Care Plus
Quality
Account
2011
Document Reference:
Report Authors:
Version Number
Last Updated:
Quality Account 2011
Jo Barnes, Associate Director of Care
Nic Glen, Performance and Information
Manager
1.0
23rd May 2011
Contents
Part One – Introduction
Page no
1.1 Statement on Quality from the Chief Executive Officer
3
1.2 Statement of assurance from the NEL Care Trust Plus Board
4
Part Two – Priorities for improvement
2.1 Care Plus Services in North East Lincolnshire
5
2.2 Review of Services within Care Plus
11
2.3 Registration with the Care Quality Commission
11
2.4 Care Plus priorities for quality improvement during 2011 – 2012
12
2.5 Participation in Clinical Audits
21
2.6 Goals agreed with Commissioners
23
2.7 What others say about Care Plus
26
Part Three – Review of Quality, Performance and 2010 – 2011 priorities
3.1 Patient/service user safety
30
3.2 Clinical/support effectiveness
39
3.3 Patient/service user experience
42
3.4 Statements from NEL LiNK/Overview and Scrutiny Committee
44
3.5 Conclusion
44
Appendices
Appendix 1 – Care Plus Group Organisational Infrastructure
Appendix 2 - National Quality Requirements in the Delivery of Out of Hours Services
Appendix 3 - April 2011 Care Plus Quality and Performance Report.
Appendix 4 – Learning Disability Annual Health Check
Appendix 5 – Person Centred Planning Annual Report
Appendix 6 – Easy Read Summary of Quality Account
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Part One
Introduction
1.1 Statement from the Chief Executive Officer
This is the first Quality Account produced by Care Plus (North East Lincolnshire Care Trust Plus) and it
is timely that we are now required to do so. Care Plus provides a diverse range of integrated
community based health and social care services and from July 1 2011 will be operational as Care
Plus Group social enterprise, constituted as a Community Benefit Society. We are very proud of what
has been achieved this year through the commitment, hard work and sheer determination of our
highly valued workforce. Our vision is for Care Plus to become the provider of choice and we can
only achieve our vision if the quality of our services remain consistently high and demonstrate value
for money. This Quality Account sets out how we provided high quality, accessible and cost effective
care in 2010 -11 focussing on the three areas that constitute a quality framework:
Patient/service user safety – ensuring that people are kept from harm
Clinical/support effectiveness – ensuring that our interventions achieve the best possible
outcomes for people
Patient/service user experience – ensuring that people who receive care and support feel
that they have been treated with dignity and respect
The journey to social enterprise also provides Care Plus Group with new opportunities and during
the coming year we will continue to develop our excellent services, despite the rigour of the financial
challenges ahead. This Quality Account will detail our priorities for improvement going forward to
ensure that we become not just a good, but a great organisation.
Lance Gardner
Chief Executive Officer
Care Plus Group
Port Office
Grimsby
DN31 OLL
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1.2 Statement of Assurance from the Board.
The North East Lincolnshire Care Trust Plus (CTP) Board are pleased to comment on and approve the
Quality Accounts for Care Plus.
2010/11 has been a challenging year with the implementation of the national policy on transforming
community services which has seen the separation of providers and commissioners. These accounts
reflect on the year 2010/11 when services were provided and commissioned by the CTP. They also
look to the future with on-going services provided as a social enterprise.
The CTP has always been committed from both a commissioner and a provider perspective to ensure
services are of the safest and highest quality. The Board would like to congratulate all staff for their
contribution to the achievements over the past year and their on-going work to improve the quality
of services. There will always be challenges to meet and both commissioners and providers will
strive for the highest quality in all care provided, putting patients at the heart of everything we do.
The Quality Accounts reflect the creation of a holistic, integrated care system built on a long history
of partnership across health and social care which is now showing real benefits to the local
community. This has enabled the development of a model of care for services valuing people
working alongside the person, their families and carers to support enablement and inclusion. We
have also worked closely with community members, your representatives, to ensure we focus on
those things which mean the most to people and listen to your views of the care you received changing this when necessary and always seeking to improve.
As a result we have focused a large proportion of our time on quality, looking at the things that
really matter to our community – safe services, high levels of customer satisfaction, and improved
clinical outcomes.
We are satisfied that the indicators contained in the report gives a balanced view focusing on
successes whilst highlighting areas for continued development and improvement within 2011/12.
I have been proud to witness the on-going commitment and enthusiasm and energy within the CTP
for delivering a high quality service to the public and I am sure this will be reflected in the further
development and implementation of the quality framework and improvement in outcomes for the
local community.
To the best of my knowledge the information contained in this report is true and accurate.
Val Waterhouse
Chairman
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Part Two
Priorities for improvement
2.1 Care Plus Services in North East Lincolnshire
Currently, the majority of Care Plus operational activities are within the boundaries of North
East Lincolnshire Unitary Authority, serving a community of 157,100 people1 of which about
1.4% is from minority ethnic communities. By 2029, the population is predicted to increase
to 163,9002. North East Lincolnshire covers an area of 74.1 square miles and offers a
surprisingly dense population with 88% of the population living within 5 miles of the main
hospital site. This population density is indicative of the state of local housing with a rate of
8.3 people per hectare compared to a national average of 2.3 per hectare. This is largely
due to the compact terrace housing which served the fishing industry during the early
decades of the twentieth century. The two major towns of Great Grimsby (87,574) and
Cleethorpes (31,853) are conjoined, and between them have a population of almost
120,000.
Population
The 2008 mid-year estimates are the most current population statistics for North East
Lincolnshire. The breakdown by age is shown in the chart
1
Population data in this paragraph is from the Office for National Statistics.
2
North East Lincolnshire Council, Sustainability Appraisal Report 2009
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below:
2008 Mid-Year Population Estimates for North East Lincolnshire
14,000
12,000
Population
10,000
8,000
6,000
4,000
2,000
0
0
1-4
5-9
1014
1519
2024
2529
3034
3539
4044
4549
5054
5559
6064
6569
7074
7579
8084
85+
Age band
Ethnicity
The clear majority of the population in North East Lincolnshire identify themselves as White
British (98.6%); this is higher than the England average of 90.9%. As we can see from the
table below the percentage of resident population in ethnic groups in North East
Lincolnshire is consistently and significantly lower than the average for England.
North East
Lincolnshire
England
98.6
90.9
0.4
1.3
Mixed
0.5
1.3
Asian or Asian British
0.5
4.6
Indian
0.3
2.1
Pakistani
0.1
1.4
Bangladeshi
0.1
0.6
Other Asian
0.1
0.5
White
of which White Irish
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Black or Black British
0.2
2.1
Caribbean
0.0
1.1
African
0.1
1.0
Other Black
0.0
0.2
0.3
0.9
Chinese or Other Ethnic Group
Source: 2001 Census, ONS
Seasonal fluctuations in population serve to increase the size of this coastal community
during the summer holiday season by approximately 12,000 people over a holiday season of
approximately 6 months per year. This seasonal population, predominantly from the
industrial heartlands of South Yorkshire, Derbyshire and North Nottinghamshire, tend to
suffer from a range of industrially related chronic illness such as COPD, Diabetes, arthritis
etc.
The headline health features of the community of North East Lincolnshire, drawn from the
‘Association of Public Health Observatories’ health profile can be summarised as: The health of people in North East Lincolnshire is generally worse than the England
average. Life expectancy for men and women, early deaths from heart disease and
stroke and from cancer are all worse than England averages;
There are health inequalities within North East Lincolnshire. For example, life
expectancy for men living in the least deprived areas is nearly nine years higher than
for men living in the most deprived areas;
Over the last ten years, death rates from all causes and early deaths from heart
disease and stroke and from cancer have all improved, but these rates remain worse
than the England averages;
Teenage pregnancy rates are worse than the England average, but are improving;
Estimates suggest worse percentages of adults who smoke or who are obese than
the England averages;
The North East Lincolnshire Local Area Agreement has prioritised tackling heath
inequalities (specifically heart disease, cancer, road casualties and smoking), alcohol,
unhealthy housing, childhood obesity, teenage pregnancy and vulnerable adults.
The community of North East Lincolnshire has a strong sense of local identity based on its
heritage as a fishing port; however with the deterioration of this industry consequently the
economic outlook of the locality has seen a similar decline. The Index of Multiple
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Deprivation (IMD) 2007 score shows that North East Lincolnshire is ranked as 49th most
deprived out of 354 Councils in England. However, this masks differences across the
Borough. Many of the Borough’s areas are amongst the most disadvantaged 20%,
highlighting pockets of deprivation in the urban area.
The population of North East Lincolnshire is predicted to grow over the next five years.
Most of this growth is in the older adult (65+) group, with a little growth also predicted in
the working age adult (18-64) group3. The composition and predicted shifts in the age
profile would seem to indicate the difficulty of retaining younger adults and graduates
within the area.
During 2010 – 2011 Care Plus has provided a diverse range of integrated health and social
care community based services which have been delivered through one principal
Community Services Contract. The resources within Care Plus have been allocated through
two delivery units being Services Valuing People and Integrated Community Services with
each unit director being responsible for managing its operations and finances.
Services Valuing People
Services Valuing People provide a service which in the main, support, advocate and enable
individuals with a diverse range of needs to function meaningfully in local communities and
society as a whole. The population served are primarily, but not exclusively:
People with learning disabilities
Older people requiring support to maintain independent living in their own home
People with physical disabilities
People requiring support to overcome the challenges they face around substance
misuse.
A range of employment initiatives to support vulnerable people and marginalised
groups furthest from the labour market to gain and sustain employment.
For the majority of cases the SVP workforce aspires to move away from traditional care
models but to work alongside the person and their families or carers to create and realise
their own solutions, supporting their enablement and inclusion within the community. The
range of services on offer includes supported employment, housing, financial management,
respite, intensive support for people with complex needs, therapeutic intervention as
required, social skill development and integration into the wider community.
3
ONS 2006 based population projections for 2010-2015.
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Integrated Community Services
These services are primarily focussed on supporting people either during an acute
disturbance to their physical health, or to assist them to reconfigure their lives taking
account of a chronic condition[s] which impact on their state of wellbeing in a potentially
negative way. This is achieved through a catalogue of resources and services all aimed at
achieving the outcomes chosen by the individual. The range of services includes:
Short term - Intermediate tier – including:
Rapid Response [for the initial 72 hours of an acute episode],
The Beacon [residential and nursing care for the sub-acute/ recuperative phase of an
illness or injury]
Intermediate care at home [enabling services provided temporarily within the
persons own home during a sub acute phase]
Short to Medium term care – this includes:
Community nursing services
Allied health professional support [in partnership with NLAG]
Sub-acute care home bed provision
Long term care support services. This is achieved through a range of services
and individuals including;
Specialist nurses
Macmillan and Marie Curie services
Continuing Care
Care Plus is currently working primarily to a sole commissioner which is North East
Lincolnshire Care Trust Plus, however the reality is that the Care Trust acts as the broker for
the commissioning intentions of North East Lincolnshire Council for Adult Social Care and
therefore in essence there are two main commissioners. Currently services are also
commissioned on behalf of the GP community but as the General Practice Commissioning
Consortium comes increasingly to the fore it is anticipated that they will begin to exert a
much greater influence on the commissioning requirements on Care Plus.
Care Plus currently employs approximately 790 staff with the majority of these staff coming
from a traditionally social care background before the Care Trust Plus came into being, and
9|Page
thereby have radically altered the shape of services provided within Care Plus. There are
also a small number of allied health professionals employed by Care Plus, but the vast
majority of therapists who support Care Plus are employed by NLAG under a service level
agreement. This is an area which Care Plus would like to re-shape in the future with all
allied health professionals currently working in the community shifting to Care Plus over
time.
Whilst the majority of care is provided in peoples own homes or care homes, the staffing
compliment is still widely dispersed within eighteen buildings across North East Lincolnshire.
This is primarily to facilitate integrated working with primary care. Much of this estate is
less than two years old, and to an exemplary standard, but a small number of buildings are
in a poor state of repair and will need to be closed or renovated in the next few years.
During the three years since the inception of the Care Trust Plus, Care Plus has made
significant strides towards its goal of becoming provider of choice and this is evidenced in
the following ways:
The scale of innovation, experimentation and creativity that has already improved
outcomes for people and achieved local, regional and national awards;
The capacity to re-design care systems and challenge traditional approaches in areas
such as the Intermediate Tier;
The creation of a holistic, integrated care system built on a long history of
partnership across health and social care;
A strong foundation of public engagement which positions Care Plus extremely well
to take forward the shift in national policy from state to local ownership and
supports the concept of the Big Society;
A local workforce that wants to be empowered and take greater responsibility for
the services they deliver;
A directorate which has significantly contributed to improving the corporate
performance of the CTP, which has moved from middle quartile to the top 10% of
national performance over the past 12 months in World Class Commissioning;
Developed a quality and performance management framework which ensures
effectively delivery and consistently met all National Indicators;
Achieved Clinical Quality Indicators (CQUINs) during the first year of their operation;
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Successfully relocated people with learning disabilities from an unfit for purpose
institution into bespoke supported housing;
Won the tender for the Emergency Duty Team contract;
Won the tender for GP Out of Hours call handling;
Managed to cope with 62% increase in community nursing activity despite being
inadequately resourced;
Providing exemplar care for increasing numbers of medically unstable people or
increasing acuity of illness within the community;
Supporting increasing numbers of people to die in the place of their choice;
Achieving excellent outcomes in drug and alcohol intervention services which are
receiving national acclaim.
2.2 Review of Services within Care Plus
This section of the Quality Account covers aspects of our quality review that we are required
to report on.
As previously stated, during 2010 – 2011 Care Plus provided all services under one
Community Contract and resources were allocated across the two service directorates.
As the organisation moves towards a social enterprise model, a review of the current
infrastructure has been undertaken and services/teams will be aligned according to one of
three themes being:
Acute
Long term conditions
Inclusion
An organisational infrastructure which will be operational from June 2011 is attached at
Appendix 1.
2.3 Registration with the Care Quality Commission
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Care Plus Group as a social enterprise is required to register with the Care Quality
Commission.
Historically CQC registration and compliance for North East Lincolnshire Care Trust Plus has
been co-ordinated by a dedicated small team. The team ensured registration was accurate
and that all service areas were compliant against CQC outcomes. The team assisted
managers with the gathering of evidence to support service and organisational compliance.
Care Plus Group have aligned the responsibility for CQC registration and compliance to one
of the Heads of Operational Services, supported by an Assurance and Compliance Officer.
The organisational application was submitted on 31st March 2011 along with the required
Registered Manager applications. All applications have been received and acknowledged by
CQC and are progressing through registration. Task and Finish Groups have been developed
to support evidence gathering and provide on-going support to the managers who are
engaged in this process. These have proved effective in the on-going evidence gathering
and are also used as a discussion and information sharing point.
The Care Quality Commission has not taken enforcement action against Care Plus during
2010 – 2011 nor has Care Plus participated in any special reviews or investigations by the
CQC during the reporting period.
2.4 Care Plus Group priorities for quality improvement during 2011 -2012
During the last year we have carried out a significant amount of work that has resulted in
the development of a robust quality and performance management framework that takes
into account the three areas that constitute a quality framework being :
patient/service user safety,
clinical/support effectiveness
patient/service user experience.
This work has included staff at all levels within the organisation and the feedback from our
most important stakeholders, being patients/service users, has been essential to the design
of the framework.
The development of the framework will ensure that we can continue to monitor and
measure the effectiveness and quality of the services that we deliver and challenge quality
issues in a timely and responsive way. We have focussed the development of our
organisational priorities on a thematic approach which will evidence outcomes both
quantitative and qualitative.
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2.4.1 Care Plus Quality Pledge
Our quality pledge is as follows:
1. We demonstrate commitment to Quality and Value
We provide high quality services and offer value for money
2. We use personalised approaches
We put people at the heart of what we do
3. We have a well managed workforce
We strive to support our staff and make them feel valued
4. We promote health and wellbeing
We work together to improve people’s lives
5. We contribute to reducing the environmental impact
We aim to be green
6. We contribute to community wellbeing
We support people to have the best life possible
During the coming year we will produce measurable outcomes and produce evidence
against each of the above quality statements in order to demonstrate our commitment to
driving up quality. Our approach will also ensure that if quality issues emerge in any area of
service delivery, we will be in a position to respond efficiently and effectively. Our
performance and quality measures take into account the requirement to respond to our
commissioners, our external regulators, our staff and our public.
The following describes our quality and performance framework detailed against each of
the themes:
We demonstrate commitment to Quality and Value
We provide high quality services and offer value for money
Financial Position - we will continue to report our financial position on a monthly basis which
will ensure that we can take remedial action as required
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Incident Reporting – as an organisation we are committed to preventing harm to
patients/service users and have adopted DATIX, a system that effectively gives our staff relevant
information about different sorts of incidents so that we can learn lessons from them.
Financial saving through development of Complex Case Management & Rapid Response –
through the continued development of an effective Intermediate Tier and complex case
management model, we will continue to be able to divert people away from acute
services/residential care by successfully supporting them in their own homes
Productive Community Services – Involvement in this programme will ensure that service
provision processes are streamlined thereby offering financial efficiencies
Quality Requirements in the delivery of GP Out-of-Hours Call Handling - From 1st April 2011
we were commissioned to deliver this service and will be measured against the relevant
National Quality Requirements (see Appendix 2 attached)
We use personalised approaches
We put people at the heart of what we do
Patients/service users with Care Plans – in order to ensure that our patients/service users
receive the best possible continuity of treatment/care it is essential that care plans are
completed with the person at the beginning of their intervention. We must then ensure that
care plans are monitored and reviewed effectively by competent staff
LD Carers Experience – we have developed a service that supports carers of people with
learning disabilities, recognising that without their support many individuals would require
much a greater level of provision including respite, supported housing and residential/nursing
care. It is therefore of paramount importance to Care Plus that we care for our carers and that
they inform us of how they feel about the support we offer
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Service User Experience – we no longer wish to depend on purely on complaints and
compliments to determine the level of satisfaction of patient/service user experience and
therefore we have focused our attentions on the development of a feedback questionnaire that
is accessible to our patients/carers and we are in the process of rolling this out across all service
areas
Dignity & Respect - this is an essential ingredient of a positive patient/service user experience
and as such we have embedded this as part of the patient/service user satisfaction survey
CQUINS - Nutritional Screening within 24hours (The Beacon) – Patients at the Beacon are
screened automatically as part of the admission process at the Beacon and this information is
held on the individuals file. This information ensures that individuals receive the most
appropriate care and support
Achieving Independence in Older People (NI 125) - This indicator evidences our success in
respect of sustained enablement of older people aged 65 years + who have remained at home
for 91 days following hospital discharge
CQUINS - Number of Patients on the Palliative Care Register that are on the Liverpool Care
Pathway The LCP is a useful template to guide and direct the delivery of care for the dying, to
complement the skill and expertise of the practitioner using it. It is a document to ensure the
delivery of holistic care during the dying phase. It reviews physical and psychological needs and
supports other dimensions of care including communication between the health professionals
and the patients and their family, and spiritual care.
GP practices have registers for those patients that are at the palliative stage and this CQUIN
wants to know how many on those registers are also being cared for on the LCP
CQUINS - Number of Patients who died whilst on the Liverpool Care Pathway & had a
preferred place of death - We have now developed/amended the ‘green handover form’ that is
used by community nurses etc and which now contains information such as current medication,
syringe drivers left with patient and also whether the patient wishes to die at home and a DNAR
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statement. We now collate this information especially the preferred priorities of care and
DNAR. By capturing this information we can answer this CQUIN under the ‘preferred priorities
of care’ section
CQUINS – Percentage of Patients on the LCP that died at their preferred place of death - As
part of best practice, this is recorded to monitor the number of individuals on the register that
actually died at their place of choice. This is not always achievable due to clinical needs of the
individual sometimes overriding the patient, carer and families’ wishes
CQUINS - Number of EOL patients with a pain management plan - For ALL patients NOT just
those on the LCP, the nursing notes / medical records would need to be audited to see if a pain
management plan was in place (the pain management plan may be in place, particularly if
Macmillan Specialist Team have been involved in the care planning )
CQUINS - Number of Patients with a Grade Two and above pressure ulcer - A bespoke
template has been created locally with visual as well as written aids to demonstrate the
different grades of pressure ulcers. Training courses are also being offered to all relevant staff
and carers to help reduce and prevent the number of pressure sores that are acquired locally.
We have a well managed workforce
We strive to support our staff and make them feel valued
Managing Sickness - Sickness levels have historically been a major issue within the public
sector/NHS. Recognising the challenge, we have equipped our managers with skills and tools to
manage absence effectively and we will continue to monitor ‘hot spots’ on a monthly basis to
ensure that we develop a positive organisational approach. We also firmly believe that a happy
staff team result in a culture of absence by exception.
PDRs - We promise to support our staff because they are our greatest asset and we will do this
in a number of ways including ensuring that every staff member receives an annual Personal
Development Review which supports clear objective setting and meets development needs. We
need to ensure that we develop the diverse talent that we have in Care Plus Group and an
effective PDR system lies at the heart of this
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Supervisions – We recognise that effective and regular supervision results in better outcomes
for both our staff and our patients/service users. We will continue to monitor the frequency and
effectiveness of both clinical and management supervision and we will ensure that our
managers throughout the organisation are equipped with the knowledge and skills to undertake
this most essential aspect of their role.
Staff satisfaction - We have measured the level of staff satisfaction in a number of ways
including through the NHS National Staff Survey and through the creation of a range of
feedback tools. We have worked with a group of staff to develop a bespoke Care Plus Group
Staff Satisfaction survey which will be facilitated on an annual basis. We have proactively
encouraged our workforce to complete the survey and promise to use the results to produce a
meaningful action plan that will focus on increasing the level of staff satisfaction
Infection Control Training – As part of induction/mandatory training we provide a level of
Infection Control Training to all staff to ensure that service user/patient/staff safety is not
comprised and we have a dedicated team that supports this.
Safeguarding Adults Training – As part of induction, all Care Plus staff attend awareness
training and then subsequently attend enhanced levels of training as determined by their role.
Once again, this mandatory training is designed to minimise risk to patient/service user/staff
safety.
Promoting health and well being
We work together to improve people’s lives
LD - Number of Service Users living locally that are in receipt of commissioned services who
have received a Health Action Plan – A very well implemented local strategy for people with
learning disabilities has resulted in significant improvements to equal health care for this service
user group; Care Plus will continue to drive this agenda forward during the coming year
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LD – Number of people with a learning disability and their carers who have been supported by
the team to undertake a healthy activity – Care Plus has developed a number of local strong
partnerships which ensure that people with LD and their carers continue to benefit from a
range of opportunities that result in improved outcomes for health and wellbeing
LD - Number of contacts made with the LD carers by the Support Care Workers - We will
continue to work hard to ensure that our carers feel supported and we will continue to monitor
and evaluate the outcome of that support
LD – Number of people with a learning disability living locally who have received a Health
Action Plan – Through an enhanced partnership approach with our GPs, most of whom have
signed up for the Local Enhanced Service for people with learning disabilities, we will continue
to offer health and wellbeing support to those people who do not access our other bespoke LD
services
LD - Number of people with a learning disability who have received a Health Action Plan
Review – We recognise that the health needs of our learning disability population change with
time and therefore we will ensure that Health Action Plans are reviewed with the person that
owns it
LD - Number of people with a learning disability who have received a Person Centred Plan /
PCP Review – We continue to ensure that people with a learning disability have the best
possible outcomes based on well established person centred planning methodologies. We will
also continue to support young people with complex needs in transition to ensure that they
benefit from access to person centred transition reviews
Clients remaining in their own home after intervention (The Beacon) – The delivery of a
person centred reablement programme within the Beacon, following an exacerbation to an
existing condition or an acute episode, gives people the opportunity to realise their maximum
potential with a view to returning to their own homes and continuing to live independently. This
programme can be delivered for up to a maximum of six weeks
Clients remaining in their own home after intervention (Intermediate Care at Home) – The
delivery of person centred reablement programme to people within their own homes following
an exacerbation to an existing condition or an acute episode. This supports individuals to
continue to live in their own home. This programme can be delivered for up to a maximum of
six weeks
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Percentage of Clients Leaving with no support services (The Beacon) – The most successful
outcome after a period of reablement within the Beacon is for the person to return home and
live independently with no support services
Percentage of Clients Leaving with no support services (Intermediate Care at Home) - The
most successful outcome after a period of reablement with the Intermediate Care at Home
service is for the person to subsequently be able to live at home independently with no support
services
Total number of avoided A&E Attendances - An attendance at A&E has been avoided as a
direct result of attending the person’s home and enabling them to remain at home. If the
service had not been in attendance then the ambulance would have been called and the person
would have been assessed in A&E
Total number of hospital admissions prevented per month - An admission to hospital has been
avoided as a direct result of treatment being provided at home which has allowed the person to
remain at home. This is further supported by evidence/history suggesting that the person would
usually have been admitted to hospital
Percentage of direct contact against contracted hours – Intermediate Care at Home – It is
important that the service utilises staff time effectively to ensure that as many service users can
be supported as possible, to reduce shortfalls and reduce cost of direct care per hour
Total Percentage of bed occupancy – The Beacon – To ensure that bed occupancy is at its
optimum thus ensuring that shortfalls to the service are kept to a minimum
Reduction in the average length of stay – The Beacon – Evidence suggests that a reablement
programme which is developed by a multidisciplinary team and delivered promptly can enable
the person to their optimum potential within a reduced timescale and encourages people to
regain life skills more effectively
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Reduction in the average length of stay – Intermediate Care at Home - Evidence suggests that
a reablement programme delivered in a timely way can enable the individual to their optimum
potential within a reduced timescale and encourages individuals to regain life skills more
effectively
We contribute to community wellbeing
We support people to have the best life possible
KPI 2 - DIP - Adults who test positive and have an initial required assessment imposed who
attend and remain at the required initial assessment – The effectiveness of our Drug Invention
Programme will continue to be measured against a set of national Key Performance Indicators
which evidence the success of the service in respect of supporting service users to become drug
free
KPI 3 - DIP - Adults assessed as needing a further intervention who were taken onto the
caseload – The Drug Intervention Programme now works with service users until such time that
the cessation of their drug dependency becomes sustainable
KPI 4 - DIP - Adults taken onto the caseload who commenced treatment – The success of the
service will be dependant on outcomes achieved through service users having committed to a
course of treatment that leads to an improvement in their life
KPI 5 – DIP - Adults referred to the CJIT from a prison who were reported on by the CJIT – The
success of this indicator will evidence that we have developed robust communication channels
with our partners within the Criminal Justice System
Supported Employment - Adults with learning disabilities in (paid) employment – The
challenge of succeeding in meeting the demands of this indicator are further exacerbated by the
economic downturn. However, Care Plus Group will demonstrate itself as a role model employer
and will apply for the ‘Positive about Disability’ mark
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Supported Employment - % of Adults with LD in Voluntary Employment – Care Plus provides a
range of training and voluntary work opportunities both within the organization and with like
minded partners. Success in this indicator will lead to increased health and wellbeing levels
within our LD population
Supported Employment - Adults with PD in Employment (paid and unpaid) – Care Plus
acknowledges the same challenge as described about during the forthcoming year in achieving
success in this target
COAST - % Tested 15-24 – Care Plus COAST (Chlamydia Outreach Advice and Screening Team
will continue to ensure the service is reaching the appropriate demography within North East
Lincolnshire and that the service continues to lower the rate of Chlamydia within the local
population by offering a quality service. This is our only service that currently spans North and
North East Lincolnshire
COAST - Number of Positives 15-24 - In relation to the number of young people that are tested,
this is about to be updated within North East Lincolnshire and North Lincolnshire to show a
percentage per 100,000 of the population (2400 per 100,000 of the 15-24 year old population).
This is believed to be already being achieved by COAST
EMPLOYABILITY – Number of individuals that have commenced the Scheme– This service is
new to the Care Plus and has had no targets set for it previously. The data that is currently been
collected has been analysed and appropriate targets set
Number of people that have left the EMPLOYABILITY Scheme and have not gone on to further
employment, training or education – Care Plus will monitor the numbers of individuals that are
leaving the scheme and the reasons for their departure. Those leaving for further employment,
training and education are believed to have reached a positive outcome from being on the
scheme and it is therefore necessary to scrutinize those that are leaving for other reasons to
investigate if there are other measures that need putting in place within the service
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2.5 Participation in Clinical Audits
The national clinical audits and national confidential enquiries that Care Plus was eligible to
participate in during 2010- 2011 are detailed in the following link:
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/di
gitalasset/dh_120071.pdf
The national clinical audits and national confidential enquiries that Care Plus participated in
during 2010 – 2011 are as follows:
National Continence - organisation and clinical,
National Diabetes 2009/10,
National Falls and Bone Health Care Audit 2010 - organisational & clinical
National audit of services for people with multiple sclerosis 2011 - Organisational
and clinical Primary Care Trusts / Local Health Boards
The reports of two national clinical audits were reviewed by the provider in 2010 – 2011 and
Care Plus intends to take the necessary action locally to improve the quality of healthcare
provided.
National Continence - The National Audit of Continence Care 2009 provides the largest,
most detailed evaluation of continence care in Europe. This latest round demonstrates that,
although the amount of authoritative guidance is increasing, the quality of continence care
remains variable and in some respects remains poor. The report has provided Care Plus with
the information on which to base changes and improvements in our local services where
they are necessary. There is a need for improved and equitable practice for all people with
bladder and bowel problems.
Further work must be done to continue to achieve an acceptable standard of care for the
many individuals with incontinence, by developing, for example:
• Commissioning frameworks
• Training health professionals with regard to national evidence based guidelines
• Empowering patients to increase their expectations of cure.
National Diabetes - All local practices contributed data to the national audit and the
national report is awaited.
The outcomes from this audit can be found using the NDA PIANO toolkit.
22 | P a g e
http://www.ic.nhs.uk/services/national-clinical-audit-support-programme
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2.6 Goals agreed with commissioners
Use of the CQUIN payment framework
A proportion of Care Plus income in 2010/11 was conditional upon achieving quality
improvement and innovation goals agreed between North East Lincolnshire Care Trust Plus
and Care Plus and any person or body they entered into a contract, agreement or
arrangement with for the provision of NHS Services, through the Commissioning for Quality
and Innovation payment framework. Further details of the agreed goals for 2010 – 2011 and
for the following 12 month period are available electronically at
http://www.institute.nhs.uk/world_class_ commissioninh/pct_portal/cquin.html
Care Plus achieved all targets for 2010/11 set both nationally and locally.
CQUINS requirements 2010/11
1. Percentage of people with a long term condition that have a single personalised care
plan developed by the community provider which is shared with, recognised and
used by all agencies in contact with the patient
There has been no target set nationally although a decision locally and in line with
best practice states that the figure should always be 100%. All patients and clients
should have a care plan recording their individual needs and requirements. The
figure is believed to have been lower for Q1 due to data issues and not due to the
fact that the Care Plans were not being completed.
24 | P a g e
2. Percentage of people on the end of life care pathway who have a single personalised
care plan developed by the community provider which is shared with, recognised
and used by all agencies in contact with the patient
As per the patients with Long Term Conditions, all patients should have a care plan
and 100% has been achieved within the last two quarters. This is now part of core
business within the teams and low figures at the beginning of the year are believed
to be related to recording issues and not due to the fact that the care plans were not
being completed.
3. Percentage of people identified as being End of Life that are on the End of Life Care
Register
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Percentages of patients that are on the End of Life Care Register continue to be high
and have been above 95% for all four quarters of 2010/11. The above figures are
done as a snapshot at the end of the quarter and all individuals ARE placed on the
register but at the time the snapshot was carried out, one of the Care Plans was not
on the system.
4. Percentage of people on the Liverpool Care Pathway or equivalent that died at their
preferred place of death
The local target for this is 80%, and although this has not been achieved quarter on
quarter, annual figures show that of the 317 people that had a preferred place of
death, a total of 260 died there. This is a figure of 82%.
The aim is to allow as many people as possible to die at their preferred place of
death but clinical needs for the patient sometimes mean that this is not possible.
26 | P a g e
5. Percentage of patients admitted to a community ward that received a nutritional
assessment within the initial 24 hours of care.
100% has been achieved month on month for the whole of the period as the
nutritional assesssment of all patients is done as part of the admissions process.
2.7 What others say about Care Plus
The following information is based on responses received in 2010/211. This includes
information gathered from the following:
Patient Advice and Liaison Service (PALS)
Statutory Social Care and Health complaints, concerns, compliments and
representations
MP Enquiries
Surveys
North East Lincolnshire Care Trust Plus’ (NELCTP) Customer Care Team administered the
Local Authority Social Services and National Health Service Complaints (England)
Regulations 2009 on behalf of Care Plus Group during 2010/2011. This activity is
supported by a robust Complaints procedure as well as strong links with Safeguarding
Adults and Serious Incident investigations.
Quarterly Public Experience reports covering complaints, concerns, compliments,
representations and enquiries received through the Customer Care Service are
presented to the CTP’s Integrated Governance Committee for scrutiny and ratification.
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Annually a report is prepared for the CTP Board and also presented to North East
Lincolnshire Council Cabinet as open documents.
During the period 1st April 2010 to 31st March 2011 the following public experience
information was collated:
There were no MP enquiries and no Ombudsman referrals for Care Plus during 2010/11.
Key service improvements as a result of this activity are outlined in the table below:
Theme
Details
Outcome
Communication
Complex care being provided to
Service User (SU) but provider will be
changing and there is concern about
the lack of communication between
Services and the SU.
Consent sought from SU to
discuss care needs with the new
provider to ensure the same
level of service could be
provided.
Care and Service
provided
Concerns about the assessments
done by all involved in this case
Agreed that further visits and
assessments would be
completed which satisfied the
family.
Care provided/
Communication
Concern about the care provided by
staff within Intermediate Tier Setting
Discussion with all staff about
the importance of
communicating with each other
and the standard of record
keeping.
28 | P a g e
Service Provided
General concerns about the Triage
service offered by GP Out of Hours
OOH's to triage calls through
Care Plus from April 2011,
rather than contract with Local
Care Direct.
Attitude of staff
Unhappy with the service provided
Staff member will attend staff
and the attitude of a member of staff training on approach to
patients.
Care provided
Concern about the level of care being Best Interest meeting pulled
provided to a service user with no
together with all staff/ agencies
capacity.
involved so decisions could be
made.
Information
provided/
communication
Concern about information provided
by Occupational Therapist
(Community)
Staff reminded about the
importance of providing
accurate information to service
users.
Fifteen compliments were received thanking staff for the support and care given. Including:
Learning Disability Services including Day Services,
Older Peoples Day Services
Rapid Response Team
Lessons Learnt & Service Improvements across Health and Social Care
The Intermediate Tier Services team have pledged to improve the quality of
information provided and processed appropriately due to issues raised by PALS
(Patient Advice and Liaison Service). They also explained they will improve
communication, case management and ensure practitioners are proactive when
dealing with active cases.
As a direct result of a PALS enquiry, staff training regarding the approach to patients
was provided in the GP Out of Hours unit.
As a result of several PALS enquiries and complaints a review was undertaken of the
service provided by GP Out of Hours unit and a new service was launched on 1st
October 2010.
29 | P a g e
Part Three
Review of quality, performance and 2010 - 2011 priorities
This section reports on our improvement initiatives for the previous year.
During 2010 – 2011, Care Plus has reviewed all the data available to them on the quality of
care in the provision of NHS services. The income generated by the NHS Services reviewed
in 2010 – 2011 represents 100 per cent of the total income generated from the provision of
NHS Services by Care Plus for the reporting period.
During 2010 – 2011, we undertook a significant development process in determining the
appropriate framework against which to measure the quality of our performance. A number
of indicators were mandatory and agreed at either at local or national level
(CQUINs/KPIs/NIs). The development of the Quality and Performance Framework has been
an organic process and as such has evolved during the year; we are now confident that the
indicator set will effectively measure performance against the three dimensions of quality
being patient/service user safety, clinical/support effectiveness and patient/service user
experience. However, our Quality and Performance framework will be subject to regular
rigorous review to ensure that we continue to develop an outcomes approach to evidencing
Quality and Performance. The April 2011 Care Plus Performance Report is attached at
Appendix 3.
The Quality and Performance framework is underpinned by the strategic objectives for Care
Plus as follows:
To be the provider of choice – we will engage staff at every level in the journey
towards excellence
Service improvement and excellence – will be achieved by embedding a performance
and quality management culture
Engaging communities and service users – through effective and inclusive
partnerships
Supporting personalisation – providing real choice to individuals and supporting
enablement and assisting people to fulfil their potential
Developing the workforce and promoting a culture of innovation and creativity
In turn, our strategic objectives can be aligned against one of more of the three domains of
quality.
30 | P a g e
3.1 Patient/service user safety
3.1.1 Infection Control
This objective is being taken forward into this year’s work
What we did:
We have an Infection Control Team that responds effectively and proactively to
potential outbreaks and advises service sites about their processes
There was an on-going initiative to raise awareness of hand washing and availability
of gel
Infection Control training was a CQUINS target for Community Nursing and was
adopted by Services Valuing People as best practice. The end of year target of 80% of
community nurses receiving training was exceeded (as per the graph below). This
was also achieved by Care Plus as an organisation overall.
As we move forward as a separate organisation, stringent processes are being put in place
to ensure that the individual teams all maintain the 80% level of compliance now that it has
been achieved.
3.1.2 Managing Sickness
Analysis of the national picture in relation to absence from work showed that the worst
factors in the UK for sickness are:
-
Females
Public Sector Workers
Residing within Yorkshire and the Humber
This was a cause for concern and therefore achieving a reduction in overall sickness levels
has been and continues to be prioritised.
This objective is being carried forward into this year’s work
31 | P a g e
What we did:
We used the North East Lincolnshire CTP Managing Attendance Policy to empower
managers and supported them to apply it fairly with staff throughout Care Plus
We determined a local indicator and set a monthly target of 6% (based on the
national average) which is currently being exceeded by both Services Valuing People
and Integrated Community Services
Scrutinising the data and the sickness levels for each area month on month ensures that the
sickness policy is adhered to as well as all processes related to both long and short term
sickness.
The graph demonstrates that the 6% sickness has been mostly achieved and the peak for
the first month for Integrated Community Services overall is actually believed to be due to
recording issues and not due to the level being so high. The graphs also demonstrate that
there was a rise in sickness levels within ICS as a whole and within the ICS nursing
community within December 2010. Many of the issues are due to long term sickness within
the teams and this is being addressed on a case by case basis.
3.1.3 Managing Incidents/Serious Untoward Incidents
This objective is again being carried forward into this years work
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What we did:
We used the DATIX system to effectively manage and monitor incident reporting and
ensured that our staff were trained in its application
We developed a process for the rigorous reporting of Serious Untoward Incidents
and ensured that sufficient staff were trained in the investigation through the Root
Cause Analysis process
Purchased the DATIX system to use within the Care Plus Group to enable continued
improvements within the processes as well as in other areas of business including
complaints and compliments
Qualitative analysis will now be carried out quarterly to establish patterns in locations, times
and types of incidents.
The following is analysis of the incidents for Q3 and Q4 of 2010/11:
Services Valuing People October 2010 – March 2011 – Incident Data
The general trend of incidents sitting around the 25-30 mark throughout the last six month
period, the only exception is January 2011 with a large spike of 43 incidents.
The January 2011 spike can largely be attributed to the increased reporting in the Supported
Housing Service, as seen below.
33 | P a g e
The Supported Housing Service reported an increasing number of Slips, Trips, Falls or
Collisions in January which only party accounts for January spike.
Also seeing an increase in reported incidents in January 2011 was Queen Street Resource
Centre. The month saw a large increase in the number of incidents identified as Accident
34 | P a g e
Caused by Some Other Means. Although in the following two months only one incident has
been identified as such, whilst there has been an increase in Slips, Trips, Falls and Collisions.
This can perhaps be attributed to staff confusion between two similar types of incidents.
Queen Street Resource Centre and the Supported Housing Service have reported by far the
largest share of SVP incidents with a respective 29.21% and 43.82% of the total in the six
month period. Therefore it is no surprise to see the general trend of SVP Incident Reporting
mirroring that of the two services. Enquiries are on going with the staff within these services
to ensure that the required level of training and support is being given in order to minimise
the risk to service users. However, it must be acknowledged that the service users
supported by this area of provision are some of most vulnerable and as such often have
mobility and behavioural issues which undoubtedly impact on the numbers of reported
incidents.
35 | P a g e
Integrated Community Services October 2010 – March 2011 – Incident Data
There has been a general trend of a steady decline in incidents since November 2010 apart
from February 2011.
February 2011 spike can be predominantly attributed to a large increase in incidents
reported for The Beacon. Over the six month period The Beacon accounted for 62.35% of
Integrated Community Services incidents.
36 | P a g e
Whilst the increase in incidents reported at The Beacon in February 2011 can largely be
attributed towards an increase in reported number of Slips, Trips and Falls (see below).
Smaller numbers of incidents previously not reported also occurred at The Beacon (Financial
loss, Appointment, Admission, Transfer, Discharge etc.)
37 | P a g e
As can be seen below by all incidents by type across Integrated Community Services, the
general trend of Slips, Trips and Falls (by far the most heavily reported incident – account
for 46.82% of all incidents in ICS in the six-month period) mirrors the general trend across
the ICS Service.
3.1.4 Effectively managing disciplinary/grievance situations
As part of the transition to Care Plus Group social enterprise, we are reviewing our HR
policies and procedures and ensuring that our managers are equipped with the skills and
knowledge to effectively manage disciplinary and grievance situations. We will also develop
a process that harmonises and aligns the response to Serious Untoward Incidents and the
management of complaints and disciplinary investigations.
What we did:
We used managers meeting to improve the knowledge and learning around the
instigation of disciplinary investigations
We became more rigorous in our response to allegations against staff members and
ensured that these were dealt with in an effective and timely manner
This area of work will continue to be prioritised during 2011 - 2012
3.1.5 Adult Protection Training (Safeguarding Adults)
What we did:
38 | P a g e
We have dedicated staff that provide the relevant training
There was an on-going initiative to raise awareness of the importance of the training
Adult Protection Training was a CQUINS target for community nursing and was
adopted by Services Valuing People as best practice. The end of year target of 80% of
community nurses receiving training was exceeded
This will continue to be prioritised within Care Plus during 2011/12
3.1.6 Skin Integrity
What we did:
Worked on data quality to ensure that accurate figures were being captured
Produced a template including visual aids and written explanations to support
identification of each grade of pressure ulcer
Identified training requirements for community nurses
Number of Pressure Sores identified per Grade per Quarter
The low levels of pressure sores recorded in Q1 initially looks like there has been an increase
in the number of pressure sores within North East Lincolnshire. This is not the case; infact
there has been an improvement in quality and data recording and the figures are therefore
now more accurate than they were a year ago. The intention for 2011/12, is to focus on
decreasing the figures now that the actual numbers are known and processes have been
implemented. A reduction of 50% for each grade from baseline figures that will be set in
July 2011, has been set as a CQUINS target by local commissioners for 2011/12.
39 | P a g e
3.2 Clinical/support effectiveness
3.2.1 Clients remaining in their own home after intervention (The Beacon)
This objective is being carried forward into this years work.
What we did:
We worked with commissioners to redesign intermediate tier to ensure that services
are responsive and effective and focussed on re enablement
We focussed on equipping staff with the skills and knowledge to support people to
remain in their own homes after discharge from The Beacon – this included
supporting 12 members of staff to undertake a foundation degree which will qualify
them to become Assistant Practitioners
The graph above demonstrates that the target has not yet been achieved and this is due to
be discussed with local commissioners. The Beacon, is not always being used for the
purpose that it is designed for and patients are being admitted outside of the intended
remit. This issue is currently being addressed and improvements will hopefully be seen
during the next 12 months.
3.2.2 Total number of avoided A & E Attendances
This objective is once again being carried forward into this years work.
What we did:
We worked with commissioners to redesign the access to integrated health and
social care services which resulted in the development of A3, which is a one stop
access point.
We have developed the Rapid Response team to ensure that there is an effective
and timely integrated response to support an decrease in A & E attendances
40 | P a g e
There is no target currently set for this area of business but as the chart above
demonstrates, the introduction of the service has resulted in an average of 120 avoided A &
E per month based on the last nine months data.
3.2.3 Total number of hospital admissions prevented per month
This objective links closely with the above and is being carried forward into this years work.
What we did:
As described above, we worked with commissioners to redesign the access to
integrated health and social care services and intermediate tier to ensure that
whenever appropriate people do not have to be admitted to hospital
We have piloted integrated complex case management and equipped staff with the
necessary skills and knowledge to ensure that people can be supported in the
community
Total number of hospital admissions prevented per month – This indicator has been
monitored over the last 10 months and the figure has never been achieved. The graph
below shows the month on month levels that were achieved:
41 | P a g e
The RED broken line shows the target level that has never been achieved. The BLUE solid
line shows the level that is believed to be more realistic as a target for 2011/12 and analysis
that was carried out on behalf of the commissioners also supports this.
3.2.4 Reducing health inequalities for people with a learning disability
This objective will be carried forward to this years work
What we did:
We undertook the Annual Health Check and the results were favourably
benchmarked against every other local authority area in the Yorkshire and Humber
region
The Health Sub Group, which reports to the Valuing People Partnership Board,
monitored and evaluated the action plan that was produced for the reduction of
health inequalities following the Annual Health Check
We worked with Primary Care to increase the take up of the Local Enhanced Service
We supported people with a learning disability who were admitted to hospital to
ensure that their needs were effectively met.
Number of learning disabled service users that have received a Health Action Plan this
year
A target of 100 new plans was set for 2010/11 and this was achieved as shown above. This
work will continue into 2011/12. As well as the new action plans, reviews were also carried
out on existing ones (as per the graph below).
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Number of service users with learning disabilities who have received a Health Action Plan
Review
In addition to Health Action Plans and reviews, other work that has been carried by the
Learning Disability Provider Team includes a total count of 1005 separate healthy activities
with individuals in 2010 - 2011 and 444 separate contacts with other agencies to ensure that
people with learning disabilities have been able to access mainstream services.
An easy read copy of the 2010 – 2011 LD Annual Health Check is attached at Appendix 4
3.3 Patient/service user experience
This objective is being carried forward to this years work
What we did:
We have developed a patient/service user satisfaction survey which was piloted in
specific service areas and has now been rolled out across all Care Plus provision
There are specific questions around dignity and respect that are included in the
patient/service user satisfaction survey
We have worked with colleagues in the acute trust and primary care to ensure that
people with a learning disability are treated with dignity and respect and
communicated with appropriately
We have ensured that wherever possible patients/service users are involved in
forums that promote self-advocacy
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We have continued to develop and implement person centred planning ways of
working across Care Plus and have been able to evidence positive outcomes. (The
Annual PC P Report for 2010 – 2011 is attached at Appendix 5)
Below are the Quarter 4 results from the questionnaires that were distributed within the
social care element of Care Plus. 320 clients were surveyed and of this a total of 311 found
the services to be good or excellent. Nine clients thought their experience was average but
no one found the service poor or very poor. Quarter 4 is being shown as this is a process
that has only just been implemented and therefore this is believed to be an accurate set of
results.
Services Valuing People
Service
Carers' Support Workers
Health & Wellbeing Service
PCP Service
Walk Leader Service
Bert Boyden Centre
Meals on Wheels
Supported Employment
Supported Housing
Transport
DIP
AIP
Physical Disability Day Service
Pulmanory Rehab
Falls Rehab
Cromwell Resource Centre
Queen Street Resource Centre
Number
returned
10
12
8
6
7
107
10
56
16
4
66
18
17
7
7
11
5
Excellent
90.00%
83.00%
87.50%
50.00%
71.43%
95.33%
80.00%
55.36%
62.50%
75.00%
71.21%
55.00%
82.35%
71.40%
86.00%
45.00%
4
Good
0.00%
17.00%
12.50%
50.00%
14.29%
3.74%
20.00%
37.50%
31.25%
0.00%
25.76%
28.00%
17.65%
28.60%
14.00%
55.00%
3
Average
10.00%
0.00%
0.00%
0.00%
14.29%
0.93%
0.00%
3.57%
6.25%
25.00%
3.03%
11.00%
0.00%
0.00%
0.00%
Integrated Community Services
The process for Integrated Community Services is already fully developed as this was a local
CQUINS target for community nurses for 2010 - 2011. The results have been above the
required 80% for all four quarters and have ended the year having achieved 100%.
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3.4 Statements from North East Lincolnshire LiNK.
This is the first Quality Account produced by Care Plus and in addition to receiving a
statement of assurance from the North East Lincolnshire Care Trust Plus Board, a copy was
also sent the NEL LiNK for feedback and commentary. Positive feedback was received but
also a recommendation was made, ‘around commitment to increased public involvement
and meaningful engagement to shape the priorities of Care Plus’. An easy read summary of
the Quality Account has also been produced (Appendix 6) and has been discussed with and
circulated to all members of the Valuing People Partnership Board, which in the future will
operate as a subcommittee of the Health and Wellbeing Board.
3.5 Conclusion
It is recognised that the production of the Quality Account will support Care Plus into the
future to do the following:
Inform the public about the quality of services that we provide, the areas in which
significant progress has been made
Focus the Care Plus Board on continuously improving the quality of care by the
review of services and identifying areas for improvement
Involve patients/service users and staff throughout the organisation in deciding on
the areas of improvement and how these priorities will be achieved and measured
Due to time constraints and the fact that Care Plus is in transition to becoming a social
enterprise, it must be acknowledged that we have not been able to ensure that the process
of developing the Quality Account has been fully inclusive. We will, however, use the
coming year to develop processes that result in a more comprehensive approach to the
Quality Account published in 2011 – 2012.
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Staff Structure
june
2011
Non - Executive Directors
Yvonne Bramall
Craig McKay
Cllr Rosalind James
Non - Executive Directors
Val Waterhouse
Chair
Jan Young
Finance Director
Lance Gardner
CEO
Jane Miller
Deputy CEO/COO
Finance team
Business Unit
Services/Quality and
Performance Team/HR team
• Financial management
• Audit
• Business Assurance
•
•
•
•
•
•
Corporate issues
Business Development
Contracts
Partnerships
Estates and Assets
Communications and
Marketing
•
•
•
•
•
•
•
•
•
Service delivery
Service development
Governance
Quality
Performance
Regulation
HR/OD
Engagement
Emergency Planning and
resilience
Jane Miller
Chief Operating Officer
Lisa Revell - Associate Director
Kirsteen Redmile - Head of Service
Neil Cartwright - Head of Service
Lucie Johnson - Head of Service
Paul Watson - Head of Service
•
Rapid Response
Professional Education
•
Discharge Liaison/
support
Workforce development
•
Intermediate Care at
Home/Day Services
•
End of Life care
•
Community OT
•
GP Triage/call
handling
•
The Beacon
•
Hope Street
•
Macmillan
•
Marie Curie
•
CHC Hub/CHC
assistants
•
Skin Integrity
Emergency planning
•
•
•
•
•
•
•
•
•
•
•
Drug Interventions
Programme (DIP)
Alcohol
Interventions
Programme (AIP)
Roundabout
Supported
Employment Team
(Jobs4All)
Employability
Meals on Wheels
Transport
Collaboratives
Chlamydia Outreach
Advice Screening
Treatment (COAST)
Sexual Health
Outreach Team
(SHOUT)
ASGARD
Jo Barnes - Associate Director
Andy Quigley - Head of Service
HR team
Quality and
Performance Team
•
LD provider Team
•
Supported Housing
•
Day Services
•
IST/Psychology
•
Infection control
•
Continence
•
Neurology
•
Stroke
•
Community Nursing
/Complex case
management
•
Specialist nurses
Finance Team
Business Unit
Ian Squires
Sally Wood
Caron Taylor
Lisa Holmes
Neil Cartwright
(part time role)
Lauren Green
Lucy Grice
Susan Goodfield
HR team
Quality and Performance
Team
Maria Tomkinson
Suzanne Henry
Lynsey Hutson
Diane Greenfield
Lucie Johnson
(part time role)
Donna Hill
Nic Glen
Liz Meredith
Tracey McGuire
Paul Speight
National Quality Requirements in the Delivery
of Out-of-Hours Services
July 2006
Gateway no. 6893
Introduction
1. From 1st January 2005, all providers of out-of-hours (OOH) services have been
required to comply with the national OOH Quality Requirements, first published in
October 2004. The recent report by the National Audit Office1 (NAO) identified a
number of problematic aspects of the current Requirements and, since then, the
Department has worked with the Royal College of General Practitioners (RCGP) to
review the Quality Requirements in the light of these observations.
2. While the NAO Report identified some areas of misunderstanding or misinterpretation
of the current Requirements and demonstrated further that some particular Quality
Requirements remain challenging (particularly at periods of peak demand), none of its
discussions with providers or commissioners revealed any sense that the Quality
Requirements were either inappropriate or unachievable. The Department will not
therefore be making any changes to the Quality Requirements that were published in
October 2004; for ease of reference, they are reproduced below.
3. On the other hand, there is a need to clarify a number of aspects of particular Quality
Requirements (including some important confusions about compliance). A number of
these issue were addressed in the Commentary that was published at the same time
as the Quality Requirements, and while this Introduction provides additional
clarification, it should still be read in conjunction with that Commentary.2.
4. Consolidated guidance drawing together this Introduction with a revised and updated
version of the Commentary will be published later in the summer.
Compliance
5. In a number of areas, providers have to demonstrate 100% compliance (see in
particular Quality Requirements 8, 9, 10 and 12). In many circumstances, achieving
compliance at all times would require a disproportionate provision of resources and,
for that reason, compliance with these standards is defined as follows:
5.1.
Full Compliance: Normally, a provider would be deemed to be fully compliant
where average performance was within 5% of the Requirement.. Thus, where
the Requirement is 100%, average performance of 95% and above would be
deemed to be fully compliant.
5.2.
Partial compliance: Where average performance was between 5% and 10%
below the Requirement, a provider would be deemed to be partially compliant
and the commissioner would explore the situation with the provider and identify
ways of improving performance. Thus where the Requirement is 100%,
average performance of between 90% and 94.9% would be deemed to be
partially compliant.
5.3.
Non-compliance: Where the average performance was more than 10% below
the Requirement, the provider would be deemed to be non-compliant and the
commissioner would specify the timescale within which the provider would be
required to achieve compliance. Thus, where the Requirement is 100%,
average performance of 89.9% and below would be deemed to be noncompliant.
1
The Provision of Out-of-Hours Services in England, London, 2006
The Commentary is available at http://www.dh.gov.uk/Urgentcare : click on ‘Out-of-Hours’ in the menu on the left-hand
side of the page and, in the new page that opens, click on ‘Key Policy Documents’ – scroll down to ‘New quality
requirements for out-of-hours services’
2
Page 2 of 7
6. All the above measures record average performance, and this can conceal wide
variations in practice from day to day, and at different times within the day. It is
therefore important that commissioners look behind the averages to see whether
there is any recurring pattern which reveals a more serious situation. Where further
analysis reveals an inability to put in place sufficient resources on a particular day or a
particular time of the week or both, the provider could be deemed to be partially or
non-compliant. Thus, for example:
6.1.
A provider might achieve an average of 96% (where the Requirement is
100%), and thus be deemed to be fully compliant. But closer inspection would
reveal that on a Sunday this might regularly drop to around 85% and, in such
circumstances, it could be deemed to be partially compliant.
6.2.
A provider might achieve an average of 91% (where the Requirement is
100%), and thus be deemed to be partially compliant. But closer inspection
would reveal that on a Saturday morning this might regularly drop to around
75%. In such circumstances it could be deemed to be non-compliant.
7. Furthermore, wherever a provider is not in full compliance with a particular
Requirement, the commissioner will want to be clear that performance has not
reached a plateau from which no further improvement is taking place. Thus, in this
circumstance, the commissioner would be looking for evidence of ongoing
improvement over time and, in the absence of such evidence, would downgrade its
assessment of compliance accordingly.
8. Where a provider is commissioned to deliver services for a number of different PCTs,
it is important that its compliance data is disaggregated by PCT area. Data averaged
across the PCTs could conceal wide variations in the quality of service provided in
each locality, and it is only by reporting performance for each separate PCT
population that commissioners will be able to assess the quality of the service that is
being provided to their patients.
9. Those responsible for writing a service specification and the resulting contract, need
to ensure that both these documents include the detailed approach to compliance set
out in paragraphs 4 through 8 above.
10. The Quality Requirements provide a clear and consistent way of assessing
performance. Regular and accurate reporting of the precise levels of compliance with
each Requirement will enable the commissioner and the provider together to identify
what action is needed in those areas where performance falls short of the standard
that service users should expect.
Definitive Clinical Assessment
11. This term is used in Quality Requirements 9 and 10 and there appears to be some
confusion as to its meaning. Definitive clinical assessment is an assessment carried
out by an appropriately trained and experienced clinician (not a call-handler) on the
telephone or face-to-face. The adjective ‘definitive’ has its normal English usage, i.e.
‘having the function of finally deciding or settling; decisive, determinative or
conclusive, final’.3 In practice, it is the assessment which will result either in
reassurance and advice, or in a face-to-face consultation (either in a centre or in the
patient’s own home).
3
Oxford English Dictionary, Second Edition¸ Oxford, 1989.
Page 3 of 7
Focusing more clearly on quality and patient experience
12. Quality Requirement 4 requires providers regularly to audit the clinical quality of the
service they provide by auditing the work of each and every individual working within
the organisation who contributes to clinical care. The Department is aware that some
providers have had difficulties in delivering effective clinical audit and has
commissioned the Royal College of General Practitioners to develop a new toolkit to
support this particular Requirement. The toolkit will be published in the autumn of
2006.
13. Quality Requirement 5 requires providers to audit patients’ experience of the service
and the Commentary that was published alongside the Quality Requirements made it
clear that this is very different from traditional tools for measuring patient satisfaction.
Thus, an effective questionnaire designed to explore the patient experience of the
service will range much more widely than satisfaction, looking at patients’ access to
the service (including the timeliness with which the service responded to their needs),
the character and quality of their telephone encounters with the service, the character
and quality of any face-to-face consultation, the environment within which face-to-face
consultations take place and so on.
14. As the original Commentary emphasised, however, patient questionnaires are only
one of a variety of tools which providers could employ better to understand the quality
of the service they provide. While public and patient involvement has become
increasingly common in other NHS organisations, it has (as yet) played little role in
OOH organisations. Useful as questionnaires and focus groups and other methods of
sampling experience may be for exploring patients’ firsthand experience of the
services they have used, none create the transformational opportunities presented by
involving members of the public directly in the decision-making processes at the heart
of the service. Effective public and patient involvement, coupled with regular audits of
the patient experience could constitute a particularly powerful way of giving reality to
Quality Requirement 5.
Matching capacity to demand
15. The NAO data showed that the overwhelming majority of PCTs reported very high
levels of compliance with Quality Requirement 7 (the obligation to plan capacity to
meet predictable fluctuations in demand), while at the same time reporting very low
levels of compliance with those Quality Requirements that are designed to measure
the match between capacity and demand (Quality Requirements 8, 9, 10, 11 and 12).
16. Both commissioners and providers will want to reflect on this mismatch in the data.
Evidence from individual services suggests that it is at periods of peak demands that
providers struggle to achieve compliance with the access Requirements, and yet
Quality Requirement 7 explicitly sets out an obligation to plan effectively to meet those
peaks in demand.
Conclusion
Nothing in the work that the NAO did in its review of OOH services suggested that the
Quality Requirements were either inappropriate or unachievable. Regular and accurate
reporting of performance against the Quality Requirements will ensure that the ongoing
dialogue between commissioners and providers will be meaningful and well-informed, but
its primary purpose is to give the service provider regular, accurate data about the quality
of that service and thus provide a firm foundation on which to deliver further
improvements in the quality of the service in future.
Page 4 of 7
The National Quality Requirements
1. Providers4 must report regularly to PCTs on their compliance with the Quality
Requirements.
2. Providers must send details of all OOH consultations (including appropriate clinical
information) to the practice where the patient is registered by 8.00 a.m. the next
working day. Where more than one organisation is involved in the provision of OOH
services, there must be clearly agreed responsibilities in respect of the transmission
of patient data.
3. Providers must have systems in place to support and encourage the regular
exchange of up-to-date and comprehensive information (including, where appropriate,
an anticipatory care plan) between all those who may be providing care to patients
with predefined needs (including, for example, patients with terminal illness).
4. Providers must regularly audit a random sample of patient contacts and appropriate
action will be taken on the results of those audits. Regular reports of these audits will
be made available to the contracting PCT.
The sample must be defined in such a way that it will provide sufficient data to review
the clinical performance of each individual working within the service. This audit must
be led by a clinician with suitable experience in providing OOH care and, where
appropriate, results will be shared with the multi-disciplinary team that delivers the
service.
Providers must cooperate fully with PCTs in ensuring that these audits include clinical
consultations for those patients whose episode of care involved more than one
provider organisation.
5. Providers must regularly audit a random sample of patients’ experiences of the
service (for example 1% per quarter) and appropriate action must be taken on the
results of those audits. Regular reports of these audits must be made available to the
contracting PCT.
Providers must cooperate fully with PCTs in ensuring that these audits include the
experiences of patients whose episode of care involved more than one provider
organisation.
6. Providers must operate a complaints procedure that is consistent with the principles of
the NHS complaints procedure. They will report anonymised details of each
complaint, and the manner in which it has been dealt with, to the contracting PCT. All
complaints must be audited in relation to individual staff so that, where necessary,
appropriate action can be taken.
7. Providers must demonstrate their ability to match their capacity to meet predictable
fluctuations in demand for their contracted service, especially at periods of peak
demand, such as Saturday and Sunday mornings, and the third day of a Bank Holiday
weekend. They must also have robust contingency policies for those circumstances in
which they may be unable to meet unexpected demand.
4
A provider is any organisation providing OOH services under GMS, PMS, APMS or PCTMS
Page 5 of 7
8. Initial Telephone Call:
Engaged and abandoned calls:
‰ No more than 0.1% of calls engaged
‰ No more than 5% calls abandoned.
Time taken for the call to be answered by a person:
‰ All calls must be answered within 60 seconds of the end of the introductory
message which should normally be no more than 30 seconds long.
‰ Where there is no introductory message, all calls must be answered within 30
seconds.
9. Telephone Clinical Assessment
Identification of immediate life threatening conditions
Providers must have a robust system for identifying all immediate life threatening
conditions and, once identified, those calls must be passed to the ambulance
service within 3 minutes.
Definitive Clinical Assessment
Providers that can demonstrate that they have a clinically safe and effective system
for prioritising calls, must meet the following standards:
‰ Start definitive clinical assessment for urgent calls within 20 minutes of the call
being answered by a person
‰ Start definitive clinical assessment for all other calls within 60 minutes of the
call being answered by a person
Providers that do not have such a system, must start definitive clinical
assessment for all calls within 20 minutes of the call being answered by a person.
Outcome
At the end of the assessment, the patient must be clear of the outcome,
including (where appropriate) the timescale within which further action will be
taken and the location of any face-to-face consultation.
10. Face to Face Clinical Assessment
Identification of immediate life threatening conditions
Providers must have a robust system for identifying all immediate life threatening
conditions and, once identified, those patients must be passed to the most
appropriate acute response (including the ambulance service) within 3 minutes.
Definitive Clinical Assessment
Providers that can demonstrate that they have a clinically safe and effective system
for prioritising patients, must meet the following standards:
‰ Start definitive clinical assessment for patients with urgent needs within 20
minutes of the patient arriving in the centre
‰ Start definitive clinical assessment for all other patients within 60 minutes of
the patient arriving in the centre
Providers that do not have such a system, must start definitive clinical
assessment for all patients within 20 minutes of the patients arriving in the centre.
Outcome
At the end of the assessment, the patient must be clear of the outcome,
including (where appropriate) the timescale within which further action will be
taken and the location of any face-to-face consultation.
Page 6 of 7
11. Providers must ensure that patients are treated by the clinician best equipped to meet
their needs, (especially at periods of peak demand such as Saturday mornings), in the
most appropriate location. Where it is clinically appropriate, patients must be able to
have a face-to-face consultation with a GP, including where necessary, at the
patient's place of residence
12. Face-to-face consultations (whether in a centre or in the patient’s place of
residence) must be started within the following timescales, after the definitive clinical
assessment has been completed:
‰
‰
‰
Emergency: Within 1 hour.
Urgent: Within 2 hours.
Less urgent: Within 6 hours.
13. Patients unable to communicate effectively in English will be provided with an
interpretation service within 15 minutes of initial contact. Providers must also make
appropriate provision for patients with impaired hearing or impaired sight.
Page 7 of 7
Care Plus
Monthly
Performance
Report
Document Reference:
Report Authors:
Version Number
Last Updated:
APRIL
2011
CPG – April 2011
Nicola Glen/Jo Barnes
1.0
18 May 2011
Introduction
This monthly digest report brings together the organisational quality and performance
framework information of Care Plus under the following six themes: 1. Demonstrating commitment to Quality and Value
We provide high quality services and offer value for money
2. Personalised approaches
We put people at the heart of what we do
3. Well managed workforce
We strive to support our staff and make them feel valued
4. Promoting health and wellbeing
We work together to improve people’s lives
5. Reducing environmental impact
We aim to be green
6. Contribution to community wellbeing
We support people to have the best life possible
RAG Rating System
The Red, Amber and Green (RAG) rating system is used to provide an easily accessible at a
glance indicator of the present and predicted status of a defined indicator.
RAG Status
R
Cause for concern
A
Warning, needs attention
G
Performing well
?
Undefined target
Page 1 of 33
Executive Summary
This is the first combined Quality and Performance Report for Care Plus and is intended to
result in a more streamlined and whole organisational approach to this key agenda. The
report due to be presented in June will be further refined due to the imminent
management realignment taking place within Care Plus which will result in the abolition of
the Services Valuing People (SVP) and Integrated Community Services (ICS) divisions which
will be replaced by thematic led operational directorates.
Exception Reporting
During the month reported upon there are very exceptions to be noted and the vast
majority of targets are reporting as green. The amber/red exceptions are described below:
Amber Ratings
ICS – Financial position (Page 5)
ICS reported a year-end overspend of £33,400 which equates to only a quarter percent of the
total budget. This is also balanced out by the fact that Care Plus as a whole finished the year
with a combined underspend of £215,000 due to the underspend achieved by Services Valuing
People.
SVP – Dignity and Respect (Page 15)
The Transport Service and PD Day Service received one return that stated that the client
believed that they were not treated with the correct level of Dignity and Respect; this was
believed to be the same person.
Red Ratings
SUI progress (Page 14)
There are new guidelines from the Strategic Health Authority which indicate that grade 3 and 4 pressure
sores may not necessarily constitute an SUI. Therefore a decision has been take to undertake a more
concise Root Cause Analysis (RCA) to establish if the incident meets the threshold for an SUI
investigation. This RCA investigation and if required the full SUI investigation will be concluded by May
30th
Page 2 of 33
ICS Supervisions (Page 21)
Ensuring that all staff members within ICS receive the correct level of supervision and support
continues to be an issue but it is hoped that the management realignment and introducing new
ways of working will result in a gradual improvement in respect of this indicator
ICS - Clients remaining in their own home after intervention (The Beacon) (Page 25)
This is a quarterly target that isn’t being achieved although the figures are continuously improving.
Based on April 2011, the current figure is 62.50% showing that the figures continue to move in the right
direction.
ICS - Total number of hospital admissions prevented per month (Page 25)
Work has been carried out by an Integrated Commissioning consultant demonstrates that the target for
this area should be one a day and not the original target of three; therefore we are hoping for a
renegotiation
There are three other targets within this indicator set (ICS – Percentage of clients leaving with no
support (The Beacon), ICS – Total number of avoided A&E Attendances and ICS - Total Percentage of
bed occupancy – The Beacon) which have decreased in performance during April but for which targets
have yet to be negotiated
SVP - COAST - % Tested 15-24 (Page 31)
The Vital Sign Indicator target set by the Department of Health for 2010/11 was a cumulative target of
35% of tests undertaken on 15-24 yr olds. This opportunistic screening programme has no formal
call/recall system and is entirely voluntary.
The commissioners indicated that of the 35% uptake that 40% of tests should come from within COAST
and the remaining 60% from with core services (defined as Community contraception and sexual health
services). To date providers in those core services have significantly under performed in relation to the
number of tests delivered.
Good news
As we move towards the go live date of July 1st our Quality and Performance Team is now fully recruited
to and we believe that Care Plus is well placed to demonstrate that we are a high performing
organisation, not denying however, that there is always much more to do. There are a number of factors
that underpin this belief and the following are highlighted:
Care Plus is incrementally achieving lower sickness levels
Personal Development Review (PDR) targets for 10/11 have been achieved
Page 3 of 33
All CQUINS targets for 10/11 were achieved
We are receiving a low number of complaints
Our newly developed GP Out of Hours Call Handling Service is achieving their national quality
requirements
The next round of Quarterly Performance Review (QPR) confirm and challenge sessions have
commenced and feedback received to date has been very positive
Processes for dealing with and processing SUIs are being reviewed and implemented to ensure a
robust approach
We will use the coming year to further develop and refine our response to the Quality and Performance
agenda and ensure that we continue to embed a quality and performance culture throughout Care Plus.
Other issues for consideration
Care Plus as a role model employer
The current round of ‘confirm and challenge’ Quarterly Performance Review discussions has
highlighted the fact that Care Plus needs to operate as a role model in respect of offering
training and employment opportunities within the organisation for people with disabilities. We
would like to illicit the Boards view in respect of determining an outcome/target in this area.
Page 4 of 33
1. Demonstrating commitment to Quality and Value
We provide high quality services and offer value for money
Indicator Title
ICS - Financial Position
(MONTHLY update)
SVP - Financial Position
(MONTHLY update)
ICS - Financial saving
through development of
Complex Case Management
& Rapid Response
(MONTHLY update)
Previous
Figure
(A/Q/M)
Year End
Forecast
2010/11
Year End
Budget £11,979,000
(Financial
Position –
Overspend
of £60,400
or 0.5%
Year End
Forecast
2010/11
Year End
Budget £3,806,000
(Financial
Position –
Underspend
of £186,800
or 4.91%
£1,712,669
March
Latest
Figure
(A/Q/M)
Year End
Actual
2010/11
Year End
Budget £13,067,200
(Financial
Position –
Overspend
of £33,400
or 0.26%
Year End
Actual
2010/11
Year End
Budget £4,933,700
(Financial
Position –
Underspend
of £248,400
or 5.03%
£163,358
April
Current
RAG Rating
End of Year
RAG Rating
A
A
G
G
£1,800,000
(2011/12)
Annual
Cumulative
G
G
Target
Balanced
Annual
Balanced
Annual
ICS - Incident Reporting
(MONTHLY)
20
March
16
April
Qualitative
See Notes
See Notes
SVP - Incident Reporting
(MONTHLY)
25
March
24
April
Qualitative
See Notes
N/A
N/A
9
(as at
12 May
2011)
Qualitative
See Notes
See Notes
Serious Untoward Incidents
Page 5 of 33
1
Complaints received
N/A
April
No Target
Currently
Set
?
?
PERFORMANCE & QUALITY TEAM UPDATE
Incident Reporting
ICS Incident Figures – April 2011
For the second consecutive month, the figures for ICS have seen a decrease – from 21 in March 2011 to
16 in April 2011.
As can be seen on the chart below, this is a gradual trend within ICS, with the exception of February
which was in fact the highest reporting month since the roll-out of Datix-Web.
All but one of the incidents in April 2011 came from CTP Residential Care (The Beacon), the remaining
incident reported within a community nursing team.
Page 6 of 33
The Beacon is by far the largest contributor the incident number for ICS, as can be seen over the last 6
month period below.
Page 7 of 33
In the last six months a total of 169 Incidents were reported within ICS with The Beacon accounting for
113 (67%). The month of April actually saw an increase in incidents at The Beacon, from 9 to 15 – with
no real trend emerging from the incident numbers.
Unsurprisingly the Category ‘Accident that may result in Personal Injury’, is by far the most reported
incident within The Beacon and indeed within ICS.
As can be seen below, the trend of Incidents categorised as ‘Accident that may result in Personal Injury’
are mirrored by both data from The Beacon and ICS overall. The only real exception is the decline in
incidents across ICS as a whole during April, however this arguably relates to the other services within
the directorate and not the Beacon.
Page 8 of 33
SVP Incident Figures – April 2011
Although seeing a slight decrease in incident figures from 28 in March 2011 to 24 in April 2011, the
figures for SVP remain fairly consistent.
As can be seen on the chart below, there is a slight gradual decrease in incident numbers of the last six
months, with the exception of the high reporting month of January.
Page 9 of 33
During April 2011, the Supported Housing Service accounted for the largest section of incidents across
SVP with 10 (42%) whilst Queen Street Resource Centre accounts for 8 (33%)
Page 10 of 33
Over the past six months 179 incidents have been reported in SVP with Supported Housing accounting
for 76 (41%) incidents whilst Queen Street Resource Centre had 52 (28%). Both figures for the sixmonth period parralel the percentages for April 2011.
One area that has seen a significant decrease for the month of April 2011 is Cromwell Road Resource
Centre, as can be seen below. Having accounted for 21% of incidents in the five-month period from
November 2010-March 2011, the month of April saw Cromwell Road Resource Centre account for just
13% of incidents.
Page 11 of 33
Due to the nature of services, the Category ‘Accident that may result in Personal Injury’, is by far the
most reported incident within SVP.
.
As the line graph below details, the trend for both highest reporting areas within SVP and for the highest
reporting type of Incident (Accidents that May Result in Personal Injury) generally follows the theme for
incidents reported across SVP as a whole.
Page 12 of 33
Serious Untoward Incidents
Care Plus currently has nine Serious Untoward Incident reports that are being progressed.
The table below provides an up to date summary of the status of these SUI’s.
Status
Number of cases
Lisa Revell agreed that this 1
case does not relate to Care
Plus therefore this needs to
be highlighted to the
appropriate organisation.
Care Plus
Group
rating
G
Report and action plan sent 2
to NLAG awaiting update
G
Report completed and sent 0
to Lisa Revell for ratification
G
Report completed and sent 3
to Gary Johnson for
G
Page 13 of 33
ratification
2 awaiting RCA level 1 2
completion
R
In essence this means that there are two reports awaiting ratification within Care Plus Group before
being sent to commissioners for conclusion. There are two cases that require RCA investigations to be
undertaken. These investigations fall under the new guidelines from the Strategic Health Authority
which indicated that grade 3 and 4 pressure sores may not necessarily constitute an SUI. Therefore a
decision has been take to undertake a more concise Root Cause Analysis (RCA) to establish if the
incident meets the threshold for an SUI investigation. This RCA investigation and if required the full SUI
investigation will be concluded by the 30th of May.
Current Performance Risks
Financial Position – ICS
As per the results above, ICS has had a year-end overspend of £33,400. Taking into
consideration that the overall budget was over £13 million, the finance team do not see this as
an issue as this is only a quarter percent of the total budget and is seen as a good result. This is
also balanced out by the fact that despite the loss, Care Plus as a whole finishes the year with a
combined underspend of £215,000 due to the underspend achieved by Services Valuing People.
Complaints
There was also one complaint received in relation to Rapid Response from a patient who was
unhappy with the assessment undertaken.
None of the above complaints are currently concluded and therefore there are no outcomes or
service improvements to report.
Recommendations
NIL
Page 14 of 33
2. Personalised approaches
We put people at the heart of what we do
Previous
Figure
(A/Q/M)
98%
Latest
Figure
(A/Q/M)
98%
Q3
Q4
Quarterly
99.30%
98.91
85%
March
April
Monthly
ICS - Service User
Experience
(Quarterly)
95.75%
Q3
100%
Q4
80%
SVP - Service User
Experience
(Quarterly)
81%
97.18%
80%
Q3
Q4
Quarterly
100%
Q4
100%
Indicator Title
ICS - Patients with Care
Plans
(Quarterly)
SVP - Appropriate Clients
with Care Plans
(Monthly)
Target
Current
RAG Rating
1010/11
End of Year
RAG Rating
G
G
G
G
G
G
G
G
G
G
A
A
G
G
85%
Quarterly
N/A
ICS - Dignity & Respect
(Quarterly)
SVP - Dignity & Respect
(Quarterly)
ICS - CQUINS - Nutritional
Screening within 24hours
(The Beacon) – CQUINS
(Quarterly)
100%
Q3
Quarterly
100%
97.5%
100%
Q3
Q4
Quarterly
100%
100%
100%
Q3
Q4
Quarterly
Page 15 of 33
ICS - Achieving
Independence in Older
People (NI 125)
(Monthly)
95.24%
100%
88.5%
March
April
Cumulative
Annual
ICS – GP OOH - Providers
must send details of all
OOH consultations to the
practice where the patient
is registered by 08:00 am
the next working day (95%)
95.5%
96.2%
95%
Feb
March
Monthly
ICS – GP OOH – Calls
answered in 60 seconds
96.6%
98.3%
95%
Feb
March
Monthly
ICS – GP OOH - Telephone
assessment - Identify
emergency life threatening
conditions and pass to
ambulance service within 3
minutes
100%
100%
95%
Feb
March
Monthly
ICS – GP OOH – Start
definitive assessment for
urgent cases within 20
minutes of the call being
answered
96.4%
99.5%
95%
Feb
March
Monthly
ICS – GP OOH – Start
definitive assessment for all
other calls within 60
minutes of the call being
answered
97.1%
ICS – GP OOH –
Identification of life
threatening emergency
within 3 minutes
100%
100%
95%
Feb
March
Monthly
Feb
99.7%%
March
G
G
G
G
G
G
G
G
G
G
G
G
G
G
95%
Monthly
Page 16 of 33
ICS – GP OOH – Start clinical
assessment of urgent cases
within 20 minutes of arrival
96.1%
98.2%
95%
Feb
March
Monthly
ICS – GP OOH - Start clinical
assessment of non-urgent
cases within 60 minutes of
arrival
100%
100%
95%
Feb
March
ICS - CQUINS – EOL 1 Percentage/Number of
Patients on the Palliative
Care Register that are on
the Liverpool Care Pathway
58/153
37.9%
(Q3)
11/140
7.85%
(Q4)
81/111
72.97%
61/66
92.42%
Q3
ICS - CQUINS – Percentage
of Patients on the LCP that
died at their preferred place
of death
ICS - CQUINS - Number of
EOL patients with a
symptom management plan
ICS - CQUINS - Number of
Patients with a pressure
ulcer Grade two and above
New
CQUINS
Indicator
April 2011
New
CQUINS
Indicator
April 2011
G
G
Monthly
G
G
No Target
Currently
Set
?
?
Q4
No Target
Currently
Set
?
?
?
?
?
?
?
?
?
?
Page 17 of 33
PERFORMANCE & QUALITY TEAM UPDATE
SVP - Dignity and Respect – The overall figure is at 97.5% for the results that have been collated to date,
against a target of 100%. The table below lists the returns for the last quarter team by team and shows
that 8 of the 12 teams achieved 100% from their clients
Service
Carers' Support Workers
Health & Wellbeing Service
PCP Service
Walk Leader Service
Bert Boyden Centre
Meals on Wheels
Supported Employment
Supported Housing Service
Transport Service
PD Day Service
DIP
AIP
Number
returned
10
12
8
6
7
107
10
56
16
18
4
66
Yes
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
100.00%
92.86%
93.75%
94.00%
100.00%
96.97%
No
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
6.25%
6.00%
0.00%
0.00%
Don't Know /
unanswered
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
0.00%
7.14%
0.00%
0.00%
0.00%
3.03%
The Transport Service and PD Day Service received one return that stated that the client
believed that they were not treated with the correct level of Dignity and Respect. This is
believed to be the same person as the small cohort that were surveyed for the Transport
Service for this quarter, being the individuals that were transported to and from the William
Molson Centre for the PD Day Services.
The Supported Housing Service received no negative comments with regards to Dignity and
Respect but for some unknown reason, four people did not answer this question. This is
believed to be due to the fact that the service users in question did not have the capacity to
fully understand what was being asked of them. The survey is being revisited for future
distribution to try and simplify it but it is believed that some may still struggle to answer this
question and therefore a mechanism will be sought to illicit a person’s view. There were also
two people from the Alcohol Intervention Programme who didn’t answer this question.
Page 18 of 33
End of Life Services
EOL 1
The current CQUIN target that is listed within the contract is Number of Patients on the Palliative
Care Register that are on the Liverpool Care Pathway. The graph below shows the overall numbers on
the Palliative Care Register per quarter in comparison to those that are on the Liverpool Care Pathway.
The percentages vary greatly quarter on quarter as demonstrated in the graph below.
Page 19 of 33
This indicator does not illustrate quality as all it is showing is the number of people that have
been identified as dying (possibly up to a year prior to death), against the number of those that
are in the last 48 hours of their life and are on the Liverpool Care Pathway.
The CQUINS targets are currently being re-written by the Quality and Performance Manager
and submitted to the Commissioners for agreement. An updated version will appear in the
next report.
Current Performance Risks
NIL
Recommendations
NIL
Page 20 of 33
3. Well managed workforce
We strive to support our staff and make them feel valued
Indicator Title
ICS - Managing Sickness Overall
(Monthly)
ICS - Managing Sickness –
Community Nurses
(Monthly)
SVP - Managing Sickness
(Monthly)
Previous
Figure
(A/Q/M)
4.2%
(2176 Hours
Lost)
March
Latest
Figure
(A/Q/M)
4.2%
(2100 Hours
Lost)
April
3.4%
(796 Hours
Lost)
March
1.7%
(384.5
Hours Lost)
April
3.8%
(1671 Hours
Lost)
3.14%
(1470 Hours
Lost)
March
April
86%
87%
Target
Current
RAG Rating
Projected
End of Year
RAG Rating
G
G
G
G
G
G
G
G
G
G
R
R
6.00%
Monthly
6.00%
Monthly
6.00%
Monthly
85.00%
ICS - PDR’s
(Monthly)
SVP - PDR’s
(Monthly)
March
April
Annual
93.93%
98.21%
March
April
85.00%
Annual
ICS - Supervisions
1:1/Group
(Monthly)
47%
66%
March
April
80%
Monthly
Page 21 of 33
77.56%
94.39%
Jan/Feb
Mar/Apr
80%
SVP - Supervisions
1:1/Group
(Bi-Monthly)
Staff Satisfaction Care Plus
Group
(Annual)
ICS – CQUINS - Infection
Control Training
(Community Nurses)
(Quarterly)
SVP - Infection Control
Training (Overall)
(Quarterly)
G
G
G
G
80%
Cumulative
G
G
80%
Annually
G
G
Bi-monthly
81%
81%
60.55%
88.23%
Q3
Q4
38.8%
94.66%
Q3
Q4
80%
Annual
PERFORMANCE & QUALITY TEAM UPDATE
Infection Control – The individual totals are as follows:
Lincs to Care – 93%
The Beacon – 87%
360 – 100%
HOPE - 82%
Current Performance Risks
ICS – Supervision (Groups/1:1) – Monthly
The parameters for supervision within the organisation are currently set differently for the two
areas of Care Plus. This is due to the differing needs across the organisation, the health side
needing clinical supervision as well as managerial supervision. This area of business will be rePage 22 of 33
visited as the current target cannot be met due to the size of the teams and the supervisors are
stating that workload is also an issue.
TEAM
Infection Control
Scartho Medical
Continuing Care Liaison Team
Discharge Liaison
Lisa Revells Team
Weelsby View
Clee Medical
Beacon Medical
Pelham Medical
Chantry Health Group
Birkwood
IC @ Home
Assitant Practitioners
Occupational Therapy
Rapid Response
OOH
Grimsby Community Clinic
Pilgrim PCC
Macmillan
Kingsley Grove Admin
Beacon Medical Admin
Weelsby View (KT)
The Beacon
I/Tier Admin
Continuing Healthcare
Number of Staff
3
9
17
5
11
14
18
7
6
7
4
80
12
26
39
12
17
18
12
3
3
2
54
12
4
Number
Supervised
this month
1
0
11
5
7
10
14
0
0
4
4
44
0
18
0
0
17
18
11
3
0
0
15
4
0
Percentage
Supervision
33.33
0.00
64.71
100.00
63.64
71.43
77.78
0.00
0.00
57.14
100.00
55.00
0.00
69.23
0.00
0.00
100.00
100.00
91.67
100.00
0.00
0.00
27.78
33.33
0.00
March
RAG
Rating
G
R
A
R
R
A
A
R
R
R
G
G
R
A
G
A
G
G
G
G
R
A
R
A
R
April
RAG
Rating
R
R
A
G
A
A
A
R
R
A
G
A
R
A
R
R
G
G
G
G
R
R
R
R
R
Rapid Response had a return of 39 out of 39 having had supervision during March yet in April
the return was zero moving them from a GREEN position to a RED.
Weelsby View and Clee medical have been AMBER for the last 2 months but they are very close
to achieving the target
Staff Satisfaction Survey - The survey has been distributed to all staff within Care Plus and the
response rate has been high. A total of 399 of the 760 staff, have completed the survey
(52.5%). Full analysis of the survey will be included within the next report and an action plan
will be written for any areas of business that is deemed to be subject to improvement.
Page 23 of 33
Recommendations
ICS – Supervision –
Action plan to be written
Quality and Performance Manager to collate specific reasons from the teams as to why
the supervision targets are not being met
Care Plus as a role model employer
The current round of ‘confirm and challenge’ Quarterly Performance Review discussions has
highlighted the fact that Care Plus needs to operate as a role model in respect of offering
training and employment opportunities within the organisation for people with disabilities. We
would like to illicit the Boards view in respect of determining an outcome/target in this area
Page 24 of 33
4. Promoting health and wellbeing
We work together to improve people’s lives
Previous
Figure
(A/Q/M)
47%
Latest
Figure
(A/Q/M)
55%
Q3
Q4
Quarterly
ICS - Clients remaining in
their own home after
intervention (IC@Home)
(Quarterly)
83%
80%
75%
Q3
Q4
ICS - Percentage of Clients
Leaving with no support
services (The Beacon)
(Monthly)
6%
4%
March
April
Indicator Title
ICS - Clients remaining in
their own home after
intervention (The Beacon)
(Quarterly)
Current
RAG Rating
Projected
End of Year
RAG Rating
R
R
Quarterly
G
G
?
?
?
?
?
?
?
R
R
Target
80%
Monthly
ICS - Percentage of Clients
Leaving with no support
services (IC@Home)
(Monthly)
60%
63%
March
April
?
Monthly
ICS - Total number of
avoided A&E Attendances
138
123
March
April
?
37
(1.19 per
day)
35
(1.17 per
day)
3 per day
Monthly
March
April
(Monthly)
ICS - Total number of
hospital admissions
prevented per month
(Monthly)
Page 25 of 33
ICS - Percentage of direct
contact against contracted
hours – IC@Home
57%
March
N/A
?
?
?
?
G
G
G
G
Cumulative
No target
for 2010/11
?
1000
Cumulative
G
G
3000
Cumulative
G
G
100
Cumulative
G
G
Monthly
(Monthly)
ICS - Total Percentage of bed
occupancy – The Beacon
?
89%
83.21%
March
April
(Monthly)
?
Monthly
ICS - Reduction in the
average length of stay – The
Beacon
(Monthly)
ICS - Reduction in the
average length of stay –
IC@Home
(Monthly)
SVP - LD - Number of Service
Users living locally that are
in receipt of commissioned
services who have received
a Health Action Plan
(Quarterly)
SVP - LD - Number of people
with a learning disability and
their carers who have been
supported by the team to
undertake a healthy activity
(Quarterly)
SVP - LD - Number of
contacts made with the LD
carers by the Carers Support
Workers
(Quarterly)
SVP - LD - No of service
users living locally with an
LD who have received a
Health Action Plan this year
(Quarterly)
19 Days
19 Days
April
March
21 Days
26 Days
March
April
60.40%
68.3%
Q3
Q4
972
1005
Q3
Q4
2659
3677
Q3
Q4
83
108
Q3
Q4
Less than 20
Days
Monthly
Less than 26
Days
Monthly
Page 26 of 33
SVP - LD - No of People with
an LD who have received a
Health Action Plan Review
(Quarterly)
SVP - LD - No of People with
an LD who have received a
Person Centered Plan / PCP
Review
(Quarterly)
SVP - LD - No of times team
members have worked in
partnership with other
agencies to ensure people
with an LD can access
mainstream services
(Quarterly)
80
110
Q3
Q4
103
110
Q3
Q4
326
444
Q3
Q4
100
Cumulative
G
G
100
Cumulative
G
G
G
G
360
Cumulative
PERFORMANCE & QUALITY TEAM UPDATE
Current Performance Risks
Both indicators for the Beacon focus on the service being able to actively support people with
enablement and rehabilitation programmes, supporting daily living skills and maximising individuals’
level of independence.
Over the last six months the people who have accessed the service are very frail and in a number of
case, still unwell and require a period of recovery and recuperation rather than re-enablement. The
team have seen an increase in numbers of individuals being readmitted or admitted to hospital.
The strategy for The Beacon over the next 6 months will be to remodel the service delivery, focusing on
enablement and rehabilitation, and becoming a community resource for individuals who require 24/7
nursing care to get through an acute episode reducing unnecessary hospital admissions. It will take
several months to remodel and refocus The Beacon, therefore putting continual pressure on the two
indicators.
ICS - Total number of hospital admissions prevented per month (Monthly)
Although this indicator was agreed last year, it needs to be revisited for the Rapid Response team. Due
to the nature of the service, the team is more likely to save A&E attendances than hospital admissions.
This has been evidenced on a monthly basis over the last year; however what the information doesn’t
show is out of the 123 A&E avoidances, how many of those would have become hospital admissions?
The work completed by the Integrated Commissioning Directorate also demonstrates that the target for
this area should be one a day and not the original target of three.
Page 27 of 33
ICS - Clients remaining in their own home after intervention (The Beacon) (Quarterly)
This is a quarterly target that isn’t being achieved although the figures are continuously improving.
Based on April 2011, the current figure is 62.50% showing that the figures continue to move in the right
direction.
Recommendations
The ICS target - Total number of hospital admissions prevented per month needs renegotiating with
commissioners
Page 28 of 33
5. Reducing environmental impact
We aim to be green
PERFORMANCE & QUALITY TEAM UPDATE
This area continues to be discussed to establish appropriate areas to be monitored. Possible areas for
consideration are:
Travel – Patients/Visitors/Staff
Goods and Services – where they are purchased
Consumption – in relation to heating/water/electricity
Food – how much that is purchased is produced locally
Waste – Food/stock/pharmaceutical
Recycling – plastics/cardboard/paper
- Cardboard is proving a particular issue within Care Plus as many sites report that they have a
lot of recycling potential.
- Within the HQ at Port Office, plans are underway to recycle plastic, cardboard and unclassified
paper with staff volunteering to take the items to recycling points
Requests have gone out to all teams to establish what is being recycled and it is hoped that following on
from the example at the Port Office, other locations will take on the “good will” approach and follow
suit.
Page 29 of 33
6. Contribution to community wellbeing
We support people to have the best life possible
Indicator Title
SVP -DIP - KPI 2 - Adults
who test positive and have
an initial required
assessment imposed who
attend and remain at the
required initial assessment
(Monthly)
SVP - DIP - KPI 3 - Adults
assessed as needing a
further intervention who
were taken onto the
caseload
(Monthly)
SVP - DIP - KPI 4 - Adults
taken onto the caseload
who commenced treatment
(Monthly)
SVP - DIP - KPI 5 – Adults
referred to the CJIT from a
prison who were reported
on by the CJIT
(Monthly)
SVP - Supported
Employment - Adults with
learning disabilities in (paid)
employment
(Monthly)
SVP - Supported
Employment - % of Adults
with LD in Voluntary
Employment
(Monthly)
Previous
Figure
(A/Q/M)
96%
Latest
Figure
(A/Q/M)
95%
March
April
Target
Current
RAG Rating
Projected
End of Year
RAG Rating
95%
G
G
G
G
G
G
?
?
G
G
?
?
Monthly
100%
95%
March
April
85%
Monthly
100%
100%
March
April
95%
Monthly
?
?
SEE NOTES
95%
Monthly
15.63%
40.76%
March
April
17.5%
Monthly
10.82%
7.83%
March
April
?
No Target
Page 30 of 33
SVP - Supported
Employment - Adults with
PD in Employment (paid
and unpaid)
(Monthly)
SVP - COAST - % Tested 1524
(Monthly)
SVP - COAST - Number of
Positives 15-24
(Monthly)
SVP - EMPLOYABILITY –
Number of individuals that
have commenced the
EMPLOYABILITY Scheme
(Monthly)
SVP - Number of individuals
that have left the
EMPLOYABILITY Scheme
and have gone on to further
employment, training or
education
(Monthly)
10
11
March
April
?
?
?
35%
Cumulative
Annual
R
R
?
?
?
?
?
?
?
No Target
23.97%
26%
Feb
March
42
28
Feb
March
Cumulative
Annual
23
4
March
April
11
0
March
April
New for
2011/12
New for
2011/12
PERFORMANCE & QUALITY TEAM UPDATE
Employability – Although the numbers are currently being collated, no targets have been set for
2011/12 and further discussions need to take place to finalise exactly what targets will illustrate positive
outcomes as well as quality of service.
Current Performance Risks
Supported Employment
NI 146 has been carried forward into 2011/12 but the parameters for individuals that meet the criteria is
changing. These alterations have not as yet been agreed but based on initial beliefs of the
commissioners, the current figure is now 40.76%.
Page 31 of 33
Further indicators are being identified for Supported Employment to illustrate and monitor other work
that is being carried out by the team. The current figures are as follows:
Adults with learning disabilities in (paid) employment – 64
Adults with LD in voluntary employment – 35
Adults with PD in voluntary or paid employment – 11
This is a total of 110 individuals. The Supported Employment Team currently have a caseload of 220
clients. This means that only 50% of the work that is being carried out is being evidenced and other
services are therefore obviously being offered by the team to support the local community.
DIP – KPI 5 - Adults referred to the CJIT from a prison who were reported on by the CJIT
The figures being submitted to the Home Office but no feedback is being received due to data
mismatches across the country and is being addressed nationally.
Locally, the DIP team is engaging with more people than expected to and is therefore exceeding the
target.
COAST
The VSI target set by the Department of Health for 2010/11 was a cumulative target of 35% of tests
undertaken on 15-24 yr olds. This is an opportunistic screening programme and hence there is no formal
call/recall system – it therefore depends on young people voluntarily coming forward to screen. The
total number of tests performed April 2010-March 2011 was 5723 this equates to 26.3% of the total
population of young people in the target age group of NEL (22200)
The commissioners indicated that of the 35% uptake 7700 they wished to see 40% of tests coming from
within the screening programme and the remaining 60% from with core services (defined as community
contraception and sexual health services- but excluding GUM- GP practices Pharmacies and antenatal
and termination of pregnancy services ). Providers in those core services have significantly under
performed in relation to the number of tests delivered and therefore commissioners need to take a
more stringent approach in performance managing these services if future targets are to be achieved
Recommendations
The Quality and Performance Manager to arrange a meeting with Employability Manager to
finalise the indicator requirements
Page 32 of 33
North East Lincolnshire Valuing People Partnership Board
Learning Disability
Annual Health Self Assessment
Summary Report
April 2010 - March 2011
Introduction
For the past four years we have been asked by the Yorkshire and Humber
Strategic Health Authority to tell them about what we are doing to improve
health services for young people and adults with a learning disability in North
East Lincolnshire. This is called the Annual Health Self Assessment
Framework. This is so that the Health Authority can monitor what
improvements we are making each year.
Some of you have been involved with completing this year Self Assessment
Framework either by providing information or attending meetings such as the
Valuing People Partnership Board Health Day to talk about local health
services.
These are some of the main things we have said in our report about what is
happening in North East Lincolnshire
Better Health Care for people with a learning disability
More people with a learning disability received
an annual health check with their GP practice
last year. More GP practices have now signed
up to deliver the Local Enhanced Service so
even more people should receive a health check
this coming year.
368 people now have a My Health Book and Health
Action Plan. Health and Wellbeing Co-ordinators are
reviewing the plans to make sure that people are
receiving the right health services and keeping as
healthy as possible.
Lots of people with a learning disability (98%) have told us they are happy
with the Health Services they receive. Where people have said they are
not happy we have reported this so that it can be looked into.
99 people now have care plans to help them with their swallowing
problems (dysphagia). These have been written and are reviewed by the
Learning Disability Speech and Language Therapists.
The Learning Disability Physiotherapy Team have set up a Postural Care
Forum (group of people) to help improve services for people who have
additional physical disabilities who may need specialist wheelchairs and
other equipment to help them to have good posture.
The Postural Care Forum is arranging a conference which
will be held at the Oakland’s Hotel on October 14th this
year. The conference will have local and national
speakers talking about good Postural Care.
During 2010 there were 40 admissions into hospital by
people with a learning disability. Health and Wellbeing Coordinators visited the hospital 81 times to support the
individual, carers and hospital staff during these
admissions.
When some people with a learning disability and complex needs have
gone into hospital for a planned operation or medical treatment the Health
and Wellbeing Co-ordinators have done preparation work with the
individual, their carers and hospital staff prior to the admission.
28 people with Down Syndrome were seen in the multidisciplinary learning
disability health assessment clinic during the past year. 12 people were
found to have a previously undiagnosed health problem for which they
were referred onto their GP practice
A group of staff from mental health and learning
disability services have met to develop a Care
Pathway for people with a learning disability who
are admitted into Mental Health Services. The
Care Pathway says how staff from both services
will work together whilst the person is not well.
Keeping healthy and active
More groups and activities have been set up to help
people with disabilities to have fun and stay as active and
healthy as possible. These include Health Walks, Sports
Taster Days, Men’s Health Group, New Me Club, dance
sessions, swimming, trampoline and adapted cycling.
This has been done in partnership with Public Health,
Sports Development, and Leisure Centres. For more
information about these groups please contact the
Community Learning Disability Team on 01472 629322.
Everyone attending Cromwell Road Resource
Centre has had a person centred plan looking at
what activities they would like to do at the centre and
in the community. The centre programme has now
been changed to reflect people’s choices and
wishes.
People are safe in Health Services
More people with a learning disability, who do
not have close family or friends to help them,
have had an Independent Mental Capacity
Advocate to support with big decisions such as having medical treatment
or moving home.
There is accessible information and complaints forms on the Saying it All
website if anyone with a learning disability or their carers wish to make a
complaint about health services. To go onto the website type in
http://sayingitall.nelctp.nhs.uk or Google Saying it All.
During the past three months
alone over two thousand
different people have been
onto the website and
downloaded over twelve
thousand items of information
about local health services.
Staff working in North East Lincolnshire Care Trust or Northern
Lincolnshire and Goole Hospitals can get onto the Saying it All website
from their intranets (work websites) and download accessible information.
Health and Wellbeing Co-ordinators are working closely with Customer
Services Staff and Complaints Officers when they are investigating
complaints made by people with a learning disability or their carers
The Customer Services Manager at the
hospital and the Community Learning Disability
Team have worked together to develop easy
read evaluation forms and accessible leaflets
about going to the hospital.
There have been lots of improvements to help Safeguard Vulnerable
Adults from abuse. A special team has been set up to look into allegations
of abuse. This team has staff from the Care Trust and also the police
working in it.
There has also been a big publicity campaign about
preventing abuse. Posters have been put up on buses, bus
shelters and other prominent places across North East
Lincolnshire informing the public about where to report
suspected abuse.
Developing local services for those people who have more
complex needs
A group of professionals and services (Reshaping
the Market Project) have got together to start
developing a range of supported living
accommodation for young people and adults with
complex needs.
.
The Specialist Learning Disability Psychology Service and the Intensive
Support Team have provided support to help people who are harder to
help remain at home or in their local community rather than having to go
out of area.
The Intensive Support Team is also working with commissioners (people
who buy services) to bring people back from out of area placements where
it is in their best interests to do so
The Person Centred Planning Co-ordinator has
been asked to give a presentation at a National
Conference in London about the joint work he and
his team have been doing with schools to
implement Person Centred Planning Transition
Reviews
Some young people with a learning disability have been involved in
making a DVD called Transition a New Journey. The DVD will be used in
schools as part of a wider transition guide
20 young people are currently taking part in the Getting a Life Project. As a
result 5 people have got a job. 3 young people have now got work
experience and 3 others are training to be Sports Coaches
Some families from North East Lincolnshire
have travelled to London to talk to Disability
Ministers about the Getting a Life Project.
The Valuing People Partnership Board held a
workshop Valuing Older Families. A report from
the workshop will be available later.
A steering group has been set up to help improve services for people with
Autism. The group has worked with the National Autistic Society to put
together an action plan. Part of the action plan was to establish an Autism
Partnership Board. From the 1st July this will be Part B of the wider
Valuing People Partnership Board which will concentrate on how we
implement locally Fulfilling and Rewarding Lives the national strategy for
adults with autism.
Some people with autism have been delivering training
on autism to the local police service.
In North East Lincolnshire we are developing a web based person centred
planning tool called My Plan. This is so people can log into and contribute
to their plan when they wish.
The Community Learning Disability Team and Rethink Advocacy Services
have worked together to develop an action plan for supporting people with
a learning disability who are from an ethnic minority. The action plan will
be presented to the Valuing People Partnership Board in July.
A group of people have been meeting to improve services for people with
a learning disability and eye problems. They are developing a range of
information about eye care, opticians who do special eye tests etc.
If anyone would like a copy of the big health report to read please let Anne
Walker Lead Nurse Learning Disability know on 01472 629322 or email
Anne.Walker11@nhs.net
Anne Walker May 2011
Annual Report
Person Centred Planning
April 2010 to April 2011
My Life
My Choice
My Future
1
Annual Report
Name:
Person Centred Planning
Barry Osborne
April 2010 to April 2011
Date: 12/04/2011
Summary of plans & reviews completed this year:
Forwarded to: Anne Walker / Andrew Quigley
Target set for April 2010 to April 2011
PCP 35
Total number of New Plans set up this year (April 10 to Ap 11)
ELP 5
102
PC REVIEWS 75
( 36 PCP / 6 ELP / 60 One Page Profiles)
Total number of ongoing Previous Plans being supported / reviewed
78 – 138 PCP reviews carried out
Total number of P C Transition Reviews supported this year
68
Total number of referrals received since April 2010
62
Number of referrals not taken up
Number of referrals awaiting allocation
7
45
PCP Team at present directly supporting 110 Plans – this year – carried out 138 reviews, and supported development of
60 one page profiles (Day Opps), and is also supporting transition reviews.
2
Annual Report
Person Centred Planning
April 2010 to April 2011
For detailed breakdown of Planning quarterly figures and contacts carried out this year: see appendix 1
For detailed breakdown of outcomes from plans set up this year: see appendix 2
Summary
From April 2010 to April 2011 we continued to support process of personalisation, we have increased the number of people we plan
for and continue to support other Teams / Services with Person Centred Approaches.
(From our 3 year PCP Plan 2010 to 2013 “Supporting Personalisation and Informing Commissioning,” Plan Objectives set for year 1 - 2010 to 2011 were:
1.
To provide ongoing support to enable the transition planning process across Children & Transition Services.
2.
To support and enable Day Opportunity (Queen Street, Cromwell Road & Molson Centre), Service Users to identify
alternative local options choices (leisure, community and employment) available to them.
3.
To link with and support local Care Management in developing/implementing support planning and individual budgets.
3
Annual Report
Person Centred Planning
April 2010 to April 2011
Objective 1
We have concentrated on supporting Cambridge Park Maths & Computing College in developing its transition reviews: they now
have in place Y9, Y10, & Y 11 Person Centred reviews (68 PCTR’s carried out this tear), and are introducing Employment support
services at an earlier stage. We have also supported PC Transition Review training and Joint working with the GAL Team.
Objective 2
Within Day Opportunities we have reviewed all those Service Users with PCPs and are now supporting staff to develop one page
profiles for all its users. These profiles are helping construct centre programmes based on user’s requests.
Queen Street Centre: 56 users have one page profiles – now supporting rest to develop theirs -new programme developed based
in community locations.
Cromwell Road Centre: 49 users have a one page profile – now supporting rest to develop theirs - new programme developed
based on communication (intensive Interaction) and Physio & mobility.
William Molson Centre: all users have a one page profiles – now moved to new location – to open up community links.
Objective 3
We are supporting care practionners with PCPs to inform IBs – these are now increasing and are based on users and family
aspirations. Now supporting local Housing (KEYRING) development
For detailed summary of progress to date: see appendix 3
Conclusion:
4
Annual Report
Person Centred Planning
April 2010 to April 2011
Is planning changing lives?
Many people now, have greater choice in day opportunities and are developing mixed day programmes based on - work, leisure,
and centre based activities. More people now have Health Action Plans and are supported to access local Health Services, and
maintain their Health & Wellbeing (increased numbers are accessing local H& W activities). Increased numbers of (non-eligible
Social Care), people have been enabled to access community services: (Foresight / employment / leisure).
Here are some examples of how plans change lives:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
A Plan for a Young man – employment profile to identify work aspirations: now on work placement
Young man used Individual budget to purchase more education & training: continuation of provision ensured
Young man & family identified future specialist housing & support: now in place
Supported mother via son’s PCP to access more respite & enable him to have a short break
A plan for young lady to have varied day option programme: that matched her likes & wishes
Young lady enabled to access an advocate: to look at and ensure her future wishes were met
Supported LAC team to develop a PCP for a young man in transition: to remain in foster home
Supported young lady to access Health Plan and engage with a variety of community Leisure activities
A Plan to ensure a young lady in residential care is enabled to pursue community inclusion: staff to fulfil plans actions
A Plan to ensure communication became an essential action of a young persons plan: all support staff to follow
A plan for a lady to ensure her friend was invited to tea: build on existing friendship – now going out
A Plan to support Open Door Services to support a young man to access leisure
A Plan enabling a young British Asian man to meet distant relatives in another county: in process
A Plan for young lady with high support needs: emphasising the importance of risk management / likes & dislikes
A plan to support a man who is involved within the criminal justice system: showing possibilities/alternatives available
A plan to ensure extra support for a man receiving acute care at local hospital
A plan to support a man with continuing health care: ensure his wishes are central to future care
A Plan to ensure a man (no family) is supported well and his aspirations are developed.
A Plan for a young mother to express her wishes regarding child care.
5
Annual Report
Person Centred Planning
April 2010 to April 2011
PCP is joint working with the Cares Support Workers in supporting older carers to access long -term future planning (developed
Future Plan). This is enabling pro-active planning – ensuring decisions reached are at a time when everyone is satisfied.
Younger people and their families are now beginning to have greater choice and control: making joint decisions that enable future
planning. Young people are now beginning to take an active role in their futures.
Is planning happening well?
We continue to, and have developed a range of planning tools: My Plan (on line planning pilot), one-page profiles; Employment
profiling; For When I Die Plan (End of Life Team), and Future Planning for Carers: These are moving forward.
The relationship with Cambridge Park Maths & Computing College has developed an excellent inclusive review process to enable
young people and their families to plan effectively within transition for the future.
We are recognised locally, and have been regionally and nationally recognised as an area of good practise for Person Centred
Planning. Ellen is training to be a National Disability Champion with Valuing People.
Is planning changing services?
Day Centres are now focusing on its user’s wishes and aspirations: developing centre programmes based on its user’s choices
(see above).
Services are linking up and joint working. Close links with Open Door (Mental Health Out reach), and The Intensive Support Team
(Psychology) have enabled a number of young people to develop Person Centred Plans and move forward.
Person Centred reviews are helping change transition processes enabling a whole life approach to planning: stronger co-working
with Young People and their families giving them more choice and control: and thereby informing future commissioning. Children’s
Services need to continue to develop person centred working: a great number of staff has received PC Facilitator training.
6
Annual Report
Person Centred Planning
April 2010 to April 2011
Person Centred Planning / working are beginning to cross to other client groups: it is being valued for developing choice and
actioning people’s requests. We have significantly increased the number of reviews held as well as continuing to move forward one
page profiling within Day Opportunities.
Competing demand for Person Centred Planning (support) has increased considerably: Commissioning has asked for increased
support to look at reshaping the market and priority planning demands mean a waiting list is continuing to grow: It has been a very
productive and busy year.
Name: Barry Osborne
Date: 12th April 2011
7
Annual Report
Person Centred Planning
Target set for April 2010 to April 2011
Number of
PCPs
completed in
Number of
ELPs
completed in
Started
October
2003
12
2004
PCP 35
ELP 6
REVIEWS 75
Number of
PCP reviews
completed in
Transition
number of
ELPs
completed in
Transition
number of
reviews
completed in
Plans not
taken up
0
6
0
0
10
12
2
51
0
0
8
2005
33
4
33
4
0
5
2006
34
1
50
4
0
3
2007
29
3
39
4
4
4
2008
31
1
55
4
18 = Y9
1 =Y10
8
Quarter
April to April
Number of
One Page
profiles
Completed
in
April 2010 to April 2011
8
Annual Report
Person Centred Planning
2009
41
0
2010
36
0
62
April 2010 to April 2011
73
0
15
6
= Y9
= Y10
7
138
6
33
30
5
=
=
=
7
Y9
Y10
Y 11
2011
2012
2013
9
Annual Report
Person Centred Planning
April 2010 to April 2011
Appendix 1
QPR Break down of Planning and contacts carried out this year
10
Annual Report
Person Centred Planning
April 2010 to April 2011
Annual Target set for Mar 2010 to Apr 2011: 35 PCPs / 5 ELPs / 75 PC reviews
Number of
premeetings
completed
Number of
PCPs
completed in
Number
of ELPs
completed
in
Number of
one page
profiles
completed
Number of
PCP reviews
completed in
Transition
number of
ELPs
completed in
Transition
number of Y9
& Y10
reviews
completed in
Plans not
taken up
April to
June
21
9
0
22
30
4
Y9 = 9
Y10 = 10
1
July to
September
12
9
0
11
32
0
Y9 = 9
Y10 = 6
5
October to
December
12
9
0
6
41
1
Y9 = 4
Y10 = 2
Y11 = 5
1
January to
March
22
9
0
21
35
1
Y9 = 11
Y10 = 8
0
67
36
0
62
138
6
Y9 = 33
Y10 = 30
Y11 = 5
7
Quarter
Years Total
11
Annual Report
Quarter
Person Centred Planning
April 2010 to April 2011
Total Number
of Carer
contact in
Total Number of
External agency
contacts in
Total Number of
referrals to
Supported
Employment
Team in
Total number of
referrals to
Health &
Wellbeing Team
in
Total number of
follow up actions
completed by
PCP Facilitators
in
Total number of
training sessions
to other
agencies in
156
167
5
5
54
5
156
167
5
5
54
5
April to June
July to
September
October to
December
Began recording
January to
March
Years Total
12
Annual Report
Person Centred Planning
April 2010 to April 2011
Appendix 2
Detailed break down of outcomes from new plans carried out this year
13
Annual Report
Person Centred Planning
Learning (Education)
Number of people supported
to:
April 2010 to April 2011
Summary
I can access education and
learning?
Access to community
education (adult Ed)
1
Directly supported through
transition
12
Access to further / higher
Education (Linkage GIFI)
3
Access Foresight
8
What service or support issues
are getting in the way of
achieving aim?
What solutions / actions where
taken
Adult community Education
has decreased.
1 into 6th form college
2 into employment
1 into GIFHE
1 into Linkage day college
4 into day opportunities Care
Plus
3 with I Bs self Directed
support
14
Annual Report
Person Centred Planning
April 2010 to April 2011
Transition Summary
.
Cambridge Park Maths & Computing College
We continue to support Y9, Y10, & Y11 PC reviews: A core team of facilitators is now trained.
Hopefully this year Employment support services (Connexions, Supported Employment Team &
Disability Employment Advisors) will be linked and introduced at an earlier stage.
Graphic training was provided for C P Facilitators & Transforming Care Manager via
Commissioning.
For detailed breakdown of Year 9, 10, & 11 Person Centred reviews held: see appendix 4
Humberston Park School
We have supported the transition of - 5 young people with complex needs - (Essential Life Style Plans): several linking into local
Day Opportunities (Cromwell Road Resource Centre).
Linkage
We continue to offer support and guidance: mentor in person centred reviews, and led on several.
For detailed breakdown of plans held at Linkage Trust: see appendix five
Getting a Life Project
We are supporting the project: Ellen now job coach and piloted Employment focused profile meeting. Cambridge College 6th form is
to carry out a profile meeting. PCP to support with planning where required.
Person Centred Approaches training is: being delivered by Helen Sanderson Associates via Transition Service (Aiming High
funding). 4 sets of PCTR training carried out (PCP supported) – one page profile training, and others to enable FE and Children
Services planning / assessments.
15
Annual Report
Person Centred Planning
April 2010 to April 2011
Commissioning
Housing
Seven young people with complex needs have been identified for specialised housing and two locally based homes have been
commissioned to meet their needs (Thus avoiding out of county commissioning).
Community Inclusion: Young people’s Community Activities now in place Community Project (Get Hooked on Positive Activities), Fishing, car racing, bikes, Laser shooting, sailing: 2000 activities to date.
Evening Activities: O’Neil’s Pub, Stamford Club
Saturday Club
Foresight Centre
The ROCK Centre
Duke of Edinburgh Scheme
School Club
Summer Play schemes
Play equipment in local Parks
Changing Places facilities (toilets x 3)
Access to Employment: work opportunities now in placeJobs 4 all (Social Enterprise) 27 young people now on placement or in paid work
Supported Employment Team developed café 4 and now support carers back into work.
Next developments:
Young People’s Chalet offering respite and job opportunities
Cycle project: summer leisure and job opportunities fro young people
16
Annual Report
Person Centred Planning
Leisure & Fun
(Community /Leisure)
Number of people supported
to:
I take part in community life?
I have a social life that I
choose?
Access to local shops
Access to local Cinema
Access to local clubs / pubs
Summary
April 2010 to April 2011
What service or support issues
are getting in the way of
achieving aim?
What solutions / actions where
taken
15
4
12
Access to local transport
9
Have an annual holiday
16
17
Annual Report
Access to local leisure centres
/ amenities
Person Centred Planning
April 2010 to April 2011
16
Commissioning:
A new adapted cycle project, (funded by Aiming High) as been commissioned for the Sea Front at Cleethorpes. This along with the
Changes Places facility enables People with Complex Needs (who especially live in-land), to enjoy summer at the sea side.
18
Annual Report
Person Centred Planning
Where and how I live
(Housing)
I feel safe?
I choose who supports me?
I choose how I am supported?
I get good quality support?
Number of people supported
to:
Access short term breaks
(respite)
5
Access local housing
information
1
Move home
2
Awaiting move
3
Summary
April 2010 to April 2011
What service or support issues
are getting in the way of
achieving aim?
What solutions / actions where
taken
19
Annual Report
Person Centred Planning
April 2010 to April 2011
Updated Housing requests list (Mar 2011) - Via PCP
Immediate Housing
required
18
Housing wanted in (within
6 to 12 months)
Housing wanted in (1 to 2
years)
Housing wanted in ( 1 to 5
years)
2
6
10
Housing Summary;
To date 25 people have been found housing and accommodation
20 now await immediate housing - 8 of which have elderly Carers 65+
A number of carers are using holidays as short term breaks (respite) – however this does not give them a complete break.
Commissioning:
KEYRING (Community - Living Support Network) has been commissioned to set up two local networks for 18 people.
7 young people with complex needs have been identified for specialised housing and two locally based homes have been
commissioned to meet their needs (Thus avoiding out of county commissioning).
20
Annual Report
Person Centred Planning
April 2010 to April 2011
One person identified where he wanted to live and using his Individual Budget was supported to commission it. He is living where
he wants to live and especially who he wants to live with
An Elderly Carer had a future plan and with her son was supported to identify suitable housing for him. Working together services
were able to co-ordinate a plan that enabled his transition at a pace acceptable to all.
21
Annual Report
Person Centred Planning
Friends family and
relationships
I have a social life that I
choose?
Carer: I get the support to
continue in my caring role?
Number of people supported
to:
Develop friendships (attend
local clubs / social scene)
12
Maintain relationships
18
Seek specialist support /
counselling
Summary
April 2010 to April 2011
What service or support issues
are getting in the way of
achieving aim?
What solutions / actions where
taken
4
To access a carer’s
assessment
Access Community Learning
Disability Team support
2
22
Annual Report
Engage Carer’s Community
Support Workers
Person Centred Planning
12
April 2010 to April 2011
Number supported with future
planning
Joint working with The Carers Support Workers a Future Plan Format has been created enabling elderly carers to address future
needs at a far earlier date. Previously this issue would have been significantly delayed.
An Elderly Carer had a Future Plan and with her son was supported to identify suitable housing for him. Working together services
were able to co-ordinate a plan that enabled his transition at a pace acceptable to all.
23
Annual Report
Person Centred Planning
Choices control and rights
(Money / Advocacy)
People treat me with respect?
I make important decisions
about my life?
Number of people supported
to:
Access Direct Payments
April 2010 to April 2011
Summary
What service or support issues
are getting in the way of
achieving aim?
What solutions / actions where
taken
9
Access ILF funding
Take up self directed support
Individual Budgets
5
People earning an income
(paid employment / wage)
3
Accessed advocacy support
2
Numbers of people with IBs
increasing
Via Open door
24
Annual Report
Person Centred Planning
April 2010 to April 2011
Commissioning:
One person identified where he wanted to live and using his Individual Budget was supported to commission it. He is living where
he wants to live and especially who he wants to live with
One young man who wanted to continue his college courses used his Individual Budget to pay for sessions to continue.
25
Annual Report
Person Centred Planning
Keeping healthy and feeling
good about myself
I can manage my own health?
Number of people supported
to:
Request a Health Action Plan
April 2010 to April 2011
Summary
What service or support issues
are getting in the way of
achieving aim?
What solutions / actions where
taken
9
Access Podiatry Service
Access Dental Service
1
Access Physiotherapy /
mobility service
10
Access specialist service
(Intensive Support Team)
13
Joint working between Open
Door, IST and PCP developed.
Enable person to plan for preretirement
Take up a healthy activity
19
Numbers of non eligible (Social
care) now accessing activities.
26
Annual Report
Person Centred Planning
April 2010 to April 2011
The range of Community Healthy Activities now available has enabled countless people to access local amenities in a way that has
increased their confidence and inclusion.
People with Complex needs now have access to all year round community activities.
Planning can now offer varied mixed programmes that include community and service based activities for all levels of ability.
27
Annual Report
Person Centred Planning
Work
I can access work
opportunities?
Number of people supported
to:
Access employment support
Summary
April 2010 to April 2011
What service or support issues
are getting in the way of
achieving aim?
What solutions / actions where
taken
8
Summary of 8 people forwarded to Supported Employment Team
Take up work skills training
1
Gain a work experience
placement
1
Gain a part – time job
(Voluntary)
2
28
Annual Report
Person Centred Planning
April 2010 to April 2011
1 through GAL project
Gain a part – time job (paid)
4
Gain full time employment
Carers are also receiving support back into the work place.
29
Annual Report
Person Centred Planning
April 2010 to April 2011
Appendix 3
Detailed break down of PCP work carried out this year
30
Annual Report
What
Person Centred Planning
How
Who
April 2010 to April 2011
When
Outcome
•
ANNUAL TARGET
To carry out 35 Person
Centred Plans & 6 ELPs
Submit annual report to
Partnership Board and
LD Managers.
Provide evidence report
of PCP outcomes.
Submit Quarterly reports Barry / Anne walker
– numbers of PCP /
ELPs completed
number of PCP reviews
carried out
Quarterly
Sub mitt PCP evidence
to Valuing People via
Paradigm.
Nov 2010
Mar 2011
Barry
Target met and
exceeded.
April 2011
110 Plans being
supported
138 reviews carried out
68 PCT reviews
60 one page profiles
Barry / Kate Fulton
Submitted / extra
contact information also
included
•
Evidence
Included in
National Valuing
People resource
31
Annual Report
Promoting PCP
Person Centred Planning
April 2010 to April 2011
Introducing PCP to
students & Carers
attending GIFE
Barry & Ellen & Kathy
Pocklington
May 2010
•
Presentation to
students & carers
Introduce PCP to end of
year leavers at
Humberston Park
School
Barry
March 2010
•
Presentation to
Student council
Person Centred
approaches session to
PUFIN group (Parents
of young children)
Ellen & Barry
Sept 2010
•
18 Parents &
carers &
Providers – over
view of local PCP
in Adult services
A4 profile training / work
shop
Ellen & Vanessa Bray
Oct 2010
•
Parents –
supported to do
A4 profiles for
young children
York Inclusion North
regional Event
Andy Kay & Barry
Oct 2010
•
Promote Web
site & PCP
MY Plan web-site
development
Andy Kay & Ellen
Nov 2010
•
New Planning
development on
line – develop
pilot: 5 people
32
Annual Report
Person Centred Planning
April 2010 to April 2011
Big Health Day regional
event – Inclusion north
Barry Sue Over & Anne
Walker
Nov 2010
Invited to talk at
National Children &
Families Conference in
London
Barry
May 2011
•
Promoted local
Person centred
health Pathways
to York &
Humber
33
Annual Report
Person Centred Planning
April 2010 to April 2011
TRANSITION
Support PC working
with Children’s Service
Joint planning with LAC
team
Barry Julia & Amanda Parker
May 2010
•
•
Cambridge Park Maths
& Computing College
Support Y9 & Y10 PCT
reviews
Barry , Jacqui, Ellen &
Vanessa Marley Harris
May 2010
•
June 2010
•
July 2010
March 2011
•
•
•
Support development of
Y11 PCT review
Nov 2010
•
PATH Plan for
young man aged
15 – completed
Review
supported
Immingham
centre
Facilitated 2 Y10
reviews
Facilitated 2 Y10
reviews
Facilitated 1 Y10
Facilitated 2 Y10
reviews
Facilitated 2 Y9
reviews
Supported to
develop Y11
process
34
Annual Report
Humberston Park
School
GIFE
Person Centred Planning
April 2010 to April 2011
Barry
June 2010
•
Facilitated 2
ELPs
Ellen
June / July 2010
•
Facilitated 2
ELPs
Barry
March 2011?
•
Facilitated 1 ELP
Introducing PCP to
students & Carers
attending GIFE
Barry & Ellen & Kathy
Pocklington
May 2010
•
Presentation to
students & carers
Joint PCP review held
Barry
July 2010
•
Facilitated 1
Transition plan
•
Link up
Employment &
Planning
•
Profile meeting
held
Profile meeting
held
Facilitate 5 ELPS
Linkage Trust
Getting a Life Project
Support project planning Barry / Wendy Dilks
Year 9 & 10
Mentoring training
Ellen
Feb 2011
Christine Scott / Ellen
Mar 2011
•
35
Annual Report
Person Centred Planning
April 2010 to April 2011
DAY OPPORTUNITIES
Support future
development of Day
Opportunities ( Queen
Street Centre)
Carers update on
Service User
consultation process
Barry Anne O’Flinn Tina
Hooper Nicola Harmon
Ongoing support to
develop one page
profiles / and review
process
Barry / Vanessa Charlton
Alison Hickson
April 2010
July 2010
Jan / Feb 2011
•
Update on DVD
of Queen St New
activities / future
developments 20
carers attended
Weekly support to
develop service profiling
• 12 one page
profiles
completed
• 11 One page
profiles
completed
Support Service Users /
interview new staff
Barry
May 10th 2010
•
3 staff appointed
Prepare Service Users
for temporary move to
William Molson centre
Barry
Jan / Feb 2011
•
General
presentation to
all Users & group
support at WMC.
36
Annual Report
Cromwell Road
Resource Centre
Person Centred Planning
April 2010 to April 2011
Collate all PCPs to
inform future planning
Barry / Ellen / Sue Walker /
Claire Cottingham / Diane
Brown / Alison Hickson
July 2010
•
48 PCPs
reviewed
Support Planning for
those not had a PCP
(one page profiles)
Barry / Alison Hickson
Nov 2010 –
ongoing
•
25 One page
profiles
completed
•
All requests
collated
•
Weekly support
to develop
service profiling
•
12 One page
profiles
completed
Ongoing support to
develop one page
profiles / and review
process
Jan / Feb 2011
37
Annual Report
Person Centred Planning
April 2010 to April 2011
Supported Employment
Enable Joint working to
develop in Transition
Barry/ Wendy Dilks / Kay
Brown / Connexions / Debbie
Burres / Graham Scott
Feb 2011
•
Joint working via
GAL project
Physical Disability Day
Service
Support and review set
action Plan
Barry/ Stuart Farmery / Mandy
Matthews
April 2010
•
Action plan
reviewed next set
June 2010
•
Action plan
reviewed next
set
•
Action plan
reviewed next set
Aug 2010
38
Annual Report
Person Centred Planning
April 2010 to April 2011
JOINT WORKING
Training – developing
Person Centred
approaches
2 work shops on Person
Centred approaches /
developing one page
profiles
Barry CTP Lori (H Sanderson
Assoc), Angie Kershaw NELC
May 13th & 18th
2010
2 work shops GAL
PCTR training for
Transition Services
H Sanderson / Barry & Ellen
Nov 2010
Feb 22/23rd 2011
2 days P C Assessment
training focused on out
comes
H Sanderson
Febr 3 & 4 2011
2 work shops for PCTR
training for post 16
education services
Helen Sanderson / transition
4 & 5 April
17 & 18 April
2011
•
•
22 students
31 students
attended
•
12 students from
schools & FE
39
Annual Report
Person Centred Planning
Transforming Care
Market place event for
Public
Health - Care
Management
Review new health Care
Plan / doc
Supporting Criminal
Justice System
Act as appropriate adult
April 2010 to April 2011
June 4th
•
Meeting &
discussing PCP
and
Personalisation
Barry / Leigh Holton
June 2010
•
New format
developed
Barry
April 2010
•
Assist detainee /
police and
solicitor in
interview process
•
Initial training
given to 4
managers
Barry / Tukes
May 2010
June 2010
Housing Support
Solutions
Support managers to
develop one page
profiles & support
reviews
Barry / Steve Colgan
Aug 2010
40
Annual Report
Intensive Support Team
Open Door
Person Centred Planning
April 2010 to April 2011
•
Support case workers to
develop one page
profiles & support
reviews
Barry / Dave Mason
Aug 2010
Facilitate plan & refer to
Open Door for support
Ellen / Rob Batey
January 2010
•
Case worker
appointed /
support to access
employment /
work experience
Achieved at
TUKES
Facilitate plan for HASS
solutions
Barry / Dave Whittock / Open
Door
Oct 2010
•
Plan to identify
positives prior to
court review
Facilitate plan & support
young mother
Ellen / Lac team
March 2010
•
ELP completed –
Plan to identify
positives prior to
court review
Initial training given
to 3 case workers
Supporting People with
ASC
LAC Team
Supporting Carers with
a Learning disability
41
Annual Report
Valuing People
Partnership Board
Person Centred Planning
Support Carers &
Service Users with
review
Barry / Sam Clarke
April 2010 to April 2011
•
Assisted
inclusion North –
organise 2 events
/ reviews
Oct 2010
Review of CLIP
Support Event to
Barry Matt Bowski & Sam
develop new 3 year plan Clarke
Jan 2011
•
Draw
Consultation
plan, agenda &
write speech for
Chairs.
Housing Development
Commissioning group
Support to set up 2 local
KEY RING net works
Feb 2011
•
Support Housing
event to
implement Key
Ring
End of Life Team
Support Person centred
approaches / working
Jan 2011
•
Developed for
When I die
Format & support
Health training
Barry
Barry / Andy Kay / Linda
Navaran
42
Annual Report
Care Plus – Social
Enterprise
Person Centred Planning
Support managers in
developing social
enterprise
Barry
PCP presentation to all
stakeholders
Barry Ellen & Sue Over
April 2010 to April 2011
July 2010
•
Mar 2011
•
Oct 2010
•
Facilitated Action
Plan set & drawn
Easy read Staff
survey
Good practise
show case PCP
43
Annual Report
Person Centred Planning
April 2010 to April 2011
Appendix 4
Detailed break down of year 9, 10 & 11 Person Centred reviews held at Cambridge Park Maths &
Computing College Sept 2010 to March 2011
19
Year 9 Person Centred Reviews were held
17
Year 10 Person Centred Reviews were held
27
Year 11 Person Centred Reviews held
Summary
Person Centred Transition Reviews are enabling young people and their families to focus on what is important to them enabling
them to have more choice and control. Young people are concerned with developing friendships and learning key skills such as
using local transport and money skills. They are keen to participate in reviews and take close satisfaction in knowing career and
future employment is being taken seriously through out their annual reviews.
Parents and Carers like having time to open up and discuss everyday matters, and especially see as important - how school and
home can reinforce values. Action plans ensure momentum is kept up throughout the review process.
Professionals work collectively to offer choice and early access to services.
The outcomes below show a year on year review process that is an effective whole life approach to planning.
44
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y9 Actions / Outcomes Sept 2010 – March 2011
HEALTH
Identifying Health & Wellbeing actions
Anger management
Stress Management / Calm Behaviour (CAMHS)
Continue Physiotherapy
Become advocate for ‘Getting Heard ‘ project
Consult with V CONNAH (AS ) re: OCD strategies
Opportunity to discuss feelings / Emotions
Number
requesting
3
2
1
1
1
1
45
Annual Report
Person Centred Planning
SENART statement amendments?
Plan Together Database given (Carers info)
George Hardwick foundation leaflet /info (Carers info)
Support to administer medication
Continued monitoring of Medication & visits to Dr
Health plan pupils attend Meds Appt
Possible change of Statement ref Health Plan?
Diagnosis Tourettes
April 2010 to April 2011
2
2
3
1
5
4
2
1
46
Annual Report
Person Centred Planning
Represent school in PE activities
April 2010 to April 2011
1
47
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y9 Actions / Outcomes Sept 2010 – March 2011
HOUSING
Identifying – Housing / personal development actions
Buxton trip ( Activity Week )
Possibilities of travel / trips with family
Support with personal hygiene
More challenging tasks Social & Independent
Arrive school on time ( too early )
Become more independent - Living skills ( Home & School)
Number
requesting
1
1
2
1
1
4
48
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y9 Actions / Outcomes Sept 2010 – March 2011
DEVELOPING RELATIONSHIPS & COMMUNITY INCLUSION
Social Leisure / Community Inclusion actions
Access / attend Western Young People Centre
Stepping Stones club (GIFHE)
Take up music lessons- Guitar
Transport to Immingham for After School Clubs
Attend after school activities
Stepping Stones Activity Club at GIFHE
Number
requesting
2
2
2
1
4
7
49
Annual Report
Person Centred Planning
Foresight club / Activities
Western Youth Club
West Marsh Tigers Football
Oasis Academy football
Participate in Sports Day
Extra Swimming
More ‘ girl friendly ‘ PE
Creative activities day in school
April 2010 to April 2011
3
2
1
1
1
1
1
1
50
Annual Report
Person Centred Planning
Fishing Club
Attend summer school
Transport training ( Bus ) Independence
Road safety
April 2010 to April 2011
1
1
1
1
51
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y9 Actions / Outcomes Sept 2010 – March 2011
EMPLOYMENT
Employment / Skills development actions
Connexions meetings / info
Work experience
motor project (w / experience)
Research JED database / Careers Lessons
Access : GIFHE and Franklin College - Taster day
Access : GIFHE and Franklin College - Link course
Number
requesting
8
2
1
6
11
13
52
Annual Report
Person Centred Planning
Attend Open Evening College
Prospectus given as requested
Post 16 provisions at school (CPS)
Reassessment to higher level to access Diploma
Increase effort and Homework requested for GCSE Maths ICT Science
School Homework reading
Extra reading in school
Request for class jobs / tasks
April 2010 to April 2011
1
3
0
1
3
2
3
2
53
Annual Report
Person Centred Planning
Timetable change ( - music )
Individual Alternative timetable
Support to transition into KS4
Home school book for Communication
Visual checklist
April 2010 to April 2011
1
1
1
4
1
54
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y10 Actions / Outcomes Sept 2010 – March 2011
HEALTH
Identifying Health & Wellbeing actions
CAMHS appointments in school
Meds issue check all inhalers
Continued Medical appt / consultation
Time out system
Number
requesting
1
1
3
1
55
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y10 Actions / Outcomes Sept 2010 – March 2011
HOUSING
Identifying - Housing / personal development actions
Become more independent
Independent living skills programme
Open own Bank Account
Communication via Home / school book
George Hardwick Foundation Info/ Visit (Carers info)
Number
requesting
1
2
2
5
56
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y10 Actions / Outcomes Sept 2010 – March 2011
DEVELOPING RELATIONSHIPS & COMMUNITY INCLUSION
Social Leisure / Community Inclusion actions
Foresight Activities
Number
requesting
4
Access / Attend Western Young People Centre
After school clubs
Foresight Football Kent RD
West Marsh Football
Public transport Training
1
1
1
1
57
Annual Report
Person Centred Planning
Enquiry to Befriender Service
Violin Lessons
Singing
Reading Books at home
Cinema Pass
Referral Tea Visit to Cromwell
CAF Assessment
SEN Tracking group
April 2010 to April 2011
1
1
1
1
1
1
1
1
58
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y10 Actions / Outcomes Sept 2010 – March 2011
EMPLOYMENT
Employment / Skills development actions
Research jobs JED database – Careers Lessons
Work experience - general
Work experience - cycle repair
Work experience - runner bean café
Work experience - motor project
Work experience - animal care
Number
requesting
6
1
1
3
1
1
59
Annual Report
Person Centred Planning
Work experience School TA
Work experience - Rock foundation
Help at Foresight tuck shop
Access GIFHE Taster days
Access Link course
Post 16 provision (CPS)
Transport Enquiry for College
Decrease time at LACE to attend school
April 2010 to April 2011
1
1
1
10
9
2
1
1
60
Annual Report
Person Centred Planning
Continue with Study Centre strategies
Attend lessons on time
Extra reading ( English) in school
Work Hard for expected GCSE ‘s
Work Hard for expected -GCSE Science
Work Hard for expected – Maths
Work Hard for expected – ICT
April 2010 to April 2011
1
1
1
2
1
1
1
61
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y11 Actions / Outcomes Sept 2010 – March 2011
HEALTH
Identifying Health & Wellbeing actions
Wear helmet during PE
Commitment to ‘take responsibility for own actions’
In House Anger Management
Appointment for Speech Therapy
Assessment (at college) Visual Aids necessary
Incentives to attend school on Mondays
Number
requesting
1
1
1
1
1
1
62
Annual Report
Person Centred Planning
Timetable change for Fridays encourage attendance
Investigate feasibility of installing chair at Cromwell
George Hardwick Foundation Info/ Visit (Carer’s support info)
CAMHS support requested
Walking for fitness
Visit to dentist
Optician appointment
Request for Health Care Plan
April 2010 to April 2011
1
1
6
1
1
3
3
1
63
Annual Report
Person Centred Planning
Change to Educational Statement
Hearing appointment in school
Support to gain independence with Hearing Aids
Continued Medical appt / consultation
Medication to be reviewed
Request letter from Dr K for Bus Pass
April 2010 to April 2011
1
1
1
6
2
1
64
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y11 Actions / Outcomes Sept 2010 – March 2011
HOUSING
Identifying - Housing / personal development actions
Become more independent Independent living skills programme
Open own Bank Account
Transport Training – Bus
Future Housing needs Supported/ Sheltered
Visits to Community facilities
Community care assessment request
Number
requesting
1
2
3
3
1
1
65
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y11 Actions / Outcomes Sept 2010– March 2011
DEVELOPING RELATIONSHIPS & COMMUNITY INCLUSION
Social Leisure / Community Inclusion actions
Information about Foresight Activities
Grimsby Town Study Centre programme
Encourage attendance After School Club
Enquire possible term time holiday
Cinema Visits - Pass
Befriender referral ( Social Worker )
Number
requesting
5
1
1
1
2
1
66
Annual Report
Get a Prom Dress
Person Centred Planning
April 2010 to April 2011
1
67
Annual Report
Person Centred Planning
April 2010 to April 2011
PCTR Y11 Actions / Outcomes Sept 2010 – March 2011
EMPLOYMENT
Employment / Skills development actions
Research jobs JED database – Careers Lessons
Work experience - runner bean café
Work experience - at school
Connexions meetings completion Section 139a
Apply to GIFHE
Attend open evening College
Number
requesting
5
2
1
15
5
3
68
Annual Report
Person Centred Planning
Informal college visit
Skills for life at college
Access: GIFHE Taster days
Access: Links courses
Access: Post 16 provision (GIFHE/CPS)
Access: Spend time at 16-19 centre
Access: Transport Enquiry for College
Discuss other sources of FE provision
April 2010 to April 2011
1
1
6
19
3
2
5
1
69
Annual Report
Person Centred Planning
Research RAF requirements
Visit SEN fair April 2011
Interest in Getting a life project
April 2010 to April 2011
1
4
1
70
Annual Report
Person Centred Planning
April 2010 to April 2011
Appendix 5
Break down of Person Centred Plans held at Linkage Trust
71
Annual Report
Person Centred Planning
April 2010 to April 2011
Summary of Linkage Trust Person Centred Planning April 2010 to April 201 1
Number of PCPs action-ed
41
Number of ongoing PCP
reviews
43
Number of requests waiting for
allocation
22
Plans not taken up
1
72
The Care Plus Quality Account
2010 / 2011
A Quality
Account
Report
A Quality Account is a report that is written for the public by an
organisation to tell them about how good the services that they
provide are and how they can be improved during the next year.
The report must talk about the following areas:
How we keep people who use our
services safe from harm
How we make sure that the services
we provide are the right ones for people
How we make sure that we always
treat people with dignity and respect.
This year is the first time that the NHS have told
Care Plus that they must write a Quality
Account. We are writing the Quality Account
now and it will be finished by the end of May.
We also need to ask the public and people who
use our services what they think of what we
have written in the report.
This is what we have
said in the report.
2010 / 2011
Report
2010
During the last year we have got better at producing information
about how our services are performing. Some of the good things
we have done are:
We have trained many of our staff in important areas
such as infection control and safeguarding adults
We support staff who have been ill to come back to work
We have got better at reporting accidents and incidents
and then working out how to make sure that it doesn’t
happen again
We have helped more people to stay living in their own
homes and not have to go into hospital or residential
care
We have helped people with learning disabilities get
better health services
We have improved the way we have helped people
who have pressure sores
Our End of Life Services have helped more people to
die in the place of their choice
We have got much better at asking people who use
our services what they think about them
2011
We will continue to work on the good things and we have also
decided what other important things that Care Plus needs to
concentrate on this year. They are:
We are value for money and provide
really good services
We put people at the heart of what we do
We try to support our staff and make
them feel valued
We work together to improve peoples lives
We support people to have the best life possible
We aim to be green
If anyone would like to have a full copy of the report to read
please let Jo Barnes know
Jo Barnes
May 2011