Barchester Healthcare’s
Independent Hospital Services
Quality Account
2013–2014
Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Introduction
Barchester Healthcare is pleased to report back on the 2012 to 2013 Quality Account
from our independent hospital services, and to set new targets for 2013 to 2014.
This document provides a basis for all stakeholders involved with our hospitals to look back
over and reflect upon the quality improvements we have made over the past year, and
to plan actions for the improvements we have set ourselves going forward into next year.
I founded Barchester Healthcare as a member of a family with caring responsibilities
myself, because I was so dissatisfied with the care facilities available at the time. I have
always wanted to ensure that Barchester delivers the very best in quality care. Our
independent hospital’s Quality Account for 2012 to 2013 was an important contribution
to positive change. Though we did not meet all our targets we made significant progress
in all areas – and we are increasingly focused on what we need to do to achieve targets in
the future: we know where more work is needed and what kind of approach we need to
take to make sure targets are delivered upon. Much of the value of a Quality Account is
the help they offer services in measuring progress objectively, identifying problems,
thinking through and planning new approaches. They are iterative, too, which is to say
that we get better at them as we repeat the processes involved over time.
Moving forward to the Quality Account for 2013 to 2014, we have identified five
areas of improvement that we believe will improve quality within our services, based
on discussions with the individuals we support, their families and carers, our staff and
other stakeholders. These initiatives are chosen from within the domains of Good
Mental Health, Recovery, Good Physical Health, Patient Safety, Positive Experience of
Care, Reduction in Avoidable Harm and Reduction in Stigma, areas for improvement
across England overall, identified by the Department of Health as part of their
‘No Health Without Mental Health’ initiative.
We are committed to open and transparent working practices, reporting on what we
do, and on where we need to improve. Quality is always evolving, responding to
changes in values, expectations and perceptions. We are committed to measuring and
reviewing our planned outcomes regularly, to adapting them wherever necessary, and
ensuring that the service given to our patients, staff and other stakeholders is based on
best practice. As a result, planning for improvements on the basis of working with a
Quality Account is a useful and natural approach for our organisation.
I can confirm that the content of this report has been reviewed by the Barchester
Executive Committee in June 2013 and to the best of our knowledge the information
contained in it is accurate.
I would like to take this opportunity to thank all those involved in providing
feedback, ideas or actions for our Quality Account. This includes the individuals we
support, relatives, friends, our staff and internal and external stakeholders, particularly
commissioners and visiting care professionals. Without their input the progress we
have made towards our aims and objectives would not have been possible.
Mike Parsons
Founder and CEO, Barchester Healthcare,
On behalf of the Executive Committee.
It is not always easy to involve stakeholders. For example, some of the people we offer
services to do not find it easy to communicate. Some of the health professionals who
commission those services struggle to find the time to be involved with the Quality
Account planning process.
For 2013 to 2014 one of the challenges we have set ourselves is to increase involvement
in our Quality Review Panel meetings. Nonetheless, I know that the Quality Account
initiative is actively owned by the individuals we help support, and by relatives, friends
and care professionals involved in that support. There has been eagerness and
enthusiasm for involvement in the Quality Review Panels, and our hospitals have
worked inventively to make the most of the opportunities the process offers.
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Statement of Accuracy of our Quality Account
We have also introduced new reporting metrics for the hospital services.
Directors of organisations providing hospital services have an obligation under the
2009 Health Act, National Health Service (Quality Accounts) Regulations 2010 and
the National Health Service (Quality Accounts) Amendment Regulation 2011 to prepare
a Quality Account for each financial year. Guidance has been issued by the Department
of Health setting out these legal requirements.
Examples include:
• Risk registers for the use of physical intervention
• Monitoring and reporting against the use of anti-psychotics,
and psychotropic medications.
In that context we need to formally record that over the period covered by the Quality
Account for 2012 to 2013 Barchester Healthcare provided NHS mental health services
within its seven independent hospital sites. 100% of the total income generated by
these services was procured through Barchester providing care and treatment to those
in need on behalf of the NHS.
Monitoring and reporting progress
The Barchester sub-board Quality and Clinical Governance Committee and its Review
Panel meet at least every month between them. They regularly review the quality and
risk profiles covering all service provision, including mental health service provision.
The Committee identifies any areas of care practice that need improvement.
It links with the Hospital Quality and Governance Committee to make sure that
action plans are put in place to improve service delivery and maintain safety.
