Reducing incidents and facilitating progress in specialist recovery
The Huntercombe Group's Cedar House site provides specialist support to people with mental health problems, learning disabilities, brain injuries, and a range of other conditions. In this low-security facility, people learn how to cope with and manage their difficulties with the aim of progressing towards more independent environments and ultimately moving back into the community. Each patient is supported with a personal treatment plan designed to help them become as independent as possible and to live the healthiest and most fulfilling life they can.
The Group continually looks to further enhance its care, including through adopting technology-enabled care (TEC). Spotting the potential for reduced crisis incidents, smoother and safer transitions along care pathways, and better self-management of anxiety, Huntercombe implemented Brain in Hand.
A multidisciplinary team of Huntercombe staff - including psychologists, occupational therapists, nurses, support workers, and a programme lead - worked with Brain in Hand programme staff with specialist knowledge of mental health services. A key objective in implementing Brain in Hand was ensuring that it would become integrated into existing structures and wider processes rather than being a stand-alone or add-on bit of kit.
More than eighty staff were trained in how to use Brain in Hand and how to help patients use it to the best possible effect, and ten patients were collaboratively identified as the people most likely to benefit from the system.
The process of setting up the ten Brain in Hand users was undertaken carefully, with input from all relevant Huntercombe and Brain in Hand team members, to ensure that the information included in each person's system accurately reflected the personal strategies that they, with the help of psychologists and other staff, had already developed over their time at Huntercombe.
Each patient could use the Brain in Hand system's timeline function during sessions with staff members, allowing them to look back at exactly when the person was feeling anxious and which strategies helped them to overcome the problem. This helped to inform discussion and develop the most appropriate solutions to cover areas of difficulty.
It also provided an opportunity to celebrate successes: periods where the person experienced less difficulty or anxiety, and what could be done to recreate that.
Engagement with Brain in Hand has been thoroughly recorded so that the Huntercombe Group can evaluate how well the system has worked. Each month, patients use Brain in Hand almost 2,000 times to help with events, and approximately 750 times to solve a problem.
When keeping a note of their anxiety using the traffic light system, patients only needed to press red and ask for extra help once every 3 days on average; most presses were green, indicating that they felt that things were alright and they did not need extra help.
Staff reported that patients were more able either to self-manage or to ask for help before they become too distressed. Brain in Hand also provided a valuable safety net when patients were out in the community, allowing people to feel that they could easily get help if they needed it and the Huntercombe team to have greater visibility of their patients' needs.
Outcomes have included increased engagement, with one patient who had previously declined most of their psychology sessions now attending more often, better communication between staff and patients, increased confidence, and even a safer discharge for one patient who was able to move into a local NHS supported living facility in the community. With Brain in Hand, she was able to maintain access to the coping strategies and knowledge she'd developed and smooth the transition to a new support team who could learn what worked for her and how they could best support her.