2009/10
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Introduction
Cornwall Partnership NHS Foundation Trust provides
specialist mental health, learning disability and substance
misuse services. We are an integral part of the health and
soical care network for the people of Cornwall and Isles of
Scilly.
I am delighted to provide this first Quality Account for the
services provided by Cornwall Partnership NHS
Foundation Trust for 2009/10.
The Trust’s aim is to continue to be one of the most highly
performing and leading public sector providers of ‘Whole
Life’ mental health and learning disability services in the
country. The patient is at the heart of everything the Trust
does, which is encapsulated in our vision, ‘Excellent
Services - with People in Mind’.
The Trust approach to quality is based on continuing
improvement and achieving external validation of our
services, which gives the public and our commissioners in
health and social care, confidence that our services are
rated as among the best in the country.
During 2009/10 we have worked hard to innovate, ensure
consistently high standards and equity across our services,
and to provide care in more efficient and better ways to
improve the patient experience.
We have a good track record of improving quality and we
aim to continuously grow, refine and develop the services
we provide.
We will continue to work closely with all our staff and the
people we serve to make improving services a priority for
us in the coming year. The Trust seeks to embed new
quality initiatives throughout the Trust and a culture of
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continuous quality improvement. I hope you will take the
time to read our first Quality Account which details our
achievements for 2009/10 and priorities for 2010/11.
I confirm that, to the best of my knowledge, the information
in the document is accurate.
Lezli Boswell
Chief Executive
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Priorities for improvement: Patient Safety
7
Priorities for improvement: Clinical Effectiveness
11
Priorities for improvement: Patient Experience
15
Statements relating to quality of NHS services provided
18
Statements relating to quality of NHS services provided
19
Recognition of our Quality
29
Demonstration of quality of NHS services
31
Appendix 1: PEAT Performance
34
Commentary on our services, provided by key stakeholders.
38
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the Trust since 2006. The Trust has undertaken a number
of initiatives over the past 4 years, which have successfully
reduced the number of incidents.
Reduce the number of falls in hospital
Why is this a priority?
About a third of people aged over 65 years of age fall each
year and this rises to 42% of people over 75 years. Falls
cause a high level of mortality and morbidity as well as
both physical and psychological stress. The the most
common serious injury is hip fracture. The majority of older
people admitted to Cornwall Partnership NHS Foundation
Trust inpatient wards suffer from dementia, which can
increase the risks of falling.
Figure 1: Reported slips, trips and falls in Cornwall
Partnership NHS Foundation Trust in the calendar years
2006 - 2009
What is the issue?
Falls account for almost two-fifths of the patient safety
incidents reported to the National Reporting and Learning
System. There is good evidence that some falls can be
prevented.
Figure 1 shows the reduction in slips trips and falls across
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The Trust has reduced falls over the past 4 years by the
following interventions:
• A review of the causes, frequency and impact of falls
What will be done?
•
•
•
•
•
•
• New flooring on Cove ward.
• New improved lifting and patient transfer equipment.
• Ongoing medication and care plan reviews for
New flooring
Staff training in falls prevention
Designation of a Falls Lead for the Trust
The falls policy will continue to be implemented to include:
individuals who have a high risk of falls
Developed a Falls Prevention Strategy
‘Health and wellbeing’ activities in in-patient wards
Medication and care plan reviews for individuals with a
high risk of falls
• ‘Keeping People Safe in Our Care Scheme’ which
• Enhancing the Healing Environment on Garner ward.
• Participating in the 2010 Royal College of Physicians’
National Audit on Falls and Bone Health
• Local audits and reviews related to slips, trips and falls,
as appropriate.
includes reporting incidents to share learning
• Worked in partnership with NHS Cornwall & Isles of
Scilly
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What will be measured?
Commissioning for Quality and Innovation (CQUIN)
Target (2010 - 2011)
1. Introduction of the seven simple steps programme
(Patient Safety First – How to guide to reducing harm
from falls (V1 200909))
2. Decrease falls in the elderly (over 65 yrs) on in-patient
wards by a further 10%
All CQUIN targets are monitored by the Trust Board
through the monthly Performance Report.
References
National Service Framework for Older People. Chapter 6
Department of Health 2001.
CG21 The assessment and prevention of falls in older
people November 2004.
www.fallsprevention.co.uk
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with mental illness often miss out on relevant health
promotion, in particular smoking cessation interventions.
