Monday, 23 April 2018

Dyfed Powys Police - Powys Partnerships

Rhiannon (far right)  with colleagues at the recent 2018 mental health conference
This week our guest author is Chief Inspector Rhiannon Ivens of Dyfed Powys Police.

Chief Inspector Rhiannon Ivens has served in both Hampshire Constabulary and the Metropolitan Police service and performed the role of Chief Inspector Operations for several years prior to taking up her role as a substantive Chief Inspector with Dyfed-Powys Police.

I was appointed by Chief Constable Mark Collins on the 10th April 2017 as Chief Inspector and am responsible for Partnerships in Powys. I have a significant amount of experience in this field and am keen to support existing partnerships in addition to creating an environment whereby working together with other agencies and stakeholders is as seamless and effective as possible to achieve excellent outcomes for the residents and visitors to the county. 

On 1st March 2018 at Police Headquarters in Carmarthen, the Police & Crime Commissioner and Chief Constable hosted their second annual Dyfed Powys St David’s Day Conference. I was honoured to be involved in arranging this event which was enjoyed by many.

The focus of this years’ event was Mental Health.

Chief Constable Mark Collins took up his role as national lead for mental health in January 2017 and is committed to learning from the experiences of those living with mental ill-health, people external to policing, and from those within the service itself.

Despite the snowy weather conditions so many people and partners joined us on the day with an audience of 80 - 90 people present, including partners from mental health services in Powys Teaching Health Board. This goes to show that so many people cared deeply about being there and the subject of mental health. 

Police and Crime Commissioner Dafydd Llewellyn opened the event (above).

Guest speakers from different fields gave presentations and answered questions from the floor. They included:

Inspector Michael Brown OBE, who works with the College of Policing and National Police Chiefs' Council and is the author of the Mental Health Cop blog (below).

John Williams (below) is a Professor of Law at Aberystwyth University, and has presented papers at numerous conferences including the International Academy of Law and Mental Health.

Tony Herbert, whose son died in police custody in Somerset in 2010.

Social justice, and the way that we treat people with mental health issues, have been important to Mr Herbert even before James’s tragic death. 

Tony Herbert
“Mental health demand is rising not just in policing but across our whole emergency system and in society as a whole. Much of policing and mental health is not about major crisis incidents or serious adverse events; it is about the daily challenge of quietly responding to vulnerable people, often collaboratively. Today’s conference has been a great opportunity to share stories and learning but also encourage attendees to think creatively about how, in our respective roles, we can get better at early intervention.”

“I am very happy with the success of the second Annual St David’s Day Conference. Having a focus on mental health provided local organisations, partner agencies and Dyfed Powys Police itself with an opportunity to discuss and debate on a very important topic.”

The conference was instrumental in supporting the police and our partners to provide the best possible service to those suffering with mental illness. More recent improvements, increased awareness, understanding and compassion for service users has led to many incidences of positive intervention and our commitment to further progress is cemented by our Force Mental Health Strategy and Delivery Plan moving forward.

I received a lot of positive feedback from the event and it was encouraging to know that attendees have pledged a commitment to improving and raising awareness of how to deal with mental health.

Some examples below:

“I will read up more of the roles different agencies play in supporting mental health sufferers to enable better signposting if and when we encounter the issue.”

“I will discuss with clients their experience of police involvement in times of crisis highlighting positive and negative points.”

“I will feedback to the organisation the positive comments I’ve heard here today and include pointers from speakers in my presentations with Time to Change Wales on stigma and discrimination towards mental health.”

“I will promote positive mental health and ensure my staff and I receive relevant training.”

Police and Crime Commissioner Dafydd Llywelyn said:

"It was a pleasure to work alongside the Police and Crime Commissioners staff and police staff who all worked really hard to ensure this was a successful event."

Thank you for the opportunity to provide a bit of an update of my recent work regarding mental health and I look forward to continuing this work with fantastic partners in and around Powys and in Powys Teaching Health Board.

Many thanks to Rhiannon for telling us all about the mental health conference which took place last month - really appreciate it especially as we were snowed in here in North Powys!

If you have any questions about mental health in relation to policing that you would like to ask Rhiannon, please post them in the comments box below. We love to hear from you.

Finally, those featured in the photo at the top are as follows:

Brieg Dafydd & Mair Harries - Office of the Police & Crime Commissioner, Sharon Reynolds - Corporate Communications, Michael Henry - Staff Officer to Chief Constable Mark Collins, and Chief Inspector Rhiannon Ivens.

Wednesday, 18 April 2018

Celebrating the One Powys Connecting Voices project

On a wintery Tuesday in late March, Carl Cooper, the PAVO Chief Executive Officer, spoke at the Powys COVERED (Connecting Our Voices Embracing Real Engagement and Dialogue) event which celebrated the achievements and legacy of the lottery funded One Powys Connecting Voices project. PAVO managed a portfolio of six projects over five years aiming to empower citizens to have a greater influence on the design and delivery of statutory services in Powys.

Over the past five years on this blog we have observed and recorded some of the achievements of one of the portfolio projects in particular: YAPS (Young Adult Peer Support project) run by Ponthafren Association (read The YAPS project at Ponthafren Association, Young Adult Peer Support project @ PAVO AGM and YAPS Sharing the Voice).

