Safe, Safe, Safe – Standards for Health for mental health organisations

Nicky Morris (Ponthafren Association) receives a Standards for
Health certificate from Lesley at the charity's recent AGM 

My colleague Lesley Austen has been working for the past 12 months at Powys Association of Voluntary Organisations as the Safe Services Officer. Amongst many other things, she has supported organisations in the mental health voluntary sector to engage with the “Standards for Health” quality assurance scheme.

Safe Services is an increasingly important element of supporting the Third Sector to grow and thrive and we wanted to find out more. We caught up with Lesley at her PAVO base at Plas Dolerw in Newtown to ask a few questions.

What does a Safe Services Officer do on a daily basis?

I provide one to one support to organisations to help them comply with the standards. We map the standards against any existing quality assurance which may already be in place to avoid duplications.

Can you give us a bit more background information about the Standards for Health and explain why they are so important?

The ‘Doing Well, Doing Better Standards for Health Services in Wales’ came into force from the 1st April 2010 and replaced the previous standards that were introduced in 2005. The framework of standards (2010) sets out the requirements of what is expected of all health services in all settings.

Engaging with Standards for Health ensures organisations have the quality assurance in place to comply with Welsh Government issued National Minimum Standards for Independent Healthcare Services in Wales and be eligible to apply for Health Board funding, through grants, commissioning and tendering.

How can an organisation and/or service use the Standards?

A ‘How To’ guide has been developed to assist third sector organisations to use the Standards for Health Services. The guide aims not only to support you and your organisation/service to use the Standards, but also help NHS organisations and professionals to assure themselves that third sector partners delivering health services and care meet and use the Standards too.

If organisations do not comply with the Standards what implications does that have?

Current funding may not be renewed; opportunities for commissioning may be closed to them.

If an organisation is unclear about how to achieve the necessary Standards, what can the staff and/or volunteers do?

PAVO provides FREE information and training to help voluntary organisations in Powys comply with the Standards. You can contact me to find out more (see details below) or check out the PAVO website here.

How much work is involved in achieving the Standards?

For established organisations, not very much – most of the policies and procedures are already in place, and unlike some quality assurance system there is no requirement to produce a huge portfolio of evidence.

Organisations are asked to firstly identify which of the 26 standards apply to the service they provide, document what they have in place (on prepared electronic templates) and index where physical evidence (policies, documents, posters etc) are stored or displayed.

Then they identify what if anything they need to do to comply with the standards and develop an improvement plan (again on a prepared template) in order to achieve it.

Talk us through a particularly rewarding aspect to your role

PAVO recently had the great pleasure of presenting a certificate of completed engagement with the Standards for Health Quality Assurance system to Ponthafren Association at the organisation's recent AGM.

Ponthafren Association is the first organisation in Powys supported by PAVO to complete the process and their commitment and diligence will not only act as an incentive to other organisations, their approach will act as a framework of good practice and an aid to working with the Standards.

What are the most challenging aspects of the role?

The geography of Powys – everywhere takes so long to get to – but it also makes the journeys very enjoyable!

Tell us about the most valuable thing you have learnt since starting your role?

The variety and varying needs of the Third Sector in Powys and the untiring commitment of the army of volunteers who sustain it.

How did you come to work at PAVO originally?

Finding too much time on my hands after working for over 20 years in the voluntary sector in Wales, I thought my experience may be of benefit as a volunteer. I was fortunate to find an interesting opportunity at PAVO, and using my previous experience of Quality Assurance implementation I assisted in the achievement of PQASSO (Practical Quality Assurance System for Small Organisations) level 2.

After volunteering for a year, when a part time post became available, I applied, and the rest – as they say – is history!

Of course, you’re not just the Safe Services Officer at PAVO. You’ve had a number of other roles since joining the organisation. Tell us a little about them.

Whilst I was volunteering, I undertook the stakeholder feedback survey for the year, and was both surprised and honoured to be asked to write up the final report; de-duplicated the contacts in our complicated data base system and did preparatory work on other quality assurance systems.

As well as my Safe Service role, I also work as a Community Development Officer 2 days per week, providing advice and training to both new and established voluntary organisations, deliver outreach information sessions, assist with preparing grant applications, constitutions, charities registration etc.

What do you like to do in your own time when you’re not working for PAVO?