Physical Healthcare
Why is this a priority?
People with severe and enduring mental illnesses (SMI)
such as schizophrenia and bipolar disorder are at
increased risk of a range of physical illnesses and
conditions, including coronary heart disease, diabetes,
infections, respiratory disease and obesity. They are almost
twice as likely to die from coronary heart disease as the
general population and four times more likely to die from
respiratory disease. Life expectancy in people with
schizophrenia is reduced by 20%, with 60% of the excess
mortality due to physical illness.
What is the issue?
The responsibilities for the NHS with regard to the mental
and physical healthcare and treatment of people with
mental health problems, are outlined in the National
Institute for Health and Clinical Excellence (NICE)
guidelines on schizophrenia, depression, bipolar disorder
and depression in children and young people.
Effective intervention to support smoking cessation, reduce
obesity, enable the management of raised lipids,
hypertension and diabetes could help to reduce the
inequalities associated with severe and enduring mental
illness and learning disability.
Despite this, people with mental illness or learning disability
frequently do not always receive the timely health
interventions they need, including health screening. People
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What will be done?
• Implement the new Physical Healthcare Strategy.
• Communicate relevant findings to general practitioners
What will be measured?
• Clinical audit of the routine completion of physical health
checks for inpatients, including physical assessment,
observations and relevant investigations; weight and
nutritional status
(GPs) following identification of physical illness.
• Advise general practitioners (GPs) about
recommendations for physical monitoring of people with
severe and enduring mental illness and learning
disability.
• Clinical audits through the Prescribing Observatory for
Mental Health of patients using depot medication,
Assertive Outreach Team clients and clients with a
learning disability who take anti-psychotic medication.
• Support primary care in maintaining an accurate register
of all people with severe mental illness (SMI), enabling
professionals in primary care to review progress
• Continue delivery of individual and group health
improvement services such as one-to-one support on
diet and food diary reviews and healthy activity and
exercise group – “weight off your mind”
• Continue health promotion in groups for patients with
learning disability.
• Promote health and well-being activities.
Clinical audits are reported through the Quality Group to
the Risk Quality and Standards Committee.
Commissioning for Quality and Innovation (CQUIN)
Target (2010 - 2011)
All allocated service users and inpatients to be offered (at
least once a year) “Stop Smoking advice” in the form of
“Stop Smoking pack”. Information available at all bases
and inpatient units.
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All CQUIN targets are monitored by the Trust Board
through the monthly Performance Report.
References
CG 82 Schizophrenia National Institute for Health and
Clinical Excellence March 2009
CG 38 Bipolar Disorder National Institute for Health and
Clinical Excellence July 2006
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Complaints provide feedback only when the system may
have broken down and does not give sufficient opportunity
to intervene early to improve the patient experience.
Listening and responding to feedback
Why is this a priority?
Quality of care includes quality of caring. This means how
personal care is – the compassion, dignity and respect with
which patients are treated. It can only be improved by
analysing and understanding patient satisfaction with their
experiences. The experience of care is believed to have an
impact on recovery.
As well as the national surveys, we have other ways of
using patient experience to inform decision making and
planning:
• Service users sit on interview panels for medical
consultants, senior clinicians and managers.
What is the issue?
• Service user representatives contribute to the Patient
National surveys of inpatients and community clients offer
an insight into the patient experience but occur only
annually and ask a limited range of nationally agreed
questions. A few ad-hoc clinical audits seek systematic
feedback from specific services e.g. survey of Early
Intervention in Psychosis clients at discharge.
Environment Team reviewing, monitoring and improving
the cleanliness, environment and food in our hospitals.
• Service user representatives sit on our quality group
• Service user independent visitors evaluate inpatient
units
• Positive feedback on privacy and dignity from the Dignity
Champion engaged by NHS Cornwall & Isles of Scilly.
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healthcare needs is also planning to devise and
distribute information to families.
What will be done?
We will use a new electronic system to seek service user
feedback at the end of every inpatient stay so that we can
find ways of measuring, responding to and improving the
experience of patients in our care. We will extend these
surveys to patients and /or carers in every service during
the year.
We also believe that better information for patients and
carers can improve service user involvement in care
planning and delivery.
What will be measured?
The results of surveys of patient experience will be
available in all services by the end of 2010 – 2011. Reports
of the outcomes of surveys will feed into planning and
service design through summaries to the Risk Quality and
Standards Committee.