Carl summed up some of the achievements of the OPCV project as a whole at the event:

 “About 7 years ago the Big Lottery Fund in Wales had an idea. It wanted to try to support people in getting their voice heard and in influencing decisions that affected them. They then invited County Voluntary Councils such as Powys Association of Voluntary Organisations to put in a bid (it was a competitive process - not every area of Wales was successful), in relation to getting voices heard to make a difference, but also in a way that reflected the local context and local environment.

To be frank, I was surprised we were awarded the money. That’s not because I thought that what we set out to do wasn’t important, but our approach here in Powys has been very unique in that if you were to look at the projects elsewhere in Wales they have a very, very distinct focus. One was focussing exclusively on mental health. Another on learning disabilities and so on. We took a risk I think, in that at the time, together with the council and health board and other partners, we were developing the One Powys Plan. And the OPP was a diverse plan wanting to do lots of things. So we brought together a portfolio of projects to enable voices to have an influence on different aspects of the OPP. So as you will see around the room we have got people supporting carers, people that were focussing on neurological conditions, others that focussed on older people, others that focussed on the environment and sustainability, on younger people, on children and so on. 

My slight nervousness was that the Big Lottery Fund might look at this and say, hmmmnn, not sure about this because it feels a bit fragmented. It doesn’t really hang together very well. Gladly they didn’t, and I think what we have been able to do over the last five years is bring that diversity of people’s voices to bear on planning and decision making here in Powys. And it’s been a delight to work with our partner organisations represented in this room and I want to thank you for working with us so readily, so effectively and in a way that I think has built relationships between ourselves but also within the wider sector and partnership arena.

So what has this project actually done? Well, in one way it’s very simple. We wanted to try to support people in getting their views, observations, comments and concerns heard by Welsh Government, by the commissioners of services, by our statutory partners in the council and health board, by emergency services such as the police and many others. And I’m pleased to say that that was done and it was done well. Nothing is perfect and it would be invidious of me to stand here and pretend that things are ever perfect. But this project has made a difference. And that is crucial.

Barbara Perkins, OPCV Officer and Martin Nosworthy, Chair of the PAVO Board
So when I look at some of the evidence and information from this portfolio of projects, I see some of these things we know are true of Powys, for example how the geography of Powys is a constant challenge, particularly when it comes to access to services. But over the last five years, when you look at what has actually emerged, we now have virtual wards operating in Powys that the voluntary sector, health, social services and so on come together to realise and to run. We have video links, which connect patients to GPs and special consultants, be they local or a further distance away. That’s just the first of a number of examples really. I don’t want to claim that this project was the one and only influence on those decisions, but the crucial thing is that we can evidence that this project influenced those decisions.

You, and the people you represent, not only got your voices heard but your voices were listened to and they made a difference. That is crucial. Also the way in which young carers were brought into contact with social workers. The way in which those young carers were then involved in the training of social workers. So that workforce development, as well as operational delivery, was part of how the voice was mobilised to make things different. The commissioners for older people’s and children’s services have been involved in discussion and dialogue around transport, around social isolation, loneliness, and certainly if you look at some of the initiatives that have been taking place over the last years, and that will continue under the new area plan and wellbeing plans, then again things are different.

We’ve seen lots of other things develop. Again partly influenced by this project, be it around recycling and the involvement of communities and volunteers in recycling. So called upcycling. So, you take what might one time have been discarded and you give it fresh life for new use. We have repair cafes that have emerged over Powys over the last years. Again partly as a result of this project. 

Julia Gorman and Robin Green ran the YAPS Project at Ponthafren Association
Further examples include dementia cafes, and dementia support groups. Children have led campaigns about children’s rights. Young adults have provided services to local employers especially around training and workforce development. We’ve also seen in this project, and because of it, impact around helping people with shopping and making sure that particularly older people who find it difficult, if not impossible, to get out of the house, get affordable goods delivered to them. And we’ve been able to link that with some support around cooking and healthy eating and again that wouldn’t have happened, certainly not in the same way, had it not been for what this project was doing. 

My last example is around digital accessibility. We all know that transport is a perennial intractable problem here in Powys. But crucially we are very aware that people need to be plugged in digitally in the 21st century in order to be able to access health, social and commercial services at all times. And part of what this project has done is to help people in terms of upskilling and training and information when it comes to technology and internet services. Again another example of an accessibility barrier that has been overcome.

So, I’ve just tried to focus on literally ten or so examples of where what we’re doing today is not just saying well done and let’s go home, but well done and you’ve made a difference. Things are not the same in Powys today as they were five years ago because of what you and colleagues have done. And that’s a testimony not just to the project but to the value of participation, the effectiveness of public engagement, and to use a bit of more modern jargon, the importance of so-called co-production. 

