MINDFUL
EMPLOYER
PCH-QACC12-13

Mount Gould Local Care Centre
200 Mount Gould Road
Mount Gould
Plymouth
PL4 7PY visit: plymouthcommunityhealthcare.co.uk
Phone: 01752 434700
Please contact 01752 434711 if you require this information in another language or format.
An Easy Read version is also available.

I am pleased to share the information in the Quality Account with you. Plymouth Community Healthcare is a community interest company that provides NHS funded services to the people of Plymouth, and in some specialist cases, further into Devon and Cornwall.
Our Quality Account not only reports on how we did last year, but also lets you know our healthcare priorities for the coming year.
I would like to recognise and thank everyone at Plymouth Community Healthcare for the hard work and dedication they have shown over the last year to help us achieve our excellent results.
I am also confident that this will continue in 2013/14 to enable us to deliver against our new priorities outlined in this document, which will continue to keep the people of Plymouth safe, well and at home.
To the best of my knowledge the information contained within these Quality Accounts is accurate.

Steve Waite, CEO Plymouth Community Healthcare, CIC

Quality Accounts are annual reports to the public from providers of NHS funded healthcare. Quality
Accounts aim to improve our accountability to the public. We do this by providing open, honest and meaningful information on the quality of healthcare services that we provide for the communities of Plymouth.
You can use this Quality Account by Plymouth Community Healthcare to understand:

Plymouth Community Healthcare provides NHS funded healthcare to more than a quarter of a million people living in the City and, in some specialist cases, to people in the surrounding areas of Devon and Cornwall.
Our community healthcare services are organised around five geographic localities: North West,
Central and North East, South East, South West,
Plympton and Plymstock. Specialist services are based in a sixth locality - City/Coporate.
To learn more about us and our services please visit our website: www.plymouthcommunityhealthcare.co.uk
We are one of more than 600 not for profit companies working in the UK’s health and social care arena. Our services offer support across the whole of a person’s life, from our support in the community sexual health services, through health visiting, school nursing, minor injuries unit, children’s mental health services, adult physical rehabilitation services, adult and older person’s mental health services, community nursing and specialist inpatient rehabilitation services, including brain injury rehabilitation. We provide primary care services at four main sites, plus an acute GP service to Derriford Hospital, dental services, prosthetics and orthotics to all ages.
These services are based out in the community including from the following sites:
Local Care Centre Mount Gould Hospital
Cumberland Centre
Syrena
Plym Bridge House
Glenbourne
Lee Mill
Nuffield Clinic

Always involve the adults, children, and young people we care for in deciding how we can provide our services to best meet their needs.
Are committed to working collaboratively with other organisations to achieve improved health outcomes for the local population.
Make sure that the people we care for are able to access the right help, at a time that they need it and in a place that is close to their home.
Recognise the contribution our staff make and believe in making sure that our staff receive the right training and support to help them do their job to the best of their ability every day that they come to work.
Understand that offering services across the age range offers opportunities to develop a ‘Think Family’ approach to the care that we deliver.

developed our list of potential priorities under the headings: Patient Experience, Patient Safety and Clinical Effectiveness.
Understanding what is important to our stakeholders is a key objective of our organisation.
Consulting on our Priorities for Improvement gives us an opportunity to clearly ask for input from stakeholders on what is important to them.
Consultation process
To ensure that our priorities for improvement are reflective of our stakeholders’ wishes, we carried out a consultation exercise to identify our priorities for 2013/14. We reviewed data collected during
2012/13 from various sources such as Patient
Opinion, patient satisfaction surveys, audit results, customer services data, incident reporting, infection prevention and control, medicines management and waiting times.
From this data we looked for key themes and trends to inform our priorities for 2012/13 and
This list was then sent to our stakeholders and we asked them to prioritise what they felt was important. All the responses were collated and we then determined our nine Quality Improvement
Priorities. The final stage of our consultation process was to issue our Quality Account to our statutory stakeholders and their statements are published in the final chapter of this document.
Plymouth Community Healthcare would like to thank all stakeholders for their involvement in the production of the Quality Improvement Priorities and supporting statements.

