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PART ONE
Statement on Quality from our Chief Executive............................................... 2
PART TWO
Improvement priorities for 2015/ 2016............................................................ 4
Improvement priorities for 2014/2015............................................................. 7
Statement of assurance from the Board.......................................................... 12
Review of services......................................................................................... 13
Care Quality Commission............................................................................... 14
Research....................................................................................................... 15
Data quality................................................................................................... 15
Information Governance Toolkit attainment levels............................................ 16
Clinical Coding error rate................................................................................ 16
PART THREE
Review of quality performance........................................................................ 17
Our participation in Clinical Audit..................................................................... 18
Patient and families‟ experience of our services................................................ 18
Staff experience of working at Trinity.............................................................. 21
PART FOUR
Statements from:
Fylde and Wyre Clinical Commissioning Group................................................. 22
Blackpool Clinical Commissioning Group.......................................................... 22
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PART ONE
Statement of Quality from our Chief Executive:
It is with considerable pride that I write this year as Chief Executive of the 2014-15 prestigious Charity
Times national award of „Charity of the Year‟ 1 – an honour which I believe reflects our commitment to providing excellent care to our patients and their families and a drive for continuous improvement.
Over the past year, we have transformed the patient experience in our inpatient unit and in Brian House
Children‟s Hospice with a major refurbishment. Our improved environment now provides greater choice, privacy and enhanced dignity within a stunning high quality environment. We have been praised by the
Kings Fund as well as the above award which also focused on our „fit for the future‟ change programme getting us ready for an increasingly unpredictable health environment with significant challenges and growing demand.
As you will see in this report, our commitment to enhancing the quality of our care remains as strong as ever. Over the past year, we have focussed on improving discharge planning, holistic assessment as well as launching a pilot hospice at home service which to-date has been a great success. We have also taken a significant step forward in providing timely and less onerous access to prescribing for patients by introducing non-medical prescribers in the community and in Brian House. This also helps GPs who would otherwise have to prescribe directly on top of already heavy workloads. We have also looked to further reduce the risks around prescribing for children through a review of medicines management in Brian
House. During the year, it was wonderful to see so many of the children in our care have further life enhancing experiences through the introduction of a music therapist – a few budding pop stars are now amongst us!
Looking forward to 2015, we are determined not to rest on our laurels. Whilst our record on skin care has been exceptionally good, a recent complaint highlighted that even one error here is one too many. We took full responsibility for this and are introducing further training and system improvements to further reduce the likelihood of re-occurrence.
2015 should see us take a quantum leap forward in the goal of ensuring all clinicians across the Fylde
Coast have up-to-date access to patient palliative care records and key information from care plans such as preferred place of death. A cross-organisational partnership sees us, GPs and community District Nursing
Teams adopting a new electronic palliative care coordination system to this end.
We are also committed to truly listening to our patients and their families and learning from them as we endeavour to keep our patients at the centre of our decision making and care. We will introduce a new patient and family satisfaction survey „iwantgreatcare‟ which also provides us with the ability to gain their thoughts on further service improvements. It also provides the wider public with a „real-time‟ web-based review site – a further commitment to transparency in our work.
I hope you will agree that all the above bodes well for a continued focus on our patients and their families.
We are committed to implementing the patient centred principles set out in the recent NHS England report on palliative care - „What‟s Important to Me‟. We also recognise the importance of supporting and caring for our staff and volunteers to set the right foundations for great quality care for our patients. We are investing in greater training, introducing enhanced staff benefits and have updated our values from the grass roots creating „Trinity Ways of Working‟ to describe the behaviours and attitudes staff want to see to build the strong working relationships we need.
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For charities with an income of £5m-£10m
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I am confident that these improvements will make a significant contribution to our continued high quality care. Thank you too for your on-going support – without it, we would not be able to make such a difference.
Best wishes
David Houston
Chief Executive
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PART TWO
Looking Forward: Our improvement priorities for 2015/ 2016
These Quality accounts link to Trinity Hospice Board and represents our quality strategy.
The Board of Trustees fully supports the continuous development and improvement of Trinity‟s services to ensure that the care it provides evolves to meet patient and carer needs in future years.
