Your Questions Answered

Here are some of the many questions carers ask with some answers. There are links to further information.

Click on the question for answers.

Am I a carer and what’s a Carers Assessment

You know you are a carer if you support someone who has needs which you think are important and they rely on you to help them meet them. You are not getting paid for this unless you are a professional so you are an ‘informal carer’. It might be your spouse or a friend or neighbour. As a carer you have rights (see more here). One of these is the right to a Carers Assessment. This is a process you access through the Nottinghamshire County Council (or the Nottingham City council) which enables you to discuss your situation with a professional. Its about your needs and this results in a ‘Care Plan’ for you. This may have financial benefits to you. Get more information from the County Council here.

Where can I get carer support near me

Answer…There are many mental health Carer Support groups across Nottinghamshire. See Useful Contacts where you will also find the Carers Hub where you can search for groups in your area.

What does a Section mean, kinds of Sections – what rights does the carer and patient have?

Answer here…See ‘Helping Hands‘, How care services are organised, Mental health Sectioning

Hospital Admission – how do I access my relative, what rights do they and us have, getting to know hospital routines and rules?

Answer..If you know your relative is in hospital and you have some details of the admission then call the reception number and tell them you are the carer, and ask to speak to the ward. You should be able to visit your relative by special arrangement or they will give you visit times. As the carer you have the right to access. If you dont have much detail Reception should still be able to search Admissions and tell you more detail. Your relative has the right to have you receive information and for you to visit even in a ‘secure’ hospital. On your first visit get the names and job roles of the person who has been delegated to be the Lead Nurse for your relative and the name of the Consultant.

What are Forensic services? – how to access when a patient is locked up – rights and rules

Answer …. If your relative has been charged with an offence because of some form of ‘incident’ while they were unwell, they may be put on a Section (see ‘Helping Hands, How services are organised, Sectioning’) and kept under Lock and Key for observation and after a appearance at a Court they may be sentenced and kept under Lock & Key . Forensic services are for people in that situation whose support and treatment is carried out under some form of restriction in a special hospital and under supervision in the community. Their treatment is controlled and monitored by the Ministry of Justice. Your access to a relative is still allowed under more stringent conditions and you still have the right to be part of the CPA (Care Programme Approach) meetings. See ‘Helping Hands‘, How services are organised, Mental health Roles for more information about CPA.

What are the other MH services – where do I get details, who can help me access these services?

Answer … The main provider of Mental health services in the East Midlands is Nottinghamshire Healthcare Trust. See their web site for more details. If you need help with this look at Carer Support,  and Useful Contacts

Who do I need to get to know (influence my relatives care without causing trouble for my relative?

Answer …The first person to get to know is your own and your relatives GP. They are the start of the referral process. Also ask at your GP Practice ‘who is the carer Champion’? Once your relative is covered by the mental health system you need to make contact with your relatives Consultant / CPN and Social Worker (see the mental health roles). A relationship with the Consultant or CPN are essential to find out what is happening to your relative and to ensure you are involved in care reviews as you have a right to be. However you need to get your relative to agree to you being fully involved. Even if your relative does not want you to have this involvement you should still seek to discuss this with the Consultant/CPN who should explain to you your position in this situation and they should also be encouraging your relative to seek your involvement. There are rules about ‘confidentiality’ which limit what health professionals can tell carers if their relative is not agreeable to sharing information.

What kinds of questions should I ask to keep abreast of the care process?

Answer…You should be thinking of yourself as well as your relative. For your relative inside the mental health system you need to keep track of the CPA (Care Programme Approach) processes. After each CPA review there will be a report of the meeting spelling out next steps in the support for your relative. You should  be involved in that. There may be medication changes which your relative might appreciate some support in coping with. There may be ‘leave’ which you could be part of to encourage getting the best out of. There may be other professionals or agencies who become involved who you need to understand their role.

For yourself you should consider having a Carers Assessment which should result in a Care Plan which you need to keep on top of to ensure that the support agreed is being delivered. There may be financial support for yourself if you need it. There will be a Carer Support Group near you that might be of help because you will meet other carers who understand what you are going through. You might need information (see our Useful Contacts)

What is a Multi Disciplinary team (MDT) – who are they – what do they do - how can I be part of the process?

Answer…Your relatives care will involve a number of professionals (see ‘How carer services are organised’ mental health roles) and they meet at regular intervals to discuss the care they are giving, how is it going, what needs to change. Your relative will meet with the individual professional giving them support so the MDT meeting has up-to-date information about the care being given. The MDT usually meets before a CPA review which you can attend. You and your relative can ask questions. If you ask you will be able to meet with any of the professionals separately (your relative may be happy not to need to be there if they tell the professional) to ask about their work and share concerns you might have. You should find that professionals welcome that interest. You might find it helpful to talk to experienced carers about the best way to establish a helpful relationship so it is not seen as negative and critical. There is always the issue about professionals and carers sharing information that the service user may not be aware of so it’s important to talk to your relative about what you need to know and how they can be assured that any such conversation is going to be helpful to them as well.

How do I query things that don’t seem right

Answer…This is a difficult situation particularly at the start of any episode of treatment. At that point neither you nor your relative will know much about services and whats in store for you both. Establishing a trusting relationship with professionals is a big help. They will usually understand that there are times when the care they give is not seen by you as helpful to your relative if it causes problems for them. If you feel that as you probably will at times, then you first have to accept that they provide care in your relatives interests. In their turn they need to understand what you can bring of benefit to their work. It is an emotional time but if you can share these thoughts without being over-critical you will usually get a positive response. So the answer to the question is to explain that you see things happening that you may not understand but want to understand and help with if you can.

How does confidentiality affect me?

It can be a problem for carers not being given information when professionals say “it’s confidential”. What do you do  in this case? See more here

How to prevent removal of 117 section

There are no clear rules in the Mental Health Act for deciding when a person no longer needs aftercare; but section 117 of the MHA says that it is up to the health and social services who are dealing with your case to make a joint decision that you no longer need it.

If you want to know more information go to https://www.rethink.org/advice-and-information/rights-restrictions/mental-health-laws/section-117-aftercare/    

See also Carer Support