The Home Treatment Accreditation Scheme (HTAS)

Sophie Hodge & Nicky Buley

Programme Manager & Project Worker

What is the Home Treatment Accreditation Scheme (HTAS)?

• Quality improvement

• Accreditation

• Crisis resolution and home treatment teams in the UK & Ireland

• Royal College of Psychiatrists’ Centre for Quality Improvement (CCQI)

Standards • Based on available literature & expert

consensus

• Looks at functions of teams and not a specific model

• Aspirational

• Revised regularly to ensure they are up-to-date e.g. changes to Care Act

• Available to download at www.rcpsych.ac.uk/HTAS

http://www.rcpsych.ac.uk/HTAS

Examples of standards

• Type 1: The team is able to conduct assessments in a variety of settings

• Type 2: If hospitalisation is required, the person experiencing a mental health crisis is informed of the reasons why home treatment was not appropriate, the purpose, aims and outcome of the admission, and their expected length of stay

• Type 3: The team has dedicated sessional time from nurse prescriber(s)

How it works

1. Self review – 3 months

2. Peer review visit – 1 day

3. Reviewed by appointed Accreditation Committee – accreditation decision made

• Approximately 6-9 months from beginning to accreditation

• 40 member teams including South Gloucestershire & Bristol

• 23 Trusts in England & Wales

• Different models

• 26 accredited

Membership

Contextual data • Caseload

– Average 27 people (6-66)

• Number patients seen in 2 weeks

– Average 35 (12-108)

• Time between referral & assessment

– Average 11 hours (0-24)

• Number of staff

– Average 26 (13-51)

• Collected as part of self-review

• Anonymous, and returned directly to HTAS

• Demonstrates areas where teams are doing really well...

- e.g., 97% of people said the team contacted them to arrange a time to meet

• And areas for improvement...

- e.g., 55.6% of people were told how to make a compliment or complaint

Service user feedback

http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCOeo7NbFlsYCFWQG2wod8rkABQ&url=http://www.topdrivereducation.com/221860/2011/09/03/how-to-evaluate-the-quality-of-a-driving-school.html&ei=NU-BVae6AuSM7Aby84Io&bvm=bv.96041959,d.ZGU&psig=AFQjCNFn4hXVXNp-XIKrfdg3JG1GA3LbAQ&ust=1434624005991482

• Free text boxes included in the questionnaire to

collect peoples’ comments.

• Comments are frequently very positive:

“Very non-judgemental. Empathetic, patient, listened, advised, calm, made me feel comfortable about going through this, not making me feel like a 'weirdo' or someone who can't cope with anything.”

“The whole team are such dedicated people and I was so grateful to know that I could contact them at all times if the need arose. They gave me the confidence I needed and their kindness and consideration was outstanding.”

Service user feedback

http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCLCa48_GlsYCFSxr2wodsR8Aag&url=http://live.surveyshack.com/see-what-feedback-can-do-for-your-company/&ei=MlCBVbC5J6zW7Qaxv4DQBg&bvm=bv.96041959,d.ZGU&psig=AFQjCNFn4hXVXNp-XIKrfdg3JG1GA3LbAQ&ust=1434624005991482

Service user feedback

• Comments also provided constructive suggestions

for improvement

• Key theme was a wish not to see lots of different people: - e.g., “I wasn't told if I had a keyworker, but I didn't see or speak to the same

person each time I was contacted, which I found quite difficult at times.”