Spending time with my family – husband, five children and eight grandchildren - which takes up quite a lot of my time as they are spread between Anglesey, Brighton, Glasgow and Amsterdam!

I love to cook, especially to bake and always enjoy trying something new and the combination of those two activities is great – when my dining table is jam-packed with the people I love and the food that they love to eat. You can watch Lesley’s cookery YouTube channel here.

My other great passion is family history and so far I have traced mother’s maternal ancestry back to the 1600s and my father’s paternal ancestry to the early 1700s – it is an ongoing quest with every answer posing another dozen questions.

I also enjoy spending time in my garden, though my role is more artistic director than using the spade and hoe!  It’s a wild country cottage garden and not everyone’s taste – but I love it.

For more information please contact Lesley Austen, Safe Services Officer, email: lesley.austen@pavo.ork.uk or tel: 01597 822191.

Power and participation Part 2

by Jane Cooke

Last week Jane wrote the first of two blog posts on power and participation. This week we follow up with Part 2.

A long time ago I went on some race equality training. The trainer opened the first day by saying: “You can’t learn from someone who you feel is inferior to you," or words to that effect. That gave me a lot to think about. I wonder if it’s a challenge to lay down now to the many people who make decisions over and about what/who to ‘do to’, and who are also saying, in just about every report one reads, ‘we need to ensure effective participation’.

In our trainings and professional and personal development we don’t give enough time to considering the ‘other’; we gather around ourselves our professional identities, our roles, our pride in our achievements and positions. And, one way and another, we end up thinking about ‘them’ and often how to change and improve ‘them’. What we share, what we can learn from true openness, from open-hearted listening, is rarely in the frame.

In the realm of mental health there is another dimension. Do we question, think about and examine what we feel about the experience of ‘madness’, what we think about people who we categorise as ‘ill’? We are, I believe, still influenced by deep seated ‘folk’ theories about madness. Moral degeneracy had currency not so long ago. If you think that underpinning belief has gone, think about some of the notions that drive the endless, fruitless, search for medical markers, genes for ‘mental illness’. There is often an underpinning assumption that if such things can be found, we will eradicate them, the genes, the carriers, the ‘bad’ foetuses. In my book that’s eugenics. (I’m not anti-abortion by the way or condemning individual decisions about terminations, it’s the broader, unrecognised societal views that I’m saying are not questioned).  Didn’t eugenics die out with the Nazis? No. And it’s not just the domain of the far right, do a search around modern eugenics and you’ll find plenty there. I’m hoping you’ll find it chilling. I do.

We still, as a society, think of those ‘other’ people with characteristics, behaviours, ways of organising thoughts and experiences, as ‘flawed’. Intergenerational shame was (is?) an explanation. Or how about genetic flaws? I heard, about 10 years ago, a senior medical professional declare the view that the explanation for there having been three psychiatric hospitals built around Bridgend was that this was to meet a need generated by a flawed local gene pool. Seriously. As far as I can see there hasn’t been much of a sea change to counter such views.

I hear quite often references to people’s ‘condition’; sometimes there is a reference to someone being a ‘service user’ – a code quite often for ‘difficult’, a way of saying it’s them who is at fault because they are (lowered tone) mentally ill. Not us for having a closed mind, for not being able to manage the discomfort of difference, of challenge to our cherished views.

Many people who use, willingly or otherwise, mental health services have had very difficult life circumstances. Sometimes they, and services, know what these are, sometimes they don’t. Sometimes it is more a case of a slow accretion, many compounding experiences. We know this statistically. We know it anecdotally, we know it empirically. But then there’s a gap in our thinking. We don’t seem to think “How can we adapt ourselves, our views, our ways of working that acknowledges that range of experiences, those various views and understandings of life in order to best share power, to best truly design services with citizens and service users. We say: to join us in our territory you must behave like we do, you must follow our codes (which by the way include the view that you are other, inferior, flawed, suspect). We offer training to ‘them’. Training is very good, personal and professional development is very good; but for all of us. Some people might need to skill up in one area, some in another, whoever they are; everyone brings something of value that others can learn from. There doesn’t, however, seem to be a view that there is a need, let alone a joy, in learning and developing together. There are a bunch of people who are seen as deficient until they know how to play the game. (Then they’ll be seen as a-typical).

Too cynical? Maybe. Let me know some stories to uplift my sometimes jaded optimism.

