Maintaining Quality

Affinity are committed to delivering treatment and care which demonstrably improve the lives of our patients. We maintain our service quality by:

• an excellent and thorough approach to clinical governance, including achievement of the quality assurance registration of ISO 9001:2000.
• a detailed and extensive audit programme.
• all clinical staff being required to participate in regular supervision, appraisal, and training.
• links with practice development networks, such as the National Association of Psychiatric Intensive Care Units (NAPICU) and QNIC for children's services
• ensuring that clinical teams have access to, debate and draw on the latest clinical evidence
• a strongly multidisciplinary approach. Nurses, psychiatrists and other therapists share responsibility for both individual care plans and for the wider processes of practice development. We encourage real listening and debate.
• responding to our patients. All patients are invited to complete a satisfaction questionnaire at the end of their stay, or at intervals during it for longer-stay patients. We also offer regular community meetings, varying from daily, to weekly to monthly, according to the unit. There is access to advocacy, and a bi-monthly Patients' Council.

These formal systems supplement, but in no way replace, our core aim of responding to patients throughout our routine contact with them. We aim to be as patient-centred as possible, within the limitations of safety and risk - and never to say no if we can say yes.

The Recovery Pathway

Recovery can sometimes mean regaining good health; it can sometimes mean having a good quality of life, despite persisting mental health problems. Our centres of expertise offer a distinctive emphasis on carefully graduated treatment and rehabilitation, with specialist units for each stage of care, and on detailed monitoring and transparent reporting of progress. Our recovery pathway has the following elements:

• referral, where (except in emergencies) we will always assess the patient face to face, using one of a series of standard frameworks
• a multidisciplinary assessment, and agreement of a care plan
• a clear and structured approach to monitoring progress. We aim to establish the patient's aspirations, to be clear as to what has helped or hindered in the past, and to develop goals alongside the patient
• regular review of care plans using the Care Programme Approach (CPA). We place great emphasis on structured measurement of progress and outcomes, using a range of validated instruments. Patient feedback also forms an essential element of monitoring progress.
• a wide range of therapeutic services and activities from our multidisciplinary teams. Care is coordinated and led by the key nurse and the responsible psychiatrist. Therapies and disciplines offered include Psychology, Occupational Therapy, Physiotherapy, Art Therapy, and Music Therapy. There are many therapeutic and psycho-education groups.
• Physical health needs are addressed through access to a GP service, and through other services, including exercise and healthy lifestyle groups, and smoking cessation services.
• safety as an essential concern, with formulation of a thorough risk management plan, constantly reviewed, for every patient.
• discharge planning, starting at admission, with care plans which make clear the steps required to make discharge possible. This is sometimes a gradual process. Our range of units means that, within the same campus, patients can progress to differing levels of security, and test out their recovery within a safe environment. If required, we will work directly with local services, such as housing, to help to ensure a patient's social circumstances enable their continuing recovery beyond their time with us.

We are happy to provide aftercare for our patients, with community-based follow-up and continuing telephone support, by agreement with the patient and the home team.

Working Together

Good mental health care requires many partners to work together effectively. Our key partners include:

• the mental health team from a patient's home area. We are happy to respond to the level of involvement which individual home teams wish to have. We are also happy to visit home areas to help to link and co-ordinate services properly. We send regular and frequent reports, and we inform the home team of any important changes or events in a patient's care. Care co-ordinators are routinely invited to ward rounds and CPA meetings, and home team staff are welcome to contact us and visit us as they wish to.
• commissioners and funders, whom we are happy to involve in care decisions in accordance with their particular wishes and approaches, with open sharing of monitoring and progress data.
• family members. We always try to make contact with family members, and to involve them, with the patient's permission. We offer information and reassurance, and we actively encourage visiting.
• regulatory and professional bodies, whose scrutiny, challenge and support we welcome. We aim to achieve and maintain the highest possible standards in these bodies' structured assessments.
• each other! We work as a team. Our network of units works closely together to ensure the best possible care for each patient. Unit staff come together, both to plan the care for and support the welfare of individual patients, and to ensure the effective coordination of Affinity's services.