| Single Assessment Process - training materials mental health The following listing is subject to ongoing review and revision... An age-old problem? A perception that depression is a "natural" part of old age, means many older people are not getting the help they need [author:Mike George] (1 February 2005) Article in: Care and Health Magazine, issue 99, pp22-23. This article considers the needs of older people in Britain who suffer from depression, which is estimated to be between 1.4 million and 1.9 million. It is considered one of the most prevalent health problems facing older people today. It is argued that age discrimination prevents older people from being referred to services, especially speciliast mental health services, when needed. This process may be reinforced by the National Standards Framework for Mental Health which focuses predominantly on those of working age and below, yet Professor Susan Benbow (Chair of the Faculty for the Psychiatry of Old Age at the Royal College of Psychiatry) urges a higher priority to be given to older people's needs and believes better support can be given by community-based health and social care services. Ben Bano, Director of Social Care and Older People's Services at East Kent NHS and Social Care Partnership Trust is in agreement and East Kent already has a local area agreement framework which "offers an ideal opportunity to work on a multi-agency basis on common approaches to promoting social inclusion of older people who are isolated and potentially prone to depression." In the same way, "SAP can be used as an opportunity to identify issues before they become problems" advocates Jonathan Ellis, Policy Manager at Help the Aged. Further work undertaken by Hertfordshire Partnership NHS Trust is also mentioned. Contact Details: Mike George Tel: | Fax: E–mail: | Web links: http://www.careandhealth.com | Target group: LA/HAs | Type / Format: article Availability / Price: | ISBN/ISSN: 14779994 Notes: Conversing with clients a generic approach to mental health needs assessment [author: Malcolm T Firth] Article in:: Practice, vol 11, no 2, 1999, pp 35-48. Good practice requires mental health professionals to engage service users in a reciprocal working relationship, and good assessment underpins care management and the Care Programme Approach (CPA). Both processes can be aided by a comprehensive assessment of needs which allows workers to be flexible, and which invites clients to have an active voice in service provision. This paper examines how a structured form of needs assessment, the Manchester Care Assessment Schedule (MANCAS), can encourage purposeful conversations between clients and workers which assist engagement, and which are relevant to care plans and to review. The approach is broad-based, and relies as much on workers' use of self and pre-existing professional skills as on the written format. Contact Details: British Association of Social Workers, 16 Kent Street, Birmingham B5 6RD. Tel: 0121 622 3911 | Fax: 0121 622 4860 E–mail: | Web links: http://www.basw.co.uk | Target group: | Type / Format: article Availability / Price: | ISBN/ISSN: 09503153 Notes: Copy supplied by Malcolm Firth, Lecturer in Social Work, CHSSC, University of Salford, Allerton Building, Frederick Road, Salford, Greater Manchester M6 6PU. Tel 0161 295 6425 E-mail: m.firth@salford.ac.uk Malcolm Firth was formerly Lecturer/Practitioner - Social Work, ,Manchester Mental Health and Social Care NHS Trust, and Hon Research Fellow, University of Manchester Department of Psychiatric Social Work. Respect your elders [mental health services for older people] [author: William Little] (17 March 2005) Article in: Health Service Journal, vol 115, no 5947, pp 25-26. Report on progress made by the Department of Health as compared to the NSF for older people's mental health services (Standard 7). Voluntary organisations claim none of the milestones that should have been established in April 2004 have been achieved; and the DH also admits to progress that is "patchy". There is concern that age discrimination is particularly entrenched in the mental health services. Further analysis of the situation is supported by Age Concern and Susan Benbow, of the National Institute for Mental Health in England and examples of good practice are cited - flexible carers service - by Age Concern Oxfordshire and training being carried out by Bolton, Salford and Trafford Mental Health Trust. Readers are also directed to Godfrey and Denby's book " Depression and Older People: towards securing wellbeing in later life" (2004, Marston Book Services)(see separate entry). Contact Details: Tel: | Fax: E–mail: | Web links: http://www.hsj.co.uk | http://www.publications.doh.gov.uk/nsf/olderpeople Target group: | Type / Format: article Availability / Price: | ISBN/ISSN: 09522271 Notes: The use of assessment scales in old age psychiatry services in England and Northern Ireland [authors: S Reilly, D Challis, A Burns, J Hughes] (May 2004) Article IN: Aging & Mental Health, vol 8, no 3, pp 249-255. Implementation of the Single Assessment Process (SAP) in the UK is designed to ensure that more standardised assessment procedures are in place across all agencies, that practice improves, and older people's needs are comprehensively assessed. This study by the Personal Social Services Research Unit (PSSRU) provides a unique picture of the range and prevalence of standardised scales used within old age psychiatry services in England and Northern Ireland, reported by 73% of old age psychiatrists. Most services (64%) used three or more standardised assessment scales (range 1-12). 