Turas Counselling Services Ltd -...

Turas Counselling Services Ltd

2013

Annual Report

Turas Counselling Services Ltd 2013

Contents Page NoChairpersons’ Statement 2

Managers’ Report 3

Board Members 7

Staff & Volunteers 8

Mission Statement 9

Policy Context 9

Range of Services10

Key Activity Outcomes11

Testimonials 13

Audited Accounts 201318

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CHAIRPERSONS REPORT

Turas Counselling Service has been in operation for the last nine years since 2005. The Project has been to the fore in the provision of a number of services and programmes which make up part of the continuum of care that address the needs of service users in Dundalk and the North East Region.

As a committee member since the Projects inception and being Chairperson for the last year, I have come to realise and see at first hand the level of work, commitment and expertise that is in place in the centre. This is evident through the professionalism and diligence of all the workers who deliver the numerous programmes and services offered.

This is backed up and supported through the varied expertise, knowledge and acumen of the Board of Management. They have the governance of the Service and its focus on best practice as its highest priorities. I would like to put on record a major word of praise for Niall Mulligan who stepped down off the board earlier in the year due to him taking up a new work position. His energy, understanding and tactful approach on all matters were greatly valued and appreciated.

Turas recognise and thank both the HSE and NERDATF for their continued support and funding of a Service that I believe is client-centred in its ethos, outcome-orientated and value for money. As funding allocations come under greater duress, the role of Turas’ Fundraising Committee is ever more crucial. They deserve particular praise for the numerous activities they organise throughout the year. Their efforts help maintain a level of service that would be greatly affected otherwise.

This year has seen a concentrated effort to develop protocols between Turas and the Louth Probation Team which have borne fruit. This has occurred through dialogue and numerous meetings. A similar approach is in process to address a continued lack of referrals through the HSE.

There is a need in the near future to add to both the Board of Management and Fundraising Committee of Turas with people who have expertise in particular areas. There is also a challenge and aspiration by the Board and Managers of Turas to become fully QuADS compliant during the forthcoming year.

I also look forward to the launch and implementation of Turas Three Year Strategic Plan (2015-2017) in the near future. This will act as both a template and guide for the Service in the short to medium term. It would be the Board of Turas opinion that consolidation of the service is its greatest priority and challenge at present in these uncertain times.

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Niall Weldon

MANAGERS REPORT

During 2013 the Staff of Turas has once again worked diligently and tirelessly to offer our service users a range of supports appropriate to where they present in the cycle of change. Through this work it has been our privilege to witness a number of our service users making substantial changes in their lifestyle supporting their ability to access and engage with important life opportunities such as training, employment, further education and contributing healthily to their communities through volunteering. The work undertaken has in many cases also supported the very difficult task of reconnecting with their families in a healthier more responsible manner.

Inter-agency Many of those presenting to Turas for support have multiple interconnecting needs that span medical and social issues combined with problematic substance use and mental health concerns.

Given the diversity of the supports required during their rehabilitation, we recognise that no one agency has the range of competencies, expertise or resources to meet the needs of a service user holistically, therefore Turas has continued throughout 2013 to support the building of stronger inter-agency links with current partner services and in particular with local G.Ps. We hope to shortly complete the development of formal referral protocols with the Louth Probation Team.

The care planning process, with the service user’s consent has supported Turas to assess their needs and identify the additional appropriate supporting services they may require.

However further challenges remain in building a structured and positive relationship with the HSE Addiction and Mental Health Teams. This is an ongoing concern that we will continue to work towards addressing in 2014.

DKIT

Turas has also continued to facilitate DKIT student placements that provide valuable work experience with a strong mentoring and supervisory element.

Staff

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Staff Competencies

To deliver a service that offers a package of support tailored to meet the individual’s needs and supports their rehabilitation within the community, it is crucial to have a compliment of staff that has the skills and competencies necessary to accommodate this. Turas continuously review staff skills and competencies to identify if additional up-skilling is necessary and appropriate. All senior counsellors are currently accredited with either IACP,BACP, or IAHIP and are required to engage in a process of continued professional development. All staff are encouraged and supported to attend any NERDATF training. All counsellors as part of their core training would have completed a core module on CBT (CBCS) and in-house training on Motivational Interviewing techniques.