And so I'll end my comments by saying that this work does not stop here. During the lifespan of this project we’ve had a so called Issues Log. And each of the projects has added issues to that log and so we have been able to see what issues and what comments people have been presenting with. Over the five years we’ve had thousands of issues. But six hundred of those issues were taken forward in dialogue and engagement and in conversation with local partners and with local agencies. And that will continue. Because PAVO is building a new website and this will be live very soon. And one of the things you will see on the website is an online portal which will be the updated version of our Issues Log. So, although the project is coming to an end it will still be possible for environmental groups, for carers, for children, for older people, for younger people and many others to go to the PAVO website and actually make sure that your issue is logged.

But it doesn’t stop there. We will then regularly collate and analyse that information, and make sure that it continues to influence decisions through our links with partners and strategic partnerships. So it’s not the end today. The end of the project, but things will still continue.”

Monday, 19 March 2018

Owen's 5 x 5 Ways of Wellbeing: Part 3

by Owen Griffkin
Mental Health Participation Support Worker

In Part 1 of my series I looked at how to Connect. Part 2 was all about Keep Learning.

Number 3 in our series on practical ways to follow the Five Ways to Wellbeing plan is Take Notice!

According to the mental health charity Mind reminding yourself to ‘take notice’ can strengthen and broaden awareness. The research shows that being aware of what is taking place in the present improves wellbeing. It’s thought that becoming more aware of your surroundings in turn leads you to become more self-aware, and allows you to have a better understanding of your motivations, and helps you make positive choices.

This might actually be the easiest of the five steps to implement, as it can be something as simple as changing your route to work/school run. So here are 5 ideas for you to try out yourself.

1. Leave your phone at home

This one is self explanatory - leaving your phone at home might mean that you aren’t wandering around checking email, being interrupted by a Facebook notification that is of no interest to you, or if you’re in a social situation you might engage more with your friends or colleagues. I do this a lot and it works a treat (admittedly I usually leave it by accident). Once you lose that 'no-phone' anxiety then it becomes quite enjoyable, and will help some of the other ideas in this article. Except for...

2. Bring your phone out with you

"What? But you just said leave it at home?? I’m confused!"

Yeah, phones are a big barrier to becoming aware of surroundings, but they do have a great feature, which can really help you notice the world around you. The camera. There was a recent challenge shared on social media which encouraged people to post 7 black and white photos in 7 days. Taking photos of your daily commute, using one of those fancy filters which seem to be the norm on all social media pics, really gives you a new eye on what’s around you, and allows you to maybe see something beautiful that wasn’t there before.

I had a quick go at this myself, and you can see a sample of my pics that I did around the photogenic offices of PAVO. Very arty.

3. Start a bullet journal

I recently started a bullet journal, after my partner and others raved about theirs for ages. It’s a simple idea; imagine a superpowered, creative, analogue diary. It’s simple to set up, and the more time you put into it, the more info you can pack into it and usefulness it can bring.

Bullet Journal by Eleanor Outram-Rees
My artistic talents are pretty low, so mine isn’t the most beautiful work ever, but I have seen examples of other people's that are creative and useful. As well as helping with future planning, which is a great help to wellbeing, it also allows you to record thoughts, ideas and feelings to reflect on later. 

It’s explained in much better detail by the creator Ryder Carroll on his website Bullet Journal.

Bullet Journal by Jessica Rose
There are also two great Facebook groups you can join for inspiration and advice: BuJo (Bullet Journal) Beginners and Bullet Journal Junkies UK.

4. Take a walk on the wild side

I usually drive my daughter to school due to time issues and the fact it is just that little bit too long to walk. However on the occasions when we do walk together it is a much happier time. We have longer conversations that we wouldn’t have in the car, and everything seems a bit less hectic. Even on my own, a walk instead of a drive leaves me feeling relaxed and helps with my mindfulness. SO if there is a journey you regularly make by car, that you could actually walk, give it a try every so often. Another tip is to change your route up, and go a way you don’t usually go to add extra ‘awareness points’.

5. Notice the seasons

I’m a city boy by birth and upbringing, and one of the things I’ve noticed and enjoyed most since moving to Powys is how much more noticable the changes in the seasons are. Take a walk and take stock of the landscape and nature, then repeat this over a period of time. Maybe you could even record it creatively, either by drawing, or writing about how it makes you feel. You can also combine this with the photo challenge, taking pictures of the same scene over time and building them up into your own personal work of art.

I really appreciate this ‘way to wellbeing’ as Powys is the perfect place to take comfort from your surroundings and there is always something or somewhere new to see. It’s a cheap and easy way to improve your wellbeing just by taking a step back and contemplating and reflecting on your own feelings. Now I’m off to go and look at all the fresh snowdrops and crocuses/croci and wait for spring to arrive properly.

Is that cup of coffee really blue....?

The Five Ways to Wellbeing was devised by the clever folk at the New Economics Foundation and is supported by Powys Teaching Health Board and Public Health Wales.

Thursday, 8 March 2018

R.A.B.I – supporting farming families in Powys

Becky with her Dad, and his dog, Merle!
This week’s guest post is from Becky Davies
Regional Manager of R.A.B.I for North Wales and Warwickshire 

My name is Becky and I work for a charity called R.A.B.I, aka the Royal Agricultural Benevolent Institution. We are a national farming charity working throughout Wales and England. We aim to help people of all ages from the farming community, particularly those who have found themselves in difficult circumstances through no fault of their own.