So, then, to move toward power with? Well first, like that old light bulb, we all need to really want to. And then we need to let go, to feel the discomfort and fear and, together, do it anyway.

Written by Jane Cooke in her capacity as a counsellor and psychotherapist, trainer and facilitator. All views are entirely her own. Email jane.cooke@heartfeltwork.co.uk

Power and participation Part 1

by Jane Cooke

I have been thinking a lot about power recently. Often my trains of thought are prompted by consideration of personal power. Some people assume that they have personal power and that seems to prompt a response in others that confirms this; other people defer, give away their own power. I am not sure that this is good for anyone, but I see a lot of it. Then I wander off into thinking about structural power. Who, as a result of the position that they hold in an organisation, has the power to require or demand certain actions and responses from others?

My experiences over the years have ranged from working with groups and networks of people who use/have used mental health services to working as a counsellor for a year in a prison, to being involved in reviews of NHS mental health trusts. Throughout all of these experiences there has been a theme; that many people, no matter what their position, feel that ‘The Power’ lies elsewhere. Someone else, some other group of people or some structural body, such as a Committee somewhere has ‘power over’ services, chief executives, service users, or the ‘power to’ concede or deny, for example, a place on a joint committee or board, or to close a service or to require that changes to working practices are made, to give or withhold funding or services.

The ‘power to’ sense that individuals and groups of people can take on board themselves seems to be dimmed right now. People working in services who would like to question views and cultures in their services can feel as if they had better not stick their head above the parapet. Organisations can feel limited in their capacity to explore and support challenging ideas (and people!) if they feel that a funder ‘won’t like it’. People who might coalesce around some form of collective action, identity or pressure group can feel that such actions might jeopardise their chances of making progress in the situations where they are involved, or participate.

This feeling that some OTHER has ‘power over’ or ‘power to '(do unto us)’ both stems from and leads to fear – fear of censure, or public criticism, of withdrawal of something valued, of negative comparisons. We live in an age that generates and feeds on fear. Our many forms of communication can spread and heighten fear. Much advertising is based on promoting fear, if you don’t buy this product whether it’s insurance or some sort of ‘germ’ killer, you will be endangering yourself or those you love. Much news coverage is based on fear and a lot of political policies and promotion major on fear; capturing media interest as they do so.

But what if we moved toward a conception of ‘power with’? As far as I know these ideas of power over, power to and power with originated in the peace and non-violent direct action movements. I find them very helpful. So; power with, what would that look and feel like? I wonder if people who are involved as citizens or service users in formal situations, committees and boards, feel as if they are in a ‘power with’ situation? I’d be inclined to imagine that often they don’t. It would be really interesting to hear from those of you in such situations. Do you feel as if you are truly sharing power and if so, what leads to and supports that? In my own experience, which goes back nearly 30 years, people in these situations have been asking for parity in one form or another for at least as long as that: receiving minutes in time, important paperwork circulated in a timely manner, acceptance that agenda items can be added, access to administrative facilities as a right, recognition of the representational time-frame required if people are to be ‘representatives’, meetings at a time and place accessible to all who want to and maybe have been elected to, attend, out of pocket expenses met in cash, broadband and Information Technology (IT) costs met. I would be very interested to hear of examples where there has been ‘up-front’ thinking around these issues before people are invited to the table, before it has been brought up by those ‘reps’, or equally current examples of representatives still finding themselves in these situations.

‘Power with’ requires a shift of mind-set. Power over might appease an ego, I would venture to say that it doesn’t do much good for the soul.

Look out for Part 2 of Jane's piece on Power and participation soon. What are your thoughts? We would like to hear from you. If you have any comments or questions just add them below.

Written by Jane Cooke in her capacity as a counsellor and psychotherapist, trainer and facilitator. All views are entirely her own. Email jane.cooke@heartfeltwork.co.uk

My Recovery

This week we feature a blog post by a new guest author from South Powys. The author writes about the impact of creating art on recovery from heroin addiction, and the invaluable support provided by a number of organisations, including Brecon & District Mind.

I am 49 years young and about 3 – 4 years ago I tried heroin. I had never done any kind of drugs until then and because of the circumstances and one thing and another I got hooked on heroin. It is all true what they say about it, it’s so addictive you would not believe. I would not want my worst enemy to try it.

Anyway back to my journey.

