The SALT Liaison Nurse: An Innovative Approach to Meeting the Communication Needs of Offenders with a Learning Disabilit

1. 1 April 2012 The SALT Liaison Nurse: An Innovative Approach to Meeting the Communication Needs of Offenders with a Learning Disability Malcolm Cape Forensic Services Northgate Hospital Northumberland Tyne & Wear NHS Trust

2. 1 April 2012 SALT LIAISON NURSE Introduction Background Is there a benchmark? Development of the role so far Future plans/vision Summary Questions and discussion

3. 1 April 2012 I am ���. Malcolm Cape � Senior Registered Nurse � Seconded to SALT Dept � Role as liaison nurse Forensic Division Northgate Hospital Northumberland, Tyne and Wear NHS Trust (Formerly Northgate and Prudhoe NHS Trust)

4. 1 April 2012 Setting the scene The aim of this presentation is : Outline the remit of the SALT Liaison nurse What are the benefits / does it have a knock on effect for patient care? Discuss the viability of a long term role for nurses working in partnership with SALT within the context of Forensic practice.

5. 1 April 2012 Background There is evidence (literature / previous Preston conferences etc) that effective communication is pivotal to successful intervention with this client group Increased awareness that: communication deficits are widespread within this group (literature; personal experience) communication underpins all aspects of life At Northgate the importance of communication is recognised but there is still a need to share this knowledge with wider group of staff increase collaborative working as SALT resources are limited and less effective when used in isolation

6. 1 April 2012 Based on previous initiatives: - Jointly designed screening tool between SALT and Nursing (all Forensic Nurses involved) - Communication co coordinators for each ward. - Greater staff awareness through training initiatives and discussion

7. 1 April 2012 Ongoing concerns over providing an equitable, consistent, effective and comprehensive service. Due to limited resources, throughput of patients and general pressures within the division. Recognition of there being a gap between professional (SALT/nursing) practices. Do staff really understand the importance of effective communication?

8. 1 April 2012 Does anyone have similar problems?

9. 1 April 2012 Options Another SALT -More of the same / gap would not be filled SALT Assistants -Inexperienced for role required / historical issues Qualified Nurse

10. 1 April 2012 Benefits Experienced Nurse provides: -Wider knowledge base -Awareness of culture / systems -Support at different levels / angle -Increase staff�s awareness of communication issues -Breaks barriers

11. 1 April 2012 Overall aim To marry SALT and Nursing skills in providing practical and applied service delivery - Partnership NOT to replace SALT NOR be a handmaiden Innovative � change practice

12. 1 April 2012 Definition of role Innovative multi-disciplinary (mini) initiative aimed at identifying and resolving communication problems with the overall aim of improving the lives of forensic learning disabled patients

13. 1 April 2012 Limited Evidence Base (with offenders) No previous benchmark in Forensic Some nurses in specific roles e.g. Dysphagia In general LD specific skills needed but no similar role. e.g. Autistic services

14. 1 April 2012

15. 1 April 2012 Role has been allowed to develop rather than have a set criteria (evolve) Understanding around each others practices (trust, honesty) Joint decision making, shared vision (at times) Meeting MDT philosophy

16. 1 April 2012 Experiential learning / getting hands dirty. - Seeing / doing / familiarising - SALT assessments - Understanding the issues - Immersed in the SALT process - Working out treatment strategies with staff, SALT and MDT

17. 1 April 2012 Using assessment results to apply functional strategies at the right level for patients / ward staff Recognising hiccups / breakdowns in practice Treatment must be transferable into real life. Therefore the role of the nurse is crucial and must be involved in crafting treatment plans. Working with a patient on these plans. It�s not just staff who need ownership of plans.

18. 1 April 2012

19. 1 April 2012 EXAMPLE Taking present systems further

20. 1 April 2012 Communication Engagement Styles All patients to have a communication engagement style Communication styles for given situations. What is the best way to interact with someone. TOP TIPS Information needs to be accessible to all Easy to read document for all staff User friendly Information gathered from staff as well as assessments Feeds into all care plans

21. 1 April 2012 What Next / Vision Input with student nurses to raise a greater understanding of communication issues: e.g. Provide a new learning zone for student nurses. Input into nurse training or college. Ongoing development of existing staff : e.g. Offering rolling programme of short secondments. Extension of staff awareness training e.g. dealing with communication breakdown, communication styles etc Getting transitions right: e.g. Supporting ward transfers Working with external agencies Developing systems and procedures to support communication More of the same Write it all up

22. 1 April 2012 Summary Most forensic patients with learning disability experience difficulty with communication � at some level At Northgate there are measures in place in which to identify and meet these needs but there are still gaps A major gap is at the interface between SALT / nursing practice The Trust has addressed the concerns by developing a new post -The SALT Liaison Nurse Main aims of this role are to: Develop a closer working partnership between SALT and Nursing Foster increased knowledge and understanding of communication issues within nursing teams Ensure knowledge about individual patient�s communication strengths and needs is applied functionally across the board Enable patients to become more involved in all aspects of their treatment

23. 1 April 2012 Thank you for listening Any Questions? malcolm.cape@nap.nhs.uk jan.mitchell@nap.nhs.uk