I work for R.A.B.I four days a week as a “Regional Manager”. What this means is that I help to raise money for the charity and also raise awareness of what we do, and how we can help people. The charity has its head office in Oxford, but I get to work from home, and my work takes me out and about throughout North and Mid Wales, and Warwickshire. I am originally from a farming family in Shropshire but I have recently moved to live on a farm near Dolgellau. My colleague Linda Jones also works with me as a Regional Manager in Powys. Linda and I have two fabulous colleagues working with the farmers in Powys – Mel Jones and Claire Critchard. Mel and Claire are Regional Welfare Officers. They both work very hard visiting people in Powys and beyond, making sure that we are doing all we can to help.

Some people don’t understand how farmers can end up feeling depressed. It can be a lovely, rewarding occupation. They are surrounded by our beautiful Welsh countryside, getting out into the fresh air each day. But from time to time it can be difficult to pick your head up and notice the beauty in your surroundings.

Farming is a 24/7 business and many in the industry work very long hours in isolation in remote, rural areas. On top of that, there will always be factors that can quickly cause stress and anxiety to escalate such as market fluctuations, poor harvests, bad weather and animal disease. Not seeking support when symptoms first emerge can make things much worse.

People approach the Royal Agricultural Benevolent Institution (R.A.B.I) for all sorts of reasons. At R.A.B.I we give out grants to people from the farming community, and provide a range of additional support. For some people, our help might just provide a breathing space to hopefully take the pressure off. It’s incredible how having someone to talk to can so often be that vital first step on the road to recovery. For some people, tackling their financial problems can immediately relieve some of the stress, anxiety and worry.

Farmers Lizzie and David Ottley with R.A.B.I Regional Welfare Officer Sally Hubbard
We offer a free, and confidential service. Most of the people that we help, choose to remain anonymous (as is their right), but some individuals agree to share their story. David Ottley is one of these people.

David and wife Lizzie run Blue Welly Farm and have three young daughters. David remembers the time before he called on R.A.B.I for help: “I had the farm and the family I’d always wanted but something was not right. I was not happy.”

Over the years, David’s problems worsened. A string of unfortunate circumstances befell the farm and David felt that he had ‘hit the bottom and crashed’.

David described a particularly difficult time when his ewes developed health problems, leading to them lambing four weeks early. Most of the new-born lambs could not survive.

“I was afraid of going into the lambing yard to see what I’d find next. I couldn’t do it. Lizzie held it all together, until the morning that she needed my help with a ewe that was having trouble. She said it was like watching someone who had never lambed before. I didn’t know what to do.

“I sat on the floor and felt empty and dead and just for a second I felt I might as well be because I had no feelings.

“I went to the doctor's and went on medication, but I was still under a very dark cloud. Months of not being on the ball had meant that money had gotten very tight. I started hiding the bills from Lizzie, but also from myself.

“One day I sat outside at our table. Everything was dead, there were no birds and no life. I decided I had to do something because this couldn’t carry on.”

David sought the help of R.A.B.I, and Sally Hubbard, one of our welfare officers, met with him to work out how the charity could help him and his family.

“She came out and went through everything. She helped us put together a plan on how we were going to pay off these bills. Things weren’t as bad as I thought they were. She also called some of our creditors and spoke to them on my behalf, which is something I couldn’t do.

“Most of all, she listened. She listened without rushing me.

“The money R.A.B.I gave us kept the house running so the farm had a little bit of time to rest and pay for itself. We could function and pay our bills.

“Sally and R.A.B.I helped me focus on the farm and walk through the fog to see the sun and hear the birds. They helped me get back on track to do farm work again. I’m looking ahead with a smile again.”

People are generally surprised when I talk about all that R.A.B.I can offer. Our primary aim is to offer financial support to farming people, but in reality, we do so much more than just hand out grants. You can explore a bit more on our website. Many of the people who have made the brave step to contact R.A.B.I are often relieved once they have contacted us. If you know of anyone linked to the farming community that might need our support, please get in touch with R.A.B.I by emailing: or ringing the freephone helpline: 0808 281 9490.

Thursday, 1 March 2018

Powys Befrienders - knitting for wellbeing

When I have time, especially in the winter, I like to knit and listen to the radio. I find it very therapeutic. Its rhythmic and repetitive nature has often been compared to meditation. Many of my office colleagues knit too, and we love to pass on tips about our favourite yarns and patterns. We might have a bonding moment or two comparing bamboo knitting needles and angora wools when the broadband dips out for a couple of minutes…

This Tuesday I was invited to meet another friendly group of knitters and crocheters at Abbeyfield House in Newtown for their regular fortnightly session. If you’re a knitting enthusiast, you’ve probably come across the Knit & Natter concept. This incarnation is the Newtown Knit Tea Together group set up by the Powys Befriending Service. (Read Powys Befrienders – it’s given me back my life for more on this PAVO project generally). It was snowing, so not all the regulars had been able to make it, but Eileen, Betty and Carol were joined by first-timer Olive for a chat, loads of laughs, and plenty of knitting, sewing and crocheting.