It all started about a year ago. I was told by a friend to “go to Kaleidoscope, they can help you”, so I did. When opening the door of Kaleido I did not know what to expect. I was shocked, it was friendly and had a good feel about the place, not what I thought it would be like.

Anyway, I made an appointment. The first meeting you have is to discuss your addiction and how best to deal with it. After that you have an appointment to see a doctor. Then you have a chat and they will tell you how much methadone to put you on. I started with 50mg which took away any kind of cravings for heroin, gear, brown, smack, whatever you want to call it.

Then it’s back to Kaleidoscope to arrange courses and other things you may be interested in. At the first meeting there were about nine people all with different addictions. A few people I knew, which was good. Did not make me feel as nervous as I may have been. The course was a varied amount of topics. By the end of the course I felt good and more to the point looked good (LOL). And life was starting to look good too.

While on this journey of mine, I was living in sheltered accommodation through Gwalia. They have helped me with items for the flat, trips away for the day and just a chat. I was told about a place in town that would be good for me. So I went, it is called MIND, and that is where I met two painting artists. They got me painting and now I have won competitions and other things with my art work. I do watercolours mainly, I like working with this medium.

So it was thanks to everyone from Gwalia and Kaleidoscope for getting me involved with these activities. Otherwise I would never have known that I had a raw talent for painting, which was a shock to me because I could not even draw before let alone paint. So, just proves that it is worth going to activities and things with Kaleidoscope, Gwalia and Mind.

Even though I was taking my medication there were a few times that I was tempted to have a smoke as they say. Then I think back to how it was when I was on heroin. The sleepless nights, the stomach cramps, sweating and feeling like shit. So you could say that sometimes I do struggle with my addiction. Sobriety can seem like an impossible goal. But with the treatment and support that Kaleidoscope gave me, by addressing the root cause of my addiction - the road to recovery often involves bumps, set backs - but by examining the problem and thinking about change I was already on my way.

Another thing I thought about was the cost and how I looked when I was taking the drug. And believe me I could not believe what I looked like and when people found out I was on drugs, they would not talk to you or give you the time of day. That felt bad.

Addiction affects your whole life, relationships, health, work and psychological well being. And the ways to handle stressful situations.

The other good thing about my recovery is that I was taking a small amount of gear. Because the longer and more intense the heroin use, the longer and more intense the treatment will be. But regardless of the length in weeks, months or even years, the follow up care is crucial to the recovery. Another thing I did was not to bother with anybody that is on drugs. To stay away from some of the boys I used to smoke with. And I do not drink any more. That was down to heroin. Made me sick if I had a drink, so good in a way. I don't even like the smell of beer at all.

One of the main things that has helped me is my art. I paint every day without fail because I love it. Never knew how painting can bring back and raise so many emotions. So I look at life differently now.

Also I would like to say that the staff at Kaleidoscope are an invaluable asset in my recovery. I was very reluctant to turn to my family for help, because I felt I let them down before, so it can be hard. But remember, there is help out there no matter how you feel. Or think that the whole world is against you. All you've got to do is believe. Who knows, maybe you will find you have a raw talent. There are some of my mates that are helping me get back to some kind of life. Some of them know what it’s like to be where I've been, so that can be a great help.

Back to my recovery. Like I said before, I was with Gwalia who helped me get off the streets. You would not believe the help and commitment these people have doing their job. They helped me no end. That is why I have got where I am today. Because of the staff there and other bodies that have helped me.

After discovering this talent for drawing and painting I have not stopped. I am always out walking to see what catches my eye to paint. I can't describe the feeling I get when painting but it’s a good one, and I get lost in my artwork. I spend a lot of my time at my painting table. Well happy.

Without Mind and the staff there, I would never have been able to get where I am today. The staff at Ty Croeso (Brecon & District Mind) are brilliant and friendly. You just feel welcome, safe and at home there. Everybody is brilliant. So thanks to the staff at Mind.

So my recovery journey to now, you would not believe. The transformation from me being a smack head to now an Artist. I owe a lot of it to Kaleidoscope for getting me where I am today with the art and recovery. And the staff of Gwalia and Mind.

So a big thank you to everybody.

I hope your recovery journey is as eventful as mine.

Once again. Thank you all for helping me, on my recovery journey.

You will never know how much you have done for me.

Many thanks to our guest author for writing about a very personal recovery journey. If you want to tell us about your experiences you can comment  below.