Care Pathway Months 1-3:

Admission and Assessment Phase

Admissions are carefully planned and a supportive transition period and adherence to CPA process precedes arrival at Vestige healthcare. During the admission period the focus is on MDT assessment of need and psychologically-led interventions aimed at engagement and safety and stabilisation in acknowledgement of the high-risk transition period.

Developing relationships is key to successful engagement in therapeutic programmes and our MDT prioritise getting to know the person in our care through formal and informal assessments and activities. Our staff will support individuals to orientate to their environments and personalise living spaces as a tool to engagement and will encourage a daily routine and sleep plan to aid wellness.

It is essential to plan for discharge from services at the point of admission to reduce the risk of dependence and avoid therapeutic milleau. Aspirational discharge plans will be central to the plan of care during month 1-3.

  • Vestige Psychiatry team will:

    Undertake assessment of mental health and diagnosis. Assess lifestyle, sleep, diet, substance use. Review mental health act status and community access; plans to reduce restrictions and increase community access will be formulated. Review medication – efficacy and side effects. Consider the need and plan for PRN or rapid tranquilisation. Undertake physical assessment and medical history taking. Facilitate initial CPA meeting as required.

  • Vestige Psychology team will:

    Undertake psychological assessment, informed by the Cognitive Analytic Therapy model. Utilise appropriate scales and measures in a needs-led way. Identify presenting problems, predisposing factors, precipitating, perpetuating and positive factors to inform an initial formulation. Support individuals to recognise difficulties and utilise a Cognitive Analytic consultation model to support the MDT team to work in a psychologically-informed way; promoting engagement and relational security.

  • Vestige Nursing team will:

    Assess mental health, coping strategies, daily living skills, lifestyle, diet, sleep, relationships, risk behaviours and sexual health. Undertake full risk assessment and lead the MDT on formulation of a risk management plan. Work within a psychologically-informed, Cognitive Analytic model, to develop relationships, engage in co-production and begin symptom management. Formulate initial plans of care; including positive behaviour support plans and an aspirational discharge plan.

  • Vestige Occupational Therapy team will:

    Assess occupational functioning, activities and interests and the impact of mental health difficulties in those areas using appropriate scales and measures. Develop a weekly activity schedule and provide guidance to support staff on the implementation of plans. Lead on in-house activities and therapeutic routines. Liaise with community and voluntary services to enable community activities or visits from appropriate agencies if community access is compromised by mental health difficulties.

  • Vestige Support Staff will:

    Work within a psychologically-informed, Cognitive Analytic model, to develop therapeutic relationships and actively engage with people in our care to optimise effectiveness of initial interventions.