Reference
High quality care for All: Next stage review final report.
Department of Health June 2008
• Information packs are already used in memory
assessment services, substance misuse services and
early intervention in psychosis services.
• Information for service users, devised by service users
on discharge from hospital care is a priority.
• The Short Breaks service for children with high
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This section includes all the mandatory statements which
we are required to provide. These give an overview of the
Trust, its services and their quality.
1.1 The Cornwall Partnership NHS Foundation Trust has
reviewed all the data available to them on the quality
of care in all five of these NHS services.
1. Services provided by Cornwall
Partnership NHS Foundation Trust
1.2 The income generated by the NHS services reviewed
in 1st April 2009 to 31st March 2010 represents 86 per
cent of the total income generated from the provision
of NHS services by the Cornwall Partnership NHS
Foundation Trust for 1st April 2009 to 31st March 2010.
During 1st April 2009 to 31st March 2010 the Cornwall
Partnership NHS Foundation Trust and its predecessor
body provided and/or sub-contracted five NHS
services. These are:
• Adult mental health services
2. Clinical Audit: Evaluation of the Quality of
Care and Treatment
During 1st April 2009 to 31st March 2010 3 national
clinical audits and 1 national confidential enquiry
covered NHS services that Cornwall Partnership NHS
Foundation Trust provides.
• Mental health of complex care (currently older
persons’) services
• Community Learning Disability services
• Specialist Substance Misuse services
• Community mental health services for children and
families.
2.1. During that period Cornwall Partnership NHS
Foundation Trust participated in 100% national clinical
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audits and 100% national confidential enquiries of the
national clinical audits and national confidential
enquiries which it was eligible to participate in.
2.3. The national clinical audits and national confidential
enquiries that Cornwall Partnership NHS Foundation
Trust participated in during 1st April 2009 to 31st
March 2010 are as follows:
2.2. The national clinical audits and national confidential
enquiries that Cornwall Partnership NHS Foundation
Trust was eligible to participate in during
1st April 2009 to 31st March 2010 are as follows:
Confidential Enquiry: National inquiry into suicides
and homicides by people with mental illness (NCISH).
National clinical audits: Prescribing Observatory for
Mental Health (POMH): prescribing topics in mental
health services.
Confidential Enquiry: National inquiry into suicides
and homicides by people with mental illness (NCISH).
Royal College of Physicians Continence Care Audit
National clinical audits: Prescribing Observatory for
Mental Health (POMH): prescribing topics in mental
health services
Royal College of Physicians Continence Care Audit
Royal College of Physicians National Falls Audit
Royal College of Physicians National Falls Audit
2.4. The national clinical audits and national confidential
enquires that Cornwall Partnership NHS Foundation
Trust participated in, and for which data collection
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Our response rate for this audit between 01/01/03 and
31/05/09 was 99.15%, compared with a national rate of
98%.
Registered
Eligible Cases
Confidential Enquiry: National Confidential Inquiry
into Suicides and Homicides by People with Mental
Illness (NCISH).
Cases
Submitted
was completed during 1st April 2009 to
31st March 2010, are listed below alongside the
number of cases submitted to each audit or enquiry as
a percentage of the number of registered cases
required by the terms of that audit or enquiry
%
Topic 2: March
2010
Topic 2: Data collection for screening for
metabolic side effects of antipsychotic
drugs in patients treated by assertive
outreach teams
70
n/a
n/a
Topic 6:
October 2009
Topic 6b re-audit data collection
Assessment of side effects of depot
antipsychotic medication
55
n/a
n/a
Topic 9:
June 2009
Topic 9a baseline data collection Topic 9:
Use of antipsychotic medicine in people
with Learning Disability
20
n/a
0
0
Date
Description of topic
Presribing Observatory for Mental Health: prescribing topics
National Continence Care Audit
Feb 2010
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Baseline data collection of patients with
urinary catheter on inpatient units.
n/a
August 2009 Topic 9a baseline report Topic 9:
Use of antipsychotic medicine in people with Learning
Disabilities - 20 cases.
2.5. The reports of 2 national clinical audits (which
includes 4 POMH topics) were reviewed by the
provider in 1st April 2009 to 31st March 2010.
