Annual Review & Impact Report 2011/12
Contents Introduction 3 Key Turning Point sector statistics 2011 – 12
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Turning Point Strategic Objectives 7 Executive Summary 8 Achieving and sustaining high quality services
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Building confidence with commissioners
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Developing strategic partnerships
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Shaping innovation for service delivery
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Management and leadership agility
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Contact details
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Introduction This annual report has given us the chance to take stock, and look back, not only at the 12 months it covers, but at the whole five year period of our last organisational strategy which this year concludes. The strategic goals you’ll see referred to throughout this report are those we set ourselves back in 2006-7. It goes without saying just how much has changed since then, within Turning Point and the cataclysmic change in health and social care, particularly in funding. But one thing remains constant our determination to provide the best possible support for those people using our services. That is our whole purpose – today, just as it was back in 1964 when Turning Point first opened its doors. This report illustrates our progress against the strategic goals from that period but there is much more being achieved at Turning Point than we can ever squeeze into one document. The examples you’ll find throughout this review – of excellent services delivered
nationwide from Northumberland to Somerset, of innovation in Wakefield and Great Yarmouth, and of new areas of intervention from the Earl’s Court Health and Wellbeing Centre to HMP Thameside – tell a story of an organisation that is continuing to find new ways of enabling people to turn their lives around, new ways of making a difference.
And during a time of real challenge, and fast-moving change in the health and social care landscape, we are driven to build and deliver great services that benefit those we care for. So we’ve been engaging with emerging
Clinical Commissioning Groups, working on responsive service design with service user representatives, building community resilience via our Connected Care team, and developing new models of integrated care to support service users in more effective, innovative ways.
Turning lives around is our business and our passion - every day.
Photo: Victor speaking at the Community Leadership Network conference, July 2011
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Key Turning Point sector statistics 2011-12
660 Mental Health
In 2011/12 more than 660 individuals were referred to Turning Point mental health services. During the year, 79.4 per cent of those who started with the services had a planned discharge. These discharges were agreed jointly with the client and formed part of their individual care plan. Turning Point mental health services work with clients to continually adapt support to meet their changing needs. Planned exits, as part of care plans, offer clients the ability to take control of their support.
17,500 Substance Misuse
During the year, more than 17,500 individuals were referred to Turning Point services from professional bodies, GPs, prisons and by self-referral. In 2011/12, 78 per cent of drugs clients who started Tier 3/4 treatment had an exit which was discussed, agreed and planned with them in advance and formed part of their individual on-going care plan. Turning Point’s personalised support and recovery focused approach, combined with planned exits, ensure clients have the best possible chance of successfully continuing their recovery once they leave our services.
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440 Learning Disabilities
For more than 20 years, Turning Point has been supporting people with a learning disability. In 2011/12 Turning Point supported 440 people with a learning disability in existing services. More services opened during the period providing high quality, personalised, community-based support.
825 Employment Services
Since its launch in July 2011, more than 825 clients have been referred to the new Turning Point Work Programme service supporting people to build confidence, gain new skills, find jobs and stay in employment.
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6,200
Connected Care – Community led commissioning Operating in 10 areas with a total population of 131,000 people, Connected Care has undertaken research with more than 6,200 people through its community audits, ensuring local people can influence the design and delivery of new health and social care services.
27,000
Rightsteps Improving Access to Psychological Therapies (IAPT) In 2010/11, 27,000 individuals were referred to the six Turning Point services using the Rightsteps model. Rightsteps successfully delivers integrated talking therapies to give clients total support including advice on employment and skills, debt, housing and relationships.
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Turning Point Strategic Objectives The following sections reflect on activities undertaken in 2011/12, but all relate back to Turning Point’s 5-year strategic plan set out in 2006/7
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Strategic Objectives: Executive Summary Turning Point is a leading health and social care organisation. Our progress towards achieving our key strategic objectives during 2011/12 is summarised below:
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Achieving and sustaining high quality services
Meeting the changing needs of individuals and commissioners Turning Point services are designed, developed and delivered in partnership with commissioners, clients and the local community. Our services are personalised, integrated, accountable and high performing. They continue to evolve to meet the changing needs of individuals and commissioners. As a social enterprise, Turning Point achieves and sustains high quality services through continually investing in them, and reinvesting in its staff; empowering them to create innovative models of care and support that focus on the individual to deliver real results.
