A clear and consistent approach to the prevention of crisis across all agencies within the LLR system Need for a multiagency approach is identified by any individual in contact with person Health Social Care placement provider ID: 919465
Download Presentation The PPT/PDF document "LLR LDA Dynamic Support Pathway (DSP) Re..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
LLR LDA Dynamic Support Pathway (DSP) Referral Process A clear and consistent approach to the prevention of crisis across all agencies within the LLR system
Need for a multiagency approach is identified by any individual in contact with person (Health, Social Care, placement provider, family, education).
Deterioration in wellbeing of individual identified where there is a significant concern around any reason health or social care, family dynamics, carer breakdown, placement breakdown, increased anxiety, aggression, property damage, self-harm.
Referrer who identifies deterioration of the individual (CYP or adult) completes online
DSP referral form
https://llrldadmissionavoidancetool.leicestershire.nhs.uk
Support with organising MAM could be due to a lack of agencies involved/ engaged; existing processes are not effectively managing the risks requiring escalation.
Amber
and Green referrals will generate an automatic addition of this individual to the Dynamic Support Register (DSR).
*DSR admin lead
will attach the DSP referral form / MAM request to invitation to ensure all attendees are aware of the reason for the referral, rationale for the meeting and brief history of the individual.
The completed referral form will automatically transfer to the appropriate DSR admin lead who where indicated* will liaise with the referrer and arrange the Multi-Agency Meeting (MAM)
Is person at risk of hospital admission within 24 – 48 hours?
Inpatient discharges to be reviewed following 2 weeks post discharge and either removed from DSP or RAG increased to amber.
Where existing processes are effective/ already established MAM to be organised by referrer & MAM notes template to be used.
Referrer to identify on referral form if MAM is to be organised by the DSR admin lead and provide details of other professionals / placement providers / family who need to be invited to the MAM.
Level of risk and urgency must be identified
.
Individual meets the referral and RAG rating criteria for DSP.
Meeting date will be in line with the level of urgency requested by the referrer to the DSP.
MAM organiser
will ensure the correct attendees are invited to the meeting & identify who will chair and who will take notes.
Red
referrals will generate an automatic addition of this individual to the
Risk of Admission Register (ROAR)
and automatically be directed to the Transforming Care Officer
Agree additional interventions, support to remain safely in the community
After 2 weeks
Is the person safely supported in the community and no longer at imm
inent
risk of admission?
Either RAG amber and add to DSR or rated green & removed from DSP
Arrange a follow up CETR (until the person is no longer at risk of admission) or an admission is required
No
Referrer to select
ROAR
if RAG rating is determined as ‘
RED
’ & patient requires urgent C(e)TR or LAEP (if no time)
Referrer to select
DSR if RAG rating is determined as ‘AMBER’.
Yes
Yes
No
DSP admin lead will endeavour to take notes of the first MAM organised by them.
Only individuals who are discharged from inpatients should be RAG rated as ‘
GREEN
’ –see SOP
Slide2LLR LDA Dynamic Support Register – The Multi-Agency Meeting
A clear and consistent approach to the prevention of crisis across all agencies within the LLR system
MAM – full and open evaluation of need and clear action plan is developed to provide the additional support and meet the increasing needs of the individual
The notes taker will capture the agreed actions of the meeting onto the MAM Notes Template
[available on the DSP website page & SystmOne)
MAM organiser to ensure notes circulated to the attendees (timeline agreed at the meeting)
Follow up MAM arranged to monitor impact of actions and improvement
MAM agrees risk is such that a C(e)TR should be requested
Follow up MAM
Has patient wellbeing improved/
risk has reduced/ stabilised
The date/time of further MAMs is agreed at the current MAM. Agreement on note taker of subsequent meetings.The MAM organiser will send out the invitations as required.Timeline is dependent upon the individual circumstances / urgency of actions
Referrer to notify DSP admin lead once deterioration in wellbeing has been addressed in order for the individual to be removed from the Dynamic Support Register (DSR)
Referral and MAM notes will remain in confidential file
The chair of the meeting will ensure that all the key lines of enquiry are discussed in the meeting
Chair and notes taker will be agreed prior to the MAM
Additional support remains in place for as long as required
Further MAMs continue until group agree they are no longer required
Individual wellbeing restored
Individual removed from DSR
Referrer to notify DSR admin lead to increase RAG to Red/ROAR.
DSR admin lead to update referral and notify Transforming Care Officer
Referrer to complete gaps in service form and escalate
through the appropriate line management system for further input/resolution.
Yes
The MAM identified further deterioration and
significant
increase in risk of admission / re-admission / offending / re-offending since the referral was made.
Yes
No
If no resolution is found,
send the gaps in service
form to the DSP admin lead so that it can be logged.
To monitor actions delivered/in progress. Follow up MAM identifies barriers to progressing actions/ gaps in service
No