DISCUSIÓN DE RESULTADOS

• the child or young person’s age, developmental level, maturity and ability

to take into account the future as well as the present

• the severity of a mental disorder and the risks posed to themselves and others

• the degree of care and protection required

• the relationship with the parents and the degree of the parents’ involvement in their care

• the current competence of the child or young person to make a decision about confidentiality

(adapted from MHA Code of Practice, 36.79).

PART 15 : CPA & OTHER FRAMEWORKS

15.1 This section outlines the relationship between the CPA framework/procedures

and other assessment and planning frameworks. CPA should be integrated with other frameworks as far as possible. Assessments, care plans and reviews should not be duplicated. CPA describes the process used in delivering care in mental health services. It is not a gateway to other services. Assessments to establish entitlement to other services, such as social care, are legally separate, although they may be carried out at the same time as CPA assessments and may use the same assessment documents, which can have multiple uses.

Care and Assessment Frameworks : Summary

15.2 If initial assessment establishes that someone needs care from secondary

mental health services, there will be decisions about whether they should receive care under CPA or Lead Professional Care. This does not

automatically mean they need any other services. Needs for other services are assessed under whichever framework is appropriate for the group they belong to:

• Children and young people (up to the age of 18) are assessed by children’s services and under the Common Assessment Framework for Children and Young People (CAF)

• Adults (over 18) – including adults with substance misuse and physical health problems as well as mental health problems - are assessed under

Fair Access to Care Services (FACS)

• Older Adults (over age 65) are assessed under the Single Assessment Process (SAP)

• People with learning disabilities are assessed under Health Action Planning (for health services) and Person Centred Planning (for housing, education, employment and leisure).

Hospital Admission

15.3 Anyone admitted to hospital with mental health problems should normally be

on CPA. If they are not currently in contact with services there should be a full assessment of need and the CPA process should normally be

commenced. If they have been receiving Lead Professional Care their care should be reviewed to decide whether they should receive care under CPA. The principles of the CPA process set out in Part 12: CPA Roles &

Responsibilities apply to in-patients in the same way as for any other service users, except for the adjustments identified below.

Hospital Admission Procedures

15.4 Wards should inform the relevant community team of all admissions to ensure

that communication is established, the CPA process can be facilitated and discharge planning is started from the point of admission:

• If service users are already in contact with services the Care Co- ordinator/Lead Professional should maintain contact with the service user throughout the admission

• If service users are not currently in contact with services the relevant team should identify a Care Co-ordinator/Lead Professional within 14 days of a request

• The hospital key/primary nurse will act as Care Coordinator until a community team worker is in place

• A draft care plan should be developed/updated (as appropriate) before a CPA review meeting is held on the ward

• A CPA review meeting should be held within the first 10 days of admission and in the two weeks before discharge

• Additional CPA review meetings should be held as necessary. In long admissions, a CPA meeting must be held at least every 6 months.

• Times and dates of CPA review meetings should be arranged by the Care Coordinator in consultation with the service user, any carer/s, ward staff and others involved

• CPA meetings should be separate from ward rounds wherever practicable • The Care Co-ordinator should attend ward rounds whenever possible and

must attend CPA meetings

• The Care Co-ordinator must be involved in care planning and should take the lead in discharge planning

15.5 Recording:

• The relevant CPA documentation for the service should be used

• If nursing care plans are used to itemise in-patient care arrangements these add detail to the CPA care plan and must be compatible with it. Hospital Discharge and Aftercare

15.6 Service users who are discharged should normally remain on CPA unless it is

clear and agreed in a formal review meeting that their needs can be met by either Lead Professional Care or primary care services. If it is proposed to discharge someone to primary care the procedure set out in paragraphs 11.27 – 11.30 should be followed.

15.7 Carers and other providers of services should be kept fully informed of leave

arrangements, discharge dates and discharge planning arrangements, subject to confidentiality arrangements.

15.8 7 Day Follow Up: All service users discharged from hospital, whether on

CPA or not, must be followed up within 7 days of discharge. Follow up means face to face contact. If this is not possible, telephone contact must be made and reasons for not seeing the patient must be recorded in the notes. If contact cannot be made team managers should contact Service Directors outlining the reasons.

15.9 Post-Discharge CPA Meeting: All service users on CPA should have a

CPA meeting within 12 weeks of discharge from hospital. All service users under Lead Professional Care should have a meeting within 12 weeks of discharge where their care plan and post-discharge arrangements, including any need for care under CPA, are reviewed.

Section 117 Aftercare

15.10 Anyone who has been detained in hospital under treatment sections 3, 37, 47