Topic 1: April 2009
Topic 1d supplementary report for prescribing high
dose and combined antipsychotics on adult acute and
psychiatric intensive care wards - 50 cases
Royal College of Physicians National Falls Audit
2.6. Cornwall Partnership NHS Foundation Trust intends to
take the following actions to improve the quality of
healthcare provided
Topic 6b: January 2010
Topic 6b re-audit report Topic 6: Assessment of side
effects of depot antipsychotic medication
• A Physical Healthcare Strategy will be implemented
to improve physical care within Cornwall Partnership
NHS Foundation Trust and strengthen links with
primary care to ensure physical healthcare needs
are met.
Topic 8: May 2009
Topic 8a baseline report Topic 8: Medicines
reconciliation
• A new medication card to improve the prescribing
and administration of depot medication has been
introduced.
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• Medication leaflets, written in plain English by the
• A training day was held for all nurses working in the
UK Psychiatric Pharmacists’ Group and a checklist
to monitor side effects are now available for care
co-ordinators to download from the intranet.
• The Medicines Management Forum is implementing
the NICE guidance on medicines reconciliation,
using the results of the Prescribing Observatory for
Mental Health (POMH) audit as a baseline.
Community Learning Disability Service to learn
about standards of care planning and record
keeping.
• A business case has been prepared to offer
psychological interventions to patients with breast
cancer.
• Communications from the Psychiatric Liaison
Service have been expedited.
2.7. The reports of 43 local clinical audits were reviewed by
the provider in 1st April 2009 to 31st March 2010.
2.8. Cornwall Partnership NHS Foundation Trust intends to
take the following actions to improve the quality of
healthcare provided.
• Discharge planning from adult and older persons’
community mental health teams has been improved
in consultation with the Mental Health Forum
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• Lone worker action plans have been established for
each team.
• Training in the safe use of anti-coagulants has been
utilised from the BMJ e-learning website.
• In East Cornwall, the primary care register of
patients with dementia has been updated in
conjunction with the eldercare community team. This
means support and health checks can be
appropriately targeted by general practitoners (GPs).
• Closer working between dementia wards and
palliative care services will improve the experience
of end of life care for patients with dementia.
• Improvements have been made to the information
given at referral from the general practitioner to the
memory assessment service
3. Research: Contributing to new learning
for the NHS
The number of patients receiving NHS services
provided or sub-contracted by Cornwall Partnership
NHS FoundationTrust in 1st April 2009 to
31st March 2010 that were recruited during that period
to participate in research approved by a research
ethics committee was 258.
Cornwall Partnership NHS Foundation Trust was
involved in conducting 27 clinical research studies in
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the financial year 2009-2010. The Trust was involved
in 16 National Institute for Health Research (NIHR)
portfolio studies, which are at different stages of the
research process (some now finished, some now in
set-up). As measured by the Peninsula
Comprehensive Local Research Network, recruitment
of patients to NIHR portfolio studies increased by 52%
with predicted final number of 82 patients. The total
number of patients recruited to portfolio and
non-portfolio studies is estimated at 258 patients. As
we treat approximately 12,000 patients, this means
about 2.15% of patients are involved in approved
research and 0.72% involved in NIHR research.
Cornwall Partnership NHS Foundation Trust used
national systems to manage the studies in proportion
to risk. Of the 14 studies given permission to start,
57% were given permission by an authorised person
less than 30 days from receipt of a valid complete
application. 7% of the studies were established and
managed under national model agreements and 50%
of the 14 eligible research involved used a Research
Passport. In 1st April 2009 to 31st March 2010 the
National Institute for Health Research (NIHR)
supported 16 of these studies through its research
networks.
In the last three years, 20 publications have resulted
from our involvement in NIHR research, helping to
improve patient outcomes and experience across the
NHS.
4. Commissioning for Quality and Innovation
A proportion of Cornwall Partnership NHS Foundation
Trust’s income in 1st April 2009 to 31st March 2010 was
conditional on achieving quality improvement and
innovation goals agreed between Cornwall Partnership
NHS Foundation Trust and any person or body they
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entered into a contract, agreement or arrangement
with for the provision of NHS services, through the
Commissioning for Quality and Innovation (CQUIN)
payment framework.
Further details of the agreed goals for 1st April 2009 to
31st March 2010 and for the following 12 month period
are available on request from the Associate Director of
Business Development.
CQUINS 2009/10
Description of goal
CQUINS 2010/11
Value
To improve the quality of data to inform service provision
95% recording of actual ethnicity, not using categories such as
other, not stated or unknown.
