Peer Practice Review template

Aims of the review:

The purpose of this Practice Review is to focus attention on the ‘AMHP competencies’ and ‘guiding principles’ that underpin your work, for you to demonstrate areas of skill and competence and highlight any areas of future development. This Review replaces the Direct Observation previously used by the AMHP service. This work forms part of the essential yearly Re warranting Portfolio.

The Review will be of a piece of AMHP work undertaken – this will usually be a MHA assessment, or part of an assessment, but could also include other elements of AMHP practice.

The aim is to work collaboratively with your peer to plan, review and reflect on your practice to positively aid your future development needs and practice. It is not meant to be punitive.

Only if a review highlights clear concerns about AMHP’s practice or competencies would it result in further action from the AMHP service. It is intended that any feedback should be constructive and should help raise quality.

Guidance for using this template

Where possible, Peer Practice reviews should take place with your AMHP practice supervisor performing the role of the Peer Reviewer. In such cases, the Practice Supervisor will arrange this as their Quality Assurance Day. If a Peer Reviewer is doing a Practice Peer Review for an AMHP they do not supervise, then this will be an additional Quality Assurance day for them.

The Date of the Practice Review should be agreed and set in advance between the AMHP and the Reviewer and the AMHP service notified via the amhprotarequests@kent.gov.uk. to inform the Rota.

Generally a MHA assessment will be given to you for consideration at the morning AMHP handover meeting. However, if you are choosing to be reviewed on a different piece of work, for example, a Nearest Relative case, then this will need to be booked in advance with the Shift coordinator and only if there are enough AMHPS on duty on the day to cover assessment work.

If, on the day, an assessment cannot be identified for you; then please seek alternatives for your review. E.g., consideration of a case, a piece of Nearest Relative work or something else.

Both the AMHP and the Reviewer will be given a whole shift for this report, including completion of the written work . If this is not possible, then the written work should be completed and returned to the Reviewer within 5 days. If this is not achievable, for a particular reason, it must be discussed and agreed with the Reviewer, and a time set for completion. If, after this time, the review is still incomplete, the Reviewer should then email the AMHP and copy their Operational Manager into this, to discuss and provide the necessary support.

The bulk of this report is to be completed by the AMHP as soon as possible after the review. They then need to forward it to their peer Reviewer to add their comments and learning. Then jointly identify the AMHP’s future learning needs and plan.

Name of AMHP
Name of Peer Reviewer
Name of Practice Supervisor
Name of Operational Manager
Date

Preparation discussion with peer
This should be a discussion prior to the assessment taking place. This might include - Considering what you want to achieve from this peer practice review, in collaboration with your peer. You may wish to pull items from your action plan for identified learning needs, previous peer practice review and AMHP report audits, previous feedback from others. Are there any competencies or principles you haven’t yet had the opportunity to meet?

Scenario
Brief overview of the case or task being reviewed today: Suggestions for types of practice review opportunity include – any form or stage of a MHA assessment, 135(1) application, NR work, shift coordination.
AMHP to comment below. Describe and reflect on the work undertaken that meets each area…. How did you demonstrate the area, what did you do well, what would you improve? You can use a breakdown of the AMHP competencies and description of the principles to guide you (included at the bottom of this template). You may not have met all the competencies or principles today.
AMHP Competencies
Application of values to the AMHP Role
Application of knowledge - the Legal and Policy Framework
Application of knowledge - mental disorder
Application of skills - working in partnership
Application of skills - making and communicating informed decisions
Guiding principles
Least restrictive option and maximising independence
Empowerment and involvement
Respect and dignity
Purpose and effectiveness
Efficiency and equity

Peer reviewer’s comments
Please provide a brief overview of how you witnessed the AMHP demonstrate the AMHP competencies and Guiding Principles. Please comment on the AMHP’s reflections above, do you agree? What are the areas of strength for this AMHP? Are there any learning areas for future consideration?
Peer reviewer’s learning
As the peer, what did you learn from this AMHP? Is there anything that you would change in your own practice?
Feedback: Any other feedback gathered at the time of the peer practice review from the service user, a carer or family member, or other professionals involved. This could be gathered, if possible, by the AMHP or the peer reviewer!
Agreed Learning Needs:
This section should be completed jointly by the AMHP and the Reviewer, please record the agreed identified learning needs which will be taken forward to the AMHP’S Action Learning Plan.

For the Reviewer to identify themes from the review that will assist Future AMHP service training/courses:
Themes	Good practice	Need for improvement	Brief explanatory note
Considering all the circumstances of the case – background information
Nearest relative identification as per S26 MHA
Contacting nearest relative prior to interview
Consultation with family and carers prior to interview
Consultation with other professionals prior to interview
Interview – AMHP introductions and explanations
Interview - offer to speak to the AMHP alone
Interview - in a suitable manner
Assessment of mental capacity properly documented
Assessment of risk – sufficient, thorough and in-depth
Nearest Relative consultation & objection re S3- clearly recorded
Nearest Relative informed of rights
Outcome rationale sufficient, thorough and in-depth
Conveyance –details and rationale for mode of transport
IMHA Referral
Safeguarding - details provided with associated actions taken
Needs Assessment criteria met referral offered/made
Carers Assessment criteria met referral offered/made
Breathing Space criteria met referral offered/made
Protection of property - details provided with associated actions taken
Overall quality of the report and professional presentation
Unacknowledged and/or outdated copy and paste information
Any GDPR issues
Other

Once this Review is complete, it is for the AMHP and the Reviewer to file as appropriate, and for the Reviewer to send a completed copy to the kentamhpservice@kent.gov.uk for filing .