We have a five year strategy that is developed in consultation with patients and staff and is supported by annual business plans.
The following areas have been identified for development in 2015/2016 by the Clinical Quality
Improvement Group for improvement: Patient Safety, Clinical Effectiveness and Patient Experience.
Patient Safety: Skin care, management of skin integrity and pressure ulcers
How was this identified as a priority?
We have a good record of skin care and management of pressure ulcers. We have consequently taken very seriously a complaint that was received in relation to lack of pressure ulcers care and equipment available for a patient. On investigating the complaint we‟ve upheld and the following was highlighted where we felt that quality of care could and should be improved:
 Staff knowledge re pressure area care could be further improved, to reduce the risks
 Need to introduce a Body Map on admission and discharge to improve record keeping
 Audit of pressure relieving cushions
 Audit of pressure relieving mattresses
Often patients are admitted to the inpatient unit with pressure ulcers, and a small number develop low grade pressure ulcers while under our care. Despite many of our patients having increasingly complex disease and high dependency needs, we are committed to a zero tolerance approach to hospice acquired pressure ulcers of any grade. In this case the outcomes of the complaint, action plan and progress made was shared with complainant.
What do we want to achieve?
 Improved knowledge and skills in relation to pressure ulcers by introducing an enhanced training pack for mandatory training for all nursing staff
 Body Map to be completed on admission and discharge
 Audit of pressure relieving cushions and potential to purchase additional items
 Audit of pressure relieving mattresses and potential to purchase additional items
 Zero tolerances
How will progress be monitored and reported?
 Action plan in place with responsible person identified
 Review Audit of pressure relieving cushions and mattresses and purchase of extra equipment as identified
 Audit of patient records to ensure completion of body maps on admission and discharge.
 Feedback to Clinical Quality Improvement Group.
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Clinical Effectiveness: The introduction of a new Electronic Patient Care Record – Emis - across all departments of the hospice
How was this identified as a priority?
Trinity Hospice is represented on the Fylde Coast End Of Life Strategy Group.
One of the recommendations of the group was for clinicians to move to a patient electronic system that is capable of sharing of data across the area around patient choice, care and treatment.
It is part of a much wider NHS England initiative to make all palliative care patients records available across different care settings such as General Practice and the acute Hospital to improve care and reduce inappropriate interventions and if possible avoid admission into hospital.
What do we want to achieve?
This will mean that in the future we will have an
opportunity to review our existing processes and
It will allow us to access information directly from General Practice and the Trust, saving precious time that can then be spent with patients and supporting their care.
Whilst moving from SystmOne to Emis Web will be challenging and hard work, it also provides a wonderful
. This will also release time which can be redirected towards care with patients or supporting the wider activities of the hospice.
Hence our strap line for this project: “releasing time to care”. Having sharing agreements in place with GPs and other care providers across the Fylde Coast will enable timely information about interventions to be shared across teams, reducing duplications and risks whilst preventing patients from having to repeat their history.
We will be encouraging new ways of working for our community teams who will be able to view records and update on mobile devices.
Working closely with Blackpool Trust Hospital we are also going to move to E –referrals from the hospital to our Hospital Clinical Nurse Specialist Team, which will support my effective response to the referral.
How will progress be monitored and reported ?
A Project Steering Board and a Project Management Structure has been set up.
A project team has been formed that includes project manager from the acute trust, Emis and a change facilitator, and staff representation from all staff departments and grades within the hospice. An information page relating to the project is in place on Trinity Hospice home page of the Intranet to keep staff informed of progress being made.
The project team reports to a project board of the progress being made. Staff have been involved in „As Is sessions‟, „To Be sessions‟ and „Sign off sessions‟. A risk assessment has been undertaken around the project and the implementation of the system including migration of current data. A training plan for staff is currently being devised ensuring that all staff are competent on „go live‟ date.
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Patient Experience: Increase feedback from patients, families and service users – „ i Want
Great Care‟ – all departments across the organisation
How was this identified as a priority?
The hospice does receive feedback from patients, and though the majority of this is positive, we wanted to look at increasing and capturing real time feedback from patient and family experience across the various departments within the hospice.