During 2011, Turning Point extended its existing Arrest Referral Service in Newcastle to incorporate the full Drug Intervention Programme (DIP) provision. In Newcastle, we provided outreach in more than 40 locations across the city and our results were consistently above average, with 88 per cent of clients having a planned discharge. In Cumbria, we doubled the number of Turning Point shortterm accommodation services for people with substance misuse issues and the existing services continued to maintain 80 per cent successful moveon rates. Last year, in order to continue to provide high quality services we delivered a series of management training programmes in conjunction with the Institute of Leadership and Management (ILM). In addition, we undertook a staff wellbeing audit and began work on the creation of new initiatives to address the findings. In June, our Hertsreach drug and alcohol services came together to
mark Recovery Month with a series of events and activities. At the end of the month, Hertsreach gained recognition for their achievements at the National Treatment Agency (NTA) Eastern Region Recovery Awards. In 2011/12 our unique Connected Care model of community led commissioning was implemented in Great Yarmouth. Connected Care is now operational in 10 areas across England including Swindon, Warrington, Suffolk, Hartlepool and the London Borough of Hammersmith and Fulham.
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Building confidence with commissioners
Cost-effective care models Robust, high quality services We focus on creating innovative services that deliver measurable outcomes. This year, commissioners came under even greater pressure to deliver more for less and had hard decisions to make against a backdrop of increased uncertainty. Turning Point worked in partnership with them to streamline services, create new, cost-effective care models, provide evidence to support budget decisions and helped build robust services.
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In 2011/12 Turning Point continued to develop services and new models of care that meet commissioners’ and local community needs. In Bradford we were awarded a £4.5 million contract to provide personcentred support for people with a learning disability in residential care. In Somerset we introduced a bespoke model of psycho-social interventions for people with drug and alcohol misuse issues, underpinned by Turning Point’s Treatment Outcomes Profile System (TOPS), which enables commissioners to track the distance travelled by clients and demonstrate outcomes. The initial results of this bespoke, evidence-based model show increased planned exits for all types of clients. Our new Rightsteps service was launched in Wakefield, supporting people to access psychological therapies quickly. Turning Point has almost 50 years’ experience of working with commissioners to support people with substance misuse issues. This year we updated our national report into parental alcohol misuse and its effects on children and families: Bottling It Up: the Next Generation, providing commissioners and government with statistical evidence of the current issues and clear recommendations for the future. We also held a number
of local events, hosted Ministerial and MPs’ visits and entered our fifth year as secretariat to the All Party Parliamentary Group on People with Complex Needs and Dual Diagnosis.
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Developing strategic partnerships
Innovative services that turn lives around Turning Point has an outstanding record of developing long-term strategic partnerships with public and private sector organisations, cutting across traditional boundaries and silos to work with partners who have the strengths needed to create unique, purpose-built services. Partnerships are a vital element of the way we work to deliver innovative services that turn lives around.
enabled Turning Point to develop a number of large-scale integrated services including the Earl’s Court Health and Wellbeing Centre which provides GPs’ and dentists’ surgeries, signposting to services, groups and activities, a team of Wellbeing Coaches, a community space, engagement programme and peer mentors. In addition, we created a new partnership to deliver a Brighton & Hove Wellbeing Service which will operate mental health services in that area.
In 2011/12 we consolidated our existing partnership agreement with Serco and Catch 22 and continued to operate together as The Alliance. We extended our partnerships to enable greater community interaction at Thameside prison through new agreements with Harmoni for Health. With our employment sector partners we also won new contracts to deliver more services under the Work Programme and our Health in Mind partnership with Sussex Partnership NHS Foundation Trust continued to grow in strength. In addition we created a new partnership which has
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Shaping innovation for service delivery
Embracing new ways of working that deliver evermore effective services Turning Point designs and operates high quality, ground-breaking models of health and social care which offer flexibility and provide measurable results. Working closely with commissioners and government organisations we are committed to developing services that will help shape the future of health and social care in the UK. Turning Point embraces new ideas and ways of working in order to deliver evermore effective services tailored to each individual’s needs. This year Turning Point’s unique Building Futures programme constructed new specialist mental health services at a site in Mastin Moor in Derbyshire. In addition, Turning Point began work to adapt and refurbish Countisbury House in Cardiff to provide a state-of-the-art residential rehabilitation service for men with complex mental health needs. These innovative services,
delivered in purpose-built therapeutic environments, will help improve the future prospects of individuals who have traditionally presented real challenges for mental health services. In addition, we began a Payment by Results pilot to deliver drug treatment and support in Wakefield and won the contract to deliver the Local Area Single Assessment and Referral Service (LASARS) in Slough. We also increased our services for people with Long Term Conditions (LTCs), including at Earl’s Court Health and Wellbeing Centre and began LTC pilot services at Aintree University Hospital near Liverpool and the University Hospital of South Manchester.