Olive works on a twiddle mitt
This week they were busy making twiddle mitts and cushions for people locally living with dementia. (Online pattern for knitters!) “People with dementia are always looking for things to touch,” they explained, “so we sew bells, beads, eyes and Velcro to the mitts, and people find them very therapeutic.” While I was there Lesley Austen, the Powys Befriending Services Co-ordinator, arrived to gather up mounds of the mitts to take to Bethshan Care Home, also in Newtown. Past group projects have included making baby blankets for local maternity services, and creating colourful knitted toys and clothes to raise funds for the group. At a market stall in Glanhafren, Newtown Market Hall, on 8 December, they raised £380 through sales, and are now planning a summer stall.

While the women sit and sew they swop tips, plan trips – including activities and shopping – and update each other about the latest local news stories. They happily share their skills, and experience. Carol promises to teach 
Olive how to crochet the next time they meet. There’s a haberdashery moment and in five minutes Eileen’s volunteering to shop at her favourite supplier for all the others. And who would have known that the best and cheapest way to stuff a knitted doll is to pull a pillow apart for the filling? 

L-R: Lesley (Powys Befriending Service Co-ordinator), Olive & Eileen
"Tell me again, what's a split stitch in knitting...?"
Why we like to knit and crochet

"It relaxes you. It keeps your hands moving. It you have arthritis it helps to keep them moving. You have to keep active."

"It keeps your brain moving too! If you’ve got one! It helps keep your mind off a lot of problems. You can take it out in your knitting. You go faster if you’re in a bad mood!"

Several members of the Newtown Knit Tea Together group are also active Powys Befriending Service volunteers in their local community. The two volunteers present tell me about the clients they support. One is a gentleman with Parkinson’s disease who is visited at home, and another is a lady who is supported to attend afternoon teas at the Smithfield Bell in Welshpool, or the Lakeside Restaurant at the golf course near Montgomery.

Carol does crochet... and is also a PB volunteer

Later Lesley told me more about Eileen’s contribution as a Powys Befriending Service volunteer:

Eileen’s husband died after a prolonged illness and was bedridden for the last 6 months of his life. He did not want to be in hospital so Eileen had cared for him at home supported by Health and Social Services. For over a year she had rarely left the house and had lost a lot of confidence about going out on her own as well as suffering from grief and loneliness. Her daughter referred her to the Powys Befriending Service and accompanied her to one of our group lunches.

Eileen was very chatty and helped people sitting around her. At the end of the session, when I asked how she had got on, she said she loved it: “But I’m so much better off than some of the others, wouldn’t I be of more use helping them?”

Eileen duly attended the Befriending Induction training, got her DBS (Disclosure & Barring Service) approval and two glowing references and asked “When do I start?” She didn’t want to have to drive too far, so I matched her to a housebound gentleman with early stage dementia and other health needs who lived a few miles away. As we approached the gentleman’s house she told me she and her husband used to walk in the area and used to chat to a lovely man tending his garden – and this was the gentleman she was getting matched to!

Both he and his wife recognised Eileen and were delighted to see a familiar face. The client has memory loss and several health conditions requiring appointments and visits, so we agreed Eileen would visit every two weeks. The match is a great success – both client and volunteer share a farming background and enjoy talking about farming and the local countryside, reading the local paper and following sports events on TV. 

The client’s wife now has a regular couple of undisturbed hours when she can do things that she enjoys, getting out in the garden, baking and having a chat on the phone with friends, which she had not previously been able to do easily, having to keep an ear and eye out for her husband’s needs.

This still left Eileen with time on her hands and a will to help people, so she asked if it would be possible to have another client to see on alternate weeks and is now also matched with a lady who had no means of getting out and about. She takes this lady to an afternoon tea group, and is now supporting the group by helping with clients.

Eileen then asked if she could come along to the Newtown Knit Tea Together group as she loves knitting and sewing, and after a few sessions she and another volunteer were quite happy to run the group themselves with me in the background for occasional support. Lots of our female clients list amongst their interests knitting, crochet and sewing, but no longer have anyone to make things for. Eileen soon armed them with patterns, needles and wool and got them making baby clothes in premature sizes, which we now send in regular parcels to Special Care Baby Units in Welsh Hospitals.

Oh did I mention…………… Eileen is 86 years young!

Eileen told me “I get as much out of being a volunteer as the people we help. It’s been a lifeline to me since I lost my husband.”

Betty with one of her knitted dolls

If you would like to join the Newtown Knit Tea Together group run by the Powys Befriending Service (don’t worry if you can’t knit, sew or crochet – there are plenty who will happily teach you) then give Lesley a call to find out more on 01597 822191 or email:

Are you a knitter or crocheter? Does it help boost your emotional wellbeing? Let us know in the comments box below.

Monday, 19 February 2018

Memory boxes – the Ystradgynlais story

In July 2016 I posted Memory boxes – connecting with the past – about a new initiative in Brecon run by the local museum. It is aimed at anyone working with, or caring for, older people living with dementia. Across the UK the approach is spreading as more communities decide to become dementia-friendly. A memory box scheme is a relatively easy and fun project to set up. And it is a very practical way to support people to reminisce about the past and thereby improve their wellbeing in the present. 