Discussion with other clinical leads at other hospices reported increased feedback by adopting the „I want
Great Care‟ system.
The questions asked of patients and families covers the following:
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How likely are you to recommend our services to your friends and family if they needed similar care and treatment?
2.
What was good about your care, and what could be improved? – this is free text space to raise ideas for further service improvement.
3.
Were you treated with dignity and respect?
4.
Did you feel involved enough in decisions made about you?
5.
Did you receive the right information about your care and treatment?
6.
Were the staff kind and caring?
7.
Did you have confidence and trust in staff looking after you?
8.
Were you satisfied with the support you received?
What do we want to achieve?
 We want to encourage more feedback from patients and families about all the services we provide.
 We will increase the number of ways feedback can be given i.e. paper questionnaires, tablets, and website.
 We want to be able to demonstrate that we have listen to feedback and made changes, and if we were not able to make the change, then why. This information would be published and displayed within the hospice.
 Monthly and annual reports, including themes.
 Identify further service improvement opportunities under the principle of continuous improvement.
How will progress be monitored and reported?
Progress will be monitored by departmental monthly reports and feedback at the Clinical Quality
Improvement Group, which will feed into the management team and Clinical Governance Board Committee.
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Looking back: Priorities for improvement identified in our Quality Account 2014 – 15 and progress made.
Adult Services
Patient Safety: Discharge Planning
Our aim was to improve communication between the Inpatient Unit and the Clinical Nurse Specialist Team and other health professional involved in the patient‟s care to support safe and effective patient discharge.
What we did
 A member of the Clinical Nurse Specialist Team is represented at the admissions/handover meeting every morning, and the inpatient staff provide a comprehensive handover and alert the service to patients whose discharge is pending, providing a timescale in which the Clinical Nurse Specialist is able to meet the patient.
 We have redesigned the medication sheets
 We have implemented an electronic referral to the District Nursing teams
 GPs, District Nurse and the out of hours service FCMS are all notified of a patient discharge.
What was the outcome?
Improved communications with timely information passed to new caring team, Discharges are discussed daily now at our admission meeting so that the Clinical Nurse Specialist Team are up to date with the plan of care for that patient.
Clinical Effectiveness: Holistic Assessment
Our aim was to review current documentation and implement a multi –disciplinary holistic assessment
What we did
A task and finish group produced a multi-disciplinary document that captured the demographics, social, psychological, spiritual and emotional aspects of a person‟s needs, alongside capturing key decisions about advance care planning decisions. The document is a collaboration of all departments to ensure it is fit for purpose and will be the starting point in which we have reviewed the documentation previously used. We have taken the best of this and incorporated it within the new documentation, along with additions to enhance the patient‟s story.
A training programme was designed for all staff before the Holistic Assessment Tool was implemented.
We have made adjustments to the document over this period to respond to feedback from staff and audit of the document. Gaps have been identified for example: screening for malnutrition and work is currently underway to improve the document.
What was the outcome?
The paper document will form a template for our move to patient electronic system that will go live in
2015.
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Patient Experience: Hospice at Home Service
Our aim was to develop and launch a two year Hospice at Home service in conjunction and partnership with Blackpool and Fylde and Wyre Clinical Commissioning Groups, having identified a gap in service provision. For many patients and their families their greatest wish is to spend their final days at home with loved ones, and to avoid unnecessary admissions to hospital, and the Hospice at Home service will give more patients the chance for this to happen.
What we did
We launched a two year pilot of Hospice at Home to the whole of the Fylde Coast in September 2104 following recruitment and induction of staff. The service runs seven nights a week from 10pm to 8am working in close partnership with overnight District Nursing Team and out of hours medical services. We have two teams per night, consisting of a trained nurse supported by a healthcare assistant, responding to both scheduled work but mainly unscheduled requests for help and support. Use of the community care plan held by patients in the community avoids the extra work of a separate referral form, ensuring effective use and timeliness of the service.
Both a strategic and operational group were set up with broad representation from the hospice and community and out of hours services.
Collection of meaningful data was identified as crucial in being able to demonstrate the benefit of the service to secure funding for the future.