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Management and leadership agility
We are ahead of the curve, shaping the direction of health and social care in the UK Over the last five years Turning Point has undergone changes which have ensured we are a business which focuses on integration, innovation and delivering real results for the people we support, commissioners and society. In 2008/09 we established a unitary board, adopted the Financial Reporting Council’s Combined Code on Corporate Governance and transformed the structure under which we deliver our services. In 2009/10 we consolidated these changes by implementing a wideranging staff training programme and began Programme Eden, a comprehensive review of our finance function. Combined, these initiatives have ensured we are better placed to meet the challenges of a fast changing commissioning world, and in a strong position to help shape the direction of health and social care in the UK.
In 2011 we concluded our Programme Eden review which has transformed our finance function enabling us to deliver an enhanced service at a reduced cost. Once implemented, the effects of the changes were immediate. Our whole business is now aligned with our business targets, streamlined and focused on dealing effectively with issues such as budget changes and Payment by Results. In addition, this year Turning Point hosted a unique event: Bridging the Gap – Connecting government priorities and local voices. The conference was part of the Community Leadership Network initiative run by Turning Point Connected Care and funded by the Department of Health. In 2011/12 we also began work on our next five-year strategic plan and are due to launch a new Turning Point website.
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Achieving and sustaining high quality services 11
Newcastle Drug Intervention Programme In 2012, Turning Point extended its existing Arrest Referral Service in Newcastle to incorporate the full Drug Intervention Programme (DIP) provision. Continuing to offer support to individuals with substance misuse issues who are involved in the criminal justice system, the Turning Point Newcastle Team provide outreach in more than 40 locations across the city. Focusing on the individual needs of the people we support is paramount and 100 per cent of individuals receiving support have a tailored recovery plan with personal recovery objectives.
outreach work in gateshead (newcastle dip)
The success of the Turning Point approach is demonstrated by outcomes: 88 per cent of clients had a planned discharge from the service up to the end of 2011, 42 per cent of whom were drug and alcohol free. This is above the Newcastle average in a key focus area for the city, as outlined in the priorities of the Drug Treatment Plan 2011-12. Turning Point also works closely with the local probation service and the CARAT teams and has constructed a joint-working protocol to ensure seamless transfers into the community for prison releases and agreeing
additional telephone support for abstinent prisoners through the Cyrenians, a charity that helps to tackle homelessness.
Substance misuse services in Cumbria In 2011/12 Turning Point doubled its short-term accommodation support services in Cumbria, adding two further services: Haddon House in Carlisle and Castlegate in Penrith. This extension has greatly increased the numbers of disadvantaged adults now engaging in recovery from substance misuse across the whole region. Turning Point’s existing services, in Falcon Street, Workington and Bakery Court, Ulverston have an 80 per cent successful move-on rate. The new services will enable more people with substance misuse issues to achieve their personal goals, gain and sustain recovery, and move into independent accommodation.
Delivering Effective Management In order to achieve and sustain high quality services, Turning Point gives its staff the skills to manage effectively, take ownership, innovate and share best practice across the organisation.
In 2011/12, in conjunction with the Institute of Leadership and Management (ILM), Turning Point devised and implemented a series of bespoke training programmes for line managers. These on-going programmes are designed to provide the core skill and knowledge required within the social care environment, to help deliver improved performance within teams. The programmes support new managers, team leaders and prospective managers to do their job well, thereby improving morale, increasing efficiency and making a measurable difference to the service or department. For first line managers, we ran a three-day programme leading to a Level 3 Award that gave staff the opportunity to gain an understanding of leadership styles and build new skills in the areas of change management and effective communication. In addition, we focused on the performance process and management of service budgets. The second programme was an innovative combination of two accredited courses - Level 5 Diploma in Leadership and Management and the Level 5 Diploma in Leadership and Management in Health and Social Care. This programme was aimed at managers of registered services.
