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Stories Submitted thoughts and stories West Fife Community Outreach Team
Stories Submitted thoughts and stories West Fife Community Outreach Team
West Fife Community Outreach Team |
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community/socialising/inclusion | coping strategies | male | practice development | service provider | statutory mental health services (+)
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Author: Colin Welsh, Team Leader, Fife NHS Published: 10 February 2006 This story looks at elements which help promote recovery from one service provider’s viewpoint. Colin Welsh, Team Leader for the West Fife Community Outreach Team (Community Outreach Team), explains the philosophy, management and success of the team in terms of recovery. Tragically, Colin collapsed while playing football on 25 August 2010 so the story is now preceded by an appreciation of Colin and his work from close colleagues. This story was written by Colin Welsh while he was Team Leader with West Fife Community Outreach Team in 2006. Tragically, Colin collapsed while playing football on 25 August 2010 and he could not be revived. John Short, Clinical Services Manager in West Fife writes:
“Colin was an outstanding member of Fife's Mental Health Service not just because he was unusual in being a social worker employed by the NHS but because he brought extra dimensions and energy to all the work he did. As a part time commissioner with the Mental Welfare Commission he brought an added perspective to discussions and debate. His work was informed by his belief in individual capacity for development and growth and he was an inspiring advocate for the Principles of Recovery. He leaves a genuine gap in Fife and elsewhere and his passing is a great loss. Our sympathies are overwhelmingly with Colin's family.” Colin's story about the Community Outreach Team remains essentially the same four years on, Cathy Hilditch, currently acting Team Leader has provided the following as a brief update on the team's activity: “The team's approach increasingly focuses on individual strengths and this further supports recovery and self determination. In addition to ‘no current contact’ referred to by Colin, we have identified that it can be appropriate for people to be discharged from team support. This is always done through discussion and consent and though the idea can provoke anxiety and while some retain contact with services for review, it is heartening that people can pursue fulfilling lives without relying on the team's added support. “The Scottish Recovery Indicator (SRI) has been used by the team. Much of the feedback from its various elements has been positive about how the team works and outcomes achieved. However we also have plenty of food for thought. We are very aware of the need to change in tune with people's changing circumstances and through our SRI action plan we will be reviewing aspects of our approach at our next planning day scheduled for February 2011. “Colin wrote above of the importance of flexibility and we intend never to forget, or lose our belief in that principle.” Colin also contributed extensively to recovery initiatives at a national level, perhaps most notably as a key member of the group that helped develop and refine the SRI tool. The original story follows below. ----------------------------------------------------
The Community Outreach Team came together in March 2000 after a year-long research project had examined local rehabilitation and aftercare services and carried out a full needs assessment of people with severe and enduring mental health problems in Fife. The aim of the project was to develop a multi agency team that could provide continuing support and aftercare services to those with serious mental illness and received funding for its first year from the Scottish Executive. It has since become part of mainstream funding from Fife NHS. The project, based in Dunfermline, covers West Fife, with its client population coming from an area stretching from the Kincardine Bridge to Ballingry, taking in Rosyth, Cowdenbeath and areas in between. Considered as part of the local mental health service, we work closely with established local providers. The team comprises of a Social Worker Team Leader, five nurses, a social worker and an OT. The Team employ six Community Support Workers who come from different backgrounds including nursing and volunteering. We have two secretarial staff, one full time Consultant Psychiatrist and a full time staff grade psychiatrist. The Team also has access to a Psychologist. All referrals to the Team come through Consultants. We then undertake our own assessment, which is currently a Camberwell Assessment, and then decide if we can offer a service. We look to work with people with identifiable social and health needs who would benefit from a more intensive approach. Referrals are discussed as a team and assessments are carried out jointly and over a period of time. The Team work 7 days a week, 9 to 9 Monday to Friday and 9 to 5 Saturday and Sunday every day of the year. We work two shifts during the week, 9 to 5 and 1 to 9. We operate an answer system out-with our hours and utilise the local admission ward for emergency contacts. Most of our work with our clients is carried outwith our offices, which are based in a building in the centre of Dunfermline. The only exception being CPA meetings which are able to use our meeting room. The CPA is well established in Fife and many of our service users have their care managed through the CPA. We provide services to between 150 and 160 individuals in West Fife. We are not an assertive outreach team, but utilise this approach with certain individuals when necessary. Our approach requires regular assessment and review and flexibility from staff. We have two daily meetings to discuss our work and a weekly meeting where all staff attend. Prompted by the Scottish Schizophrenia Outcome Study we have also begun to augment our Camberwell care plans with Avon assessments. An evaluation of this is currently being undertaken by staff and service users. Staff have case lists which identify them as the key worker or support worker with named individuals. During episodes where we adopt a team approach the key worker remains the responsible worker. A fundamental part of this way of working has been the establishment of a no current contact system, allowing individuals who in other services may be “discharged”, to be placed on a “suspended” list. This means that people who have recovered sufficiently can leave our team in the knowledge that they can come back to us at any time without having to be re-referred. This allows for quick re-engagement if required. We all see the benefit in allowing time away from the team, as it can provide a positive message that recovery is possible and that not everything is “enduring.” We would never place someone on this list without full discussion with the individual, their carer and other service providers. All those on the no current contact list, in the main, retain some contact with other parts of the service and are all aware of how to return to us if needed. All our work stems from our care planning. The work undertaken is about meeting identified needs. We are a very practical team; helping someone establish a tenancy, decorate and acquire furniture, secure benefits, structure their time and establish relationships through group participation, comply with medication and appointments can all be part of staff’s working day. Our nursing staff manage two Continuing Care Clinics and an Effective Disorder Clinic. We run several groups; a badminton group, a table tennis group and a men’s football team. We have established a mixed social group and an active carers group. Our first meeting attracted 10 carers, and we have offered an 8 week programme of information and education as well as a social setting to meet. All our groups use community resources and we have a monthly budget of £300 for activities and general costs. We have attempted over the past 6 years to develop a service that is flexible, responsive and person centred. We have attempted to match our interventions with identified client need, and using the AVON assessment has added to this assessment process. Although we describe our work as being focused on enduring mental ill health, we remain aware that at any time individuals can make recovery and can benefit from a reduced and, at times, passive involvement with this service. If we can be flexible in offering an intensive approach then we must also be flexible in reducing our contact when appropriate. One of the criticisms made at the time of the team’s inception was that we would encourage dependency. Our methods, however, have been more about encouraging development and coping skills so that individuals can assume and gain more control over their own lives. This remains our team’s primary aim and one where we feel we have made some progress. If you’d like to share your thoughts or experiences of recovery then contact us on This e-mail address is being protected from spambots. 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Story Tags
activism community/socialising/inclusion coping strategies creativity depression employment (+) exercise female hospital male medication medication (-) peer support (informal) and befriending seeing things differently self knowledge/learning/growth self management sense of self support from family support from friends support from mental health professionals supportive spouse/partner taking control talking therapies voluntary mental health services volunteering Story disclaimer
The stories presented here are for information only. They are meant to inspire hope and show that recovery can and does happen. The stories highlight various examples of recovery and we do not advocate any of these experiences as the ‘right’ way to recover. Recovery is an individual and unique process, each person must decide for himself or herself what will work for them. Please carefully consider any decisions you make about your own recovery and consult with someone you trust if you feel unsure. See our Submit Your Thoughts pages for details on how to submit a story to us or you can contact us.
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