Turas currently are facilitating the placement of qualified counsellors working towards their professional accreditation. These counsellors avail of in-house peer supervision and mentoring by a senior counsellor. It is our aim to ensure that the service delivered is in keeping with recognised best practice guidelines and to this end all counselling/therapeutic staff attended training in “Children First” which was introduced in 2013 by the Department of Children and Youth Affairs which supersedes all other national guidelines in Child Protection. Management and therapists also attended a two day CRA training workshop, Assist training and Group Facilitation training. Management attended the IACP conference, Data Protection Training and eCASS training during the year.

Volunteers

Once again in 2013 the volunteer counsellors have facilitated the work undertaken by Turas in providing additional counselling resources to match the increased demands. Their professionalism and dedication is greatly appreciated and valued by management and board members.

CE Placements

We have continued to offer two CE Placements that support the administration of Turas with vital roles in supporting the fundraising committee and front office reception and housekeeping duties. While the CE Staff have been a wonderful addition to the service we believe they have through experience gained in working within Turas added to their skill base considerably and have enhanced their ability to compete in the job market.

ChallengesFunding

As in previous years funding has been a major concern. Our NERDATF core funding has remained at 2010 level despite the increase in service provision and the funds raised through fundraising events have become crucial to our ability to maintain the current level of service provision. In the current financial

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climate fundraising itself has become a very challenging undertaking. We are extremely grateful to the fundraising committee and volunteers for their tireless work undertaken in this area.

Development of Services

For any service to maintain its maximum effectiveness it needs to continually evaluate and where necessary develop to match the presenting needs of service users. This often creates the opportunity to develop new approaches and modalities. However the ability to respond in this way is dictated by the availability of funding to employ additional staff to deliver the services.

Governance

While having already developed an extensive suite of Governance Protocols, Turas remains committed to the process of becoming QuAD’s compliant. This work will be ongoing through-out 2014. To date it has supported us to engage in a healthy evaluation of the service provision, however it is very labour intensive.

Supervision

The supervision provided within Turas supports the delivery of safe and ethical practice and ultimately ensures the best possible outcomes for service users who access the service. Within Turas the managers ensure that all staff are provided with appropriate supervision to carry out their respective duties in a safe manner and also to support their individual career journey through annual appraisal and gaining access to training that will support their continued professional development.

SuccessesTwenty Week

From its inception in 2005 to current day Turas has developed a range of support services to meet the evolving needs of our service users who have experienced problematic substance use or who are in early recovery. These support interventions have been evidenced as achieving successful outcomes for our service users. Recent research of models of best practice delivering Aftercare Support indicate that the Turas and the environment within which the programme is being delivered meet the requirements of what is considered best practice standards.

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CAD

In 2012 the project was evaluated as part of the National Drugs Rehabilitation Framework Pilot. The report was published in 2013 and the Community Detox Pilot and the Inter-Agency working that underpinned the running of the project were cited as being an advanced site that had fully implemented the Inter-Agency Protocols as developed by NDRIC.

In 2013 the Community Alcohol Detox Project undertook to run a small pilot with benzodiazepine mis-users utilising the existing model of psycho-social supports with the nurse monitoring the clinical concerns and working closely with the service user’s G.P. It became apparent however, that the work necessary to ensure effectiveness, utilising a multi-agency approach which along with a required longer engagement meant that to fully pilot this would require increased funding.

2010 – 2014 Strategic Plan

Due to the support of the staff team and the Board of Management many of the 12 key objectives identified in the Strategic Plan have now been completed. We will be undertaking a process of review as part of the development of a new plan in early 2014.

In Conclusion

We were heartened to read that the outcome of a review by the National Treatment Agency into the service provision within the drug and alcohol services published in 2012 has emphasised the need to invest in and support services that utilise a holistic and needs led approach to recovery. They also stated that the most important task is for a service provider to identify and maintain the attitudes and beliefs required to inspire sustained change in clients. We believe that as an organisation and within our staff compliment we hold these beliefs and they are at the core of the work undertaken with our service users.

We would like to take this opportunity to thank our Board of Management for their on-going support and the dedicated staff and volunteers who work so diligently.

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Board of Management 2013Chairperson: Niall Weldon, Co-Ordinator of the Schools Completion Programme

Treasurer: Niall Mulligan, Director Dundalk Simon Community

Secretary: Paula Gribben, RAPID Coordinator, Dundalk Town Council

Members:

Nora Donaghy: Managing Director – Turas Counselling Services Ltd.

Marian Sloan: Managing Director – Turas Counselling Services Ltd.