62 separate instruments were identified. The six most used measures were the Mini Mental State Examination (MMSE, 95%), the Geriatric Depression Scale (GDS, 52%) and the Clock Drawing (50%), the Clifton Assessment Procedures for the elderly 26%), the Barthel Index (18%), and the Health of the Nations Outcome Scales (HoNOS65+, 18%). Shared documentation, along with other indicators of integration between health and social care were associated with greater use of standardised scales. The provision of a memory clinic was associated with greater use of neuropsychiatric scales and lower levels of use of cognitive scales. These results provide key material for shaping the provision of psychiatric services for older people. Contact Details: Dr Siobhan Reilly, Research Fellow, PSSRU at Manchester, Faculty of Medicine, Dentistry and Nursing, University of Manchester, 1st Floor, Dover Street Building, Oxford Road, Manchester M13 9PL Tel: +44 (0)161 275 5680 | Fax: +44 (0)161 275 5790 E–mail: Siobhan.reilly@man.ac.uk | Web links: http://www.tandf.co.uk/journals | http://www.pssru.ac.uk/manchester.htm Target group: MHTs, SAP Leads | Type / Format: article Availability / Price: | ISBN/ISSN: 1360-7863 Notes: Validation of short screening tests for depression and cognitive impairment in older medically ill inpatients [authors: Hannah Goring, Robert Baldwin, Alison Marriott, Helen Pratt, Chris Roberts ] (May 2004) Article in: International Journal of Geriatric Psychiatry, vol 19, no 5, pp 465-471. Depression and cognitive impairment in medically ill patients can be detected by screening questionnaires. Very short scales such as the short Geriatric Depression Scale (GDS4) and the Orientation-Memory-Concentration test (OMC) appear to be valid alternatives to longer ones. These very short scales may be useful screening instruments for use with the Single Assessment Process (SAP), as recommended by the National Service Framework for Older People (NSF). Appendix includes questions for the GDS4 and Short OMC test of cognitive function. Contact Details: Robert Baldwin Manchester Mental Health and Social Care Trust, York House, Manchester Royal Infirmary, Oxford Road, Manchester M13 9BX. Tel: +44 (0)161 276 5317 | Fax: +44 (0)161 276 5303 E–mail: Robert. Baldwin@man.ac.uk | Web links: http://www.interscience.wiley.com | Target group: Mental health | Type / Format: article Availability / Price: | ISBN/ISSN: 0885-6230 Notes: The research was supported by a grant from the North West Research and Development arm of the Department of Health (grant holders Robert Baldwin and Elizabeth Matthew) and by Tameside and Glossop Community and Priority NHS Trust who seconded Helen Pratt. Hannah Goring and Helen Pratt are based at Tameside General Hospital; Alison Marriott at Manchester Mental Health and Social Care Trust,; and Chris Roberts at the School of Epidemiology and Health Sciences, University of Manchester. Care Services Improvement Partnership - CSIP, Department of Health - DH Reviewing the Care Programme Approach 2006 a consultation document (November 2006) The Care Programme Approach (CPA) was introduced in 1990 to provide a framework for effective mental health care for people with severe mental health problems. The importance of close working between health and social care services was stressed, as well as the need to involve service users and their carers in assessing and planning service users' support and care. Significant developments since 1999 (e.g. the National Service Framework for Mental Health), coupled with evidence pointing to the need for improvements has prompted this review, led by Pat Holman. The overall aim is that CPA should be underpinned by a set of agreed common values and principles. This consultation asks who should the CPA be for; and proposes that national competencies should be identified for the role of care co-ordinator. Other sections consider: continuity of care; service user and carer engagement and involvement; physical health and social outcome needs; choice in mental health; clinical risk assessment and management; tackling bureaucracy; and measuring and improving quality. Annexes include