Introduction Lakeside provides time-focused, positive and specialist support for people with mental health needs in a therapeutic and caring environment focused on rehabilitation and recovery.

Lakeside’s mental health pathway can support people arriving in crisis, through step down and rehabilitation and towards discharge.

Who can we support?Our dedicated complex care, recovery-focused mental health pathway supports men and women with varying health needs including schizophrenia, bi-polar disorder, personality disorder, anxiety disorder, obsessive compulsive disorders, depression and those with a history of substance misuse.

The people supported in our specialist mental health wards may also have autism, a learning disability or ADHD.

Our focus and aimThe focus of the mental health pathway is to enable people to move on and return to their home communities through a planned and partnership approach.

Lakeside provides expert treatment and support through bespoke therapy and nursing interventions to help stabilise mental health and support people to develop or re-develop their social, educational and vocational skills.

Our ultimate goal is to help them progress to a more positive future and, wherever possible, to semi-independent or independent living.

Our servicesLakeside’s mental health pathway has a range of services offering specialist support. We can support people experiencing crisis or placement breakdown, as well as those who may be stepping down from medium secure units, people under (MAPPA) Multi Agency Public Protection Agency restrictions, who are detained under the Mental Health Act or those who come on a voluntary or informal basis.

Cooper 1 and Elstow 3 provide robust, specialist and stabilising support for people with acute mental health needs as well as learning disabilities and autism, while Elstow 5 offers a dedicated complex care mental health environment for people with severe and enduring mental illness and or those stepping down from more secure environments towards community reintegration.

Elstow 1 offers a unique service which has the skills and abilities to support women who may be experiencing problems with a co-morbidity of Mental Health, moderate Learning Disability and Autism and/or emotionally unstable personality disorder. It can also offer a modified Dialectical Behavioural Therapy programme for those who would struggle with the main DBT programme, but who would benefit from the key skills and training involved. Elstow 4 offers pre-admission placements for people before they are admitted to our specialist DBT unit.

Mental Health Services Lakeside

Lakeside encourages everyone supported in its mental health pathway to take an active and collaborative role in their care through shared decision-making, family and loved-one involvement from the earliest opportunity and through offering a choice of bespoke and specialist support and interventions.

People are encouraged to work collaboratively with the Multidisciplinary team in the planning of their care and to attend admission, multi-disciplinary team, (CPA) Care Programme Approach and pre-discharge meetings.

They will be supported in this by a registered Mental Health Nurse who will work with them to develop and review care plans. Capacity and consent is assessed monthly and there is also a monthly patient forum which people are encouraged to attend. Every person is also encouraged to access advocacy support.

Treatment and supportOur clinical model is based around the Recovery Framework, which creates flexibility dependent on the needs of the person. Its primary objective is to promote mental well-being by managing the symptoms, treating the illness and promoting recovery.

We follow the recovery model utilising the tools such as the Recovery Star. The recovery star is completed in collaboration with person and the support team and it achieves the following:

• Values perspectives and enables empowerment and choice.• Support recovery and social inclusion • Covers all dimensions linked to recovery, it is holistic.• Enables the support team to measure and summarise

changes in the individual’s mental health and behaviour.

The Recovery Star covers:• Managing mental health• Responsibilities• Relationships• Social networks• Physical health and self-care• Identity and self esteem• Addictive behaviour• Work• Living skills• Trust and hope

Interventions are evidence-based and consistent with NICE guidelines.

Lakeside is part of the STOMP pledge to reduce the use of medication for people with a learning disability, autism or both. Since becoming part of the pledge, Lakeside has seen a reduction in its use of PRN medication.

People at the heart of their care

Our TeamThe Lakeside Mental Health pathway MDT includes our nursing team, Clinical Manager, Consultant Psychiatrist, Clinical Psychologist, Occupational Therapy input and Speech and Language Therapy input as required (SLT). It also includes our Hospital Director, Medical Director or Mental Health Act Manager. We also have a a Registered General Nurse who is our Physical Health Lead on site. The GP visits weekly and can be accessed when there is need. A dietician also visits weekly. Additional clinical support can be provided such as chiropody and dental care. Art Psychotherapy is also available. The MDT is consultant led and takes a psychologically informed approach to its work.