The Committee also reviews reports on progress and challenges to these action plans.
As Chair of the Hospital Quality and Governance Committee I am responsible for its link
to the sub-board Quality and Clinical Governance group. The Hospital Quality and
Governance Committee is the key body for driving quality improvements across all our
independent hospitals. Our meetings are quarterly and there are a number of sub work
groups to the main Committee, which drive forward quality and governance projects in
between formal Committee meetings.
We have introduced early warning systems to monitor for increases in the use of antipsychotic medication and increases in the use of restraint. We review data to look for
patterns that alert us to a change in patient status.
Our strategy is based on national policy initiatives, internal regulatory compliance and
Quality Account priorities. Our Committee reviews and plans its performance to meet
the requirements of NHS commissioning bodies. Plans are shaped by Commissioning
for Quality and Innovation (CQUIN) standards and its agreed priorities.
Barchester’s independent hospitals work hard to continually improve patient
experience through monthly clinical governance meetings, patient forums, input
from clinical review teams and quality improvement initiatives. As with Barchester’s
corporate clinical governance more generally, local governance Committees are made
up by multi-disciplinary representatives.
Throughout 2012 to 2013 the Independent Hospitals ran monthly clinical audits as
part of quality checks based on our Quality Account.
We have seven independent hospitals based primarily in the north of England.
They are: Arbour Lodge in Stockport, Billingham Grange in Billingham, Castle Care
Village in Hull, Forest Hospital in Mansfield, Jasmine Court in Waltham Abbey,
South View in Billingham and Windermere House in Hull.
In the last six months we have redeveloped our hospital clinical governance reporting
metrics and KPIs to ensure that we are collecting relevant and accurate data that can
drive practice and quality development.
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Our hospital services are commissioned by the NHS. We work closely with our
commissioners to deliver local services for people with mental health needs, providing
a care pathway into the community. We have collaborative partnerships with NHS
Mental Health Foundation Trusts who we in turn commission through a service level
agreement for the provision of psychiatry and other clinical services into our hospitals.
For 2012 to 2013 most of our established hospitals were able to achieve the majority
of their goals. However, it must be noted that Forest Hospital, which opened in
March 2013 could not engage realistically with the Quality Account goals; also Castle
Lodge Hospital and Jasmine Court had to focus on service and management issues
which restricted their ability to move Quality Accounts forward. All have learned
lessons by taking part in increasingly focused Quality and Governance Committee
meetings, however, and all will go forward into the 2013–2014 Quality Account
cycle with more confidence.
We value our shared working relationships with our partners in the NHS and
appreciate the contribution that accurate reporting through our Quality Account
makes to it, and to the quality of the services we offer.
Jim Marr, Director of Care & Quality
Paul Hayes, Chair – National Hospital Quality & Governance Committee
On behalf of Barchester Healthcare.
It is in the nature of working towards fixed targets across a variety of independent
hospitals that progress will not be equal in all respects, particularly given that our
hospitals have differing client groups and so differing priorities in terms of the targets
set. We have tried to reflect these differences in our reporting below.
We have achieved some important successes, though we have not met all our targets:
some of our key achievements against the action plans in our Quality Account for
2012 to 2013 are detailed on the next page.
Based on health outcome 5: Treating and caring for people in
a safe environment and protecting them from avoidable harm:
Part One
How we performed last year (2012 to 2013)
This section of the Quality Account for Barchester's independent hospitals reviews our
performance over the last year, running from March 2012 to March 2013 but reported
on in June, following Department of Health guidelines. Overall, we worked hard to
meet the targets we set ourselves. Comparing the 2012–2013 Quality Account to its
predecessor shows that we have met more targets, that we are better focused on the
issues and that our reporting has improved. There is still considerable progress to be
made, however: Quality Account meetings need to become more embedded as part of
our routines, Quality Groups need to establish themselves as forces for change and our
reporting and monitoring must become more focused.
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1. To ensure each hospital has a robust framework to support appropriate
physical interventions when managing challenging behaviours, reflecting
evidence-based best practice.