Improving staff attitude towards people who use our services, relatives and carers through customer service training.
Aim
To ensure people who contact our company, or access our services, have a positive experience.
How will we achieve this?
By introducing customer care training at induction and mandatory annual training update sessions.
Quality Improvement Measure
Monitoring the attendance of new and existing staff who attend customer services training.
This will also include monitoring the number of staff who attend equality and diversity training. A reduction in the number of complaints/comments we receive regarding negative staff attitudes towards people in contact with, or using our services.
Improving the level of communication and information we provide to people who use our services.
Aim
To improve the experience of people who use our services by providing the right level of information.
How will we achieve this?
By developing an organisational procedure for advising people of appointment cancellations and delays, and developing three easy read-documents for three of our services.
Quality Improvement Measure
A reduction in the number of complaints/comments we receive regarding information being provided and communication regarding appointments.
Asking friends and families whether they would recommend our services to a friend or relative based on their treatment.
Aim
To improve the experience of people who use our services by providing timely feedback.
How will we achieve this?
This question will be included in our feedback methods from people who use our services.
For example, inpatient questionnaires and face-to-face interviews.
Quality Improvement Measure
Responses will be monitored and reviewed through our Safety, Quality and Performance
Committee in order to improve the experience of people who use our services.

Implementation of the NHS Safety Thermometer to help reduce the level of harm by measuring the safety of our services. These relate to falls, pressure ulcers, Venous
Thromboembolism (VTE) and urinary tract infections in patients with catheters.
Aim
To reduce the level of harm caused to people who use our services.
How will we achieve this?
A lead has been identified and data is being collected on the 4 harms, which include targets linked to reducing the number of Pressure Ulcers. This will help improve service provision and safety, and learning will be shared with care homes and outside agencies to further reduce harm.
Quality Improvement Measure
We will use the NHS Safety Thermometer for measuring and monitoring service safety.
Ensuring that records of people who use our services are held electronically.
Aim
To provide a higher quality of service by improving health professionals’ communications, and releasing more time to care for people who use our services.
How will we achieve this?
A project lead has been identified to implement electronic records.
Quality Improvement Measure
Outcomes will be measured through health record audits, feedback from health professionals and people who use our services.
Improve how we inform people who use our services about possible side effects of medication.
Aim
Reduce the level of harm caused to people who use our services by providing the right level of information.
How will we achieve this?
We will review the information and the timeliness of the information we currently provide to people who use our services and use the results to implement change.
Quality Improvement Measure
This will be measured through our satisfaction surveys, and reported in our monthly Quality
Assurance Framework. The results of the review will guide what actions we will take to improve how we tell people about possible side effects of medication.

To improve the waiting times for Child & Adolescent Mental Health Services (CAMHS).
Aim
To reduce the waiting times, regardless of what is set nationally, in order to improve the experience of people who use our services.
How will we achieve this?
By engaging staff and people who use our services in redesigning the CAMHS referral pathway to reduce waiting times.
Quality Improvement Measure
Referral to treatment times, and feedback from people who use our services will be assessed and monitored.
Improving dementia care by increasing engagement with carers of people with dementia.
Aim
To support dementia carers across the city.
How will we achieve this?
By developing a carer contact and a telephone helpline available at discharge.
Quality Improvement Measure
A reduction in the number of concerns and comments we receive regarding supporting dementia carers from people who use our services.
Improving recovery from stroke.
Aim
To offer a community focussed approach and rehabilitation.
How will we achieve this?
To continue to develop the Early Supported Discharge pathway.
Quality Improvement Measure
By the percentage of time that people who use our services spend in a stroke unit.

Statements of assurance relating to the quality of services
The report of the national clinical audit is in the process of being reviewed by PCH for 2012/13, and we intend to develop action plans, as appropriate, to improve the quality of healthcare provided. Review of Services
The purpose of the statements below is to ensure that Plymouth Community Healthcare
(PCH) has considered quality of care across all the services it delivers, rather than focusing on one or two areas for inclusion in this Quality Account.
Between 1 April 2012 to 31 March 2013, PCH provided 55 NHS services.
Plymouth Community Healthcare has reviewed all the data available to them on the quality of care for all of these
NHS services.
The reports of 20 local clinical audits were reviewed by PCH in 2012/13. For every local clinical audit undertaken, an action plan is created for the teams involved, or an organisational plan is developed if appropriate. Each audit has an identified lead and the action plans are monitored by PCH’s Safety, Quality and Performance Committee.
Participation in clinical research
We recognise the importance of involving people using our services in clinical research. Being able to use their direct experience helps us to provide better services and improve quality.
The income generated by the NHS services reviewed in 2012/13 represents 91% of the total income generated from the provision of NHS services by PCH for 2011/12.
The number of patients receiving NHS funded services provided or sub-contracted by PCH for the period 1 April 2012 to 31 March 2013, that were recruited during that period to participate in research approved by the National Institute of
Health Research was 1136.
Participation in National Clinical Audits
& National Confidential Enquiries
By being involved in clinical audits nationally, regionally and locally we can discover where the organisation is providing excellence in its services, and where we can improve.
Between 1 April 2012 to 31 March 2013 PCH participated in a national clinical audit, and details are on page 14. It was not eligible to participate in any national confidential enquiries.