We were aiming at supporting more end of life patients who would not necessarily be supported by the specialist team at Trinity and for a greater number of patients to achieve their choice of dying at home and avoiding inappropriate hospital admissions.
What was the outcome?
At the time of writing the number of patients supported in the first eight months is 471 and of these 218 patients were not known to Trinity Hospice.
Examples and evidence of good working partnerships with other health professionals. Excellent feedback from patients and families.
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Children‟s Services: Brian House Children‟s Hospice
Patient Safety – Management of medicines:
Our aim was to review current management of medicines to ensure safe practice.
What we did
 Following review of the then current practice, a new prescription chart for the children is in the process of being devised.
 Prescription charts are now regularly audited and the number of medicine errors has dropped.
 We have supported three staff in Brian House to undertake the Non – medical prescriber‟s course along with clinical assessment skills training.
What was the outcome?
The new prescription chart is almost complete and will provide safer practice. We are continuing to audit and feedback to staff the results of the prescription audits to enhance learning and good practice, ensuring safety in practice.
The non- medical prescribers have the skills to clinically assess children and young people in order to prescribe agreed medications, enhancing the care we provide to our patients.
Clinical Effectiveness: Non–medical prescribers
Our aim was to evaluate the impact of the introduction of non –medical prescribers into Brian House
What we did
At the time of writing a total of four Brian House nurses have completed the non -medical prescribing course over the last 12months, supported by our Medical Director. They have also completed the medical assessment skills course to help consolidate their learning.
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What was the outcome?
At the time of writing the first of our non-medical prescribers is now prescribing for our children and young people and checking and signing prescription sheets. This has enhanced care for our patients as they no longer have to wait for a doctor to become available. The non- medical prescribers also discuss medications with children, young people and their families. They have also completed the Clinical
Assessment Skills three day workshop.
The staffs undertaking the course have spent time at Blackpool Teaching Hospital, attending ward rounds and clinics with the medical teams and have established a closer working relationship with colleagues there.
Patient Experience: Music Therapy
Our aim was to introduce and develop music therapy for the benefit of children and young people. This project has been supported by the Charity „Jessie‟s Fund‟ that funds music therapy and the provision of musical instruments for children‟s hospices.
What we did
Brian House has had weekly visits from our music therapist, who holds individual and group music therapy sessions. During that time 22 group sessions and 73 individual sessions have been held. Brigitte has worked with 75% per cent of all the children and young people who come to Brian House and aims to work with those she has not been able to see as soon as possible.
The aim of the sessions is to involve everybody in playing the musical instruments or singing, to stimulate responses and to create musical experiences for the group members. Most times the sessions create a lot of focus and energy in the lounge area, where the children sit on staff or volunteers‟ laps, in their chairs or on their mats on the floor. A training session has also been held for the team, when members of the care team learned more about music therapy.
What was the outcome?
Music therapy has brought real benefits to the children young people and staff of Brian House. Music is a means of communication, an important consideration for the children who are non-verbal or who find it difficult to communicate with words. The biggest benefit from music therapy sessions to the children and young people is that they can feel autonomy and control; no matter how much care they need in their daily lives, in the music therapy session they are made to feel listened to, and they decide when they want to make a sound and how they want to make it.
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Statement of Assurance from the Board
The Board of Trustees remains committed to the maintenance and development of the services provided by Trinity Hospice and Palliative Care services, putting patients and their families at the centre of what we do.
Trustees have met as a Board every two months to monitor the work of the management team and the progress of our business plan. We have been very pleased to see the financial management rewarded by the Charity of the Year award, a real external endorsement of the work of David Houston and his team.
The different sub-committees of the Board including Clinical Governance have met regularly and all complaints and adverse incidents have been reviewed. Though complaints are rare this report shows how they can be learnt from, and the service to patients improved. We intend to build on the Trustee visits to evaluate various aspects of the service, improving our efforts to listen to the views of our patients their families and our staff and volunteers.
The refurbishment of the in-patient unit and the setting up of the Hospice at Home were the major achievements this year. Thanks are due to all the staff and volunteers involved. The Hospice at Home project is being continuously evaluated, and so far it is going well. Working with the CCGs we intend to continue to meet the needs of the community we serve.