To achieve this we agreed we would:
• Audit training models
• Review the training content and its delivery, in keeping with the safe practice
guidelines, evidence-based best practice and the requirements of the service
• Review the audit processes and documentation for incident management
• Review our training methods, setting a consistent standard across the service
• Review and revise our approach and documentation where necessary, using
feedback and direction from forums for the people we support and their
relatives, audits, staff meetings and Clinical Governance meetings
• Integrate the new approach and documentation into a new clinical database
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Our targets:
• By three months we agreed we would have reviewed the appropriateness of
the various models in use prior to review
• By six months we agreed we would agree and identify appropriate model
for our services
• By nine months we agreed we would review the documentation to support
the models
• By twelve months we agreed all services would have an agreed model,
with appropriate documentation to support it
• By twelve months we agreed 100% of personal care plans would be discussed
and staff would be familiar with appropriate techniques for minimising
violent and aggressive incidents
Did we achieve our targets?
This target was met.
Barchester Healthcare took action to improve the percentage of personal care plans
linked to appropriate techniques for minimising violence and aggression and so the
quality of its services, by ensuring that all hospitals now use one of two approved
models, either GS (General Services) or NAPPI. Both have been approved by the
Hospital Quality and Governance Committee and have been linked to review of
personal care plans. Training is ongoing.
Barchester Healthcare considers that this data is as described for the following reasons:
relevant data was collected by independent hospital General Managers, discussed at
Quality Review Panel meetings, reported to the Quality and Clinical Governance
Committee and reviewed by the Review Panel.
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Based on health outcome 3: Ensuring people have a positive
experience of care:
2. Introduce non-invasive complementary therapies as a choice within
all the hospital settings
To achieve this we agreed we would:
• Audit complementary therapies currently used within our services
• Ask the people we support about complementary therapies and establish
a baseline for what we should offer
• Ensure that personal care plans identify where individuals would like or
might benefit from complementary therapies
• Identify internal and external capacity to provide complementary therapies
• Measure self-rated well-being with the people we support and review the
effectiveness of complementary therapies
Our targets
• By three months we agreed we would review the current complementary
services within our services
• By six months we agreed personal care plans would establish what
complementary therapies individuals would like to be offered
• By nine months we agreed we would identify internal and external
therapists and provide complementary therapies requested
• By twelve months we agreed we would review the benefits of complementary
therapies with the people we supported including people accessing
complementary therapies away from the hospital environment
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Did we achieve our targets?
This target was largely met.
Barchester Healthcare has taken the following actions to improve the percentage of
personal care plans linked to offers of alternative therapies and the number of therapists
available and so the quality of its services, by reviewing personal care plans and
making relevant therapists available.
Of participating hospitals, two met all targets. One hospital met almost all targets but
has yet to implement complementary therapy sessions. One hospital reviewed the target
against individual care plans but concluded that the approach was inappropriate for
their service users.
Barchester Healthcare considers that this data is as described for the following reasons:
relevant data was collected by independent hospital General Managers, discussed at
Quality Review Panel meetings, reported to the Quality and Clinical Governance
Committee and reviewed by the Review Panel.
Based on health outcome 4: Ensure people have a positive
experience of care:
3. Introduce a training package for staff, which will facilitate a better
understanding of personal needs, culture and diversity, eliminating
stigmatising language or practices.
To achieve this we agreed we would:
• Audit staff interaction and communications with the people we support
through the use of observational tools to identify positive, negative or
potentially stigmatising language or behaviours
• Review how we were meeting personal, cultural and spiritual needs for
the individuals we support
• Undertake a needs analysis among our staff group to ascertain their
knowledge and understanding of personal needs
• Review research and practices with our learning and development team,
review training packages, refreshing and developing them where appropriate
• Review the effectiveness of our training and the personal care plans based upon
it with the people we support, their relatives, staff and other stakeholders
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Our targets
• By three months we agreed we would audit staff interactions and communications
with the people we supported to identify negative or potentially stigmatising
language or behaviours. We aimed to achieve this through the use of
observational tools.
• By six months we agreed we would devise a training package that supported
understanding and best practices in personalising care, diversity, cultural
awareness and avoiding stigmatisation
• By nine months we agreed we would introduce and make available a new
training package for all staff to access
• By twelve months we agreed all personal care plans would reflect best practice.
Reviews would take place with the people we supported and their families.
• By twelve months we agreed that 100% of our staff would undergo training
• By twelve months we agreed that 100% of our personal care plans would
better reflect personal, cultural and spiritual needs
Did we achieve our targets?
This target was partially met. It will be reviewed and revised for 2013–2014.