Mark Dearey: Dundalk Town Council & Dundalk Town Council

Mary Mc Donald: Probation Services Manager

Jim Ryan: Dundalk Town Council

Staff Register 2013

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Name PositionNora Donaghy Manager/ FacilitatorMarian Sloan Manager/ FacilitatorCarol Burke Senior CounsellorClair Dunne FacilitatorCarol Mac Guinness Sessional Counsellor / FacilitatorOrla Leavey Volunteer CounsellorMargot Meehan Sessional CounsellorMonica Mc Parland Volunteer CounsellorNigel Mulligan Community Alcohol Detox CounsellorCiara Hogan Outreach-Community Alcohol DetoxAlice Browne Counsellor / OutreachFelicity Fisher Art TherapistMaureen Zeltner AdministratorTeresa Watters CE –Worker/ Office AssistantMarie Lyttle CE -Worker/ Fundraising

Administrator

Mission StatementTuras Counselling Services Ltd. is a community based addiction service that aims to offer a range of confidential supports along a continuum of care that are respectful of both the uniqueness of the individual’s recovery journey and their capacity to change. Through the provision of psychological, emotional and practical supports Turas hopes to provide a bridge to reconnect service users to a substance free lifestyle.

Overview & Context

It is important to place the 2013 service delivery of Turas Counselling Services Ltd within the context of Turas’ 5 Year Strategic Plan and of the National Drugs Strategy 2009 -2016. as key priorities for the development of service provision and the current research available on drug use in the North East Region. The services provided within Turas are also consistent with our stated key objectives in our Service Plan for 2013 with the NERDATF / HSE.

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Range of ServicesCounselling Support

Turas provides a confidential screening, assessment, brief intervention and counselling service to service users who are experiencing problem substance use. The counselling support is delivered within a confidential and safe environment which supports clients in exploring their difficult life issues.

Counselling can be used as a stand- alone intervention for service users who want to reduce their use or gain abstinence as preparation to meet the criteria for accessing the Aftercare Support, or as an additional therapeutic support for those already engaged in the Aftercare Programme.

Structured Day Programme

Turas have developed a twenty week specifically designed in response to the needs of recovering problem substance users within our community who wish to look to their future with a view to change. The twenty week programme is run twice annually offering group process and individual counselling support. The principles underpinning the programme of empowerment, respect and support

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offer safe therapeutic encounters within the group process and individual counselling in which recovery work takes place.

Eligibility Criteria

over 18years of age two to three months drug/ alcohol free must be available/willing to attend three full days per week with

additional one hour counselling session for the twenty week period if on the Methadone Programme, the service user must be stabilized for a

period of two to three months if there are past mental health concerns, the service users current mental

health must be stable if on prescribed medication, the service user must be medication

compliant

Referrals

Referrals are taken from Statutory and Voluntary Services, G.P’s, Community Services and Turas also accepts Self-referrals.

Community Alcohol Detox

The service support individuals with an alcohol dependency to detoxify from alcohol using a number of methods including pharmacology and psychosocial interventions, harm reduction techniques and ensuring a range of wrap-around support is available, e.g. counselling, aftercare, housing advice and training opportunities. In this regard effective multi-agency working is essential.

The following is offered:

assessing a person’s needs developing care plans carrying out risk assessments providing harm reduction advice to clients recording accurate case notes preparing reports motivational interviewing cognitive behavioural therapy (CBT) coordinating services and liaising with other agencies engaging and supporting carers and families group work re; motivational work/ relapse prevention planning key working re: pre exit through to post detoxification

The clinical governance arrangements underpinning practice are consistent with national guidance and principles, and in line with the evidence base. (Drug Misuse and Dependence UK Guidelines on Clinical Management 2007 NTA p17). This involves:

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A GP/clinical nurse specialist in place with links to HSE Alcohol and Mental Health Services thereby providing appropriate clinical governance

Internal and external supervision in place within Turas Continuous Professional Development (CPD)

The Clinical Practice Guidelines are: to ensure that the community detox service can address both the physical

and psychological needs of the service user during withdrawal from alcohol

to deliver a practice specification for the community detox service that reflects current best practice in assessing, matching and the management of treatment needs of service users

using a continuum of care approach within a multi-disciplinary and inter-agency setting working towards supporting service users identified goals is clearly working to current best practice guidelines

Criteria for Community Detox

physical dependence on alcohol and desire to detoxify in community

no history of severe withdrawals, seizures or D.T.s an identified support person and an alcohol/drug free environment no evidence of severe physical ill health no evidence of mental health disorders which may be exacerbated

by detoxification process

Outreach

In the various stages of recovery a range of services are needed to support service users.