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To date, Turning Point has run four programmes successfully with 44 cohorts completing their seven workbased assessments. By providing a nationally recognised award and linking the qualification to Skills for Care Social Care Manager Induction Standards and National Occupational Standards, Turning Point is reinforcing best practice throughout the industry.
Wellbeing Audit In 2011 Turning Point established Working Well Together, an internal group made up of volunteer staff representatives from all sectors and all levels in the organisation. Its purpose is to explore the wellbeing of everyone at Turning Point and to think creatively about what the organisation can do collectively to promote wellbeing at a time when the external environment places high demands on Turning Point and on our employees. One of the priorities that the group identified was to carry out an audit of wellbeing to get a clear picture of what matters to our employees. We wanted to identify what currently works, what doesn’t and what ideas employees had about promoting wellbeing across the organisation. The audit was carried out in November
2011 and in the coming year the Working Well Together group will be using the intelligence gathered to put a range of initiatives in place to help meet the needs of our employees and enable them to remain fit, healthy and personally resilient.
Recovery Month To mark Recovery Month in June, all six Turning Point Hertsreach substance misuse services held events and activities to promote recovery to clients and the wider community. At the end of the month, our Hertfordshire services were ‘Highly Commended’ in the Best Recovery Events award category at the National Treatment Agency (NTA) Eastern Region Recovery Awards. To coincide with the events, Hertsreach produced a recovery booklet, consisting of stories and pictures contributed by Hertsreach
clients detailing their own recoveries. The booklet was given to the individuals supported by the service to help inspire and motivate them to reach recovery too. The booklet has proved to be extremely popular and other services are currently developing their own resources to help support recovery. Representatives from Narcotics Anonymous and Cocaine Anonymous attended the Hertsreach events to share their own stories. In addition, current clients shared their own recovery stories to inspire others.
hertsreach recovery stories booklet hertsreach staff and service users with their recovery stories booklet
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Connected Care in Great Yarmouth During 2011/12, Turning Point’s unique Connected Care model was implemented in Great Yarmouth on behalf of the clinical commissioning group, HealthEast Community Interest Company. The implementation followed a successful bid from NHS East of England’s regional innovation fund. This was the first time Turning Point’s Connected Care model of community led commissioning had been applied to a specific patient
group, in this case, people with Long Term Conditions (LTCs). The central aim of Connected Care in Great Yarmouth was to address the need to reduce ‘heat in the system’ caused by high levels of emergency admissions and A&E use by people with LTCs in the Gorleston area. Connect Care provided a structure for health and social care partners to work together with members of the community to first understand in detail the care pathways and experiences of people with LTCs and secondly, to start a process of service redesign to improve these pathways.
The result was a sustainable mechanism for partner agencies to engage with people with LTCs and to co-produce services with them. Central to the engagement was the role of the Community Advocates – a team of 15 local people with experience of LTCs. They were recruited and trained by Turning Point to conduct research with their peers and then undertake a programme of service redesign in conjunction with commissioners and service providers. The research was completed in February 2012 and the service redesign is being finalised.
An additional element of the programme analysed ways HealthEast could embed the Connected Care approach in their on-going engagement activities in the future. Together with HealthEast we assessed the viability of using Community Advocates to deliver signposting to people with LTCs in Gorleston, and recruiting other Community Advocates from different patient groups and localities. The full impact of this part of the project is currently undergoing evaluation by an external agency.
Community Advocates in Great Yarmouth
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Building confidence with commissioners 15
Turning Point Somerset - Model of Psycho-social Interventions (MOPSI) Turning Point has been working successfully with Somerset Drug and Alcohol Action Team (DAAT) for many years, supporting people with substance misuse issues towards recovery. In 2008, Turning Point began to design a bespoke model of psycho-social interventions (MOPSI). In March 2011, the model was launched in Turning Point Somerset services. Based on best practice in both the UK and USA, Turning Point MOPSI is a person centred, recovery and outcome-focused model that aligns fully with the NTA’s Recovery Agenda, NICE, BPS and UK guidance on clinical management. It supports increased numbers of people leaving treatment in a planned, drug and/ or alcohol-free way and increases successful integration back into communities. An evidence-based model, MOPSI is underpinned by the Treatment Outcomes Profile System (TOPS), which enables commissioners to track the distance travelled by the individuals we support and demonstrate outcomes. TOPS allows commissioners to see the real results of our work in local services, providing valuable transparency.
