Reshaping Community Services – The Wardown Adult Community Mental Health Team

The Wardown Adult CMHT (Community Mental Health Team), based at Charter House in Luton, are part of the Trustwide Reshaping Community Services project, focusing specifically on improving the communication between the team, and its service users, carers and their families.

The team comprises of staff from the CMHT, consultants, a service user and a carer.

Wardown CMHT Project team

Once the team was established, the project underway and a driver diagram had been developed, the team began to use a Kanban board to track their progress and as a workflow visualisation tool. We even developed an electronic Kanban board to share with the wider CMHT during MDT (Multi-Disciplinary Team) meetings. It supported the team with keeping track of the change ideas that were being tested and the progress of each PDSA (Plan Do Study Act) cycle.

The team have tested various change ideas to this point have seen great success,

Teams leaflets

However, this wasn’t without its challenges. The first PDSA  was for medication leaflets for clinicians to give to services users and carers following medication reviews. The team measured the effectiveness by calling each service user following the appointment and asking them a series of questions with regard to the leaflets usefulness. It was found however, that clinicians were not consistently giving the leaflets to service users and carers which made measurement quite challenging. The team used a Force Field Analysis to discern the barriers to clinicians doing this consistently. This resulted in a new change idea – the development of a poster to remind the clinician to give out the leaflet(s), but also to prompt the service user or carer to request one as well. After the first PDSA cycle, the poster was iterated to remind the clinician to ensure that up to date contact details were available for the service user or carer, and after the second cycle, it was adapted to incorporate a prompt for clinicians with regard to giving out diagnosis leaflets, when they started testing this change idea. It was great to see the team creatively address what looked like a failure and turn it around for a win. The feedback from service users was that the leaflets were very useful and one even said that though they weren’t well enough to read the leaflets, it was nice to know that they could refer to them later.

The team also tested a number of change ideas under the umbrella of ‘Tell My Story Once’, which was to ensure that service users, carers and their families didn’t have to constantly repeat their history when seeing a new member of staff. Again by using a Force Field Analysis, they found the barriers to making this a reality and chose two change ideas to test. The first was arrange refresher RiO training for the CMHT staff and in partnership with the RiO team, ensure that there was a program of regular training to support staff in ensuring they know where to find all the information on a service user’s history before meeting them for the first time. The team also ran a couple of PDSA cycles on creating a holistic recording template for the RiO progress notes to capture all pertinent information in one place when a service user is first referred to the team.

The project team’s successes couldn’t be achieved without the hands-on support of their project sponsor, Dr Farid Jabbar, Clinical Director for Beds & Luton Community Services, who played a huge role in removing blockages and barriers.