The outreach service offer support to service users across the continuum of care, delivering harm reduction advice, motivational and cognitive behavioural coping skills sessions. It also offers a range of wrap-around support including liaising with other agencies to co-ordinate services to maximise training, education and employment opportunities and advocacy support on housing and benefits issues. This service is available to clients who have engaged with the Aftercare or Counselling support within Turas.

Family Support

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Families are often caught up in the chaos and distress that comes with problem substance use. A family support group is a safe, confidential and non-judgemental place for family members of drug/alcohol users to come together to discuss common issues in dealing with drug/alcohol use within their family.

The North East Family Support Network facilitates a weekly family support group in Turas on: Friday morning: 11.00am—12.30pm

Empowering Women In Sobriety

Acknowledging that women are particularly vulnerable while both dependant on substance and in recovery, has prompted a women’s only self-help group, empowering women in sobriety to be established.

It is facilitated in Turas on: Friday Afternoon: 1.00pm– 2.30pm

Key Activity Outcomes

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Group Aftercare Programme Session Hours5764 Group Assessment Hours 98Care Plan Hours 47Family Support Session Hours 60Aftercare Networking Group 192Motivational Group Hours 168Inbound Counselling Calls ( 20mins per call)507Outbound Counselling Calls (15mins per call)469Counselling Sessions 1668

5764

98

4760

192 168

507 469

1668

Group AftercareProgramme

Session Hours

Group AssessmentHours

Care Plan Hours Family SupportSession Hours

AftercareNetworking Group

MotivationalGroup Hours

InboundCounselling Calls (

20mins per call)

OutboundCounselling Calls(15mins per call)

CounsellingSessions

1

2

4

8

16

32

64

128

256

512

1024

2048

4096

8192

Session Hours Breakdown in 2013

No' of Clients Who Engaged in Services Offered

Aftercare Programme 36Counselling Support 247Motivational Programme 14Client Assessment 201Family Support 10Outreach Referrals 24Counselling Calls Made 1406Counselling Calls Received 1520

36 247 14 201 10 24 1406 1520

Aftercare Programme Counselling Support MotivationalProgramme

Client Assessment Family Support Outreach Referrals Counselling Calls Made Counselling CallsReceived

1

2

4

8

16

32

64

128

256

512

1024

2048

Axis Title


Community Alcohol Detox Outcomes

13

0

10

20

30

40

50

60

70

9

59

33

10

21 23 23

CAD Referrals 2013

Series1

0

50

100

150

200

250

300

350

59

285

139

286

56

12398

CAD Sessional Hours

Series1


Testimonials

Woman in her 50’s from Navan

I was an addict for over 30 years before I got clean, at a young age I realised that I could use drugs to

cover up any emotion I wanted. If I felt down I could use drugs to pick me up and if I didn’t want to

be on a high anymore I could use drugs to bring me back down. With drugs I could change my

feelings in whatever way I wanted, but everything changed when my son was taken into foster care. I

spiralled out of control I spent a year of my life sitting on my bed and getting high. I lost that year of

my life, looking back I can’t even remember half of it, I always thought that I controlled the drugs but

in actual fact the drug controlled me, and I knew for my son’s sake I had to stop. When I lost

everything I finally reached out for help I tried to get into a treatment centre but it took 3 months

before they had a place for me. The centre was good and got me off the drugs for a while but when I

left I didn’t know how to cope in the outside world and my addiction got the better of me again. I then

heard of Turas from a friend and got into the programme straight away, it was very difficult for me to

open up with the group at first but the one to one counselling helped me to overcome that, I was able

to start making sense of my addiction and why I was so afraid to feel. Both the staff and the group

helped me to get my confidence back which was none existing before beginning the programme. I

really connected with the group there was both alcoholics and drug addicts in my group but it didn’t

take me long to realise there was no difference we were all there to get help, and live our life without

substances. The group gave me the chance to put my point of view across, we respected each other’s

opinion and shared some of our experiences with each other. Turas helped us find our voice and I

can’t thank them enough for that. We also had some great days out together from hill walking to

visiting the zoo activities, which I would have never done during my addiction and it helped us to all

feel closer as a group and see how we could socialise without having to use substances. After 30 years

of living my life sedated I am now over a years off drugs and alcohol and that’s all because of what

Turas taught me. I learnt how to avoid relapse and live my life drug free, how to deal with my

emotions and feel the feeling. Turas has given me a greater understanding of myself and my

addiction, I have learnt how to express myself and be more assertive, my life has completely turned

around. I now listen, talk when I need to and learnt to forgive and let go of resentment but most

importantly I have learned how to live without substances and to be happy. I now have my son back

living with me full time and when the judge gave me back custody of my son he said only 2% of

addicts ever get their kids out of foster care and I know I am only part of the 2% because of the help I

was given in Turas. I enjoy every moment of being a mother and every day I feel myself healing I am

so grateful to Turas they have helped me to pick my life back up and move on.