The results of MOPSI in Somerset from April 2011 to date are encouraging. The successful planned discharge rate (drug or alcohol-free) increased significantly against the same period the previous year. For people with primary drug problems (97 per cent primary problem heroin) there was a 64 per cent improvement in the rate of planned drug-free exits from the service; 38 per cent improvement in the rate of planned alcohol-free exits from the service and for people with a primary alcohol problem there was a 20 per cent improvement in the rate of planned alcohol-free exits. Turning Point MOPSI is now being used as a model of best practice locally and nationally by the National Treatment Agency, Strategic Health Authorities and NHS Primary Care Trusts.
Services for people with a Learning Disability in Bradford In early 2012, Turning Point was selected ahead of other organisations to provide services for people with a learning disability in the Bradford area. Our specialist expertise, experience and success in delivering person centred services was recognised by Bradford Metropolitan
District Council in awarding Turning Point this contract. In Bradford, Turning Point will be supporting individuals in existing residential services in a transition towards innovative person centred care. In addition, within the new services there will be a greater focus on involvement with families and carers.
Rightsteps sites now include GPs’ surgeries, community venues and children’s centres. Waiting times across the district have decreased and the service has created a number of new wellbeing drop-in centres in GPs’ surgeries.
Bottling It Up: the Next Generation
Rightsteps Wakefield Rightsteps is Turning Point’s customised Improving Access to Psychological Therapies (IAPT) delivery model: an outcome-focused service delivering integrated talking therapies to give support including advice on employment and skills, debt, housing and relationships. Rightsteps Wakefield was launched in October 2011. The service gives people flexible support through email, face-to-face conversations and over the phone. Having a job can be a vital factor in maintaining good mental health and Rightsteps Wakefield works closely with the employment services and local GPs in partnership with NHS Wakefield District.
In December 2011, Turning Point launched Bottling It Up: the Next Generation, an update of our previous report into parental alcohol misuse and its effects on children and families. In the UK, an estimated 2.6 million children live with parents who are hazardous drinkers, and around 33,000 adults who are in treatment for alcohol problems also have parental responsibilities.
Since its launch, Rightsteps Wakefield has increased the number of outreach sites from which it operates.
Substance misuse in the UK has a number of devastating impacts on individuals and society. Alcohol causes
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8,664 deaths each year and the number of hospital admissions related to alcohol reached 1.06 million in 2009-10 compared with 510,800 in 2002-03. Offenders were under the influence of alcohol in 37 per cent of all domestic violence cases and alcohol or other parental substance misuse is evident in 57 per cent of child protection cases involving either serious or fatal child abuse. The report reveals that nearly half (5,326) of people who used Turning Point’s alcohol treatment services last year were parents and their average alcohol consumption was 30 units per day; 24 for mothers and 33 for fathers - or the equivalent of 3 bottles of wine or up to 15 pints of beer. A total of 3,395 children lived with these Turning Point clients, including extended family members such as cousins or nephews. The report contains examples of bestcommissioning practice which have proved effective in dealing with parental substance misuse. In addition, the report put forward a number of key recommendations including a crossgovernment strategy to tackle the impacts, greater focus on integration, prevention and early intervention support including the extension of antenatal services. The report gained widespread coverage in regional, national and specialist media.
Local Events Turning Point works closely with commissioners to promote the work our services are doing locally. By increasing awareness of services through local events and associated media coverage Turning Point can reach more people who need support. In the last financial year, Turning Point services held a large number of events and took part in a range of activities to promote recovery in our substance misuse services. Turning Point also took part in national events to highlight World Mental Health Day and Alcohol Awareness Week.
richard fuller mp (front left) visits learning disability bedfordshire service, downfield way
During 2011/12 Turning Point services hosted a number of visits by local MPs and councillors. MPs visiting Turning Point services included Yvette Cooper, Nadine Dorries, Andrew Bridgen, Angie Bray, and Anne Main. These visits are an important way of raising awareness of the issues affecting the people we support directly with key decision makers. Media coverage of these visits and events also helps to promote the work of local Turning Point services and highlight the contribution the people we support make to their local communities.
john bercow mp (left) visits follybridge learning disability service
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All Party Parliamentary Group As well as engaging with Members of Parliament locally, Turning Point provides the secretariat for the All Party Parliamentary Group on People with Complex Needs and Dual Diagnosis. This role provides us with a unique opportunity to discuss how national changes impact on the
millions of people in the UK with complex needs. The Group is now in its fifth year and commissioners regularly attend events to discuss with MPs and experts, how policy is being translated on the ground and best practice around service design, delivery and outcomes.