current definitions for the CPA, and on the CPA in relation to the Common Assessment Framework for Adults (CAF), which notes that CAF will build on experience to date from implementing the Care Programme Approach and the Single Assessment Process (SAP). Contact Details: Dawn Fleming, London Development Centre, 11-13 Cavendish Square, London W1G 0AN. Tel: 020 7307 2450 020 7307 2431 (Good practice pro forma) | Fax: 020 7307 2432 (Good practice pro forma) E–mail: cpareview@londondevelopmentcentre.org | Web links: www.nimhe.csip.org.uk/cpa | Target group: mental health voluntary sector; MH workers/ carers | Type / Format: policy Availability / Price: Web link; downloads; or by post, e-mail or telephone, quoting ref 278106. | ISBN/ISSN: Notes: Also available accompanying this (44pp) consultation document is a summary of consultation questions and proposals (3 pp). Comments on the consultation are invited by 19 February 2007. A pro forma (2pp) seeks information on examples of positive practice when using the Care Programme Approach. Department of Health Care management for older people with serious mental health problems This document (3 pp) relates to the Care Programme approach (CPA), which should be applied to older people with severe mental illness due to schizophrenia or other psychoses. The assessment of their needs should be based on the Single Assessment Process (SAP) for older people. SAP, plus critical aspects of CPA, should be applied to other older people with severe functional or organic mental health problems, who, were they younger, would be provided for under CPA. The application of CPA to older people with depression, dementia and other mental health problems is detailed in an annex. View document Contact Details: Tel: | Fax: E–mail: | Web links: | Target group: Mental health | Type / Format: guidance Availability / Price: | ISBN/ISSN: Notes: Department of Health - DH Everybody's Business Integrated mental health services for older adults: a service development guide [authors: Care Services Improvement Partnership - CSIP, Department of Health - DH] November 2005 This set of documents are a web-based resource to support commissioners and health and social care practitioners, and should be used as a set - the Guide with the five briefings (Key messages for commissioners; Information for Commissioners; Information for Service Users and Carers; Information for Health and Social Care Professionals; and, Information for Providers). The aim of the Service Development Guide is not to develop new policies, but improve health and social care practice at the front line, so that older adults with mental health problems, and their carers, have their needs met wherever they are in the system, without encountering discrimination or barriers to access. The Guide builds on the service models outlined in the National Service Framework for Older People (May 2001) and supports the principles promoted in the "vision" document, Securing Better Mental Health for Older Adults (8 pp June 2005) (website to download is given below). There is also an Older People's Mental Health Mapping framework, launched in November 2005 to coincide with this Guide, which will support local commissioning decisions by providing national benchmarking for local services. This Guide then is supported by a comprehensive web-based resource, including the mapping framework, which provides further information for anyone involved in health and social care for older people with mental health problems. The dedicated web site also includes guidance on best practice, local service examples and links to relevant policy. Contact Details: Kate Hardy, Older People & Disability Division, Directorate of Care Services, Department of Health, 133-155 Waterloo Road, London SE1 8UG Tel: +44 (0)20 7972 4039 | Fax: E–mail: | Web links: http://www.everybodysbusiness.org.uk | http://www.dh.gov.uk/policyandguidance/healthandsocialcaretopics/olderpeoplesservices Target group: HA/LAs | Type / Format: guidance Availability / Price: Download resource | ISBN/ISSN: Notes: Department of Health - DH POPP Project profiles [Partnership for Older People] (16 November 2005) The Department of Health's Older People and Disability Division is leading a project 'Partnerships for Older People Projects' (POPP). The project's strategic aim is to test and evaluate innovative approaches that sustain prevention work, in order to improve outcomes for older people. Of the 19 pilot projects being established (during 2006/07 and 2007/08), four include the Single Assessment Process (SAP) as part of their remit: East Sussex (Independence First); Leeds (Service redesign for Older people with mental health needs); North Yorkshire; and Brent (Integrated Care Co-ordination Service). This document (65 pp) describes the 19 pilots, some of which have a mental health focus. UPDATE given in the social work magazine Community