Therapeutic InterventionsLakeside’s Therapeutic Services Group (TSG)The TSG is led by a Consultant Clinical Psychologist/Head of Therapies, and comprises of qualified and Assistant Psychologists, qualified and assistant Occupational Therapists, qualified and assistant Speech and Language Therapists, an Art Psychotherapist and a specialist therapeutic fitness instructing team (Psychesoma).

This multi-therapeutic team provide direct input into people’s care, as well as providing input into staff teams so that they are able to promote and support individualised rehabilitation via therapeutic activities and interventions developed by TSG.

The aim of the TSG is to promote rehabilitation within Lakeside, a Complex Care Rehabilitation setting, such that Lakeside is never any individual’s final destination. Our over-arching goal is to provide NICE guideline recommended treatments directly with people we support, and to be active members of the MDT, such that individuals receiving care at Lakeside are successfully discharged back into the community. Clinically Effective Psychological Treatment Approaches and Core Interventions Our Mental Health treatment pathway provides NICE guideline-informed assessment and interventions in four

phases, influenced by whether the person we support has comorbid Learning Difficulties (LD) and/or Autism Spectrum Conditions (ASC) alongside the core Mental Health diagnosis.

The four phases include:• 12 week Assessment and Treatment Planning Phase• Containment and Stabilisation Phase• Exploration and Change Phase• Relapse Prevention and Moving on Phase

Throughout the person’s treatment pathway, interventions are available on an individual and group basis, and of high and low intensity, and through direct/indirect and consultation methods.

The initial assessment phase assists in directing the person we support to an individualised treatment plan, depending on their needs and abilities, i.e. group versus individual / high versus low intensity.

These interventions can include Dialectical Behaioural Therapy (DBT) Informed Coping Skills and other skills-based groups, Mental Health Awareness, Positive Behaviour Support model, Risk Awareness, Self-Esteem, Relax/Wind Down, Mindfulness, Behavioural Inventions, and Motivational/engagement work.

Higher intensity interventions include Cognitive Behaviour Therapy (CBT) groups (psychosis, anxiety, depression), and 1:1 therapy, e.g. Cognitive Analytic Therapy, Narrative Therapy, CBT, Acceptance and Commitment Therapy (ACT).

Once the individual has reached stabilisation, the Exploration and Change Phase begins, and may include offence-focussed, trauma-related and/or relational/attachment-focussed therapy including CBT/ACT for psychosis, Fire-Setters Intervention Programme, Sex Offender Therapy, and Substance Misuse Therapy.

The Relapse Prevention and Moving on Phase, is a period focussed on consolidating learning and preparing for community living.

01480 474747info@accomplish-group.co.ukwww.accomplish-group.co.uk

LakesideThe Lane,Wyboston,Bedfordshire,MK44 3AS.

OutcomesThe formal tool used to measure change is HoNOS. Use of ‘as required’ medication, incidents of aggression, self-harm, and risk assessment are also monitored with the involvement of the person. Incidents, complaints, and safeguarding related incidents are monitored and reviewed every day.

Discharge From the point of accepted referral through to discharge, the team works with the person to identify what discharge will look like for them. Each person is supported in their choice of how and where they would like to live and the team works with them to achieve that. This often means close working with home teams, commissioners, and Local Authorities.

Referral and admissionLakeside’s mental health wards can support men and women over the age of 18. People referred will be assessed by a member of the mental health pathway’s clinical team. We aim to complete assessments within 72 hours of receipt of relevant paperwork.

When a person comes to Lakeside, a full and comprehensive handover will be completed and a 72-hour care plan begins which includes a full physical health check from our on-site Practice Nurse in collaboration with the local GP.

Mental Health Services Lakeside