Older Adult Services in Manchester

Admission to the service is based on assessment against the following eligibility criteria:

• Adults over the age of 65 (RCPsych criteria for those accepted within later life services)
• People who are diagnosed with a  a serious/severe and enduring mental illness, including those with severe disorder of personality where it can be established that there is likely to be benefit from continued contact and support within the CPA framework
• Eating Disorders
• People who suffer substantial disability as a result of their mental illness, e.g. self-neglect or social isolation etc.
• People who have suffered reoccurring crisis leading to frequent admissions/interventions.
• Have significant risk to their safety, or that of others.
• Dementia –  inclusive of those with an early onset.

 

People with Dementia who should be referred: 

• Any evidence of Behaviours that Challenge that may potentially lead to carer breakdown or loss of placement.
• Psychological symptoms including, agitation, depression and psychosis.
• Wandering where a major risk is identified and cannot be met by a social care package
• Non-Compliance with medication or support services that is due to a deterioration in mental health and potentially  leading to the above
• Those requiring nursing needs assessment for placements

 

Alcohol Related Dementia

Service users with Acquired Brain Injury due to Alcohol will be accepted into the service dependent on the severity of the symptoms in line with the criteria above. People who have a primary diagnosis of substance misuse without chronic cognitive impairment will be signposted to the appropriate specialty but will not be accepted into this service.

 

Learning Disability and Dementia

For those with a learning disability and symptoms that may be due to dementia links have been made between the CMHT and Learning Disability Community Teams to assist with assessments and treatment.. (Please see protocol).

 

The Community Mental Health team may not be suitable for those with:

• Mild to moderate mental health needs who can be managed by their GP within the Primary Care Services 
• Those individuals not known to the service who present with an immediate and obvious risk to themselves or others, or those that require urgent attention out of office hours. (should be directed to Accident and Emergency).
• Those individuals that are not known to the service and are referred for assessment of mental capacity.
• Those with substance misuse as the primary presenting problem
• Those with a primary Physical Health need
• The CMHT would not complete assessments in line with Care Act  (2014) for service users not open to the team or when the service users mental health needs can be met via primary care services alone. 

To make a referral, please send the form to the Gateway team via:

• Integrated Care Gateway
• Email – gateway@gmmh.nhs.uk

For further advice about a routine referral or to make an emergency or urgent referral please either:

• Contact gateway team on 0161 271 0260
• Contact the duty worker for the locality CMHT team which covers the neighbourhood/GP location, please see the contact information below. Each CMHT has a duty worker who is available to take calls and deal with any urgent referrals. This is available 9-5pm Monday to Friday
• Please ensure that referrals have up to date information about medications and physical health status including all relevant physical investigations.

Once a referral is received, it is sent to the appropriate CMHT team to triage within 24 hours. The team review information from the referral, collate any further information if needed, and then prioritise for action as follows:

• Emergency (same day response)
• Urgent (within 5 days)
• Routine (within 21 days)

Following the initial duty assessment, a summary of the assessment including a plan will be sent to the referring GP. This will include a plan of care and treatment for those patients being offered secondary care input.

If the person referred is not suitable for CMHT assessment, the team will write to the GP. The GP will receive a response back including the named clinician who made the decision, together with their contact details, reason for why the referrals was not deemed suitable for CMHT assessment, and advice about GP management of patient. This will be completed within 72 hours of the decision being made.

Urgency of referral	Timescale of response	Criteria
Routine	All patients accepted to be seen as a routine referral, will aim to be seen within 21 days	People who have substantial and complex mental health needs which cannot be met by primary care, the IAPT Service or other community services Ongoing severe mental illness which is impacting on day to day functioning Has requirements under the Care ACT
Urgent	During working hours Urgent referrals may arise via telephone or in writing to the Gateway service and forwarded to the appropriate CMHT by Gateway/or by telephone direct the senior practitioner dealing with referrals (see contact information) Urgent referrals will be accepted and assessed by CMHT during normal working hours. An urgent referral requires assessment within 1-5 days from referral. The CMHT will contact referrers and the patient referred  to inform on progress of the of the referral	Reason to believe that there is a risk of significant harm (immediate and serious risk to self and/or others) occurring as a result of a mental disorder, or suspected mental disorder, if no action is taken before the next community referrals allocation meeting, i.e. within one week The level of cognitive functioning that places the person at immediate risk of harm to self or others including carers (e.g. due to wandering, self-neglect, abuse) and physical/medical causation has been excluded Patient will have been ill enough to have seen by the ‘referrer’ who has knowledge of the patient and considers the risk for urgency to be linked with a perceived mental health problem
Emergency	Same day response /24-hour response	Immediate concern about risk to self /severe relapse of mental illness Patient is at risk of abuse/vulnerable and is in a location that is not safe. Patient may require home based Treatment as an alternative to admission.

Expected outcomes

With an emphasis on recovery and reablement, the CMHTs will incorporate a range of intervention based pathways to ensure appropriate care and treatment is given making best use of available resources; this will include:

• Robust screening and signposting to appropriate community based services.
• A comprehensive health and social care initial assessment for emergency, urgent and routine referrals.  This will reference all 10 Care Act (2014) outcomes and record whether the individual is able to achieve them and the impact not achieving any has on their wellbeing. 
• Short term assessment / intervention / treatment plans which will include appropriate behavioural/ non pharmacological and treatment focused interventions together with appropriate support and signposting for carers.
• Carers will be offered a carers’ assessments every 12 months a minimum requirement. 

 

Post discharge support

In line with the principles of recovery, the CMHT’s will work with patients and carers promoting recovery to support optimum mental health and independent living, at this point patients would be transitioned back to the care of their GP. In cases of patient deterioration/relapse, reassessment will be offered via the CMHT.

The duty mobile phone advice lines are additional support for the GP’s and provides direct access to a Mental Health Practitioner within their local Community Mental Health Team.

Contact details:

Contact Details

Manchester Older Adults Community Mental Health Teams	North	Hexagon Tower 11th Floor Crumpsall Vale Manchester M9 8GQ	0161 271 0277	07917572805	Eloise Weymouth
	Central	Chorlton House 70 Manchester RD Chorlton Cum Hurdy M21 9UN	0161 271 0038	0748400008	Hayley Farrell
	South	Rolandsway Civic Centre Wythenshaw M22 5RG	0161 219 2336	07795391748	Lucy Smith