Care, issue 7 December 2006, p10. Pilot schemes providing these innovative preventive services are already showing evidence of the economic benefits of earlier intervention, reported Ivan Lewis (Care Services Minister). This would help influence 2007/08 comprehensive spending review. Lewis also announced the areas to be given a share of £18.5m for the second phase of the programme which starts in 2007. The areas are Rochdale, Tameside, Calderdale, Leicestershire and Rutland, Croydon, West Sussex, Kent, North Somerset, Devon and Gloucestershire. POPP Newsletter available from CSIP website - (issue January 2008 no 2) link given below. Contact Details: Tel: | Fax: E–mail: | Web links: http://www.dh.gov.uk/assetRoot/04/12/26/23/04122623.pdf | http://www.changeagentteam.org.uk/index.cfm?pid=218&catalogueContentID=3084 Target group: | Type / Format: case study Availability / Price: Available as download only. | ISBN/ISSN: Notes: Derbyshire Mental Health Services NHS Trust Advance Directives policy [author: Phil Hopkinson] (January 2004) This policy is designed to help clinical staff to deliver an ethically and legally sound service by: defining the legal rights that an individual has to specify regarding how he or she would like to be treated at a future time. It defines the limits of such advance directives; describes how patients can be involved in their care through the formulation of an Advance Directive; and describes procedures that trust staff should follow to ascertain that any such relevant directives are honoured by clinical staff in the treatment of an individual deemed incapable of making treatment decisions. Although clearly intended for use by mental health services, the material could be applied to SAP. View policy Contact Details: Phil Hopkinson, Derbyshire Mental Health Services NHS Trust, Trust Headquarters, Bramble House, Kingsway Hospital, Derby DE22 3LZ. Tel: 01332 623737 | Fax: 01332 331254 E–mail: | Web links: http://www.derbyshirementalhealthservices.nhs.uk | Target group: MHT | Type / Format: guidance Availability / Price: | ISBN/ISSN: Notes: Derbyshire Mental Health Services NHS Trust Guidelines for people making an advance directive [author: Phil Hopkinson] (January 2004) Explains the differences between an Advance Directive, an Advance Request, and an Advance Refusal. It also explains about the trust 'Advance Directive for Treatment and Care' form (dated December 2003), which accompanies this document. Part 1 of the form deals with an individual's treatment and care, Part 2, personal and home life, and Part 3 lists people whom the patient has informed of the contents of the advance directive. Although clearly intended for use by mental health services, the material could be applied to SAP. View guidelines View form Contact Details: Phil Hopkinson, Derbyshire Mental Health Services NHS Trust, Trust Headquarters, Bramble House, Kingsway Hospital, Derby DE22 3LZ. Tel: 01332 623737 | Fax: 01332 331254 E–mail: | Web links: http://www.derbyshirementalhealthservices.nhs.uk | Target group: MHT | Type / Format: guidance Availability / Price: | ISBN/ISSN: Notes: Dorset and Somerset Strategic Health Authority Dignity on the ward audit template [author: Sharon Waight] (May 2005) Audit tool (18pp) designed to support the assessment of core standards for delivering dignity on the wards and departments of hospitals in community, acute and mental health sectors. The aim of this template is to assess patient dignity issues across a whole organisation, by looking at how well wards and departments are meeting the core standards. It covers five key themes: patient environment; privacy, dignity and modesty; communication with patients; promoting individual needs; and staff training. View template. Contact Details: Sharon Waight, Dorset and Somerset Strategic Health Authority, Wynford House, Lufton Way, Lufton, Yeovil, Somerset BA22 8HR. Tel: +44 (0)1935 384111 | Fax: E–mail: sharon.waight@dsha.nhs.uk | Web links: http://www.dorsetsomerset.nhs.uk/ | Target group: Hospitals in all sectors | Type / Format: audit tool Availability / Price: | ISBN/ISSN: Notes: Health and Social Care Change Agent Team, Department of Health Changing times: improving services for older people report on the work of the Health and Social Care Change Agent Team, 2003/04 (September 2004) The purpose of this second annual report of the Health and Social Care Change Agent Team (CAT) is to present best practice guidance and examples of good practice. The Team's broad remit is to support implementation of wider aspects of the National Service Framework for Older People (NSF). The report covers: assessing needs: the care process and pathway; improving capacity and matching needs to services; better commissioning and securing capacity through collaborative working; and partnerships and delivering change through a whole systems approach. Examples of good