Funding continues to be an issue, the refurbishment was greatly helped by a campaign in the Blackpool
Gazette and support for our fundraising events has fortunately continued to be excellent The fundraisers do a magnificent job and the Board greatly appreciates their efforts.
This year we celebrate our 30 th anniversary. Thanks to the staff, volunteers and support from the community a great deal has been achieved in that time. In partnership with the local CCGs and working with the local authorities and the acute trust we are convinced Trinity will continue to provide the highest standards of palliative care in the future.
Mary Wren Hilton
Chair of the Board of Trustees.
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Review of Services:
During 2014/15, Trinity Hospice and Palliative Care Services provided the following services in conjunction with Blackpool NHS Clinical Commissioning Group and Fylde and Wyre NHS Clinical Commissioning Group with regard to the provision of specialist palliative care services:
 Inpatient Unit 20 beds offering 24 hour care for the most complex patients and their families
 Clinical Nurse Specialist Team supporting patients and their primary care team in the community
 Community Palliative Care Consultant supporting patients in Out Patient Clinics and in their own homes
 Clinical Nurse Specialist Team supporting patients and clinical colleagues within the acute trust
 Day Therapy Unit supporting patients through a 16 week programme to live with and manage their illness build self-confidence and maximise quality of life.
 Lymphoedema Service – supporting patients both adults and children with both primary and secondary Lymphoedema
 Bereavement and Counselling Services – run from our Linden Centre supporting both adults and children, individually or in groups. We also run a School Bereavement Link Service, helping schools to support children experiencing bereavement.
 Quarterly Bereavement Services and annual bereavement events i.e. Light up a Life, Sunflower
Event, and Children‟s Butterfly Service.
 Psychology Services
 Complementary therapy – offering patients and carers arrange of complementary therapies
 Physiotherapy and Occupational Therapy – supporting discharge, promoting independence and improving quality of life.
 Social Worker – helping patients to stay in their own homes and supporting discharge planning from the inpatient unit
 Spiritual Care and Support - by our Spiritual care Co-ordinator and Chaplains.
 Hospice at Home overnight service , 7 nights per week ( 2 year pilot commenced September 2014)
- supporting people in their own homes working in partnership with both Blackpool, and Fylde and Wyre Clinical Commissioning Groups, Out of Hours medical services, District Nursing Teams and
Ambulance Service.
 Brian House Children‟s Hospice – supporting children, young people and their families with respite and end of life care (Grant 64 funding).
 Education and Training
 We have also introduce a Hospice Neighbours scheme with trained volunteers supporting patients in the community by visiting them taking them to the shops, appointments etc.
 All aspects of the above services are supported by over 850 volunteers.
Trinity Hospice and Palliative Care Services is an independent charity which provides all services free of charge. The income generated from the NHS in 2014/15 represented 40% of the overall costs of service delivery with the remaining income to fund our services coming from voluntary charitable donations, legacies, events, corporate and community fundraising, hospice shops and lottery.
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Care Quality Commission
Trinity Hospice and Palliative Care Services are regulated by the Care Quality Commission for the following regulated activities :
 Diagnostic and screening procedures
 Transport services , triage and medical advice provided remotely
 Treatment of disease, disorder or injury
Trinity Hospice and Palliative Care Services are subject to periodic inspection by the Care Quality
Commission and the last review was undertaken on the 17 th February 2014.
The areas reviewed by the Care Quality Commission and their inspection of compliance are as follows:
Standard of Quality and Safety
Consent to care and treatment
Care and welfare of people who use the services
Cleanliness and infection control
Safety and suitability of premises
Assessing and monitoring the quality of service provision
Met Standard
√
√
√
√
√
The report concluded that Trinity Hospice and Palliative Care Services were meeting all the essential standards for quality and safety.
Over the last few months in preparation for the new fundamental standards staff have attended workshops and reviewed standards to ensure that we are meeting the new requirements and are fully complainant.
We continue to submit statutory notifications to the Commission these have included deaths of service users, serious injury to patients, and change to our Statement of Purpose.