£52,000
To improve the patient experience by compliance with policy & best
practice for privacy & dignity in all settings
Ensure that all patients from BME groups admitted to in-patient
units are offered a visit from a community development worker and
for each patient admitted CDW service are notified
To improve access to all healthcare provision for all pregnant
women, children and young people with a learning disability
Dedicated CAMHS provision to children & young people with a
learning disability increased to 50 and maintained
£52,000
£52,000
Description of Goal
Value
Improve the knowledge and understanding of the service users right
to dignity and respect.
£39,000
To ensure that service users who smoke are aware of the services
available to help stop them smoking.
£39,000
To reduce the number of service users who experience a slip, trip or
fall.
£39,000
To improve staff awareness of dementia.
£39,000
To reduce sickness absence in workforce to a level equivalent to
0.75 % below the National Average of 5.49%
£39,000
To increase the number of people in the year confirmed with a
diagnosis of psychosis.
£196,000
To provide 95% of adult patients with a HoNOS baseline and 95% of
older adults with the HoNOS 65 baseline with a planned review date.
£196,000
To provide clinical outcome measurements for young people
receiving mental health services.
£196,000
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5. Registration and Regulation
Cornwall Partnership NHS Foundation Trust is
required to register with the Care Quality Commission
(CQC) and its current registration status is
unconditional. Cornwall Partnership NHS Foundation
Trust has no conditions on registration.
The Care Quality Commission has not taken
enforcement action against Cornwall Partnership NHS
Foundation Trust during 1st April 2009 to 31st March
2010.
7. Care Quality Commission Special Reviews
or Investigations
Cornwall Partnership NHS Foundation Trust has not
participated in any special reviews or investigations by
the Care Quality Commission during the reporting
period.
8. Data Quality: How valid is the data we
keep?
6. Care Quality Commission Periodic
Reviews
Cornwall Partnership NHS Foundation Trust is not
subject to periodic reviews by the Care Quality
Commission.
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Hospital Episode Statistics
Cornwall Partnership NHS Foundation Trust submitted
records during 1st April 2009 to 31st March 2010 to the
Secondary Uses service for inclusion in the Hospital
Episode Statistics which are included in the latest
published data.
9. Information Governance: How we keep
sensitive data confidential
Hopsital Episode Statistics 2009/10
Data Definition
Percentage of records
which achieved this
standard
The patient’s valid NHS number for
admitted patient care
98.6%
The patient’s valid NHS number for
outpatient care
99.9%
The patient’s valid NHS number for
accident and emergency
0%
Cornwall Partnership NHS FoundationTrust score for
1st April 2009 to 31st March 2010 for Information Quality
and Records Management, assessed using the
Information Governance Toolkit was 76%.
Note
*Not applicable
The annual self assessment of the Information
Governance Toolkit can be split into the following
initiatives:
The patient’s valid General Medical
Practice Code for admitted patient care
100%
Information Governance Management - 75%
The patient’s valid General Medical
Practice Code for outpatient care
100%
The patient’s valid General Medical
Practice Code for accident and
emergency care
How well the Trust has implemented the necessary
management structures to ensure that all information
is handled and governed appropriately.
0%
*Not applicable
Confidentiality and Data Protection Assurance - 73%
* Cornwall Partnership NHS Foundation Trust does not provide accident and
emergency services
How well the Trust ensures that confidentiality and
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data protection process are implemented and
monitored in respect to legislation and DoH Standards.
Overall Compliance Rate - 76%
NHS Trusts have to achieve 70% to prove compliance
with national Information Governance Standards.
Information Security Assurance - 78%
How well the Trust manages the IT and physical
security of all information.
10. Payment by Results
Cornwall Partnership NHS Foundation Trust was not
subject to the Payment by Results clinical coding audit
during April 1st 2009 to 31st March 2010 by the Audit
Commission.
Clinical Information Assurance - 76%
How well the Trust manages the quality of, and the
accessibility of all health related information.
Secondary Use Assurance - 76%
How well the Trust manages information in regards to
performance monitoring and reporting.
Corporate Information Assurance - 75%
How well the Trust manages and monitors all non
health information.
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We have received a number of external accreditations.
These are a valuable way of seeking peer review and
benchmarking our services against the best in the country.
