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The Core Study

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Item 30

Induction and training

Target

a) Induction for new staff involves at least 12 hours of CRT-specific training for staff who have not previously worked in CRTs.

b) At least 80% of CRT staff have received supervision at least monthly during the last 6 months.

c) The CRT has a programme of ongoing CRT service-specific training for CRT staff with sessions at least every two months.

d) The CRT manager or senior staff conduct field mentoring of at least 80% CRT staff at least once each year.

e) At least 80% of CRT staff have had a formal  appraisal within the last year.

Why this is important

Working in the CRT is a specific role requiring particular skills, and it is important that new staff members are given the opportunity to develop those skills through a structured induction programme. Steps can be taken to ensure that staff are supported to maintain and develop those skills, including regular supervision, CRT specific training, and field mentoring by senior staff.  Individual appraisals have been linked to better morale for mental health staff.

Ways of doing this well

Crisis specific induction and training

Sunderland Initial Response Team ensure that all their new staff receive a thorough induction to ensure they fully understand the roles and responsibilities of working in crisis.

Read their case study below to see what they do:

South Staffordshire and Shropshire Foundation Trust CRTs use this induction checklist to ensure that all new staff have been given a thorough induction to the trust.

SSSFT also facilitate ongoing CRT specific training for staff working in crisis teams to ensure that staff have a broad range of training in relevant areas. 

 Supervision 

West Essex CRHT scored highly on the Fidelity Item about supervision. Read about their practices below:

West Essex CRHT Case Study

Given the nature of Crisis Resolution Home Treatment Teams (CRHT) and the ever increasing demands made upon the service, clinical supervision can be easily overlooked and cast to one side as other pieces of work take priority. Yet, if ever there was a service in which clinical supervision was vital it has to be the CRHT given the complexity of presenting cases and high levels of risk the service has to manage on a daily basis.

In the West Essex CRHT at the South Essex Partnership NHS Foundation Trust we believed the best way forward to meet this need was via a group supervision approach, implemented once a month, each session lasting around one hour. This educational activity provides a unique opportunity to update the knowledge base and maintain resilience in the team.

The supervision took the form of a training session based around the clinical presentation and needs of any particular difficult case the CRHT had on its caseload. The Consultant Psychiatrist for the CRHT would facilitate the session and other Consultants, medical trainees and senior clinicians would be invited to give a presentation on various topics relating to work the CRHT was currently undertaking, such as "crisis assessment and management of elderly patients"; "Drugs and alcohol, risk and crisis"; "anxiety disorders/crisis management" to name but a few. As the training sessions progressed the levels of engagement and interest in the sessions of MDT rose. Feedback from those attending has been very positive. Since we started this approach we have noticed a distinct increase in the number and regularity of those attending the sessions and the quality of documentation in case notes and feedback at the twice weekly MDT clinical review.

Examples of good practice

In our fidelity review survey of 75 crisis teams in 2014, the following teams achieved excellent model fidelity, and can be contacted for advice about how they achieved this:

  • Sunderland, Northumberland, Tyne and Wear NHS Foundation Trust
  • Tower Hamlets HTT, East London NHS Foundation Trust
  • Eastbourne CRT, Sussex Partnership NHS Foundation Trust
  • South Essex West (Basildon) CRHTT, South Essex Partnership University NHS Foundation Trust 
  • South Hams and West Devon CRHTT, Devon Partnership NHS Trust
  • Taunton and Bridgewater CRHTT, Somerset Partnership NHS Foundation Trust 
  • Chichester CRHTT, Sussex Partnership NHS Foundation Trust