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Quality assurance visit by Blackpool and Fylde and Wyre Clinical Commissioning Group
This visit took place on 3 rd March 2015 led by the Clinical Lead Quality and Performance and the Quality
Performance Officer and focused on the following:
 Respecting and involving people who use services
 Consent to care and treatment
 Care and welfare of people who use services
 Safeguarding people who use the service from abuse
 Cleanliness and infection control
 Safety and suitability of premises
 Requirements relating to workers
 Staffing
 Assessing and monitoring the quality of service provision
 People should have their complaints listened to and acted on properly.
The Commissioners have confirmed that the report has given then assurance that our services are at the appropriate standard.
The report states:
 The hospice has recently been completely refurbished, providing a well thought out environment for patients and families. Patients are able to gain access to the lovely gardens from each bedroom and sitting room, even when completely bedbound.
 It is clear that staff education, training and development are high on the agenda. As is patient feedback and a culture of continual quality improvement.
 The visit provided us with a very positive experience of a forward thinking hospice, with high standards of patient and family centred physical and psychological care and support.
Research
During this period the hospice has been actively involved in the following research activity overseen by our research nurse. The study was „InSup-C Integrated Palliative Care for people with advanced cancer and chronic disease. The research is a European study being conducted in seven European countries from WHO and USA.
The aim of the study is to identify best practice in integrated palliative care by examining models of care delivery across a number of European countries and focuses on people with advance cancer and those in the latter stages of chronic illness, specifically chronic heart failure and COPD. It has the potential to improve the care we provide to those facing chronic long –term decline and death. The study commenced in June 2014, with a target recruitment of 10-12 patients and carers.
Data Quality
Trinity Hospice did not submit records during 2014/15 to the Secondary Uses Service for inclusion in the
Hospital Episode Statistics which are included in the latest published data (Mandatory Statement)
Trinity Hospice is not subjected to payment by results.
Trinity Hospice provides quarterly activity date in the agreed format to the local NHS Clinical
Commissioning Group.
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Trinity Hospice submits data to the Minimum Data Set (MDS) for Specialist Palliative Care Services collected by the National Council for Palliative Care on an annual basis, with the aim of providing an accurate picture of hospice and specialist palliative care services.
Information Governance Toolkit Attainment Levels
Trinity Hospice has now attained Level 2 of the information governance toolkit. This will enable us to have data sharing agreements in place to enhance the level information on patients with our new patient information system EMIS web.
Clinical Coding Error Rate
The following statement does not apply to Trinity Hospice and Palliative Care Services but must be included in our Quality Account:
Trinity Hospice and Palliative Care Services were not subject to the payment by results clinical coding audit during 2014/15. (Mandatory Statement) This is because the organisation receives payment via a grant and standard contract and not through tariff and therefore clinical coding is not relevant. Trinity Hospice and
Palliative Care Services as a registered charity only receive 40% of the total cost of running the above services from the Department of Health and Blackpool and Fylde and Wyre Clinical Commissioning Group.
The remaining £4,800,000 was raised by charitable fundraising.