In addition, services have sought to identify their own
clinical quality indicators to report next year. Asking the
local services to define quality enabled these to be well
agreed with frontline staff.
• Accreditation for Inpatient Mental Health Services
(AIMS) is an initiative from the Royal College of
Psychiatrists' Centre for Quality Improvement which
identifies and acknowledges services which have high
standards of organisation and patient care, and supports
and enables others to achieve these. It is designed to
improve the quality of care in psychiatric wards.
Standards are drawn from authoritative sources and
cover all aspects of the inpatient journey. Compliance is
measured by self- and peer-review. Accreditation is valid
for up to 4 years, subject to an annual self-review. AIMS
accredits acute and assessment wards for working age
adults and wards for older people.
The standards cover the following topics:
•
•
•
•
•
General Standards
Timely and Purposeful Admission
Safety
Environment and Facilities
Therapies and Activities
To date, Fletcher, Bay and Garner wards have been
reviewed and all have achieved Category 1: “accredited
with excellence”, which means that all essential
standards have been met.
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• The Electro-convulsive Therapy Accreditation
Service (ECTAS) is a standards-based accreditation
service designed to improve the quality of the
administration of electroconvulsive therapy. Feedback
from clinics undertaking the accreditation process
indicates that ECTAS has helped bring about
widespread improvements in the provision of ECT,
including investment in new equipment and better
deployment of staff. The standards have been approved
by the College ECT committee and the ECTAS
Reference Group which includes service users,
psychiatrists, nurses and anaesthetists.
The standards cover the following topics:
•
•
•
•
•
•
Anaesthetic practice
The administration of ECT
Recovery, monitoring and follow up
The ECT clinic and facilities
Staff and training
Protocols
Our service at Bodmin Hospital is accredited to May 2011
under Category 1: “approved with excellence”, which
means that all essential standards are met.
• have received positive Service User feedback;
• be likely to have excelled in other ways e.g. research,
audit or teaching.
• Special precautions
• Assessment and preparation
• Consent
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Access to services:
• We have maintained follow up within 7 days for all
Safety:
• We have experienced low rates of healthcare acquired
hospital discharges throughout the year. This is
important because the early days after discharge are
when service users and their carers can feel especially
vulnerable. There have been no serious untoward
incidents in the first 7 days after discharge from hospital
during the year reported.
• The Home Treatment Team has functioned as
gatekeeper to the hospital inpatient unit in 93% of cases.
This gives the best chance of offering treatment at home
if at all possible, which can improve recovery outcomes
and service user satisfaction.
• All people referred to our adult mental health services
infections - just 5 in 2009/10.
• On our dementia in-patient units, there have been fewer
serious injuries from falls.
• There have been no “never events” as defined by the
National Patient Safety Agency in 2010.
Clinical effectiveness:
• We observed good and highly improved prescribing
practice on inpatient units (POMH high dose
anti-psychotic audit) compared to a national benchmark.
This reduces the risk of side effects and adverse events
related to this specialist medication.
have been offered an appointment to be seen within 28
days.
• 100% of children and young people presenting as an
• Substance misuse services have assessed all referrals
• 83% of people receiving a diagnosis of dementia had
emergency have been seen the next working day.
their care plan updated within 28 days.
within 21 days of referral.
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anti-psychotic drug
prescribed within BNF
recommended doses
Single drug
prescribed rather than
combination
Single type of drug,
rather than both types
CPT
CPT
CPT
National
National
The survey demonstrates high scores for contacting
patients in the 7 days after discharge (top) and for
ensuring they know who to contact outside office hours
(bottom).
National
2008
62%
62%
71%
60%
78%
70%
2009
88%
69%
80%
66%
86%
77%
• EIS patient feedback
A clinical audit of the young people discharged from the
Early Intervention in Psychosis team indicated
satisfaction with their care and treatment
Patient Experience:
• CQC inpatient survey
• Bowman Ward was awarded the Star Wards “Full Monty”
Award.
This is a service user led international award, indicating
that the ward meets standards set by service users.
• Our Child and Family Mental Health Services have been
awarded the highest level 3 EEFO accreditation. EEFO
have developed a set of local quality standards that
services in Cornwall and the Isles of Scilly must prove
Page 32
they can meet. If they meet the standards, the service
will be EEFO Approved and will therefore be a ‘young
person friendly’ service.