Sally Richards
Sally Richards, the PAVO Community Connector for Ystradgynlais and District, told me more about the Ystrad scheme. She also updated me about her work in the town, particularly in relation to supporting people living with dementia and those caring for them.

Dr Anja Pinhorn, a Consultant in Health Care of the Elderly at Powys Teaching Health Board, regularly works out of the Ystradgynlais Community Hospital. She initiated this memory box scheme working closely with a number of voluntary sector agencies in the town. Pulling in different groups has resulted in some truly unique memory boxes, with themes ranging from nature and wildlife, to sport and the Abercrave Rugby Football Club, the history of the local area, weddings, sewing, Christmas and cooking. 

Anja told us: "Staff at Ystradgynlais Hospital originally borrowed a couple of memory boxes from the Brecknock Museum Service and were impressed at how it opened up conversations on the ward. This led to the idea of developing our own conversation boxes. Staff have been overwhelmed by the response when we asked for help from diverse individuals and groups including Brecknock Wildlife Trust, the British Red Cross, a photographer based at Craig y Nos and the Ystradgynlais Volunteer Centre. Thank you all and keep the ideas for boxes flowing."

The boxes live on the 20 bedded Adelina Patti Ward at the hospital where they are used to stimulate conversation and memories about patients’ lives. These could include key events and anniversaries, holidays, interests and hobbies, working lives and everyday family activities. The boxes are crammed full of intriguing objects - everything from beer mats to confetti, knitted flowers to shoelaces! All to encourage an exploration not just with the eyes but also by touch, transporting people to their past lives. Sally explained that the benefits are obvious as the boxes can actually help stop people going into a low mood during a long stay in the hospital. Following their success on Adelina Patti Ward she is keen to spread the word and encourage their use in other sections of the hospital.

In her work as a Community Connector Sally regularly supports people living with dementia and those caring for them to make links with organisations that can help. Many practical issues will arise with a dementia diagnosis, including the need for more personal and medical care, and support with finances. However, “one of the hardest things for carers to deal with is losing the person that they fell in love with, or love, to the disease”.

Clients ask Sally about legal aspects relating to a dementia diagnosis such as Lasting Power of Attorney, or benefit payments like Attendance Allowance. However, sometimes what is of crucial importance to mental wellbeing is setting up links with local groups. If someone has had their driving licence revoked and feels their independence is being stifled, it is important to arrange transport so that they can continue to pursue their interests. In Ystradgynlais people are more likely to look south to Swansea, rather than north to Brecon and Llandrindod for activities, so Sally has to be expert in knowing about a wide-range of groups and services. 

A key challenge is trying to explain to people who live right on the Powys border with Neath Port Talbot why they have to access different statutory services from their neighbours.

Sally is based at the Ystradgynlais Community Hospital, where she sits in the Older Persons Integrated Team which is alongside a team of social workers and occupational therapists. “Being in the hospital is ideal as it means I can work in an efficient manner. If I receive a referral for someone who is due in day hospital on a Thursday I’ll nip and see them when they are in rather than make a separate appointment. And I can talk to the medical departments – get regular updates – and build good working relationships with colleagues in the hospital.”

She receives referrals from many of her statutory colleagues, including Community Psychiatric Nurse Assistants based at the community hospital. There is a daily half hour Integrated team meeting that she attends, where she and colleagues are joined by the Ward Sisters, Day Hospital Sisters, Physiotherapists, and District Nurses. Up for discussion - anyone over 65 with complex needs, with staff working together to provide the best care options possible for their patients and deciding who is best placed to provide it. Once Sally has picked up new referrals she works hard to match people up to relevant agencies, but sometimes it is challenging due to the pressures on overstretched voluntary sector services. “I can sometimes wait a long time to speak to someone in a busy charity, and last week at the end of one call instead of one referral I suddenly had four!”

Working closely with Theresa Huykman of Credu (formerly Powys Carers), Dementia Matters, the Alzheimer’s Society, and Christine Finch - the South Powys Dementia Support Worker, is clearly paying off. The partners have already identified gaps in services for carers of those living with dementia. As a result, they are launching a new dementia carers’ group (“a cuppa and a chat”) this Wed 21 February. Future get-togethers will take place monthly on the 3rd Wednesday, 10.30am – 12.30pm, at The Welfare, Ystradgynlais. If you’d like to know more about the group contact Theresa on 0777 334 2128.

If you’re based in the Ystradgynlais area and would like to find out more about helping make the community dementia friendly, check out the Dementia Matters in Powys website for the latest updates and information.

For general enquiries about dementia a good option is the Wales Dementia Helpline, 0808 808 2235 or the Alzheimer’s Society Helpline, 0300 222 1122.

Here in the PAVO mental health team we are loving these Ystradgynlais memory boxes. What theme would you pick if you were making a memory box for family and friends in your local community? Feel free to let us know in the comments section below.

And you can find out how to build a memory box with these easy-to-follow instructions from the Alzheimer’s Society.