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PART THREE
Review of Quality Performance
Trinity Hospice and Palliative Care Services
Inpatient Unit Service
Total number of new admissions
Total number of re-admissions
Total number of admissions
% Bed Occupancy
Number of patients discharged
Number of deceased patients
2013/14
291
56
347
70.6%
129
223
Day Therapy Unit
Total number of new patients
Number of discharged patients
Number of deceased patients
Clinical Nurse Specialist Team
Hospital /Community
Total referrals to Hospital Team
Percentage of patients known to hospital team discharged home
Total referrals to Community Team
Percentage of patients known to
Community Team who died outside hospital
2013/14
102
70
39
2013/14
728
59.9%
1,064
88.2%
Lymphoedema Service
Total number of patients seen
Total number of referrals ended
Linden Centre Services
Number of new referrals for adult counselling
Number of referrals for children‟s counselling
Brian House Children‟s Hospice
Number of new children assessed
Children discharged from service or deceased
Bed Occupancy
Day Care Attendances
% Day Care Attendances
Number of Days use of Butterfly
Suite
2013/14
206
267
2013/14
326
130
2013/2014
15
24
87.7%
1,081
74.6%
50
17
2014/15
322
44
366
79.1%
125
235
2014/15
140
96
30
2014/15
806
66.6%
1,018
88.4%
2014/15
276
287
2014/15
341
397
2014/15
25
4
91%
1,081
90%
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Our Participation in Clinical Audit
As an independent hospice, Trinity does not participate in the National NHS Clinical Audit programme as there are no national audits or national confidential enquires covering NHS services relating to relating to palliative care. However, we regularly undertake audits as part of our annual audit programme. Audits undertaken this year include:
 Self-assessment Audit Tool for the Controlled Drugs Accountable Officer
 Controlled Drug Audit
 General Medicines Audit
 Self-Administration of Medication
 Infection Prevention Audit Brian House
 Infection Prevention Audit In –patient Unit
 Infection Prevention Day Therapy Unit
The audit results and any actions taken are reported in our annual „Qualitative and Quantitative Audit
Report‟ which also includes feedback from patient care and experience.
What patients and families had to say
 Would like to thank you for all your care, support, kindness, attention, thoughtfulness, inspirations and love whilst …… in your care.
 It‟s difficult for me, her partner, to find suitable words that in some way would go towards expressing my appreciation for the comfort and care offered to her in her final days. I can do no more that offer to each and every member of your staff my sincere thanks for all the loving attention given to ……. . Additionally I must thank your staff for the understanding they offered me, as a visitor, during my long periods at …… bed side.
 ……. was in the hospice for less than 48 hours – but he had found comfort and peace which he had longed for so long.
 I am struggling to put into words how thankful I am for the outstanding care you have given to my
Mum and also the support you have given me during her stay. There really is something rather magical about Trinity.
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Facebook reviews over the last 12 months
 Wendy Brownlie - 5 star
The palliative care service was out of this world and enabled my precious dad, to spend his last days and hours at home surrounded by his family. They kept him comfortable and well cared for, I thank you all so much, and will never forget your kindness. Hope this service will be kept going and carry on getting funded, once again many THANKS. Xx
 Marion Arkison - 5 star
Trinity and their staff, especially the hospice at home team were wonderful. They gave me so much support when my mum passed away March 2015. They are so caring and supportive even after. I just want to say a big thank you to them from me and my family.
 Carl Barratt - 5 star
My mum died in Trinity. The care was impeccable.
 Coral Horn - 5 star
The services provided by the Hospice and Brian House is so important to so many people and the staff do a great job. Please support.
 Tara Lewis - 5 star
Thank you for all your help and support when we were there with my mUm who passed on the
30th August this year. Even though she was there less than 24hrs I know she was made to feel the best she could with such a daunting prognosis. Even after she passed we spent nearly 3 whole days there and were made to feel welcome and any questions answered xxx I honestly can't thank you enough.
 Chloe Redman - 5 star
Cannot put into words how brilliant all the staff at Trinity are! You took great care of my mum who passed away March 2015, also the great support you gave me and my family, thank you ever so much!!
 Michael Boad - 5 star
These nurses are great can't do enough to help you
 Debi Weir - 5 star
These guys are fantastic in everything that they do, the care they provided for my close friend was outstanding, thank you from the bottom of my heart ❤
 Rebecca Ann - 5 star
Thank you from the bottom of my heart for taking care of my Nanna during her last few days fighting cancer. Trinity is a blessing and an oasis of peace and calm, home to some of the most incredible nursing staff. I could never have imagined that others would show such care, patience and dignity when helping those in need and I am glad that you were there.
 Amy Robertson - 5 star
Thank you to all the nurses, doctors and staff at the hospice for all you have done these past two weeks, cannot thank you enough you are all angels in your own way, amazing people and amazing place x
 Michael Cummins - 5 star
Thank you to all the team at Trinity for looking after my sister. You brought her peace, comfort and dignity and also looked after us who were with her for her last days. Words cannot express my gratitude to you all. She is resting peacefully thanks to your care. Xxx
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 Dorothy Haynes - 5 star
Thank you so much for the care you have given …. who sadly passed away Wednesday 21st May. It is a lovely calming caring place to be, he was only with you a short time but that time made a big difference to him and us. Thank so much xx
 Brian Jones - 5 star
Invaluable and necessary service, providing much needed local help and support, where and when it is needed.