The Group is Co-Chaired by David Burrowes MP for Enfield (left) and Lord Victor Adebowale CBE (right)
The Link At Turning Point we are committed to ensuring the families and carers of the people we support are really involved in the design and delivery of our services and in the care we provide. Communication is a key part of this, which is why last year Turning Point created The Link, our learning disability sector’s own quarterly magazine for clients’ families and carers. It aims to give everyone involved with Turning Point services a snapshot of what has been happening across our learning disability sector, share good news stories, successes and best practice from our services across the country.
By engaging with families and carers Turning Point can further develop the channels of communication, learning from their experiences, supporting them and in turn helping the most important people in their lives to feel as involved as they can, or wish to be, in the services we provide.
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Developing strategic partnerships 19
Primary Care: Earl’s Court Health and Wellbeing Centre
In 2011/12, Turning Point developed a partnership with Greenbrook Healthcare, NHS Dentist and Terrence Higgins Trust to provide an innovative new health and wellbeing service in Earl’s Court. Funded by NHS Kensington and Chelsea, services at Earl’s Court Health and Wellbeing Centre include a GP practice, sexual health advice, contraception, wellbeing coaches for people with long term conditions, peer mentors and an NHS dentist. By working in partnership with other specialist providers, we are better able to meet the unique and varying needs of the local community, as well as those of our commissioners.
Work Programme In 2011, Turning Point won subcontracts to deliver specialist elements of the Government’s Work Programme initiative. Through effective partnership working with prime contractors, Turning Point is supporting around a thousand individuals in seeking lasting employment. Turning Point’s employment model draws on our experience as both a mental health and employment provider, delivering holistic services that address underlying social, economic and health issues.
Earl’s Court Health and Wellbeing Centre
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The Alliance
An innovative range of recovery based interventions The Alliance is a unique partnership consisting of three leading organisations from the private, social enterprise and charity sectors - Serco, Turning Point and Catch 22. As part of The Alliance, Turning Point is running services in prisons including Thameside in South East London. This year The Alliance created an integrated offender management model, which wraps care and interventions around the individual based upon risk and need. The Payment by Results based model has enabled us to impact particularly on those with short-term sentences, with the aim of significantly reducing reoffending.
Partnership for Thameside prison At the new Thameside prison, Turning Point will be delivering an innovative range of recovery based interventions which are in line with national drug and alcohol policy. The interventions will also reflect community needs and priorities. During 2011/12, our strategic partnership with Serco and Catch 22 grew enabling us to provide specialist support to prisoners at the new Thameside prison to help them tackle their substance misuse issues. Alongside Serco who are running the prison, and another provider offering health services, Turning Point deliver an innovative range of recovery based interventions which are in line with national drug and alcohol policy. The interventions will also reflect community needs and priorities. Catch 22 will fulfil the probation role and will also be responsible for resettlement when the person leaves prison. The partners’ strengths and expertise combined will help provide high quality, personalised support linked to positive outcomes for people both during their time in prison and after their release. turning point staff at hmp thameside with service manager, Seamus Tobin (third from left)
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Mental Health Partnership - Brighton and Hove Wellbeing Service
In 2011, Turning Point was invited to tender to create a new primary mental health care service for Brighton and Hove. In response, we formed an innovative integrated service model, the Mental Health Partnership (The Partnership). The Partnership consists of Turning Point, seven GP practices in Brighton and Hove, Brighton and Hove Integrated Care Service (BICS), Sussex Partnership NHS Foundation Trust and Mind. Each partner was chosen for their proven ability to contribute to a localised and integrated model. On 5 December it was announced by the Sussex Cluster Board, on behalf of NHS Brighton and Hove and the Brighton and Hove Clinical Commissioning Group, that The Partnership had been successful in its bid to deliver all components of
the new primary mental health care service. Launched in April 2012, the new Brighton and Hove Wellbeing Service has four distinct elements which are fully integrated to provide a comprehensive service in primary care, and effective links with other specialist mental health services and community-based support services. The component services are: The Primary Mental Health Care Practitioners (PMHCP) service; Primary Care Mental Health Support service; Talking Therapies service (IAPT) and Talking Therapies HUB. Services provided by Turning Point include cognitive behavioural therapy, telephone supported self-help, faceto-face signposting, employment and vocational support and a range of workshops.
