community of Practice for LD Nurses  Presented by  Julia Shepherd LD Nurse Consultant  Nancy Marshall LD Nurse  Ged Lunt LD Nurse  6 May 2010

3. Background  The Sheffield ATU has been operational for 14 years.  Has 7 beds  Is staffed by Nurses  Receives inputs from CAISS and IMWT

4. Future service provision  The three teams are coming together to provide one new service the Intensive Support Service within the next two years.  As part of the work leading up to the new service – we wanted to check out what we are currently doing

5. Benchmark 6 - Assessment  Assessment - There is evidence that there are a range of assessments in place for individuals which identifies their personalised needs.

6. Assessment findings

7. Question 6 - If applicable assessments contain a clear description of behavioural sequences, measure, frequency, intensity and duration of behaviours  Currently 4 out of 7 meet the criteria, this is 58%

8. Question 9 – Contra- indications of using any medication or physical interventions.  Currently 5 out of 7 meet the criteria, this is 71%.  A lot of detail included around the least restrictive approach in relation to physical interventions, less clear information relating to potential side effects of medication.

9. Question 14 –the assessment concludes with details of why the behaviour occurred and is presented in accessible formats.  Currently 1 out of 7 meet the criteria, this is 14%  Very limited information in accessible formats.

10. Question 23 – Accessible formats for information are available for the individual  Currently 3 out of 7 meets the criteria, this is 43%

11. Question 25 - There is an assessment of safeguarding issues  Currently this applies to only 3 out of the 7 clients.  For individuals with no current safe-guarding issues there is a flow chart within care plans detailing who to contact to make a safe-guarding alert.

12. ACTION PLAN  Question 6 – to introduce the traffic light system – Making sense of challenging behaviour

13. Green Behaviour (Signs that the person is feeling content or happy) Red Behaviour (The person is telling us that something is wrong ) Amber Behaviour (Early warning signs of distress) Facial SignsVocal SignsBehavioural Signs Making Sense of Challenging Behaviour

14. Question 9  Monitoring to be undertaken monthly using SESCAM  All care plans to include potential side effects and contra- indications of medication

15. Question 14  Started using BILD documentation which is discussed at weekly overview meeting. To develop a shared formulation

16. Question 23  Effective communication booklets to further inform all assessment process.  To discuss in client meetings what format do individuals want. What is the key information they want to know each day.  Introducing Photo support books

17. Next steps  Repeat the exercise within 3 months and then move onto another benchmark