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Staff experience of working at Trinity Hospice
We carry out an annual staff survey which was open during June and July 2014. It was run by Birdsong
Charity Consulting on behalf of Hospice UK and 123 Trinity staff completed the questionnaire.
 96% said if a friend or relative needed treatment they would be happy with the standard of care provided by this organisation
 93% said I understand what this charity wants to achieve as an organisation
 93% said I am proud to work for this charity
 95% said they enjoy the work they do
 90% said I am clear about what is expected of me in my job
 90% said they I feel they are making a difference
 78% plan to be working for this charity in a year‟s time
Following our „Fit for the Future Programme over the last 12 months we have run a Leadership and
Management Programme for our „middle managers‟ across the organisation who either manage departments or teams within departments or are in a position which, although may involve managing other individuals, plays a key role in contacting and influencing a wide range of staff. Topics covered by the programme include:
 Context of the current hospice and health world and related external environment
 Review of the current Trinity Values
 Group exercise using Myers Briggs Type indicator about self-awareness, individual differences.
 Leadership and management topics - what is it, different skills involved, communication, situational leadership.
The work done by the group around Trinity Values has been widely shared with all staff, trustees, directors and externally and has resulted in a refreshed set of values which link to Trinity „ways of working‟.
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PART FOUR
Statements from:
Fylde and Wyre Clinical Commissioning Group
Fylde and Wyre CCG is pleased to receive the Trinity Hospice Quality Account for comment. Overall, the report is seen as reflective of the high quality work on-going at Trinity and describes a number of developments in 2014-15 that have improved the service to patients and families. In describing in-year developments in future reports, more specific detail would help the reader to appreciate the extent to which the Hospice has progressed with its improvement plans, e.g. the start and finish dates / projected target dates for pieces of work; number and themes of complaints, comments, concerns and compliments and how these have been fed back to teams and used in service improvement; numbers and types of clinical incidents, whether they be related to skin care, falls or medication errors; the reason for an increase in bed occupancy; the findings from audits and how the information has been used to improve service.
In addition, it is felt that staffing levels / issues could have been addressed in more detail. It would be useful if the Quality Account could highlight the actions taken or planned by Trinity to ensure that the positive developments in terms of increasing capacity and service provision are staffed appropriately.
The implementation of integrated systems which promote safe care by providing high quality clinical and discharge information across the 24 hour period, is very encouraging.
The report evidences the extent to which the service users greatly value the work and the care of the organisation and it is pleasing to see that an explicit set of behaviours and ways of working are part of staff induction and the culture promoted, to maintain this level of patient satisfaction. The use of I Want Great
Care is positive and combined with staff review and feedback about the care being delivered, Trinity is in a strong position to describe the impact of 2015-16 improvements in next year‟s Quality Account.
Blackpool Clinical Commissioning Group
Blackpool CCG welcome the opportunity to comment on Trinity Hospice's Quality Accounts. The account is a well written, clear concise report of the excellent work undertaken by staff and volunteers at the
Hospice.
The CCG is pleased to note the quality improvements identified for 2015/2016, which clearly evidence a service which successfully works in partnership with other organisations whilst continuing to keep the patient and family/carers at the centre of its' service provision. The document evidences this well with the use of CQC feedback reports; statements from the Blackpool CCG quality visit; patient stories and comments from family carers, as well as focussing one of the quality initiatives on improvements directly relating to a patient complaint.
Blackpool CCG confirm that the statement relating to the quality visit undertaken is a true reflection of the report submitted.
Blackpool CCG looks forward to continuing its work with Trinity Hospice over the coming year.
The conclusion of NHS Blackpool Clinical Commissioning Group (CCG) is that Trinity Hospice Quality
Accounts for 2014-2015 provides an accurate reflection of service provision, quality improvements undertaken as well as future ambitions to continue to improve the quality and safety of its' services.
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