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Man in his 40’s from Drogheda

I was a part of an Alcohol Detox group in Drogheda when I first heard about Turas. Nora and Marian

had come in and had a discussion with us about the services Turas provides and straight away I knew

I needed the help they were offering. The detox group I was in wasn’t working for me. I couldn’t deal

with being in a group with active users it just made me want to keep using. I spent years binge

drinking but at this stage my binge drinking was out of control. My family and friends had all fallen

out with me they were sick of my drinking and the person I became when I drank. I was that bad that I

spent a thousand euro in one week on drink alone, and when I drank my temper was uncontrollable I

would blow a fuse over anything there was no controlling it or the person I became drank.

Before beginning the aftercare programme I had no hobbies or interests, I would never leave

Drogheda I had lost my confidence and self-esteem. And when beginning the group I didn’t like that

there would be drug addicts in it. I had always thought that drug addicts were the lowest of the low

and that even though I had a problem with drink I still wasn’t as bad as them this was how society

taught me to think. But only after a week or two my opinions completely changed I realised I was just

like them I had a sickness, an addiction that I couldn’t quit without help and before I knew it I was

closer and closer to the group with every day that would pass.

I stared getting my confidence back I had always been a people person and I could see the old me

coming back. I hated when it came to a Wednesday I dreaded the long weekend before coming back

and though I was going to slip and that I wouldn’t be able to cope. But what I didn’t realise at the time

was that Turas had already given me new skills and tools every week to help me cope when I was on

my own. As the weeks went on the group work and one to one counselling helped me regain my

confidence and gave me strength. I rediscovered my love for Art which is now a daily hobby for me it

helps me chill out and express all the built up anger and hurt I kept in for so many years. Turas really

helped me to communicate and express my horrible anger in a healthy way and because I could

control those emotions I now have rebuilt my relationship with my daughters and I am a part of their

everyday life.

Turas is the only program I ever finished and when I was finished it I cried. I would have done

another 20 weeks I was so anxious leaving and didn’t think I would be able to cope. But day by day I

kept myself busy with art, walking, hiking, meeting up with other people in the group, and attending

counselling along with the network group. It wasn’t a case of the program finishing and that was it, I

was still able to go back to Turas for counselling and support whenever I needed it and there have

been times when I slipped and came back for counselling. Turas helped me with every part of my life

not just my drinking. They taught me how all aspects in my life are affected by my drinking.

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The day trips helped me socialise without the need for drink and I never thought I would be able to

socialise again unless I was drunk. I have a wall of photos at home from all the day trips and activity’s

I did in Turas which helps me at times when I’m struggling it gives me a boost of strength. I know I

would be dead today if it wasn’t for Turas or still sitting on a high stool in a pub somewhere. I still

attend counselling and take part in an addiction group in Drogheda which helps me stay focused. I am

now working on a book that I’m hoping will be published I have rebuilt relationships with my kids

and ex-partner and have support from them. I have recommended the program to a friend who is now

after finishing the group successfully and would recommend it to anyone with an addiction.

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Turas Counselling Services LtdFinancial results 2013

2013 2012

Incoming Resources € €NERDTF Funding: NE6 200,000 200,000NERDTF Funding: NE16 20,000 20,000CAD Funding 59,882 52,140Dundalk Town Council 13,504Fundraising 40,740 30,048

334,126 317,402

Resources Expended

Programme activities 270,803Administration and utilities 36,473 38,493

307,276 304,703

Funds to future activities 26,850 12,699

Balance SheetAs at 31st December 2013

2013 2012

Current assets € € € €Debtors 957 899Cash at bank and in hand 81,847 87,611

Creditors: amounts fallingdue within one year (82,533 ) (88,239 )

Net current assets 271271

Total assets less current Liabilities 271 271

Net Assets 271 271

ReservesRevenue reserves account 271 271

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The Services delivered within Turas Counselling Services Ltd. are part funded by the NERDATF and HSE

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