• Some lack of clarity around discharge: - e.g., “I do very much appreciate the support I received, even though it was

for a short time - but I was discharged without anything else organised apart from weekly GP visits (which aren't quite the same...) and at what I felt was unexpectedly short notice...it did set me back a few steps because I felt a bit abandoned.”

http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCKC276nHlsYCFUNZ2wodw4wAkA&url=http://www.middlebury.edu/studentlife/residentiallife/files/node/251192&ei=71CBVeCCJMOy7QbDmYKACQ&bvm=bv.96041959,d.ZGU&psig=AFQjCNG2NGK-na7ZOgRTJVcVT2io-O3aNw&ust=1434624619590652

Carer feedback

• Collected as part of the self-review in the same way as service user feedback

• Indicates that carers were kept informed about appointments:

- E.g., over 95% said the team contacted them or the person they care for to arrange a time to meet, and over 98% said they had a phone number they could call for help at any time

• Although fewer received ongoing support:

- E.g., 68% were offered a referral to the carer support service, 40% were offered information on mentoring, befriending, mediation or advocacy

http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCJuVs9HHlsYCFeMH2wodUuMAvA&url=http://www.bedminsterfamilypractice.co.uk/info.aspx?p=3&ei=QlGBVZvsHeOP7AbSxoPgCw&bvm=bv.96041959,d.ZGU&psig=AFQjCNHJmJkkRtehQ2ApCbdjFtmGWhBF1Q&ust=1434624700113113

Carer feedback

• One thing that was greatly appreciated was being kept informed:

- E.g., “Until our daughter became ill, we knew nothing of this valuable service. From the first point of contact we knew exactly what was to happen, names, dates, times and emergency contact details and out of hours service.”

• An issue highlighted was that carers assessments/carers support services were not always adequate:

- E.g., “I was referred to a carers' service, but was told they will try and make contact with me within the next month - not very supportive now.”

http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCOzqxd3IlsYCFRBr2wodO5gAuw&url=http://www.corryconen.nl/6-tips-om-de-samenwerking-met-een-trainingsacteur-optimaal-te-benutten/&ei=aFKBVeyWGJDW7Qa7sILYCw&bvm=bv.96041959,d.ZGU&psig=AFQjCNGNrDa5lAIG5-6ESYQ_Ggw4qajwyw&ust=1434624973032977

Benefits – accreditation

• Seal of approval

• Demonstrate quality to service users, carers, commissioners, colleagues, etc.

• External recognition that teams are working as they should be

• Boost morale

• Keep longer term goals from being swept under the carpet

Benefits – for teams that need some support

• External report detailing strengths and areas for improvement

• Support and advice from the HTAS team and peers

• Huge opportunities to learn from others

• Period of deferral, if necessary, gives time for teams to make changes

• With support, very rare not to be accredited

Benefits - network

• Annual conference

• Peer reviews

• Email discussion group

• Newsletter

• Avoid reinventing the wheel

• Discover new, innovative ways of working

• Feel ‘part of it’

What our members say

“The process made us review our practice and brought us together.”

“The review team were friendly and easy to communicate with.”

“It’s nice to be part of a process we have chosen, rather than something imposed upon us.”

“It wasn’t as much like an inspection as we thought.”

“The self-review process makes you really look at yourself.”

“We were anxious at the start of the [peer review] day but you’ve allayed our fears, especially as the review team also work in Home Treatment Teams.”

http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRxqFQoTCKS39brJlsYCFcOh2wod4JIAsQ&url=http://www.csusm.edu/sth/&ei=LFOBVaTxDMPD7gbgpYKICw&bvm=bv.96041959,d.ZGU&psig=AFQjCNFeZ6Afjx6zOKIgVkdLHERqEv1cHg&ust=1434625186458886

Joining HTAS

• Cost: £1800+VAT per team, per year

• 10% discount for 3-year membership

– Subscriptions are the only source of funding

– Not-for-profit organisation

– Cheap compared to benefits

• Joining form can be downloaded from our website

• Be among first accredited teams!

Contact us

www.rcpsych.ac.uk/HTAS

General enquiries - HTAS@rcpsych.ac.uk

Sophie Hodge – shodge@rcpsych.ac.uk

Nicky Buley – nbuley@rcpsych.ac.uk

0203 701 2653

http://www.rcpsych.ac.uk/HTASmailto:HTAS@cru.rcpsych.ac.ukmailto:HTAS@cru.rcpsych.ac.ukmailto:HTAS@rcpsych.ac.ukmailto:shodge@rcpsych.ac.ukmailto:nbuley@rcpsych.ac.uk