Barchester Healthcare took action to improve the percentage of personal care plans
reflecting best communicative practice and the number of training packages
supporting cultural awareness and so the quality of its services, by auditing staff
interactions, devising appropriate training packages, training staff and reviewing
personal care plans.
Of participating hospitals, one hospital met all targets. Three hospitals ran full or partial
audits of interactions, discussed issues with staff and revised care plans but could not
implement training packages.
Barchester Healthcare considers that this data is as described for the following reasons:
relevant data was collected by independent hospital General Managers, discussed at
Quality Review Panel meetings, reported to the Quality and Clinical Governance
Committee and reviewed by the Review Panel.
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Based on health outcome 4: Ensuring people have a positive
experience of care:
4. Develop and introduce improved communication systems for those individuals
we support who currently experience barriers to their ability to communicate.
To achieve this we agreed we would:
• Audit and evaluate the communication tools already in use across our services
This information would come through forums, clinical reviews, etc.
• Research the availability and success of alternative methods of communication
• Identify communication tools to be piloted within our services
• Identify individuals who would benefit from using particular communications
tools and implement their usage through individual care plans
• Review the effectiveness of communications tools on an individual basis,
through Clinical Governance meetings and Barchester’s Mental Health
Clinical Governance Group, revising approaches where appropriate
Our targets
• By three months we agreed we would audit and evaluate the communication
tools already in use across our services
• By six months we agreed we would identify communication tools to be
piloted within our services and identify individuals who would benefit from
using particular communications tools, implementing their usage through
personal care plans
• By twelve months we agreed we would review the effectiveness of
communications tools on an individual basis, through Clinical Governance
meetings and Barchester’s Mental Health Clinical Governance Group,
revising approaches where appropriate
Did we achieve our targets?
This target was partially met; work on it will continue.
Barchester Healthcare took action to improve the number of communication tools
available to our independent hospitals and so the quality of its services, by auditing and
reviewing available communications tools.
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Of participating homes, all carried out an audit. All carried out some reviews of
communication through individual care plans and some more general reviews of
communications techniques. More extensive matching of communications tools to
individual will be carried out.
Barchester Healthcare considers that this data is as described for the following reasons:
relevant data was collected by independent hospital General Managers, discussed at
Quality Review Panel meetings, reported to the Quality and Clinical Governance
Committee and reviewed by the Review Panel.
Based on health outcome 4: Ensuring people have a positive
experience of care:
5. Continue to work on developing regular Quality Review Panels across any
independent hospitals where they do not yet exist as forums for improving
services through input from the people we support, their relatives, staff and
other stakeholders, ensuring that all Quality Account targets are met.
To achieve this we agreed we would:
• Establish Quality Review Panel meetings in all independent hospitals to which
the people we support, relatives, carers and other stakeholders would be invited
on a quarterly basis
• Report back and review progress on all targets at minuted quarterly Quality
Review Panels
• Report Quality Review Panel views to Barchester’s Mental Health Clinical
Governance Group
Our targets
• By four months we agreed we would have held Quality Review Panel meetings
in all independent hospitals, with minutes going to Barchester’s Mental Health
Clinical Governance Group
• By twelve months we agreed we would have held three Quality Review Panel
meetings in all independent hospitals, with minutes going to Barchester’s
Mental Health Clinical Governance Group
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
• By twelve months we agreed we would review progress on all Quality Account
targets from 2011 to 2013
• By twelve months we agreed Quality Review Panels would be able to help shape
Quality Account targets for 2013 to 2014
3. We would demonstrate a minimum of 25 hours a week structured therapeutic
activity for each patient.
Did we achieve our targets?
This target was met.
This target was partially met. It will be reviewed and revised for 2013–2014.
Barchester Healthcare took action to increase the proportion of stakeholders involved
in decision making processes and so the quality of its services, by increasing the number
of Quality Review Panels and reporting back on progress to Barchester’s Mental Health
Clinical Governance Group.
Of participating hospitals all held at least one Quality Review Panel meeting, with
minutes going to Barchester’s Mental Health Clinical Governance Group. Quality
Review Panel meetings have informed target setting for 2013–2014 but some
elements of stakeholder involvement were disappointing.
Barchester Healthcare considers that this data is as described for the following reasons:
relevant data was collected by independent hospital General Managers, discussed at
Quality Review Panel meetings, reported to the Quality and Clinical Governance
Committee and reviewed by the Review Panel.