Learning and Development
Rehabilitation Services
Our rehabilitation services were consolidated during the
year into one unit in the purpose built environment of Fettle
Ward at Bodmin Hospital. This has allowed us to improve
privacy and dignity by offering a more gender segregated
environment. Service users on the ward have increased
therapeutic activity levels. This change has also released
funding to improve community rehabilitation and outreach
services in 2010 and onwards.
• Fettle Ward was awarded the Star Wards “Full Monty”
In October 2009, we received a good review by the
Deanery of our medical postgraduate training and in
December 2009, all of the education provided in the Trust
was positively reviewed by NHS Southwest. Feedback was
extremely positive. Our compliance with appraisals was
high (93%) and this was also reflected in feedback through
the NHS Staff Survey in 2009.
Care Quality Commission (CQC) Annual
Health Check
The Board declared fully met for all 44 core standards at
the year end 2009/10.For 2009-2010, the Trust expects to
be “EXCELLENT’’ for quality of service.
Award.
This is a service user led international award, indicating
that the ward meets standards set by service users.
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Patient Environment Action Team
Assessments 2010
We have received confirmation from the National Patient
Safety Agency of our Patient Envinorment Action Team
Assessments for 2010. The results for environment, food
and privacy and dignity for each hospital within our Trust
are as shown in the table below.
Environment
Food
Privacy and Dignity
Bodmin
Acceptable
Good
Excellent
Longreach
Acceptable
Excellent
Excellent
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Table 1 – Indicator forecast position 2009/10
Health and Wellbeing
Experience of patients – health and wellbeing domain(s)
Achieved
Clinical Quality
Patterns of care from mental health minimum data set (MHMDS)
Achieved
Clinical Quality
Completeness of the mental health minimum data set (MHMDS)
Achieved (to be confirmed)
Clinical Quality
Child and adolescent mental health services (CAMHS)
Achieved
Clinical Quality
Experience of patients – clinical quality domain(s)
Achieved
Safety
Care programme approach (CPA) 7 day follow up
Achieved
Safety
Experience of patients – safety domain(s)
Achieved
Patient focus and access
Best practice in mental health services for people with a learning disability (Green light toolkit)
Achieved
Patient focus and access
Experience of patients – patient focus and access domain(s)
Achieved
Patient focus and access
Numbers of drug mis-users in effective treatment
Achieved
NHS staff satisfaction
Achieved
Health and wellbeing
Data quality on ethnic group
Achieved
Clinical Quality
Access to crisis resolution home treatment (CRHT)
Achieved
Health and wellbeing
Delayed transfers of care
Achieved
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Q4 Compliance Report - cumulative from 1 April 2009 - 31 March 2010
Governance Perfromance Score
Target/National Core Standard
Threshold
Weighting
31 March 2010
Score
100% enhanced Care Programme Approach (CPA) patients receiving follow-up contact
within seven days of discharge from hospital.
95%
1.0
100%
0
Minimising delayed transfers of care
No more than 7.5%
1.0
4.18%
0
Admissions to inpatient services had access to crisis resolution home treatment teams
90%
1.0
93%
0
Maintain level of crisis resolution teams set in 03/06 planning round (or subsequently
contracted with PCT)
0
1.0
Fair share is 3. Agreed
with PCT to reduce to 2
0
Each National Core Standard (listed where non compliance)
-
1.0
Mental Health Targets
0
Scores as at March 2010
0
Status
Green
Governance Risk Rating Calculation: <1 = green: 1 - 2.9 = Amber:
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>3 = Red
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The NHS CIOS believes that the Quality Account is a
balanced report of the services provided by the Trust, gives
a comprehensive coverage of the provider’s services and
agrees the priorities are those that the PCT recognise as
important.
Statement by NHS Cornwall and
Isles of Scilly
All references in this commentary relate to the reporting
period 1 April 2009 to the date of this statement from
information gained through Board to Board, and contract
review meetings. NHS Cornwall and the Isles of Scilly
confirms the information contained in the quality account
appears to be accurate from the information collected
routinely through out the reporting year.
The NHS Cornwall and the Isles of Scilly commends the
Trust on achievement of Foundation Trust Status, for
continuing quality improvement and achieving external
validation. The Cornwall Partnership NHS Foundation
Trust has been inspected by the Care Quality Commission
on three different occasions and are the only Trust
inspected in the South West without having qualifications
imposed following the inspection.