Thursday, 8 February 2018

Mental Health and the Welsh Ambulance Service Trust

This week’s guest post is from Isobel Jones, who works for the Patient Experience and Community Involvement team for the Welsh Ambulance Service NHS Trust. I first met Isobel at a Welshpool meeting of the Stand up! For emotional health and wellbeing project run by our team where she introduced us to her work. I caught up with Isobel lately and asked her if she would tell us more about her role for the blog. 

What led you to this particular role at Welsh Ambulance Service Trust? 

I come from a Social Care background, and have also worked in the Third Sector, however, throughout my various roles I realised that I was becoming more and more interested in engagement. Involving people in shaping the services they receive can only help develop better services. It just makes so much sense. 

In some of my past roles I had been asked to undertake some projects which had enabled people to be involved in the planning and development of the services they received and I found these projects very insightful and interesting.

I followed this idea further by attending training courses which explored effective participation and engagement skills, and they gave me the tools and techniques to do this.

When the job was advertised within the Welsh Ambulance Service’s Patient Experience and Community Involvement Team I was excited as this was just where I could see myself. I hadn’t looked at it from a Health perspective before so I knew this would be a new challenge.

How do you educate patients and the public about the services provided by the Trust?

We have an extensive engagement model, which allows us to reach different groups and communities. We use our partners in the Health Boards, statutory, third sector and other community links to be able to engage with different people who may have used our broad range of services. It is important to go where people are. We’ll also host information stands at a range of events across Wales that helps us to talk to local people.

We then arrange to go out to meet people in these different groups and talk about our services, which includes awareness about how we respond to and prioritise 999 calls. It is important when we visit groups that we listen to people’s experiences and their stories, and encourage people to give us their feedback.

We make people aware of how they can ‘Choose Well’, by accessing a range of health services available from GP, Out of Hours, Pharmacies, A&E Units and Minor Injury Units. We also talk about self-care, and using services such as NHS Direct Wales for telephone and online advice.

My work involves engaging with mental health groups, older people and people living with dementia. I have also visited learning disability groups, schools, groups with specialist health needs like 
Chronic Obstructive Pulmonary Disease and other respiratory conditions, Parkinson’s, Multiple Sclerosis and various Black and Minority Ethnic (BME) groups.

We have a continuous engagement model which gives me the opportunity to visit groups again and again, building up trust and encouraging people to stay involved with us as a service as their contribution is so important. 

I was also given the opportunity to train as a Community First Responder for WAST which I completed in March last year. With this training I am equipped to provide awareness sessions for community groups about how to undertake emergency first aid to support saving a person’s life, by learning in basic steps what we all can do to help someone when they face a life threatening emergency like a cardiac arrest, how to use a defibrillator, what to do if someone is choking, or needs to be placed into the recovery position until the ambulance arrives.

If someone being transported by WAST is experiencing mental distress, what support is provided by staff?

All our staff should support such a person with the utmost of dignity and respect, recognising that whilst with physical health conditions these are often visible, not all health conditions are visible, especially mental health and wellbeing.

Our staff will have followed any assessments of need that are in place for mental health, including local pathways which are in place which have been agreed in partnership with local services.

WAST Staff are currently going through a training programme focusing on mental health.

What kind of training do Trust staff have to help them support someone in mental health crisis?

The new WAST Mental Health Strategy which has recently been formed is very clear that there needs to be more training for our staff on the needs of people who experience mental ill health, and for our staff to be more aware of how to treat people who call 999 in crisis. This has come out of the fact that staff have acknowledged there is a need for this, to benefit people with mental health needs.

Tell us more about the Trust’s Mental Health Improvement Plan

People who access mental health services have told us that these things are important:

  • Don’t ‘generalise’ mental illness. 
  • Consider my communication needs.
  • To be seen as a human being.
  • Need calming, understanding and polite approach for people experiencing panic. 
  • To be respected and treated equally. 
  • Be listened to and believed. 
  • Listen to carers as well as the person needing medical attention. 
  • Staff need knowledge and awareness of mental health issues. 
Our staff have told us:
  • We need a “better process for responding to patients in crisis.” 
  • We need “up to date evidenced based training.” 
  • We need “better links with crisis teams.” 
  • There are “inconsistent pathways across Wales.” 
  • There is a “variance of support across the localities.” 
  • There is a “lack of suitable alternatives to A&E.” 
Our staff need support on how to maintain their own mental health, how to prevent stress and sleep problems, ensure good nutrition avoid substance misuse, etc.

Because of this, these are the priorities we have set for our plan:

Priority 1: Putting you at the centre

  • Everybody is different and has different unique needs and experiences of mental health at different ages. 
  • Specific work needs to be done around children and young people’s needs. 
  • Think about the needs of people with dementia and of people with fluctuating mental capacity. 
  • Supporting those who are at risk of suicide and self-harm. 
  • Caring for those who may misuse substances. 
Priority 2: Training, awareness and skills for Welsh Ambulance staff
  • What do our staff need to know about mental health in terms of training, attitude and approach? 
  • Understanding people’s unique mental health needs (and the spectrum of mental health disorders).
Priority 3: Working better with other professionals
  • Working better with GPs, hospitals, local community support services, Health Boards, carers, family, social services. 
  • Working with trained mental health practitioners to support our frontline teams.
  • Developing alternative pathways for people experiencing mental distress. 
  • The purpose of these pathways is to make sure you are seen by the right person at the right time. 
  • Where possible get appropriate help in the community, rather than a hospital setting. 
  • Only considering hospital settings if physical health is at risk.
Priority 4: Caring for the wellbeing of our staff
  • Putting support systems in place.
  • Having mental health advocates. 
  • Helping staff cope after traumatic incidents.
For our staff we need to maintain optimum mental health, sleep, exercise, nutrition, management of alcohol intake, etc.

