Community Enhanced Rehabilitation Team (CERT) Guide

What do we do?

We’re here to support you every step of the way on your recovery and rehabilitation journey. We provide specialist, occupational, psychological and mental health support to help you build confidence and develop essential skills to achieve your personal goals.

Our services are delivered in a compassionate way that fosters your growth and wellbeing. They’re designed to address multiple aspects of your recovery and wellbeing and are tailored to your individual needs.

We have a philosophy of “Open Dialogue”. This means we encourage open and honest communication to support shared understanding and decision making.

Consultation (pre-assessment) process

During your consultation we consider a wide range of information from you, your wider social networks, other people involved in your care and any records we may already have.

We will consider your personal goals, your mental health needs, any current risk or vulnerabilities you may have, your safeguarding history and any additional needs.

The consultation is to decide whether the Community Enhanced Rehabilitation Service is best suited to meeting your needs. Following the consultation, you will either be signposted to an appropriate service or invited for an assessment with the team.

If you move to the formal assessment process, there are indications that your rehabilitation could continue in the community rather than you remaining in hospital.

Assessment

Your assessment is an opportunity for us to look at what’s going on for you at that moment and how we might help you cope in the community.

Your personalised care plan

We will work with you to identify the specific support and interventions that we’ll provide as part of your support. This is called your personalised care plan (PCP).

The interventions will be delivered by our team member with the most appropriate skills and experience.

All our interventions are goal and time specific and progress is regularly reviewed. This will all be discussed with you and will be recorded on your personalised care plan. We will review your progress using three main questionnaires.

These help us:

1. Look at your quality of life
2. Revisit your goals and how you feel you’re progressing
3. See how you are feeling and coping.

Examples of interventions which may be offered include:

• Graded exposure in the community
• Healthy lifestyle and wellbeing
• Daily skill development
• Communication strategies
• Developing a personalised relapse prevention booklet
• Interpersonal skills
• Psychological therapy
• Money management
• Transport support
• Medical education
• Medication management.

CERT will usually work with people for up to 12 months.

Family and carers

With your consent and wherever possible, we want to link in and work collaboratively with your family and carers to support you.

Confidentiality

All information discussed is confidential, unless we believe a child or someone else is at risk. We must then share information with other relevant agencies. If we do this, we will always try to discuss it with you first.

Our patients matter

Mersey Care NHS Foundation Trust listens andresponds to patients and their carers to help improve the services we deliver.

If you have any comments, compliments or concerns you can speak with a member of staff or contact our Patient Advice and LiaisonService (PALS) and Complaints Team.

Telephone: 0151 471 2377Freephone: 0800 328 2941Email: palsandcomplaints@merseycare.nhs.uk