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Care planning and participation

Participation in care and treatment is one of the principles of the Mental Health (Care & Treatment) (Scotland) Act 2003 and is a key element in individual recovery. Good information for individuals about their care and treatment is a foundation stone for individual participation.

Almost two-thirds of the people we interviewed said they were offered information about their illness and more than two-thirds said they had attended review meetings. About two-thirds felt that they had been able to have a say in their care and treatment. Less than half stated that their family or friends had been involved in their care planning.

That still means that about a third of people were not offered information and were not involved in review meetings. This is reflected in some of the comments we received:

"I haven't been to a review meeting, I don't know when they happen."

"I've never had a meeting with doctors and nurses. I've only seen the consultant once in the past year."

More than two-thirds of those asked said they had a key worker who they could talk to about their care and treatment. The frequency of meetings with key workers varied from daily to monthly, many people reported being able to meet on request. The most frequent response was a weekly meeting.

More than a third were unsure, or were unaware of any plans being considered for their future.

We asked staff if they thought anyone was inappropriately placed in their ward and what effect this was having. In one ward, we heard of a "volatile mix of patients", where elderly frail individuals were placed alongside younger, fitter people with widely varying mental and physical health needs. One person still needed periods in an Intensive Psychiatric Care Unit in the management of his care.

A mix of older and younger adults was described in:

  • Ailsa
  • Argyll & Bute
  • Bellsdyke 
  • Borders General 
  • Royal Cornhill 
  • Gartnavel 
  • Larbert 
  • The Orchards 
  • Gourdie House 
  • Stratheden

In some cases, inappropriate placements in wards may have arisen from closures elsewhere. This is noted in:

  • Ailsa 
  • Crichton 
  • Dykebar 
  • Gartnavel 
  • Leverndale
  • New Craigs 
  • The Orchards

Some staff interviewed felt that they had to balance the needs of individuals preparing for discharge, with those of individuals with complex needs who required 24 hour care.  Individuals requiring more intensive care were often placed in their service when other services had closed. While staff wanted to work with individuals towards discharge, competing demands made it difficult to maintain focus on rehabilitation.

Delayed discharges were identified in:

  • Argyll & Bute
  • Craigenhall 
  • Crichton 
  • Phoenix House