The NHS Cornwall and the Isles of Scilly would like to
congratulate Cornwall Partnership NHS Foundation Trust
on progress relating to reduction in harm from falls and the
physical needs of patients being addressed, and wish to
highlight the following issues which it considers to be
priorities for the quality improvement journey over the next
year:
• A more explicit focus on the quality of Care Planning for
all service users including people with dementia,
including ensure that all relevant parties have copies.
• Increased visibility of the key metrics that are generated
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by Cornwall Partnership NHS Foundation Trust that
demonstrate progress including demonstrating the
clinical effectiveness of psychological treatments offered.
• Mainstream the adoption of the North Cornwall Pilot, to
strengthen the relationship between primary care and
secondary care provision.
• Adopt and spread the learning from the Newquay
Integrated Care Pilot for people with dementia.
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Statement from Cornwall Counci’s Health and
Adults Overview and Scrutiny Committee
Cornwall Council’s Health and Adults Overview and
Scrutiny Committee (CCHAOSC) agreed to comment on
the Quality Account 2010-2011 of the Cornwall Partnership
NHS Foundation Trust. All references in this commentary
relate to the reporting period 1 April 2009 to the date of this
statement and pertain only to the Trust’s relationship with
the HAOSC. The Trust has been engaging with the HAOSC
throughout this period through meetings with the Chairman
and Vice-Chairman, attendance at committee meetings,
pre-agenda meetings and briefings.
performance in relation to the ‘Patient Experience’ aspect
of the CQC inpatient survey.
The HAOSC believes that the Quality Account is a good
reflection of the services provided by the Trust, and gives a
comprehensive coverage of the provider’s services.
The HAOSC are very pleased with the progress the Trust
has made over the last few years. The Trust organised
informative and interesting familiarisation visits for HAOSC
members to their facilities in Redruth and Bodmin. The
HAOSC welcomes the work the Trust has done to reduce
the number of falls for in-patients and recognises the high
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dementia when admitted to hospital with an unrelated
condition.
Statement from Cornwall LINk
(Local Involvement Network)
LINk [Local Involvement Network] in Cornwall was asked to
comment on the Quality Accounts 2009-2010 for Cornwall
Partnership NHS Foundation Trust. LINk and Cornwall
Partnership NHS Foundation Trust have had a developing
relationship through the period concerned and CFT have
started to attend relevant LINk in Cornwall Task Groups.
In line with issues that LINk has been told we are pleased
to see that work on the physical health of people with
mental health problems and learning disabilities has been
mentioned in the Quality Account. LINk is also happy that
discharge planning is incorporated but from issues we have
heard LINk feel that more work is still needed. LINk is
pleased that training in dementia awareness is outlined as
this is another area LINk has heard concerns about,
particularly in relation to the treatment of people with
LINk is glad that better information for patients and carers
has been identified as priority for the future, especially
information for service users when discharged from
hospital. Hospital discharge is an important area which
LINk is currently working on alongside CFT and we hope to
see real improvement to the process. It is important that
sufficient information for patients and carers is provided
and any problems associated with discharge are
monitored. A critical aspect of hospital discharge is the
communication between involved agencies and LINk would
like to see this in the Quality Account.
LINk feels that additional areas that have been omitted
from the Quality Account include:
• Support Out of Hours – LINk has been working on this
issue in the past year after hearing many concerns from
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members of LINk and the public. LINk would like to have
seen this mentioned in the Quality Accounts. The CQC
Patient Experience Survey showed users did not have
high levels of satisfaction with the service provided
which is not outlined in the Quality Account. LINk would
also like to see an explanation of why staff in the crisis
resolution team has been decreased, as an outcome of
the work that LINk conducted suggested that the service
was understaffed.
• Dementia Dignity and Care – As outlined in the CQUINS
• Transitional Phase Services – LINk has heard many
issues surrounding the transition of children to adult
services.
LINk hope that in the future more areas of concern they
have heard and passed onto CFT will be represented in the
Quality Accounts produced by Cornwall Partnership NHS
Foundation Trust, but feel that this Quality Account is a
good start and has been produced in a very accessible
format.
for 2009-2010 LINk would like to see more information
provided about the work being done around dignity and
care, particularly in relation to patients with dementia as
this is an issue LINk have been told about.
• Mental Health Provision for Children and Young People
– As outlined in the CQUINS for 2010-2011 LINk has
been told of concerns around the provision of mental
heath care for children and young people.
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