Hours were offered in all cases. It was personal choice of some service users
to decline the therapeutic activity hours offered.
4. We would review our information systems to ensure that the data we need to
routinely monitor for our Quality Account is provided through our centralised
information systems.
This target needs ongoing review but Clinical Governance Committee meetings are
gathering and discussing data effectively.
This target was met but is ongoing.
5. We would ensure that every hospital was audited on a quarterly basis to ensure
its ethical practice continued to develop across the 12-month period.
This target was met.
6. Each hospital would evidence two service improvements that have been made as a
result of direct consultation with people who use the service.
This target was partially met and needs review.
Targets from 2011 to 2012 for completion were:
1. Personalised Care Plans would be in place for everyone we supported
7. There would be a review of medication on admission and at monthly intervals for
all the people we support.
This target was met.
This target was met.
2. We would ensure that everyone was able to return to the community
as quickly as possible, with all agreed outcomes achieved.
Barchester Healthcare considers that this data is as described for the following reasons:
relevant data was collected by independent hospital General Managers, discussed at
Quality Review Panel meetings, reported to the Quality and Clinical Governance
Committee and reviewed by the Review Panel.
This target is ongoing.
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Part Two
Identified Priorities for Clinical Improvements in 2013–2014
The Department of Health’s Quality Account guidance requires that we identify at least
three priorities for improvement from the Department of Health’s ‘No Health without
Mental Health’ initiative. This encompasses a list of priority areas for improvement,
which for 2013 to 2014 involve working towards:
•
•
•
•
•
Good mental health
Recovery
Positive experience of care
Reduction in avoidable harm
Reduction in stigma
Having consulted with the people we support, relatives, staff and other stakeholders,
the independent hospitals’ Managers’ Forum and Barchester’s Mental Health Clinical
Governance Group have agreed three main work streams for 2013, which will be
developed by this group over the course of the year.
Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Our targets
Barchester Healthcare intends to take the following actions to improve the management
of mental and physical health of the people we support and so the quality of its services.
Currently our hospital services use a number of recovery models. In order to be able
to evidence outcomes in our hospitals and for people we support to be able to be better
involved in managing and tracking their outcomes our target is to develop our own
Barchester Recovery Star Models. The current number of people in our services using
a recovery star model is not currently recorded, so the target is that 80% of people in
our services will be using the Barchester Recovery Star model for evidencing outcomes
over 2013 to 2014.
• By six months we will develop outcome models for people living with dementia
with challenging behaviours and for younger people with mental health needs
• By nine months we will have piloted the outcome models
• By twelve months outcome models will be fully operational
• By twelve months we will plan review of outcome models
Based on the Department of Health’s ‘No Health without
Mental Health’ initiative, priority 2: Recovery:
Based on the Department of Health’s ‘No Health without
Mental Health’ initiative, priorities 3 and 4: Positive
experience of care, and Reduction in avoidable harm:
1. To develop Barchester Recovery Star Models for older people living with
dementia and dementia with challenging behaviours, and for younger people
with mental health needs.
2. Develop Risk Models at all hospitals, using models currently used in the hospital
services with links to our NHS Mental Health Hospital Trust collaborations
(e.g. GRIST, FACE and TARA).
To achieve this we agreed we would:
• Form a sub-Committee working group
• Involve service users and carers through Quality Review Panels
• Review best practice and develop models specific to each group
• Approve models through the Hospital Clinical Governance Quality Committee
• Review the effectiveness of the new models with service users, carers and
other stakeholders through Quality Review Panels reporting back to the
Hospital Clinical Governance Quality Committee
To achieve this we will:
• Pilot GRIST at Windermere and Castle Care Village
• Pilot FACE at Billingham Grange and South View
• Pilot TARA at Forest Hospital and Arbour Lodge
• Pilot Sainsbury Model at Jasmine Court
• Review the effectiveness of the new models with service users and relatives
where appropriate
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Our targets
Barchester Healthcare intends to take the following actions to increase the number
of supported individuals covered by Risk Models and so the quality of its services,
by introducing and piloting Risk Models in independent hospitals. While risk models
are currently in place in all of our hospitals, this work is aimed at improving practice
through directly operating the same model as each hospital’s NHS mental health
partnership trust that supports that hospital locally so that the management of risk
for clinicians is integrated with their working systems. The target is that 100% of
services will have piloted and implemented this over 2013 to 2014.
