The CAPA component rating scale [CAPA-CRS]

Management and Leadership

There is a clear working group (involving regular meetings etc) consisting of

• an informed and helpful manager
• either a clinical leader or a clinician empowered to lead on CAPA and
• an admin lead

Language

The service has changed the language and

• no longer refers to assessment, treatment or triage appointments but either describes it to the family as Choice and Partnership or another local name and
• when considering clinical skills refers to a clinical competency not a particular discipline.

Handle Demand

The service has the following features

• making sure that the referrals are appropriate i.e. using eligibility criteria such as referrer seeing child and any appropriate community intervention has happened first,
• families can chose an initial Choice appointment when their referral is accepted i.e. full-booking and
• there is also a key focus on not allowing a waiting list to develop by flexing initial Choice capacity.

Choice Framework

Initial Contact in a Choice framework which is:

• Curiosity about their views and concerns and
• Reflecting our opinion to form a
• Joint formulation leading to a
• Discussion of alternatives which clarifies a
• Choice point which is built on by focussing on their

Full Booking to Partnership

Full booking to Partnership (initial treatment or further assessment session). Needs Partnership diary. Requires no internal waits. This means at the initial contact / Choice appointment the family can be offered the next appointment with the selected clinicians there and then.

Selecting Partnership Clinician by Skill

Selecting Partnership clinician by skill: choosing the appropriate clinician for Partnership based on the family / young person's goals and chosen therapy style. Booking the family into the next Partnership appointment with the clinician who has these skills and thus often means a change from the Choice clinician.

Extended clinical skills in core work.

Idea of extended clinical skills at core level supported by specialist skills in specific part of service. Extended skills clinicians are of equal value to single specialist skills clinicians’. Majority of clinical work is carried out in core work. General principle of core work first with specific work added if required.

Job Plans

Individual and Team job planning including capacity, Choice and core Partnership activity targets. Each clinician will have an individual plan which contains their choice activity, partnership targets for each quarter, their defined specific and other time and supporting administration.

Goal setting and care planning

Goal setting and care planning with frequent reviews considering user's preferences and choices. This starts in the first contact / the initial Choice appointment and continues throughout the whole contact with the service. May involve goal based out come sheets / written care plans.

Peer group supervision

Small group multi-disciplinary supervision. Weekly to discuss on-going work. This is a letting go of patient’s task as well as developing a learning culture across many clinical competencies. This is NOT whole team discussion or individual supervision.

Team away days

Team away days (at least once a term). The agenda is set by the team and involves content around clinical learning, team relationships and business issues. Management support this time and content and do not scrutinise the agenda.