Health in Mind – Turning Point & Sussex Partnership NHS Foundation Trust
In 2010, Turning Point partnered with Sussex Partnership NHS Foundation Trust to develop Health in Mind, a pioneering evidence-based service that improves access to psychological therapy for people with common mental health problems including depression, anxiety and those individuals suffering from a posttraumatic stress disorder. During 2011/12, Health in Mind continued to build on its success. In the first three months of 2012, the service saw the number of new clients increase with more than 880 people entering psychological therapies via the service. In addition, more than 900 people completed treatment during the same period.
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Shaping innovation for service delivery 23
Mastin Moor, Derbyshire During 2011/12, work began on the construction of specially designed, purpose-built premises – independent hospital facilities – at Mastin Moor in Derbyshire. Built by Turning Point’s Building Futures programme, with our Welsh community housing partner, Gwalia, the service will provide specialist high-support care for people with mental health problems and associated complex needs. Intensive staffing combined with the latest technology will provide an adapted and personalised approach enabling Turning Point to tailor each individual’s care. The service is designed to meet the needs of people who may or may not be detained under the Mental Health Act, offenders with complex needs or people with dual diagnosis who require high support to manage risk. This purpose-built therapeutic environment and support from highly trained staff, as well as links with housing providers will maximise recovery for residents of Mastin Moor. This positive approach to recovery helps improve the future prospects of those individuals who have traditionally presented challenges for mental health services. These initiatives will deliver long-term cost savings for commissioners, turn lives
around for individuals and ensure effective levels of supervision result in public safety needs being met.
Countisbury House, Cardiff
mastin moor: blackshale house
In 2011/12, Turning Point also began work to adapt and refurbish Countisbury House to provide a stateof-the-art residential rehabilitation service for men with complex mental health needs. The service will open later in 2012 and will combine intensive staffing with the latest technology to provide an adaptable and personalised service. Countisbury House consists of sixteen self-contained bedsits, together with a number of communal facilities. Support staff will be on site 24 hours a day and the service will be registered with the Care and Social Services Inspectorate Wales (CSSIW). The emphasis will be on supporting the transition of clients into more independent living through a range of structured activities, as well as managing their mental and physical health within a recovery focused programme.
one of the bedsits in Countisbury House, Cardiff
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Payment by Results Pilot Schemes
Local Area Single Assessment and Referral Service (LASARS)
Turning Point is a key provider in the government’s nationwide Payment by Results pilot schemes in the substance misuse field. Our Wakefield Drug Treatment System is one of eight national pilot sites. The Turning Point pilot has been operating in shadow format since October 2011 and went live in April 2012.
During 2011/12, Turning Point won the contract to deliver a Local Area Single Assessment and Referral Service (LASARS) in Slough. The experience gained through the Turning Point Payment by Results pilot in Wakefield was a key factor in the contract award. The Slough LASARS is currently being implemented and will see Turning Point control all treatment referrals in Slough. This will leave Slough well-placed to convert to Payment by Results delivery in the future, using the LASARS to also set tariffs for each client referred to a substance misuse provider in the area.
The project involves the development of clustering tools, tracking methodologies and the development of early interventions matched to the outcome domains. The experience Turning Point gains from the Payment by Results pilot scheme in Wakefield will allow us to contribute to future policy changes as well as target contracts delivering similar services through delivering positive outcomes. Pilot schemes such as Wakefield will test the effectiveness of paying substance misuse treatment providers based on the outcomes they achieve for each person they support. It is scheduled to run for a two year period. As part of the pilot, our Grosvenor House service was the subject of a Ministerial visit from Lord Henley and Anne Milton MP.