Based on the Patient Inclusion and Involvement Strategy and
the Department of Health’s ‘No Health without Mental Health’
initiative, priority 3: Positive experience of care:
• By three months models will be piloted in hospitals as above
• By six months models will be fully operational
• By twelve months models will be reviewed with stakeholders through
Quality Review Panels
Based on the Department of Health’s ‘No Health without Mental
Health’ initiative, priority 4: Prevention of avoidable harm:
3. For all hospitals to use one of two organisationally approved methods
of physical intervention (NAPPI or General Services GS).
To achieve this we will:
• Continue to develop Train the Trainers for NAPPI and GS
• Work with NAPPI and GS to ensure best practice and workforce development
Our targets
Barchester Healthcare intends to take the following actions to improve the number of
hospitals with accredited methods of physical intervention and so the quality of its
services, ensuring that 100% of hospitals have the accredited methods of physical
intervention by 2013/14.
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4. To develop one, user-led customer satisfaction and feedback survey that can be
used universally across all hospital services, ensuring that alternative formats exist
for all methods of communication.
To achieve this we will:
• Form a sub-Committee working group
• Involve service users and carers through Quality Action Planning groups
and Quality Review Panels
• Develop a customer satisfaction and feedback survey
• Evolve strategies for survey use involving alternatives to speech
• Review the effectiveness of the new survey for service users, carers and other
stakeholders through Quality Review Panels reporting back to the Hospital
Clinical Governance Quality Committee
Our targets
Barchester Healthcare intends to take the actions below to improve the percentage of
supported individuals able to express levels of satisfaction and give feedback on services
and so the quality of its services. This is a new initiative that Barchester is developing,
using elements of the NHS Friends and Family Test so there is currently no baseline for
the organisation but the target is to have developed a framework and system for user led
feedback that is offered to 100% of all individuals using our services, and to achieve a
50% response rate.
• By six months we will have developed an agreed customer satisfaction survey
• By nine months we will have piloted the satisfaction survey
• By twelve months the survey will be fully operational
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Based on the Experts by Experience initiative and the Department
of Health’s ‘No Health without Mental Health’ initiative, priorities
3 and 5: Positive experience of care, and Reduction in stigma:
Based on the Department of Health’s ‘No Health without Mental
Health’ initiative, priority 3: Positive experience of care:
5. Develop an Experts by Experience programme, based on real inclusion and
designed to involve Experts in business planning and design and delivery of
services, to be piloted at two hospitals.
To achieve this we will:
• Establish a project group in two hospitals to deliver Experts by Experience,
involving all stakeholders through Quality Action Groups and Quality
Review Panels
• Agree and develop a series of half-day workshops on Experts by Experience
for users of services (including potential Experts), staff, relatives and carers
(including potential Experts), and managers
• Review progress with all stakeholders through Quality Review Panels
• Implement pilot Expert by Experience schemes at two hospitals
Our targets
Barchester Healthcare intends to take the following actions to improve the number of
hospitals where stakeholders are involved in business planning, design and delivery of
services and so the quality of its services, by establishing an Experts by Experience
pilot schemes in two hospitals.
• By six months we will have developed an Experts by Experience project
group and appropriate half-day workshops
• By nine months we will have delivered the half-day workshops
• By twelve months pilot schemes will be established in two hospitals
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6. Introduce a training package for staff, which will facilitate a better
understanding of personal needs, culture and diversity, linked to the introduction
of Equalities Impact Assessments for all policies and all major service changes.
To achieve this we will:
• Agree an Equalities Impact Assessment format
• Agree a training package with Barchester Business School, incorporating training
on Equalities Impact Assessments
• Review the training packages with all stakeholders through Quality Review Panels
• Deliver the agreed training packages
• Review the effectiveness of the training packages with Quality Review Panels
Our targets
Barchester Healthcare intends to take the following actions to improve the percentage
of staff trained to understand personal needs, culture and diversity and so the quality
of its services, by increasing the percentage of staff trained to understand personal
needs, culture and diversity to 100% and the number of hospitals using Equalities
Impact Assessments from 0 to 7.