The five overarching principles are: Least restrictive option and maximising independence Where it is possible to treat a patient safely and lawfully without detaining them under the Act, the patient should not be detained. Wherever possible a patient’s independence should be encouraged and supported with a focus on promoting recovery wherever possible. Empowerment and involvement Patients should be fully involved in decisions about care, support and treatment. The views of families, carers and others, if appropriate, should be fully considered when taking decisions. Where decisions are taken which are contradictory to views expressed, professionals should explain the reasons for this. Respect and dignity Patients, their families and carers should be treated with respect and dignity and listened to by professionals. Purpose and effectiveness Decisions about care and treatment should be appropriate to the patient, with clear therapeutic aims, promote recovery and should be performed to current national guidelines and/or current, available best practice guidelines. Efficiency and equity Providers, commissioners, and other relevant organisations should work together to ensure that the quality of commissioning and provision of mental healthcare services are of high quality and are given equal priority to physical health and social care services. All relevant services should work together to facilitate timely, safe and supportive discharge from detention. The five AMHP competencies are: Application of values to the AMHP Role The ability to identify, challenge and, where possible, redress discrimination and inequality in all its forms in relation to AMHP practice. Understanding and respect individuals’ qualities, abilities and diverse backgrounds, and the ability to identify and counter any decision which may be based on lawful discrimination. Promotion of the rights, dignity and self-determination of individuals consistent with their own needs and wishes, to enable them to contribute to the decisions made affecting their quality of life and liberty. Sensitivity to individuals’ needs for personal respect, choice, dignity and privacy while excercising the AMHP role. Application of knowledge - the Legal and Policy Framework Application of knowledge of mental health legislation, related codes of practice and national and local policy guidance. Application of knowledge of other relevant legislation, codes of practice, national and local policy guidance, in particular the Children Act 1989, Children Act 2004 and the Mental Capacity Act 2005. Knowledge and understanding of the particular needs of children and young people and their families, and an ability to apply AMHP practice in the context of those particular needs. Racially and culturally sensitive understanding in the application of knowledge of mental health legislation. An explicit awareness of the legal position and accountability of AMHP’s in relation to the legislation, any employing organisation and the authority on whose behalf they are acting. The ability to evaluate critically local and national policy to inform AMHP practice. The ability to base AMHP practice on a critical evaluation of a range of research relevant to evidence based practice, including that on the impact of the experience of discrimination on mental health. Application of knowledge - mental distress Critical and applied understanding of a range of models of mental distress, including the contribution of social, physical and development factors. Critical and applied understanding of the social perspective on mental distress and mental health needs including personality disorder, in working with people who use services, relatives, carers and other professionals. Critical and applied understanding of the implications of a range of mental distress for people who use services, children, families and carers. Crititcal and applied understanding of the implications of a range of relevant treatments and interventions for people who use services, children, families and carers. Critial and applied understanding of the impact of the experience of discrimination on mental health. Application of skills - working in partnership The ability to articulate, and demonstrate in practice, the social perspective on mental distress and mental health needs. The ability to communicate appropriately with and to establish effective relationships with people who use services and carers in undertaking the AMHP role. The ability to articulate the role of the AMHP in the course of contributing to effective inter-agency and inter-professional working. The ability to use networks and community groups to influence collaborative working with a range of individuals, agencies and advocates. The ability to consider the feasibility of and to contribute effectively to planning and implementing options for care such as alternatives to compulsory admission, discharge and aftercare. The ability to recognise, assess and manage effectively risk in the context of the AMHP role. The ability to effectively manage difficult situations of anxiety, risk and conflict, reflecting on how this affects themselves and others. The ability to work with the conflict between and the inherent power in the AMHP role and the objectives of empowering people who use services. The ability to compile and complete statutory documentation, including application for admission. The ability to plan, negotiate and, manage, compulsory admission to hospital or arrangements for supervised community treatment. The ability to manage and coordinate effectively the relevant legal and practical processes including the involvement of other professionals as well as people who use services, relatives and carers. The ability to balance and manage the competing requirements of confidentiality and effective information sharing to the benefit of people who use services and other stakeholders. Application of skills - Making and communicating informed decisions The ability to assert a social perspective and to make properly informed independent decisions. The ability to obtain, analyse and share appropriate information in order to manage the decision-making process including decisions about supervised community treatment orders. The ability to provide reasoned and clear verbal and written reports to promote effective, accountable and independent AMHP decision making. The ability to present a case at a legal hearing. The ability to exercise the appropriate use of independence, authority and autonomy and use it to inform their future practice as an AMHP, together with consultation and supervision. The ability to evaluate the outcomes of interventions with patients, carers and others, including the identification of where a need has not been met. The ability to make and communicate decisions that are sensitive to the needs of people who use services.