practice illustrate work on: the single assessment process (SAP); discharge planning; reimbursement (for delayed discharges); intermediate care; mental health services for older people; and housing and assistive technology. The Change Agent Team's first annual report, "Changing places" and covering 2002/2003 focused on some areas of the NSF, but not SAP. View document. Contact Details: Judy McCallum, Finance and Office Manager, Department of Health, Health and Social Care Change Agent Team, Wellington House, Room LG33, 135-155 Waterloo Road, London, SE1 8UG. Tel: 020 7972 1330 | Fax: 020 7972 4349 E–mail: Judy.McCallum@dh.gsi.gov.uk | Web links: http://www.changeagentteam.org.uk | http://www.changeagentteam.org.uk/_library/changing_times.pdf Target group: All staff | Type / Format: policy Availability / Price: FOC (quote 40078 and the tiitle) from DH Publications Orderline, PO Box 777, London SE1 6XH. Tel 08701 555 455. e-mail: dh@prolog.uk.com Also available on request in Braille, on audio-cassette tape, on disk and in large print. | ISBN/ISSN: Notes: Help the Aged; Nuffield Institute for Health, University of Leeds Depression and older people towards securing well-being in later life [authors: Mary Godfrey, Tracy Denby] (2004) Older people with depressive disorders are largely invisible in health and care services, and many fail to seek or receive effective treatment. The report reviews the nature and scope of the evidence on depression and older people; evaluates the current policy and practice response; and identifies gaps in the evidence base and areas for further work. The report also examines user and carer needs; risk factors in depression; and how people access services or support, identification and treatment in primary care as well as specialist mental health services. The report presents a framework and suggestions for an approach aimed at supporting a "good life" in older age. This is seen as central in developing strategies for primary prevention of later life depression. Help the Aged commissioned the report, which was undertaken at the Nuffield Health and Social Care Group, Institute of Health Sciences and Public Health Research, University of Leeds. Contact Details: Marston Book Services, PO Box 269, Abingdon, Oxon OX14 4YN. Tel: 01235 465500 | Fax: E–mail: direct.orders@marston.co.uk | Web links: | Target group: Mental health; general practitioners | Type / Format: book Availability / Price: £ 14.99 plus £2.75 P&P. | ISBN/ISSN: 1861346425 Notes: Published by Policy Press in association with Help the Aged. Openmind, the mental health magazine CPA - process or event? ... radical shift in thinking to support the CPA to deliver in the way originally intended says author [author: Steve Morgan] (January/February 2007) Article in Openmind, issue 147, pp19-21. A critical review of the current implementation of the CPA (Care Programme Approach) introduced some 16 years ago to assess needs and review progress in a way that places the individual at the centre of their care; in this article mental health care is the focus. The author sees CPA implemented too often as an administrative approach rather than a creative approach being adopted which would involve more genuine service user involvement. This would involve a greater focus on values, principles and meanings in order to achieve the radical shift in thinking required to support CPA to deliver in the way originally intended. Contact Details: Tel: | Fax: E–mail: | Web links: http://www.openmindmagazine.co.uk | Target group: LAs | Type / Format: article Availability / Price: | ISBN/ISSN: 0265511X Notes: Practice Development Unit (MHSOP) of Cardiff and Vale NHS Trust Signpost To Older People and Mental Health Matters Journal produced by the Practice Development Unit (MHSOP) of Cardiff and Vale NHS Trust in association with the Dementia Services Development Centre Wales. Produced three times a year. The journal has articles, news of developments in the field, reviews of resources, training courses, webwatch, and letters page. This specialist journal is aimed at those working with and caring for people with dementia, older people with mental health problems and their carers. Signpost provides an inter-agency and multidisciplinary communication network for formal and informal carers, with the intention of supporting common aims and a shared vision of improving quality within services. This is with the overall aim of enhancing the quality of care received by older people with mental health needs and thereby improving their quality of life. Contact Details: Simon O'Donovan (Editor) Signpost Subscriptions Practice Development Unit (MHSOP), Whitchurch Hospital, Park Road, Whitchurch, Cardiff CF14 7BP Tel: 029 2033 6073 | Fax: E–mail: pdu@cardiffandvale.wales.nhs.uk | Web links: http://signpostjournal.co.uk | Target group: | Type / Format: journal Availability / Price: Subscriptions range £15 to £25 per year. | ISBN/ISSN: 1368-4345 Notes: Social Care Workforce Research Unit, King's College London Assessing the mental health needs of older people systematic review on the use of standardised measures to improve assessment practice [author: Jo Moriarty] (November 2002) The introduction of the Single Assessment Process (SAP) highlights the importance of summarising current knowledge in the use of standardised measures to improve the identification of mental health problems in older people and their carers, as in Standard Seven of the National Service Framework for Older People (NSF). This systematic review (115 pp) presents evidence on the use of such standardised tools and scales. It is primarily aimed at supporting the assessment practice of social workers and staff in community and long-term settings with no professional background in mental health. It outlines some of the reasons for using standardised measures and the criteria for selecting between different measures. It provides information on different mental health problems (dementia, cognitive impairment, depression, anxiety, and alcohol or substance abuse) and the screening measures available to assist in their identification. It covers the assessment of carers' needs, and looks at the wider assessment context. The review cites 199 articles, books and reports, which are presented as tables of useful sources by topic or name of measure. View report Contact Details: Janet Robinson, Unit Administrator, Social Care Workforce Research Unit, King's College London. Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH. Tel: 020 7848 3752 | Fax: 020 7848 3700 E–mail: scwru@kcl.ac.uk | janet.j.robinson@kcl.ac.uk Web links: http://www.scwru.kcl.ac.uk/ | Target group: Social workers, Residential care staff | Type / Format: book Availability / Price: Also available as hard copy from the Unit. | ISBN/ISSN: 0954648129 Notes: Social Work and Social Care Section, Health Services Research Department, Institute of Psychiatry, Kings College London The King's College Quality in Later Life (QuiLL) Assessment background information [authors: Sherrill Evans, Peter Huxley, Clare Gately, Alyson Smith] The Quality in Later Life (QuiLL) Assessment is a short (27 question) operational measure of quality of life in old age (age 65+). QuiLL includes both objective and subjective questions (on a 7 point scale) in 9 life domains including social relationships. family, neighbourhood and accommodation. This background information outlines its development, psychometrics, relevance to practice and policy, and uses and findings to date. The following article reports on the development and validation of the Quill:: Evans S, Gately C, Huxley P, Smith A & Banerjee S (2005) Assessment of quality of life in later life: development and validation of the QuiLL. Quality of Life Research 14(5), pp 1291-1300 The QuiLL is being used increasingly in practice settings in the UK and Australia, and its use is planned in research studies being conducted in the UK, Sweden and New Zealand. "A community survey of quality of life in later life" is a longer research version of the tool, and is available from Sherrill Evans. The assessment is noted only as a reference in the Department of Health document, Single Assessment for Older People: Assessment Scales. (see p 13). View background information | View 'Adding Quality' Contact Details: Sherrill Evans, Senior Lecturer in Social Work and Social Care, Department of Applied Social Sciences University of Wales Swansea Singleton Park Swansea. SA2 8PP Tel: +44 (0)1792 602605 | Fax: E–mail: s.evans@swansea.ac.uk | Web links: | Target group: Health and social care professionals | Type / Format: assessment tool Availability / Price: Assessment tool available on application to Sherrill Evans | ISBN/ISSN: Notes: See also Good Practice listing. Sherrill Evans was formerly Senior Research Fellow, Social Work and Social Care Section, Health Services Research Department, Institute of Psychiatry, Kings College London. Somerset County Council, Social Services Department [SAP training handouts] The handouts comprise: Single assessment process training days (aims and learning outcomes); Older people with mental illness (how to record the assessment); National Service Frameworks (list); A person-centred approach .... and Valuing person-centred care and independence. View documents: Single assessment process; Mental illness ; NSF list ; Person centred approach ; Valuing person-centred care and independence Contact Details: Heather Roughton, Single Assessment Process Project Manager, County Hall, Taunton, TA 1 4DY. Tel: +44 (0)1823 356718 (HR) +44 (0)1823 355193 (ES) | Fax: E–mail: HMRoughton@somerset.gov.uk | ESkinner@somerset.gov.uk Web links: http://www.somerset.gov.uk | Target group: General | Type / Format: guidance Availability / Price: | ISBN/ISSN: Notes: |