Independent investigation: Sarah Smart, Oxford (2005)

The Crisis Resolution and Home Treatment Team need to develop its Risk Assessment / Risk Management practice and processes to hear and understand the risks that Carers and family members may want to report and contribute to the overall balances … Read more The Crisis Resolution and Home Treatment Team need to develop its Risk Assessment / Risk Management practice and processes to hear and understand the risks that Carers and family members may want to report and contribute to the overall balances of Risk and Risk Management. Show less

That the CRHT review the assessment procedure to include input from significant others and not just those people who are/were directly involved in an individual’s day to day life

CMHT and CRHT clinicians must ensure they enquire about the potential for domestic violence when carrying out an assessment.

The Crisis Resolution and Home Treatment Team needs to develop a psychosocial model of assessment and psychiatric care which actively assesses the social network of the Service User, seeking to understand the Service User in as wide a historical and … Read more The Crisis Resolution and Home Treatment Team needs to develop a psychosocial model of assessment and psychiatric care which actively assesses the social network of the Service User, seeking to understand the Service User in as wide a historical and social context as possible to maximise the depth and breadth of clinical interventions. Show less

In working with the above two recommendations the Crisis Resolution and Home Treatment Team will need to develop practice on working with Service Users’ consent to sharing and collecting information on a routine level.

The model of the Crisis Resolution and Home Treatment Team operates without a dedicated operational Consultant Psychiatrist integrated into the team. Whilst in this inquiry there was no concern about the role of the particular Consultant Psychiatrist in this case, … Read more The model of the Crisis Resolution and Home Treatment Team operates without a dedicated operational Consultant Psychiatrist integrated into the team. Whilst in this inquiry there was no concern about the role of the particular Consultant Psychiatrist in this case, strong evidence was presented highlighting the need to strengthen and develop the model and integrate Consultant Psychiatric and medical time into the team. The panel recommend this be explored and implemented. Show less

The panel recognises that in working cases like Mr S, who do not necessarily meet Crisis Resolution and Home Treatment criteria but do need urgent responses, there is a need for CMHTs and other teams to work effectively in transferring … Read more The panel recognises that in working cases like Mr S, who do not necessarily meet Crisis Resolution and Home Treatment criteria but do need urgent responses, there is a need for CMHTs and other teams to work effectively in transferring patient care across team interfaces. Where there is disagreement between teams there appears to be no system for decision-making resolution and arbitration. The panel recommends that the Service Management and Clinical Lead Consultant roles be developed to arbitrate and decide upon creating operational seamlessness between teams. Show less

Existing assessment and treatment models should be reviewed to ensure that there is scope for a variety of treatments to be put into place.

The Crisis Resolution and Home Treatment Team needs to develop its Risk Assessment / Risk Management practice and processes to routinely check with Child Protection systems to ensure the safety of children. In Risk Management this may then involve joint … Read more The Crisis Resolution and Home Treatment Team needs to develop its Risk Assessment / Risk Management practice and processes to routinely check with Child Protection systems to ensure the safety of children. In Risk Management this may then involve joint working with Child Protection Teams to provide family based approaches in the management of the whole family. Show less