The Core Study


Item 36

Consistency of staff and support for service users


a) The CRT allocates a named worker or equivalent for each service user who is responsible for ensuring key care tasks for that service user are completed.

b) Service users and carers are made aware who their named worker is  (at least 80% of service users).

c) The CRT has effective systems to limit the number of staff seen by a service user during an episode of CRT care. 

d) There is all-source agreement that CRT staff arrive with up-to-date information about the service user and treatment and succeed in avoiding unnecessary duplication of questions/information and provide a coherent treatment approach.

Why this is important

When interviewed, service users and families repeatedly stress the need for more consistency in CRT care. Seeing the same workers from one visit to the next is highly valued, and is felt to be key to building a therapeutic relationship. Generally service users and families are aware that seeing a number of staff is often unavoidable given the nature of crisis care shift patterns and the ways in which they work, however service users experience of this can be greatly improved if staff ensure they turn up to visits well-informed and up-to-date. Named workers have been positively received where a named worker system is in place.

Ways of doing this well 

Key Workers and mini teams

The Edinburgh Intensive Home Treatment Team (IHTT) operate a system of small key worker groups within the larger team, which means that staff have more detailed knowledge of the service users they see.

Listen to the audio clip below to hear Dr Bryn Lloyd-Evans talk about ways of improving the consistency of staff visiting service users.

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:

  • North Somerset Intensive Team, Avon & Wiltshire Mental Health Partnership NHS Trust
  • Sandwell CRHTT, Black Country Partnership NHS Foundation Trust