• By three months we will have developed an Equalities Impact Assessment format
• By six months we will have developed and agreed a diversity training
package incorporating training on Equalities Impact Assessments
• By nine months we will have delivered a diversity training package
incorporating training on Equalities Impact Assessments
• By twelve months we will have reviewed and evaluated the effectiveness of
our diversity training and Equalities Impact Assessment
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Part Three – About Barchester Healthcare – Funding,
Registration, Research, Staffing and Commissioner’s Comments
Funding: Barchester Healthcare provides services to more than 10,500 people in over
200 service sites. Our commissioners are the individuals we support, who fund their
choices through personal budgets or private income and resources from local authorities,
Clinical Commissioning Groups and the NHS Commissioning Board. That means our
health income fluctuates on a daily basis because most of it comes through individual
nursing or continuing healthcare funding. In developing this account we have specifically
reviewed the Quality Accounts of seven small independent hospitals, reporting back as
a composite. Their income represents 4% of the total income for Barchester generated
from the provision of NHS services over 2012 to 2013.
Over the course of 2012 to 2013 we have met requirements for being an approved provider
for 'locked and unlocked' rehabilitation services for Yorkshire and Humber strategic health
authority, which included an element of Commissioning for Quality and Innovation
(CQUIN) payment1. Patients in our hospitals are funded through individual contracts.
Some commissioners have set broad targets to be achieved in relation to CQUIN, which
is now part of the standard mental health contract.
Barchester Healthcare was not subject to the Payment by Results clinical coding audit
during 2012 to 2013 overseen by the Audit Commission. However, we are now involved
in the work that is being undertaken looking at including mental health services in
systems of payment by results.
Registration: Barchester Healthcare is required to register with the Care Quality
Commission (CQC). The range of services we provide are subject to different registration
for different regulated activities. For our independent hospitals our current registration
status is in respect of: ‘Regulated Activity: Accommodation for persons who require
nursing or personal care’. This covers assessment of medical treatment for persons
detained under the MHA 1983; treatment of disease, disorder or injury; diagnostic and
screening procedures.
CQC have issued warning notices of action against Barchester Healthcare during 2012
to 2013 (all of which have been complied with within the required timeframe) but
have not done so in any of our registered hospital services.
1
The Commissioning for Quality and Innovation (CQUIN) payment framework enables commissioners to
reward excellence by linking a proportion of providers’ income to the achievement of local quality
improvement goals.’, Department of Health website, 2008, http://www.dh.gov.uk
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Barchester Healthcare’s Independent Hospital Services, Quality Account 2013–2014
Research: We are a pilot site for the 'Think Local, Act Personal' initiative. We have
participated in national audit work, though not directly connected to delivery of mental
health hospital services. Barchester Healthcare did not submit records during 2012 to
2013 to the Secondary Uses service for inclusion in the Hospital Episode Statistics.
Staffing: Barchester Healthcare’s excellent service quality was recognised through
‘The Health Investor Award for Best Residential Care Provider’ in 2012.
Chief Executive Officer and founder Mike Parsons was awarded ‘The Health Investor
Award for Outstanding Contribution by an Individual’.
Barchester Healthcare Ltd was certified as one of Britain’s Top Employers for 2013 by
the CRF Institute. The company earned the certification as a Britain’s Top Employer
because our employee offerings surpassed the stringent criteria set in the following
areas: Primary Benefits, Secondary Benefits and Working Conditions, Training and
Development, Career Development and Culture Management. The independent
research has validated Barchester’s outstanding working conditions, earning a place
among the select number of certified Britain’s Top Employers.
Barchester Healthcare featured in ‘The Sunday Times Top 25 Best Companies to work
for’ for 2013, the only care organisation to feature in this list. The list is based on
confidentially researched employee recommendations.
NAPPI Award: Barchester Healthcare was awarded the NAPPI centre of Excellence
award in 2013 for its work on using the NAPPI model for managing challenging
behaviour in their dementia services. This Award acknowledges an organisation that
is working above-and-beyond the requirements of the BILD Code of Practice.
Commissioner and stakeholders’ feedback:
We asked for views from our stakeholders including Clinical Commissioning Groups and
Mental Health Foundation Trusts with whom we work collaboratively. We asked for views
from commissioners and clinicians where we have hospital sites and commissioners who
support large numbers of the individuals we support on our previous Quality Account.
We did not receive any feedback at the time of publishing this account, but will
include any subsequent feedback received in next year’s submission.
‘We look forward to working with all stakeholders over the coming year
to deliver the improvements to which we are committed’.
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