Long Term Conditions North West Long Term Conditions Pilot Turning Point began work in October 2011 as part of a 12-month pilot programme aimed at helping patients with long term conditions. The pilot services are in operation at the Aintree University Hospital near Liverpool and the University Hospital of South Manchester. To date more than 300 patients have had initial contact with Turning Point Wellbeing Coordinators at these two sites. In partnership with the hospital trusts, four registered nurses have been appointed who are studying
towards their wellbeing counselling diploma. The service targets patients who have been admitted to hospital as a result of a long-term condition such as coronary heart disease or chronic obstructive pulmonary disease. The service provides follow-up telephone-based motivational coaching support to help patients make changes to their lifestyle in order to avoid readmission. The team support patients over a period of six weeks, helping them to reflect on areas of their life in which they would like to make a change, to set goals and take the steps to achieve them. The treatment and management of long-term conditions presents a massive challenge to the NHS in coming years. Ours is an innovative model which supports patients to take control of their health and avoid costly hospital treatment. We hope to roll this model out to other parts of the country in the future. Earl’s Court Health and Wellbeing Centre – Long Term Conditions Earl’s Court Health and Wellbeing Centre opened in December 2011. Turning Point is the lead organisation for the partnership. Also the Centre is part of the national People Powered Health programme from not-for-
profit innovation foundation, NESTA, working with the Innovation Unit. The programme supports the design and delivery of innovative services for people that are living with long term health conditions and focuses on coproduction – the idea that people’s needs are better met when they are involved in an equal and reciprocal relationship with professionals working together to get things done. It is a radical approach to public services that is built around six characteristics: nn
Recognising people as assets
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Building on people’s capabilities
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Promoting mutuality and reciprocity
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Developing peer support networks
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Breaking down barriers between professionals and users
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Facilitating rather than delivering
The Centre provides a GP-led health centre, community sexual health services and NHS dentistry enhanced by an extended community offering. This includes employment support; navigators providing signposting to services, groups and activities; a team of wellbeing coaches specialising in motivational coaching for patients with long-term conditions (including drug and alcohol problems and learning disabilities), alongside a community space, engagement programme, a time bank and peer mentors.
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Management and leadership agility 26
Conclusion of Programme Eden This year has seen the successful conclusion of Programme Eden, a two and a half year project to drive transformational change in our finance function. Its remit covered designing new efficient and effective processes, upgrading and enhancing our systems, implementing new organisational structures to support our aims of making the finance function a better partner to the business, driving results and embedding financial competency and discipline throughout the business. Programme Eden was one of the biggest undertaken by Turning Point to date, and was delivered on time and below budget. Programme Eden comprised 11 separate phases of work over 29 months. It reviewed and improved more than 200 finance processes across 18 different process areas and trained more than 300 people on new processes and systems. The finance team invested more than 2000 days of effort to make Programme Eden a success and more than 500 critical and important business requirements were successfully delivered. The benefits of Programme Eden have been immediate and we fully expect
them to be enduring. Ultimately, the Turning Point finance function is now in a position to deliver an enhanced service at reduced cost. The project management methodologies developed through Programme Eden are now being rolled out across the business in support of other key initiatives we now have underway.
Chief Executive of Turning Point, gave the keynote speech.
Launch of the new fiveyear strategy
New client-focused website
Coming to the end of the 2007-12 strategic plan, Turning Point will be embarking upon its new five-year strategy in the 2012-13 financial year. The strategy moving forward is designed to equip the organisation to compete successfully in a fast moving and challenging external environment. With significant public sector funding cuts impacting on health and social care providers, Turning Point will be seeking to strengthen its position within the substance misuse, mental health, learning disability and employment areas.
www.turning-point.co.uk
Bridging the Gap – Connecting government priorities and local voices In July 2011 Turning Point hosted a unique event: Bridging the Gap – Connecting government priorities and local voices. Part of the Community Leadership Network initiative run by Turning Point Connected Care and funded by the Department of Health, this conference enabled community members and professionals to come together for the first time to discuss ways in which communities can be more involved in the design and delivery of local health and social care services. The conference was attended by members of the NHS, representatives from Third Sector organisations, local community members and the Chief Parliamentary and Political Adviser to the Deputy Prime Minister, Norman Lamb MP. Lord Victor Adebowale,
Turning Point has launched a new website. The site is a wealth of relevant up-to-date news and information, useful fact sheets and sector-specific information. Designed with the needs of individuals, friends, family members and carers in mind, information is now broken down by services available across learning disability, substance misuse, mental health and the employment sector.
Investment in our people and systems will ensure we are well placed to deliver and evidence health and social care outcomes in an environment that will increasingly be dominated by Payment by Results and the personalisation of services. We will work with our key partners to extend our offer and continue to provide integrated care to turn more lives around.
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We help turn lives around every day
Contact Turning Point Standon House 21 Mansell Street London E1 8AA T 020 7481 7600 F 020 7481 7620 E info@turning-point.co.uk
www.turning-point.co.uk Turning Point is a registered charity, no. 234887, a registered social landlord and a company limited by guarantee no. 793558 (England & Wales). Registered Office: Standon House, 21 Mansell Street, London E1 8AA