Pieces of the Puzzle is a conversation toolkit for national application in hospital wards which care for adults with learning disabilities who have either had a breakdown in care provision or have been sectioned under the Mental Health Act of 2003.

These conversation tools, designed to be used throughout an individual’s transition back to their community with their new care provider, aim to rebalance power and build a positive relationship. This makes the transition process more comfortable and reassuring for both the patients and the healthcare professionals. They complement and enhance the current system by prompting discussions that enable patient agency within their continuum of care.

The icebreaker, a crucial part of the toolkit, aims to aid individuals in recognising their efforts to progress during their time in the hospital. It also intends to start the relationship between the individual and their new care provisions on an equal footing. The questions give people the platform to introduce themselves informally, fostering a positive and comfortable environment.

The scenarios assist nursing staff in creating a bespoke graded planner. The exercise asks individuals to envisage realistic scenarios to understand their tolerance towards specific objectives that must be achieved before their departure. The prompts go in chronological order and get increasingly more challenging. The exercise aims to ensure safety and comfort as they move towards a time that can feel unsettling and disruptive.