Priority 5: Dealing with challenging situations

If an ambulance staff member is facing violence in an extreme situation, we will assess the risk and decide when it is appropriate to restrain someone to keep them and staff safe.

Priority 6: Giving necessary guidance and support to teams

  • We have people within Welsh Ambulance Service who lead our mental health work. 
  • We need to make sure staff are supported and have the right supervision to develop knowledge and skills about mental health.
  • This is for the benefit of all people who access mental health services as well as to support Welsh Ambulance Services staff.

Which other organisations do you work closely with in Powys to provide support to people? 

So far, I have only worked with ‘Stand up! For emotional health and wellbeing’ in Welshpool. I would love the opportunity to network with and meet other groups in Powys so please get in touch!

We have visited many groups that support individuals with mental health and wellbeing concerns across Wales, but we would like more opportunities to speak to people in Powys. Have you used our services and would you like to give us feedback?

We would also appreciate your help to enable us to further develop our services as part of our Mental Health Improvement Plan. If you or your group / organisation are happy to receive a visit or take part in a focus group, please contact me (details below). Your views and experiences are important to us to help shape the way we work and how we support people.

What is the most challenging aspect of the job?

Sometimes it is the amount of travelling, as I travel all across Wales!

But in the main, it is making sure I listen carefully to what people tell me, and make sure I understand what is important to them. The challenge then is to make sure that voices are heard within the organisation in such a way that can make a real difference to the way we do things in the future.

To do this effectively it is very important to be a very open, friendly person, showing kindness and respect for any person who wishes to talk with you. I feel I need to show in my face and my body language that integrity is important, and that I can be trusted.

Sometimes people are angry and hurt, for good reasons, by their experiences.

I know they are not taking this out on me personally, it is important to understand why people say what they say, in the way they may say it. It is important for me to convey in a calming manner, acceptance and acknowledgement of how people are feeling and for people’s hurt feelings to be validated. 

Tell us about some of the most rewarding work you have done at WAST

Over the last year I engaged with a wide range of groups across Wales who supporting people experiencing mental health issues from many backgrounds.

Whilst most people reported positive experiences of having used emergency ambulances and non-emergency services, their suggestions were both insightful and helpful, as were the thoughts and observations from support workers and other professionals. 

I was given the opportunity in July 2017 to attend the WAST Trust Board and provide feedback on all of the engagement work I have undertaken with mental health groups and organisations across Wales. This presentation was well received by executive leads and managers in WAST. I was able to convey thanks to all the individuals with mental health concerns, organisations and staff who have shared their (sometimes very painful) stories with me. This opportunity allowed all of these voices to be heard, which contributes toward improving outcomes for people who use our services.

Another piece of work I found really rewarding was with people from the learning disability community where I was involved in setting up a drama group. This was a group of individuals in Caerphilly who worked in partnership with us to use drama to understand some of the barriers they experience when they ring 999 for an ambulance. During a celebration event in Blackwood, the drama group, which consisted of people with learning disabilities, showcased scenarios with real live call handlers, paramedics and community first responders.

What is the most valuable thing you have learnt since starting your role?

I am always totally humbled when people I have only recently met open their heart with sometimes very painful stories to me. I always try to do my best to do justice to what people tell me, so that it really makes a difference. We want to listen to people’s stories and experiences of using our services, and to capture feedback from people to improve our services.

Also since I trained as a community first responder volunteer myself back in March last year going on an emergency ambulance ride out with a crew from Hawthorn Ambulance Station to observe the experts in full flow to help consolidate my training has also formed part of my continuing journey… The day progressed with themes of falls coming up at least twice, sepsis also twice, breathing difficulties and presenting chest pains which may have been related to post traumatic anxiety, stress or other mental health concern. There was a lot to be learned about the needs of carers as well. What if they themselves need medical treatment and to be admitted but they are worrying about what will then happen to loved ones they care for, who may have dementia, a mental health condition, a physical or a learning disability, or in fact any combination of these? Colleagues shared with us about these dilemmas, as sometimes it is not just about the patient, but it was about their family as well.

When you are not working for WAST, how do you enjoy spending your time?

I love cooking, especially making jams, marmalade, herb jellies and chutneys. I gift wrap these and give them as presents. I also sell them to raise funds for charities.

I love walking and the outside world, animals, wildflowers, plants and nature, and especially my garden where I collect and grow loads of plants, shrubs, flowers and herbs. These interests often inspire me to paint watercolour pictures, play the guitar, write, sing and perform songs and poems. So this is just a little bit about me!

Many thanks to Isobel for telling us all about her role. You can contact her by ringing: 01792 776252 Ext. 45444 or emailing: