Cambian Group
Quality Accounts 2011/12
Quality Accounts 2011/12
1
Contents
Part one
About our quality accounts
04
Statement on quality from:
Chief Executive
06
Group Clinical Director
08
Chief Operating Officer
10
Part two
Quality Standards and Processes
12
Part three
Cambian’s Priorities for Improvement 2011/12
16
Part four
Cambian’s Priorities for Improvement 2012/13
32
Statements
34
Although our work embraces
many specialist disciplines, it is
united by a common purpose:
to actively enable each and
every one of the people in our
care to achieve their personal
best, however it is defined by
them, or for them.
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Quality Accounts 2011/12
Quality Accounts 2011/12
3
About our quality accounts
As one of the UK’s largest independent providers of specialist
services in education, mental health rehabilitation and learning
disabilities to over 140 public authorities including the NHS, we
welcome the opportunity to share information on the quality of
our services. The Cambian group is proud to care for over 1,100
people in 65 locations across the UK.
Although the account only requires us to report on services
provided to the NHS, The Cambian Group takes a holistic
approach to quality and, as a learning organisation, encourages
and ensures the sharing and cross fertilisation of best practise.
To this extent we have also included in our reporting information
regarding our specialist education services.
How did we produce our
Quality Accounts?
In producing our Quality Accounts 2010/11 we
have used the Department of Health’s Quality
Accounts toolkit as our guide. This account
is an honest and accurate assessment of
the quality of services we provide across the
Cambian Group and a summary of the ways
in which we aim to improve over the next year.
We have consulted with staff, patients,
families and commissioners in the process
of compiling this report, to ensure that we
have presented the information fairly. We
believe it reflects a true picture of Cambian
as an organisation and of our aspirations
for the people in our care. We have included
all the mandatory requirements of the
account and have identified specific and
measurable improvement initiatives in
each of our priority areas.
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Quality Accounts 2011/12
We hope that this account is a useful
document that will help patients, families
and the public to understand our priorities
for delivering quality care to our patients. The
information collated for this document will
provide the next benchmark for continuous
improvement and will help us to provide even
better services in future. It will be used to
provide key progress reports to our board and
our independent governance teams whilst
keeping our key stakeholders informed of our
progress towards our goals. We welcome
feedback from families, patients, staff and
commissioners on our services and priorities.
Cambian Group is proud
to care for over 1,100
people in 65 locations
across the UK.
If you have any suggestions for the coming
year’s Quality Accounts or any queries
regarding this document, we would be very
pleased to hear from you.
enquiries@cambiangroup.com
Quality Accounts 2011/12
5
Statement on quality from
Saleem Asaria Chief Executive
At Cambian we welcome this opportunity
to scrutinise our services and highlight our
commitment to service quality. We believe that
an honest and open system of accountability
can help us to improve our services and lead
to positive solutions and new ideas.
Through collating the information for our
Quality Accounts 2011/12 we have been
able to assess what we have achieved over
the past year, reflect on where we could do
better and define our priorities for 2012/13.
Cambian is committed to robust corporate
governance and has developed a wide-ranging
system to keep this under review. Regular
reviews are undertaken with external
specialists and also by the Board of Directors,
demonstrating the importance attached to
corporate governance issues within the group.
Our values
Our achievements
Cambian is committed to providing the
highest standards of care for its patients,
students and service users. We want everyone
in our care to achieve their personal best,
however it is defined by them or for them,
and where possible we aim to reduce
length of stay through service innovation,
specialist therapy, rehabilitation and
models of care.
We have set out our achievements in 2011/12
against a backdrop of unprecedented change
in the world of healthcare provision and an
economic climate that to say the least is very
challenging. Through policy rightly the
aspirations for mental health care continue
to be raised at the same time the CQC for
very different reasons has taken a long and
very hard look at its practices and the industry
it inspects.
We believe that high quality care can only
be achieved where a culture of aspiration
and excellence extends throughout the entire
organisation and is actively promoted
throughout the organization. If high expectations
are modelled by senior managers, if staff
feel valued and empowered and if continuous
improvements are encouraged, a better
quality of care is likely to result for the people
in our care.
The safety of the people we care for is of
paramount importance and is central to the
provision of high quality care. We never forget
that it is a privilege to work in partnership
with the NHS, rather than a right, and that
care for our patients is the foundation of
everything we do. We also have a responsibility
to provide value for the NHS without
compromising standards, and this is a
commitment that we take seriously.
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Quality Accounts 2011/12
We have embraced these changes as part of
our on-going drive for quality, innovation and
value. We have continued to invest in high
quality services, such as the newly refurbished
Cambian Churchill hospital in London, since
we believe that investment in well-equipped,
attractive services has a positive impact on the
well-being of the people in our care and is
likely to enhance their journey towards
rehabilitation. Our staff members, from
psychiatrists and mental health nurses to
catering assistants and occupational
therapists, have been at the vanguard of
improvements to patients’ physical health
and well-being through the introduction
of healthier menus, healthy eating cookery
sessions and a wider choice of sports and
engaging physical activities.
We have seen continued growth in the
company this year, as you will read we have
introduced specialist learning disability
rehabilitation services which have helped
reset the expectations within the sector for
people with a learning disability.
*all Cambian Hospitals 2010
We are proud of the achievements the
group has made in the past year, through
gaining ‘outstanding’ ratings from Ofsted for
all our special education needs schools and
achieving ISO 9001 and NHS Level 2 in
Information Governance. As outlined in
this document, we have also improved our
staff recruitment processes to offer our
employee’s enhanced professional
development through the introduction
of a new e-learning training program.
86%* of discharges
are ‘successful’ from
our mental health
rehabilitation hospitals
External validation is an indicator of our
success, but we also have to deliver positive
outcomes for the people in our care. These
can be measured in different ways, from
the small daily steps that students in our
schools take towards individual goals and
achievements to the 86% of discharges being
‘successful’ from our mental health
rehabilitation hospitals that result in patients
returning to community-based care. However
we measure success, our goal is to continue
to be a dynamic, innovative organisation, one
that drives positive changes, delivers value
and raises the benchmark in high quality care.
Alongside these aspirations we must never
forget that the people in our care are
individuals, with differing needs, opinions and
aspirations of their own, and that investment
in our staff is also an investment in the people
we care for. It’s a challenging time in healthcare,
but in the coming year our goal is to work in
partnership with others to ensure that quality
of care is not compromised and that more can
be achieved for less. Everyone can play a part,
from our service users, patients and students
to staff members, families, carers and
commissioners. We welcome their ideas,
involvement and enthusiasm and hope they
will join with us in helping to make the services
we offer our clients even better in 2012/13.
Quality Accounts 2011/12
7
Statement on quality from
Tony Romero Group Clinical director
Improvement in patient outcomes is easily claimed
but often hard won. Cambian’s Active CareTM model
of care was introduced in mental health rehabilitation
services to provide a set of objective measures
of improvement in a variety of areas, such as
medication management, social skills, risk,
well-being, physical health, psychopathology,
daily living skills and behaviour management.
The Active CareTM approach also provides
a set of goals for both the individual,
patient and staff members to work
towards the road to rehabilitation.
With the support of a multi-disciplinary
team it enables patients to achieve their
personal best, whatever their individual
circumstances. In 2011/2012 we refined
and improved our Active CareTM model,
introducing new versions adapted for
different patient groups.
Our in-house multi-disciplinary teams
have drawn on the success achieved
in mental health rehabilitation to
implement the Active CareTM approach
for people with learning disabilities,
autism and CAMHS. This step by step
approach covers all areas of the
individual’s life and also gives patients
the support, encouragement and
environment needed to achieve progress.
We aim to extend this concept further
across our services in the coming year.
This approach will enable a consistency
of care across the whole of Cambian’s
services and allows individual progress
to be assessed. Measurement is not an
end in itself, but forms an important part
of a patient’s therapy – if individual
achievements, however small, are
consistently recorded and acknowledged
they can help to improve patients’ sense
of well-being and self-worth and
contribute to further progress.
Cambian’s approach to multi-disciplinary
teams also differs from that in other
organisations and we have continued to
develop the skills and specialisms of our
MDTs in 2011/12. Our MDTs are all
salaried staff, consultant psychiatrists,
specialist doctors in psychiatry, clinical
and forensic psychologists, hospital
managers, speech and language
therapists, occupational therapists,
therapy coordinators, pharmacists,
advocacy advisors, heads of care,
registered mental nurses and support
workers. We ensure that every discipline
is represented on site, with a focus on
capability and consistency of approach.
Our MDTs work in a genuinely collaborative
way, liaising closely with the patient and
family members to monitor the effect of
therapeutic inputs and to ensure
consistency of high quality care. Members
of the MDT are also encouraged to
challenge, question and review each
other’s inputs – regardless of specialism
or hierarchy – in order to achieve the best
outcomes for patients. In this way, we
ensure that every patient has the best
chance of acquiring the skills and
structure needed for a successful return
into the community or into appropriate
low cost community-based care.
Patients and families are also central
to this process, ensuring that patients’
views are taken into account and their
rights upheld. Wherever possible our
aim is to reduce length of stay for patients,
providing value for the National Health
Service and a better outcome for
individuals and families.
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Quality Accounts 2011/12
*all Cambian Hospitals 2010
In 2011/2012 we have continued to
improve outcomes for our patients and
to provide high quality rehabilitation
services for the NHS. 86% of discharges
have resulted in patients returning to
lower cost community based services
and the average length of stay across
Cambian services has been 18 months.
41% of discharges have been direct to
independent living, 22% of people
leaving our care have gone to supported
living accommodation, 13% have gone
on to live semi-independently and 9%
have returned to their families.
We aim to maintain or improve these
outcomes for patients in 2012/13. This
year we have continued to work in close
partnership with learning organisations,
both to contribute to excellence in staff
training and the sharing of best practice
across healthcare. St Augustine’s hospital
in Stoke-on-Trent has welcomed student
nurses from Keele and Stafford
universities, occupational therapy
students from Derby and Coventry and
psychology students from Birmingham.
Cambian Fairview in Colchester also
provided clinical placements for eight
student nurses from three different
universities. Several of our staff have
completed Nursing and Midwifery
Council mentoring training and our
varied programme of high-profile
seminars, conferences and training
events has continued this year for our
employees, families and partner agencies.
41%
*
of discharges have been
direct to independent living
22%
*
have gone to supported
living accommodation
Quality Accounts 2011/12
9
Statement on quality from
Mike McQuaid Chief Operations Officer
Cambian has continued to invest in robust governance
and audit processes in 2011/12, in order to maintain
accountability, to challenge practice, to ensure the
quality of its services and to engender trust in the patients
and families that it serves. The Cambian Group’s proactive
governance and audit processes, both internally and
externally, help to ensure the safety of all those in its care.
Several principles of clinical governance
underpin Cambian’s clinical, operational
and corporate objectives. These include
recognisably high standards of care,
transparent responsibility and
accountability for those standards and
a constant dynamic of improvement.
Corporate governance is undertaken
in conjunction with external specialist
healthcare lawyers to ensure both an
independent review and a means of
benchmarking Cambian’s performance
against industry trends. Corporate
governance issues are also regularly
reviewed by the Board of Directors, which
underlines the importance with which
this is viewed. Questionnaires to parents,
carers and clients, student feedback
through School Councils, patients’
contributions at daily community meetings
and family and carer attendance at
reviews also inform practice. In 2011/12
Cambian developed and implemented
an external whistleblowing process to
further support and encourage the focus
on quality and transparency within the
organisation.
Over the past year Cambian’s success
has been reflected in its growth, over the
last year we have opened 8 services with
an increase of 150 beds. This growth is
positive both for our patients and staff. It
has meant greater choice and flexibility
for our service users and their families,
with people having the opportunity
to be cared for closer to home.
The combination of specialist skills and
services within the expanded Cambian
Group has enabled us to develop
unique care packages for our patients,
comprising clinical expertise, behavioural
and occupational therapy, speech and
language programs, educational and
vocational curricula and daily living skills.
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Quality Accounts 2011/12
Our size and strength mean that we can
offer better training and career development
prospects for our staff. Combined with
the sharing of best practice and skill
sets across all our specialisms, this has
enabled us to further develop our services
and provide a better quality of care to our
patients. We can now draw on a wider
expertise for individuals within our care,
providing them with the most appropriate
care to meet their needs and helping
them to realise their personal best.
In a year where the CQC activity has been
very robust, we are pleased with the
progress we have and continue to make
in this regard. We have introduced new
services and focused on maintaining the
very highest standards we are able across
all our services, and that the quality of
care across Cambian is consistent.
The quality of our services has been
endorsed by UK regulatory bodies the
Care Quality Commission and Ofsted,
making us market leaders both through
specialism and size.
Points raised in inspections are
incorporated into operational and
strategic functions to support the on-going
commitment to best practice. Cambian
also carries out regular benchmarking
against guidance and legislation.
Internationally-recognised measurable
outcomes such as the Global Assessment
of Functioning and Therapeutic Crisis
Intervention programme are incorporated
into Cambian’s Active Care™ multidisciplinary models of psychiatric
rehabilitation and specialist education.
Our aim has always been to provide
outstanding therapeutic environments for
patients, where they can learn and can
feel valued, safe and secure. We aim to
push the boundaries of what is possible
and achievable for the people in our care,
giving everyone something to aim for, no
matter what challenges they face. Our
investment in high quality environments
and facilities plays a part in this, as does
the expertise of our multi-disciplinary teams.
Our commitment to service innovation,
which has led to developments such as
the Active CareTM approach in mental
health rehabilitation and Active Learning
in specialist education, is also important.
In 2011/2012 we have worked towards
improving the quality of care, well-being
and achievements of the people in our
care through the Star Wards initiative
in our hospitals and active community
involvement programmes in our hospitals
and schools. Our commitment to these
and other innovations will continue in
2012/2013.
As well as providing high quality care
and education, it is also essential that
an organisation ensures the safety of
those in its care. Cambian carries out
on-going clinical and organisational
risk management for all of its services
and ensures that all its facilities are fit for
purpose. All staff are CRB checked for their
suitability to work with vulnerable clients
and policies give clear directives on such
matters as Child Protection and use of
illegal substances. Any causes for concern
are carefully logged and reported so that
appropriate action may be taken.
significant results, allowing the systematic
training of staff and so ensuring that
training is up to date and so improving
the capability of the organisation.
Staff surveys in 2011/12 led to some
excellent feedback and to Cambian
being awarded Best Companies
Accreditation in 2011, in particular for
its emphasis on personal growth and
team development. Cambian’s specialist
education division also continues to
meet the requirements of the Investors
in People Standard, originally awarded in
2008. High standards in patient care and
safety, clinical and corporate governance
and staff training and development need
continued investment, if excellence is to be
maintained. This Quality Account includes
some of the areas that Cambian hopes to
improve on in 2012/13 in order to provide
an even better service for its patients.
We aim to push the
boundaries of what is
possible and achievable
for the people in our care
We will continue to invest in our
patients, staff and buildings.
In 2012/13 plans are already
underway to open another
6 Cambian services,
resulting in the
introduction of 117
additional beds.
Staff training and career development
is an important element of high quality
care and patient safety and Cambian’s
investment in staff training has continued
throughout this year. May 2011 saw
the launch of Cambian Achieve, a
new e-learning system which has had
Quality Accounts 2011/12
11
Quality standards and Processes
The COO is the board member with
primary responsibility for quality and safety
but all board members recognise their
responsibility to support and enhance the
quality and safety of services in the Group.
Business Overview
2
Quality Standards
and Processes
The Cambian Group is an Independent
company providing specialist services
funded by the NHS and Local Authorities.
The Cambian Group specialises in
people with mental health problems,
developmental disorders, and neurological
or rehabilitation needs, often with complex
specialist needs relating to challenging
behaviour and physical illness.
The Group’s services are divided in to
three broad service areas: Healthcare
(including Acquired Brain Injury) ,
Learning Disabilities and Education.
These three services work in synergy
through organisational structure and
reporting up to Board level driving
innovation and efficiency.
Leadership, Governance
and Accountability
The Board
The operating company board includes
the chief executive (CEO), the chief financial
officer (CFO), the chief operating officer
(COO), the group medical director (GMD),
the group human resources director, the
group property director, the business
development director
and is chaired by a representative of the
main shareholder.
The COO is the board member with
primary responsibility for quality and safety
but all board members recognise their
responsibility to support and enhance the
quality and safety of services in the Group.
Each board meeting contains a section
on quality at which the COO presents an
overview of the latest group data, together
with any areas of risk identified since the
previous meeting. These data are
produced from a number of supporting
meetings and forums that make up our
internal governance process.
The Group’s services
are divided into three
broad service areas:
Healthcare, Learning
Disabilities and Education.
The COO, GMD and CFO work closely
together under the leadership of the CEO
to ensure that investment is aligned with
quality as well as commercial requirements.
Cambian’s Clinical
and Corporate Governance
This operates at three levels from an
individual monthly hospital level to
quarterly corporate meetings a overview
of this process is set out below.
All meetings have minutes which
are collated and discussed at Group
corporate governance meetings.
Internal Clinical Governance meetings
take place in each hospital every month.
Any member of the hospital team is
invited to join these meetings.
The agenda for the meeting follows the
seven pillars of clinical governance:
1. Risk management
2. Clinical effectiveness and research
3. Clinical audit
4. Patient experience and involvement
5. Staffing and staff management
6. Education and training
7. Use of information
Decisions made at the meeting are minuted
and actioned by the identified individual.
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Quality Accounts 2011/12
Quality Accounts 2011/12
13
Quality standards and Processes
Joint clinical governance meetings take
place on alternate months to the internal
clinical governance meetings.
The tables below map service lines provided by the Cambian Group for the period 2010/11
Risk management should create:
safer practices, safer system of
work and safer premises. Greater
staff awareness of danger and
potential liability.
Joint Clinical Governance meetings take
place on alternate months to the internal
clinical governance meetings.
The following people attend the joint clinical
governance meetings which are hosted at
different hospitals across the UK.
1.Registered manager for host hospital
2.Head of care for host hospital
3.Responsible clinician for host hospital
4.Occupational therapist
5.Psychologist
6.Operations team
7.Registered manager and head
of care as per zone.
The agenda for the meeting again follows
the seven pillars of clinical governance.
Corporate governance promotes
corporate processes and procedures to
promote transparency and accountability.
It also incorporates the organisation’s
strategic response to risk. Corporate
Governance is commonly referred to as
a system by which organisations are
directed and controlled. It is the process
by which the company’s objectives and
systems are monitored. Corporate
governance in its widest sense concerns
the relationships and responsibilities
between the Board, Management, and
other relevant stakeholders within a legal
and regulatory framework.
At Cambian, the relationships between
the Board, Management and shareholders
are a matter dealt with by the Board who
are responsible for establishing the
company’s strategic objectives and
commercial strategy. However, these
factors are all subject to influence by
areas of commercial, regulatory
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Quality Accounts 2011/12
or trading risk and these will be addressed
by establishing a regular (half yearly)
review meeting at which such issues can
be addressed.
A key aspect of Cambian’s corporate
governance policy is to have a clear risk
management system, both to review the
company’s response to adverse incidents
and to enable us to learn from previous
incidents and near misses. By reviewing
these carefully we significantly increase
the prospect of being able to track trends
and respond to them before they become
a significant issue.
Risks at present include: The buildings
that Cambian owns and occupies, the
equipment, medication or other hazardous
substances used by Cambian, The people
employed by Cambian or visiting it as
a patient, resident, visitor or guest, the
systems or management of Cambian.
Mental Health Rehabilitation Hospitals
Learning Disability Rehabilitation Hospitals
Male
Female
Male
Female
Delfryn House*
The Aspens*
Cambian Fairview
Cambian Fairview
Sedgley Lodge and House*
Delfryn Lodge
The Manor
The Views
Sherwood
St Telio
Shear Meadow
Walkern Lodge
Storthfield
Raglan House
Chaseways
The Fountains*
Farm Lodge
The Limes*
St Augustines*
Locked Autism Hospital (Male)
Victoria House
Cambian Fairview
Cambian Churchill
Cambian Oaks
Learning Disability Day Services
ABI Rehabilitation Hospital (Male)
Risk management is a process that seeks
to harness the information and expertise
of the individuals within the organisation
and convert this into positive action to
reduce the possibility of incurring
misfortune or loss. It is a proactive
approach which addresses the activities
of Cambian, identifies the risks that exist,
assesses those for potential frequency
and severity, eliminates the risks that can
be eliminated. Where it is possible it seeks
to reduce the effect of such risk.
Cambian Lodge
Autism, SLD Schools
Asperger Schools
Risk Management should create: safer
practices, safer system of work and safer
premises, greater staff awareness of
danger and potential liability.
Hill House School**
Southlands School
Purbeck View School
Grateley House School**
The Forum School
The Wing Centre
Sheffield
Long Eaton
Learning Disability Residential Services
CAMHS - Tier 4 (Male)
Cambian Willows
Specialist Education and Care Services
*Hospitals have local community step-down houses
**Has associated transition post-19 services
Specialist Autism Services
Residential Services
Broughton House
The Fields
No.12 High Street
The Brambles
Elston House
The Gables
Fairways
Quality Accounts 2011/12
15
Cambian’s priorities for
Improvement 2011/2012
The Department of Health guidance
requires at least three priorities to be
identified for improvement. We have
chosen five broad areas on which to
report, as described below.
3
Cambian’s priorities for
Improvement 2011/2012
1.To provide services that comply with regulatory standards as set by the CQC, Health and Safety Executive, Environmental Health, Data Protection, professional regulators and all other regulators impacting on our work including those in Wales.
• To achieve ‘clean and green’
CQC ratings for all services
• To achieve 100% Outstanding
Ofsted inspections
• To achieve and maintain ISO 9001-2008 Quality Management System
• To deliver high data quality in line
with NHS governance toolkit.
2. To provide safe services.
• To develop and implement an externally managed whistleblowing policy.
3.To provide welcoming services,
giving choice, dignity and high
levels of customer service to our clients and patients.
• To achieve a patient satisfaction rating of greater that 90% as measured through CPA feedback
• To achieve ‘STAR AWARDS’ recognition
in each of our applicable services
4.To be a good employer so that staff members are trained, educated and motivated to provide the best available service.
• To deliver staff training through an online platform ensuring exceptional quality, consistency, monitoring and evaluation
• To roll out a new end to end recruitment process that will raise the benchmark
in the quality of staff we employ.
5.To provide clinically effective services ensuring the best possible opportunity for recovery and to evidence our success rates using recognised outcome measures, appropriate to each service line.
• To conduct a review of our Active CareTM model for mental health to further clinical effectiveness and outcomes
• To achieve Commissioning for Quality and Innovation (CQUIN) payment framework targets for all patients who fell under contracts where such conditions exist
• To develop Active CareTM for acquired brain injury (ABI)/CAMHS/Learning Disability/autism and Learning Disability Day Services patient groups.
• To actively promote a strong work
ethic across chronic enduring mental health patients.
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Quality Accounts 2011/12
Quality Accounts 2011/12
17
Cambian’s priorities for
Improvement 2011/2012
1
To provide services that comply with regulatory
standards as set by the CQC, Health and Safety
Executive, Environmental Health, Data Protection,
professional regulators and all other regulators
impacting on our work Including those in Wales.
These activities have all helped
complement Cambian’s efforts
to provide services that meet
and exceed the expectations
set by regulators.
•To achieve ‘clean and green’
CQC ratings for all services
Cambian opened our first hospital in 2004
and has since developed a significant
reputation for the quality services that we
provide. This has been endorsed by CQC over
many years. As we entered this reporting
period, the regulatory activity was energised by
the activities highlighted at Winterbourne View.
This had significant impact on the industry and
a renewed focus that Cambian welcomes.
The table below summaries the activity
findings for Cambian services:
Mental Health Services
Number of services
12
Number of inspections
13
Number of areas inspected
74
Number of areas standards
being met
52
Number of areas identified
for improvement
22
Enforcement action
0
Learning Disability Services
Number of services
22
Number of inspections
21
Number of areas inspected
109
Number of areas standards
being met
77
Number of areas identified
for improvement
32
Enforcement action
1
The table above demonstrates the high level
of compliance of CQC standards across our
services inspected. Where a compliance or
improvement action was indicated, progress
on the action plans to achieve the standards
is tracked and focused to ensure the rapid
resolution of any concern, Cambian work
collaboratively with host agencies alongside
the CQC with such action plans to ensure
we have transparency of progress action
being taken.
Cambian can demonstrate progress to
address areas raised by the CQC as concerns.
Most notably this can be demonstrated at
Walkern Lodge, the only Cambian Service
where the CQC took enforcement action. The
original CQC visit (Nov 11) was followed by
another unannounced inspection by the host
authority, Cambian worked together with this
authority the local safeguarding team and the
CQC. Walkern Lodge was re-inspected in
March 2012 and was found to be fully
compliant in all areas inspected.
With the Corporate Governance and
organisational learning that takes place within
Cambian we have been able to proactively
transfer best practice to all our services and
so learn from this enforcement action.
Cambian as with all providers, conducts 6
monthly unannounced Regulation 26 visits;
these support the CQC focus for quality
standards. These were all conducted in
2011/12 and were further supported by some
472 audits across all sites. These focused on
a range of activities that included amongst
other areas staffing levels, health and safety,
infection control, preventing suicide and
quality. These activities have all helped
complement Cambians efforts to provide
services that meet and exceed the
expectations set by regulators.
•To achieve 100% ‘Outstanding’ Ofsted inspections
outings, work experience and activities
involving local communities.
For over 30 years Cambian has been leading
the way in achieving outstanding results
and providing high quality education, care
and support for children and young adults
with autism and Asperger’s.
One of our goals for 2011/12 was to maintain
an Ofsted ‘outstanding’ rating for all of our
specialist education schools and we are
very pleased to confirm that this has been
achieved. The 2011/12 inspections with
overall results are set out in the table below.
Ambitious for the people in our care, we
continually push the boundaries of autism and
Asperger’s to ensure each child is achieving
their personal best. Cambian schools provide
a full range of therapies and activities to aid
learning, improve social and daily living skills
and promote personal growth.
These include equine therapy, music therapy,
art therapy, sports, cooking, life skills, holidays,
Quality Accounts 2011/12
Inspection
Date
Inspection type
Overall
Effectiveness
Including
Areas for
Development
Outcomes
for Children
and Young
People
Quality
of Care
Safeguarding
Children and
Young People
Leadership
and
Management
Equality
and
Diversity
Overall
Result
Oct 2011
Ofsted Social Care
•
•
•
•
•
•
•
Dec 2011
Ofsted Interim Social Care
•
•
•
•
•
•
•
Oct 2011
Ofsted Social Care
•
•
•
•
•
•
•
Mar 2012
Ofsted Social Care
•
•
•
•
•
•
•
Nov 2011
Full Ofsted
•
•
•
•
•
•
•
Feb 2012
Ofsted Social Care
•
•
•
•
•
•
•
Nov 2011
Full Ofsted/Residential
•
•
•
•
•
•
•
Teaching
•
•
•
•
•
•
•
Full Ofsted/Residential
•
•
•
•
•
•
•
Teaching
•
•
•
•
•
•
•
Ofsted Social Care
Inspection
•
•
•
•
•
•
•
Children Homes
The Forum School
Hill House School
Purbeck View School
Residential Special Schools
Southlands School
The Wing Centre
Grateley House School
18
Most of Cambian’s schools have now had
three or more ‘outstanding’ ratings in a row,
confirming Cambian’s position as a top-rank
provider of specialist education and care for
young people with autism. This development
also makes Cambian the only Group
specialising in autism education to receive
the top rating for each of its establishments.
Nov 2011
Mar 2012
Quality Accounts 2011/12
19
Cambian’s priorities for
Improvement 2011/2012
1
Cambian’s priorities for
Improvement 2011/2012
To provide services that comply with regulatory
standards as set by the CQC, Health and Safety
Executive, Environmental Health, Data Protection,
professional regulators and all other regulators
impacting on our work Including those in Wales.
Kilimanjaro here we come
One of our aims in specialist education is
to raise our students’ self esteem and to
empower them to deal with challenges.
To this end, a group of Southlands students
and staff are involved in an ambitious project
for 2011 which will see them climbing Mount
Kilimanjaro in Tanzania. Fundraising for the
project began in early 2011, with the expedition
planned for October 2011. Six Year Ten students
and four staff will climb the 6000 metre-high
mountain over seven to eight days, achieving
the experience of a lifetime. The team has
been involved in fitness training this year
and has already completed the Three Peaks
Challenge in preparation for this exciting event.
100% of our schools have achieved an OFSTED
outstanding rating during this reporting period.
• To achieve and maintain
ISO 9001-2008 Quality Management System
As a service provider we place great value
on good quality management systems and
believe that consistency and conformity in our
approach to standards can only be of benefit
to the people in our care. A comprehensive
approach to measuring outcomes gives us
confidence that our services are meeting the
needs and expectations of our customers
and also supports our drive for continuous
improvement. We welcome procedures for
independent, rigorous audit of our services.
ISO is one such international organisation
which facilitates international coordination
of industrial standards. It provides globally
recognised standards for good management
practice and services.
For some time, part of Cambian’s learning
disability service has merited ISO 9001 for
excellence in its quality management systems.
In 2010/11 this recognition was extended to
learning disability services in the Midlands
and to the whole of Cambian’s specialist
services in mental health.
•To deliver high dataquality in line with NHS governance toolkit
Governance requirements
At Cambian we understand how vitally
important it is to store patients’ information in
a safe and secure way. Considerable effort
and investment has gone into ensuring that
we have robust information management
structures and responsibilities in place. Our
Information Governance lead manager
ensures compliance with NHS requirements.
An understanding of and compliance with
information governance requirements has
also been introduced as part of all staff
contracts. The new e-learning online staff
training system is now fully operational and
contains a mandatory learning module on
information governance. This improves on
previous staff training and it has in-built
mechanisms for ensuring that modules have
been both completed and understood.
In 2011/12 the Cambian Group successfully
achieved level 2 in the NHS operating
standards for Information Governance.
Cambian is currently identifying a suitable
laptop disk encryption tool. This project will
result in all laptops being encrypted to NHS
Governance and ICO recommended security
levels. This project will be concluded by in 2013.
Cambian maintains an IG register for all assets
and carries out risk assessment on all new
solutions, be they hardware or software
orientated to ensure that Data protection and
Information confidentiality will not be at risk.
2
To provide safe services
By the very nature of the services that Cambian
provide we care for some of the UK’s most
vulnerable people. A safe service is essential
for such people and Cambian gives this priority
the uttermost attention.
Incident Rates
Incident reporting is encouraged within
Cambian and the comparative rates for each
service, month by month, are collected and
fed back to clinical teams. Trends are analysed
across the organisation as a routine part of the
comparison of the performance of individual
hospitals, as Cambian largely provides
identical services on different site so this
type of comparison is very meaningful.
The total number of incidents reported in the
period was 9.02 per 1,000 occupied bed days.
For comparison all NHS Mental Health Trusts
returning data to the National Patient Safety
Agency showed an average incident rate of
12.00 per 1,000 occupied bed days. These
data show that Cambian’s incident report is
below what is considered a national average.
The next section details only the more serious
incidents of a type targeted by the NHS for
elimination or marked reduction in incidence.
Deaths
One patient took their own life unexpectedly
whilst an inpatient. This case was reported to
the relevant authorities including the coroner.
This currently is still subject to a coroner's court
and findings.
No inpatients committed a homicide during
this period.
Three other deaths occurred due to natural
causes. These were not unexpected because
of the nature of the patients’ physical illness
but they were nevertheless subject to
independent reviews.
Non-fatal serious incidents
They are defined as incidents that are reportable
to the CQC as defined under CQC regulation
18. These include the deaths above. For the
reporting period these numbered 228, 10 of
these were AWOL incidents.
Cambian hospitals have no
mixed sex accommodation
and therefore all accommodation
is gender appropriate.
Age inappropriate admissions
No patient under 18 was admitted to adult
services during the period. Cambian now
operates inpatient adolescent beds registered
up to the age of 19 and a bed in this service is
always available.
Gender appropriate accommodation
Cambian Hospitals have no mixed sex
accommodation and therefore all
accommodation is gender appropriate.
All patients have their own bedroom (with
en -suite facilities) which they can use for
quiet time during the day. There are also day
rooms and outdoor areas which can be used
for socialising in single or mixed sex groups
(if this is appropriate). All adult patients sign
an agreement on admission to respect others
personal space and confidentiality and this
is enforced by care and clinical staff.
Investment in high quality buildings and
facilities also plays a part in patient safety and
we will continue to invest in new, improved
and refurbished facilities in 2011/12. It is also
important to recruit, train and support staff
who share our values and passion. The
Cambian Board approved a new e-learning
training system, called Achieve, in May 2010
which will be fully implemented throughout
Cambian by summer 2011.
The aim of the new system is to provide
consistency in training across all sites and
departments and to improve the effectiveness
of training for staff at all levels. Achieve is a
corporate blended learning programme,
Level 2 NHS IG standards successfully
attained ISO 9001 standard achieved.
20
Quality Accounts 2011/12
Quality Accounts 2011/12
21
Cambian’s priorities for
Improvement 2011/2012
2
To provide safe services
based around e-learning, that will integrate
bespoke learning content with offline learning
opportunities.
It will support all staff development at Cambian
with consistent quality training, aligned with
corporate goals and values. In 2012/13 we will
continue to share best practice developments
in patient safety and risk assessment with
partners, families and other professionals
through our extensive seminar and conference
programmes, as in 2011/12. For example, we
ran two free workshops for parents, carers
and social workers in strategies to support
young people with autism and Asperger
Syndrome in Birmingham and London in
October 2011. We also ran workshops on Girls
and Asperger Syndrome, on Sex and
Relationships for young people with autism
and on mental health recovery in 2010 and
hosted open days at Cambian Delfryn Lodge,
Purbeck View School and Southlands School.
• To develop and implement
an externally managed
whistle-blowing policy
Cambian is committed to developing a culture
where it is safe and acceptable for all
employees to raise genuine concerns about
any malpractice and misconduct. Cambian
together with external advice of best practice,
set up and implemented a refresh of the
whistleblowing policy. This was implemented
across the organisation; It’s a key part of any
member of staffs induction, and through the
Cambian Achieve e-learning and is actively
advertised through poster campaigns.
The type of serious concerns at which this
policy is aimed includes:
• Suspicions or allegations of abuse or potential harm to the individuals in our care, which for some reason cannot be raised under the normal safeguarding procedure
22
Cambian’s priorities for
Improvement 2011/2012
Quality Accounts 2011/12
3
• Fraud
• Financial irregularities
• Corruption, bribery or dishonesty
• Criminal activities
• Serious irregularities such as failing to comply with a legal obligation and creating or ignoring a serious risk to health and safety or the environment.
• A deliberate ‘cover up’ of any of the above
• Issues that are not being dealt with
through clinical governance reviews
or other legitimate routes.
If the employee is concerned that his/her line
manager is involved in the wrongdoing, has
failed to make a proper investigation or has
failed to report the outcome of the
investigations to the Board, he/she should
inform a more senior manager, a Director of
the organisation or contact the Cambian
Whistleblowing Hotline – on 0844 264 0919
who will arrange for another manager to
review the investigation carried out, make any
necessary enquiries and make his/her own
report to a senior person in the company.
Any approach to the Director or Hotline will
be treated with the strictest confidence and
the employee’s identity will not be disclosed
without his/her prior consent, unless this is
required by law.
Evidence of the understanding of this policy
can be seen in the CQC reports for the
period. To date we have had three calls to
this number, each call was followed up in
full to the satisfaction of the caller.
To provide welcoming services,
giving choice, dignity and high
levels of customer service to our
clients and patients.
•To achieve a patient satisfaction rating of greater that 90% as measured through CPA feedback
plans, regular patient meetings and forums,
advocacy meetings and informal
communications with patients and families.
We know that when people come to us for
care and treatment they are often at their most
vulnerable. Our role, in addition to keeping
them safe and aiding their rehabilitation, is
also to make them feel valued, and to build
their feelings of self-esteem and self-worth.
Through our everyday interactions, we have to
show our patients that they and their views are
important and that all our staff members will
treat them with dignity and respect. For many
of our patients, our hospitals may be a place
of sanctuary and somewhere where they feel
safe as well as a home and a place of
recovery.
During this reporting period we achieved
a patient satisfaction rating score of greater
than 90% in the 26 of our services where this
data was reported. Whilst we are pleased
with this result, we want to improve on this
in the coming year.
We aim to communicate these principles to
our patients both in the way we interact with
them and care for them and also through the
environments that we create for them. One of
our most important priorities is to invest in
attractive buildings, environments, interiors
and facilities so that both patients and staff feel
that they are valued. We provide a wide range
of therapies and activities for our patients, from
walking groups, gym sessions, pet therapy,
music, computing, life skills, work experience,
outings, cookery and healthy eating, to aid
their rehabilitation and well-being and
promote involvement with local communities.
Patient choice extends to meal times, activities
and menus as well as to active involvement in
their own care plans. Respect for individual
religious and cultural preferences and the
active involvement of families is also seen as
vital. In order to improve the services we offer
to our patients, we complete group-wide
satisfaction surveys with those patients who
are able to participate. Input is gathered
through a number of communication channels
both formal and informal, including care
We achieved a patient
satisfaction rating score
of greater than 90% in
26 of our services
These data were supported by local patient
satisfaction surveys and those conducted by
independent advocates. In the East of England
this was conducted and compiled by
representatives of Advent Advocacy. A total
of 55 surveys sent out in March 2012 were
collected and analysed. Surveys were
collected from Cambian Fairview, Walkern
Lodge, Shear Meadow, Farm Lodge,
Chaseways, The Gables and The Brambles.
The results show 89% felt they could complain
if they were not happy with the support
they received and Overall 87% stated they
were satisfied with the service they receive
from Cambian.
• To achieve ‘STAR AWARDS’ recognition in each of our applicable services
Launched in late 2009 and supported by the
National Patient Safety Agency, Star Wards,
Rethink, the Royal College of Nursing, Royal
College of Psychiatrists, The Sainsbury Centre
for Mental Health, The British Psychological
Society, College of Occupational Therapists,
Shift, the National Mental Health Development
Unit and the Mental Health Network. Star
Awards, founded by Marion Jenner, covers five
areas; tackling stigma, promoting recovery
and inclusion, commissioning and providing
better care, supporting the development of
specialist workforce and the promotion of
research and development.
Quality Accounts 2011/12
23
Cambian’s priorities for
Improvement 2011/2012
3
To provide welcoming services,
giving choice, dignity and high
levels of customer service to our
clients and patients.
50%
of patients took part in our
working practices programme
30%
took on a part time job
5%
took on a full time job
24
Quality Accounts 2011/12
All Cambian Mental Health Hospitals currently
hold and have through 2011/2012 been
reaccredited as achieving the Star Awards
standard. We are also pleased that where
every dimension is met Hospitals are able to
achieve “The full Monty award” – Cambian
Victoria House, St Augustines, Sedgley, The
Aspens, The Fountains, The Limes, Raglan
House, Storthfield, Sherwood, St Teilo and
Delfryn House and Lodge all hold this accolade.
• To actively promote a strong work ethic across chronic enduring mental health patients
Chronic mental health problems can lead to
feelings of low self-esteem, social isolation
and an inability to function well in daily life.
These problems in turn can create a vicious
circle whereby patients lose motivation and
the inclination to engage, resulting in further
barriers to rehabilitation. To this end, Cambian
aimed to improve patient care in 2011/12 by
introducing a strong work ethic amongst
patients. This was to be realised through
occupational therapy and daily and social
skills development, with support for patients’
engagement in vocational training, college
courses, work experience and engagement
in community activities. Our aim in the first
instance was to have 10% of patients
undertake and complete a college course
or alternatively to take full or part-time
employment with a local charity organization
and gain therapeutic earnings.
What we did
Our occupational therapy teams developed a
programme that would significantly enhance
working practices for patients. Patients who
were most likely to benefit or who were at a
suitable stage in their rehabilitation, received
support to write their CVs and also completed
mock interviews. Individual patients were
coached to help them with applications and a
Support at Work programme was developed.
Cambian staff liaised with local employers and
charities to maximise opportunities for patients
to take on work.
What we achieved
50% of patients took part in this programme in
2011/12 with 5% taking on a full time job and
no longer needing to claim benefits, and 30%
taking on a part-time job. Therapeutic
earnings were introduced in some Cambian
homes and hospitals, including in homes for
people with learning disabilities, with patients
working in on-site shops, gardens and beauty
salons. This enabled staff members to support
patients in developing positive attitudes to
work and in experiencing the many benefits
of paid work. We are very pleased with these
results; however we recognise that if the
benefit system in the UK were slightly different
then we would have seen a greater number
of people taking on employment.
Therapeutic earnings were
introduced in some Cambian
homes and hospitals, including
in homes for people with learning
disabilities, with patients working
in on-site shops, gardens and
beauty salons.
Quality Accounts 2011/12
25
Cambian’s priorities for
Improvement 2011/2012
4
To be a good employer so that staff
members are trained, educated
and motivated to provide the best
available service.
•To deliver staff training through
an online platform ensuring exceptional quality, consistency, monitoring and evaluation
l
e
In 2010/11 Cambian worked to develop an
improved staff training programme, called
Achieve. Achieve includes a blend of learning
opportunities, available online, in the
classroom and in the workplace, accessed
through a new e-learning portal. It features
courses, adapted for different roles within the
organisation, which allow staff members to
learn at their own pace and speed. To support
the Achieve programme Cambian is
enhancing the IT infrastructure across the
group and giving staff improved access to
computers, the internet and learning methods
and resources. Training modules were created
as part of the programme in areas such as
care skills and knowledge, safeguarding,
health and safety, infection control, food safety
and dealing with concerns at work.
In 2012 / 13 additional courses will also be
developed to continue to build the capability
of Cambian’s workforce.
Achieve enables both new, existing staff
and managers to track learning and progress
over time and ensure that key policies and
procedures have been learnt and understood.
The new learning materials are both
interactive and engaging, and also record
individual training achievements. Achieve,
launched across the group in May 2011.
The recruitment strategy for Support Workers is
based upon the maxim of ‘recruiting for values
and training for skills’. Over 50% of Support
workers (supported by supervision, appraisal
and performance management systems) are
promoted within the first year and more senior
grades such as Assistant Team Managers and
Teams Managers are typically promoted from
the ranks, hence our bank of Support Workers
are viewed as the talent pool for more senior
positions in another time period.
Over 3,300 staff are active users, to date
completing some 26,000 training modules
with 76% of staff having completed all their
assigned e-learning. This represents
approaching 35,000 training hours equivalent
26
Quality Accounts 2011/12
to one module being completed every 12
minutes. This programme was recognized
for excellence as a Gold winner, E-learning
Awards 2011.
•To roll out a new end to end recruitment process that will raise the benchmark in the quality of staff we employ
Annually the Cambian Group recruits over 400
new recruits per year and receives over 8,000
applications to fill these positions. The largest
requirement is for Support Workers which
number 60% of Cambian employees and are
the back bone of the care we provide within
our organisation. Support Workers are
recruited through direct recruit campaigns
which funnels candidate applications through
our new online Applicant Tracking System (ATS).
The Engage System (ATS) is the gateway for
candidate applications, with the recruitment
message being communicated through a
combination of roadside posters, online job
postings and a comprehensive print and
media campaign. The Engage System
facilitates recruitment of staff across the group
and ensures that core recruitment processes
from initial attraction through screening;
interviewing and job offer is as efficient as
possible. Importantly it also monitors
references and Criminal Recording Bureau
checks which need to completed before any
job offer is confirmed.
The reference checking of new staff is part of
the recruitment process and needs to be 100%
accurate as staff work with vulnerable children
and adults. The reference checking is
processed through online Criminal Recording
Bureau checking which complete 81% of
online CRBs within 10 working days. The
Engage System also controls the two week
induction training which all new recruits need
to complete so that they all of the skills
necessary to complete their role.
76%
of staff completed all their
assigned e-learning
50%
of Support Workers* are
promoted within the first year
81%
of CRBs are completed within
10 working days
With the turnover of staff along with the growth
programme at Cambian this new initiative
ensure that we are able to support services
with the staff that they require, and these staff
are well vetted and checked prior to joining the
organisation ensuring the safety of the people
in our care.
*supported by supervision, appraisal and performance management systems)
Quality Accounts 2011/12
27
Cambian’s priorities for
Improvement 2011/2012
5
To provide clinically effective services
ensuring the best possible opportunity
for recovery and to evidence our
success rates using recognised
outcome measures, appropriate to
each service line.
•To conduct a review of our
Active CareTM model for mental health to further clinical effectiveness and outcomes
In 2010/11 we reviewed our Active Care™
Model for mental health patients. Improvement
in mental health is sometimes hard to assess.
We believed that a set of objective measures
should be used to monitor every aspect of
improvement and each area of focus. The
unique Active Care™ programme combines
intensive rehabilitation therapy with patient
centred plans determined by individual needs
and allows progress in all areas of life to be
measured. The model uses an evidence based
approach to measure step-by-step, active
inputs from multi-disciplinary teams (MDT) and
their influence on recovery and progress.
Improvements can be celebrated and
consolidated and areas of difficulty can be
identified, with new objectives set.
At its heart the Active CareTM
model aims to reduce patients’
length of stay and make sure that
patients are kept safe by reducing
risk to themselves and others.
28
Quality Accounts 2011/12
At its heart the Active Care™ model aims to
reduce patients’ length of stay and make sure
that patients are kept safe by reducing risk to
themselves and others. The Active Care™
model aims to help patients to improve their
daily living and life skills and their involvement
in constructive activities such as volunteering
and work. It also aims to assist patients with
better medication management and
compliance and to reduce rates of relapse
and risk.
How the Active Care™ model
was refined
Cambian’s Active Care™ consists of goals,
modules and measurement scales for multidisciplinary inputs, including Psychiatry,
Occupational Therapy, Psychology and
Nursing. The information allows the MDT to
reference a patient’s progress in individual
areas over time and patients can also see that
they are making progress towards
rehabilitation.
Using the Global Assessment of Functioning
as its starting point, the model was developed,
tested and refined over several months to
ensure that it was fit for purpose. It was also
subjected to peer group review by both
internal and external specialists. In particular,
the occupational therapy tools were further
developed and refined for use with mental
health patients and the scoring of
occupational therapy tools was improved. For
example, the Active Care™ now includes
measures for road safety and travel
capabilities, backed by training, as well as
community involvement activities and personal
budgeting. Daily Living Skills include help with
shopping, laundry, cooking, healthy eating
and personal hygiene, with a view to patients
achieving the everyday skills they will need for
independent living.
Cambian Group Psychiatrists and
Psychologists collaborated with the Institute of
Psychiatry at The Maudsley Hospital and
King’s College, London on an academic
research project examining social functioning
in patients with schizophrenia. The aim of the
research was to improve treatment outcomes
for patients with schizophrenia.
Quality Accounts 2011/12
29
Cambian’s priorities for
Improvement 2011/2012
5
To provide clinically effective services
ensuring the best possible opportunity
for recovery and to evidence our
success rates using recognised
outcome measures, appropriate to
each service line.
Results so far
In 2011/12 86% of discharges have resulted
in patients returning to lower cost community
based services and the average length of stay
across Cambian services has been 18 months.
41% of discharges have been direct to
independent living, 22% of people leaving
our care have gone to supported living
accommodation, 13% have gone on to live
semi-independently and 9% have returned
to their families. Staff members have reported
that care planning has improved and that
patients are more engaged with their therapy.
This review is still on-going over a two-year
period and therefore concrete statistics are
not yet available. We will include these in our
priorities for 2011/12.
•To achieve Commissioning for Quality and Innovation (CQUIN) payment framework targets for all patients who fell under contracts where such conditions exist.
A proportion of Cambian Group’s income
1 April 2011 to 31 March 2012 was conditional
on achieving quality improvement and
innovation goals agreed between Cambian
Group and any person or body they entered
into a contract, for the provision of NHS
services, through the Commissioning for
Quality and Innovation payment framework.
Such measures included >25 hours
meaningful activities / week and the
submission of the Mental Health Minimum
Dataset and outcomes for contracted patients.
Where we have an NHS Standard Contract
in place and have included CQUIN as part
of that contract we have achieved all 100%
of all CQUIN’s.
•To develop Active Care for ABI/ Learning Disability/autism and Learning Disability Day Services patient groups
In 2011/12 Cambian worked on developing
and launching five new specialist care and
rehabilitation services for patients with an ABI,
CAMHS, Learning Disability, autism and
Learning Disability day opportunities. This
development was based on translating the
methodology of Active Care™ to these target
services. Each of these have been developed
using a multi-disciplinary team approach and
they have all been implemented in 2011 /
2012.
Our approach
This approach was replicated across the
other disciplines and the table below sets
out the professionals associated with these
new services.
The following describes the methodology used
to develop the ABI service which was a similar
approach to the other services:
People with ABI have a significant chance
of developing some form of mental health
problem. Dealing with a mental health issue
on top of an ABI can be very complex, especially
if the problem goes undiagnosed or untreated.
Mental health conditions can be hard to detect
amid the effects of an ABI and can dramatically
hinder a person’s ability to function well. People
with ABI may exhibit a range of challenging
behaviours, such as lack of impulse control
and aggression. Severe depression or
psychosis can also occur and can present
a risk to both the patient and others.
In 2010/11 Cambian developed a model of
care to address the very specific needs of this
patient group. This model involves input from
a multi-disciplinary team consisting of
Psychiatrists, Psychologists, Occupational
Therapists, Speech and Language Therapists
and Neurologists. The challenge was to adapt
Cambian’s Active Care™ model to create
outcome measurements for the use of both
patients and staff.
Professional Inputs Across Cambian Services
ABI
CAMHS
- Tier 4
Learning
Disability
Autism
Psychiatry
•
•
•
•
Psychology
•
•
•
•
Occupational Therapy
•
•
•
•
•
Nursing
•
•
•
•
•
SALT
•
•
•
•
Social Worker
•
Teacher
•
Physiotherapy
30
Quality Accounts 2011/12
Best practice in current
treatments for ABI were
evaluated with a view to
developing an Active CareTM
model for ABI patients and a
specialist multi-disciplinary
team was created
Cambian’s Medical Director and Heads of
Department undertook detailed research into
specialist care for patients with an acquired
brain injury. Best practice in current treatments
for ABI were evaluated with a view to
developing an Active Care™ model for ABI
patients and a specialist multi-disciplinary
team was recruited, this service has now
opened and once fully established it will be
evaluated in 2012.
LD Day
Opportunities
•
Quality Accounts 2011/12
31
Cambian’s priorities for
Improvement 2012/2013
After completion of our 2011/2012
accounts as a Board we set out
below our focus for our priorities
in 2012/2013
4
Cambian’s priorities for
Improvement 2012/2013
1. To provide services that comply with regulatory standards as set by the CQC, Health and Safety Executive, Environmental Health, Data Protection, professional regulators and all other regulators impacting
on our work Including those in Wales.
• To achieve ‘clean and green’ CQC
ratings for all services
• To maintain ISO 9001-2008 Quality Management System
• To deliver high data quality in line with
NHS governance toolkit
• To develop and advise an external Health and Safety compliance rating system
across all our services
• To review and further develop our internal audit, registration and governance function.
2.To provide safe services.
• To improve the safety of services for the people in our care by reducing serious
and untoward incidents
• To reduce absconscions from our
CAMHS service by 30%
• To review and enhance our
whistleblowing policy.
3.To provide welcoming services, giving choice, dignity and high levels of customer service to our clients and patients.
• To further improve the personalisation of care planning across MH & LD services
• To achieve a patient satisfaction rating
of greater that 90% as measured through CPA feedback
• To achieve ‘STAR AWARDS - Full Monty’ recognition in each of our applicable services and ensure that service users are actively involved in discussions and decisions about their care treatment and how service that we develop are run
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Quality Accounts 2011/12
• To further develop our customer intimacy strategies across all our services, including building on the improvements that we have seen in surveys and feedback from people in our care, their family carers and funders.
4.To be a good employer so that staff members
are trained, educated and motivated to provide the best available service.
• To align to the GMC revalidation for all doctors with individualised clinical governance data. To include; the full approval of policies and procedures by
June 2012, 75% of appraisers trained
by end 2102, 100% of doctors revalidated
by end 2012
• To reduce staff turnover across Cambian MDT team
• To implement staffing strategies that maximise patient engagement and
staff effectiveness
• To improve resources planning to ensure that staffing level are commensurate with patient throughput.
5.To provide clinically effective services ensuring the best possible opportunity for recovery and to evidence our success rates using recognised outcome measures, appropriate to each service line.
• To review of our outcome metrics so that they are aligned to customer needs, this will include amongst other areas measures on social inclusion
• To develop and implement a clinical model to support the recovery and outcome for two services, our CAMHS Tier 4 service and for female mental health rehabilitation patients who have personality disorder
• To develop and implement a process to measure progress and outcomes in our autism service.
Quality Accounts 2011/12
33
Statements
‘These Quality Accounts contain
a wide breadth of both internal
and external systems and
‘involvements’ which should
serve to generate a high level of
safety for your patient and
student group, along with
measures to improve quality.
Careful audit and ‘involvements’
are critical to minimise risk and to
ensure systems are operating as
they should. Risk cannot
unfortunately be eradicated.
However you are ahead of many
others in the field by having an
external, independent chair for
the quarterly governance
meetings.’
Andrew Parsons
Partner of Radcliffes LeBrasseur
‘As the coordinating commissioner
for East Midlands PCTs, we have
reviewed Cambian’s Quality
Accounts and in light of our
commissioning experience I can
confirm that Cambian Quality
Accounts are correct although
they have not been fully audited.’
David Gardner
Head of Procurement and
Contracts, Hardwick Clinical
Commissioning Group
Jim Connolly
Chief Nurse, Hardwick Clinical
Commissioning Group
I am delighted to have awarded all Cambian
Hospitals with Full Monty Star Awards over the
recent years. Gaining these awards is testimony to
the fantastic work that they do and the results they
are able to achieve with mentally ill people. The
experience, care and clinical inputs they provide for
each person along with their Hospital environments
are truly unique, as a service user and a champion
I am delighted with the work that they do.
Marion Janner, Star Wards
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Quality Accounts 2011/12
Quality Accounts 2011/12
35
Our Services
One of the UK's leading providers
of specialist education and care,
mental health rehabilitation and
learning disabilities.
Cambian Group
Specialist Services
Education and care
Mental Health Rehabilitation
CAMHS
Darlington
Learning Disabilities
York
Blackburn
Leeds
Doncaster
Liverpool
Sheffield
Mold
Stoke-on-Trent
Nottingham
Peterborough
Wolverhampton
Birmingham
Cambridge
Tewkesbury
Cardiff
Colchester
Bristol
London
Southampton
Exeter
Bournemouth
The Cambian Group
Working with over 140 public authorities in the UK to provide
specialist services in education, mental health rehabilitation
and learning disabilities.
The Cambian Group comprises a number of companies which are
registered in England and Wales and the Bailiwick of Jersey. The details
of those companies in the Cambian Group registered in England and
Wales can be found at www.cambiangroup.com/about/legal
www.cambiangroup.com
CAM213
of preparation
10/04/12
Quality Date
Accounts
2011/12
36