Clinical Audit YES YES YES
83
Carer Survey YES YES YES
17
Survey of people using our services
YES YES YES
43

By being involved, people not only receive benefits associated with the trials, but are actively helping to determine the most effective future care for others. Using their direct experience helps us to provide better services and improve overall quality.
TWIST:
Investigating the use of the Wii™ as a therapy and rehabilitation aid in peoples’ homes to help recover strength in their arms after a stroke.
Stroke research is one example of the type of trials we are continuing to conduct at PCH.
We are able to recruit patients along the whole stroke patient care pathway - from acute, right through to post-discharge activities - as we work together with the Research Team at Plymouth
Hospitals NHS Trust. This year, 44 people have taken part in stroke research trials at PCH.
TWIST is a local, ‘home-grown’ trial set up by a consultant from Royal Cornwall Hospital in Truro and is taking place in Truro, Plymouth, Newton
Abbot, Barnstaple, Exeter, Dorchester and Taunton, with Portsmouth and Sheffield being added recently. To date, 23 people are taking part in
Plymouth and overall 150 of the 240 target are taking part.
We have recently completed a Occupational
Therapy in Care Homes (OTCH) trial which involved following 40 stroke patients who were resident in 11 Plymouth care homes. Results are likely to be published later this year. Examples of some of our other trials include:
We have had very positive responses to the trial.
Age does not seem to be a factor as the range is from 54 to 91 years! One gentleman stated he felt he had, “definitely improved and benefitted” from being in the trial. He said he was keen to let people know, “I am proof that research is real and not just a load of numbers or statistics”.
AFD-At Risk:
Investigating how common Anderson-Fabry
Disease is, which may be linked to causing stroke in young people (under 55 years). This is thought to be rare and is an inherited, genetic disorder caused by a defective gene.
PCH staff are keen to be involved in research.
They have brought their skills and professionalism to enable this research to happen, alongside and enhancing their normal roles.
GOSH:
Investigating potential genetic issues relating to the rupture of aneurysms which cause subarachnoid haemorrhages (bleed in the brain).

TM

Goals agreed with Commissioners
A proportion of PCH’s income from 1 April 2012 to 31 March 2013 was conditional on achieving quality improvement and innovation goals agreed between PCH and NHS Plymouth
(Northern, Eastern and Western Devon Clinical
Commissioning Group) through the
Commissioning for Quality and Innovation
(CQUIN) payment framework.
Data quality
Good quality information underpins the effective delivery of patient care and is essential if improvements in quality of care are to be made.
We understand the importance of ensuring that information held within the organisation is of the highest quality possible. This enables us to make informed, accurate and timely decisions about our patient care and our community involvement.
Further details of the agreed goals for 2012/13 and for the forthcoming 12 months are available on request from daniel.otoole@nhs.net
.
How our regulator, the Care Quality
Commission (CQC), views our services
Plymouth Community Healthcare is required to register with the CQC and its current registration status is ‘fully registered without conditions’. The
CQC has not taken enforcement action against
PCH during 2012/13.
Plymouth Community Healthcare is subject to periodic reviews by the CQC and the last review was on 18 March 2013 at our Minor Injury Unit.
The CQC’s assessment of PCH following that review was that all standards that were assessed had been met.
Plymouth Community Healthcare has not participated in any special reviews or investigations by the CQC during the reporting period.
We have also continued to develop automated warnings so that errors, omissions and duplications are identified and resolved in a timely manner.
This information is now being fed back to users so that they can understand the importance of their own data quality. Clinical staff have responded positively to this initiative and are actively engaged in improving the quality of recorded data.
The NHS number is the only national unique patient identifier used to help healthcare staff and service providers match people to their health records. Whilst the whole of the NHS and independent sector have made significant improvements in the NHS number allocation, we continue to strive for 100% compliance in line with our allocation of GP surgery results for submitted records.

Secondary user service
Plymouth Community Healthcare submitted
1,199 inpatient and 2,799 outpatient records between 1 April 2012 to 31 December 2012 to the Secondary User Service for inclusion in the
Hospital Episode Statistics which are included in the latest published data. The percentage of records in the published data, which included the patient’s valid NHS number was:
99.7% for admitted patient care
(national average 99.0%)
98.5% for out patient care
(national average 99.3%)
General Medical Practice Code
The General Medical Practice (GMP) Code is an organisation code and Plymouth Community
Healthcare has its own unique code. Accurate recording of the GMP Code is essential to enable the transfer of clinical information about the patient from the patient’s GP.
The percentage of records in the published data which included the patient’s valid GMP Code was:
100% for admitted patient care
(national average 99.9%).
100% for out patient care
(national average 99.9%).
To improve data quality PCH will set up monitoring reports to ensure that there is an attempt to resolve the NHS Number and GMP code for all inpatients and outpatients where the data items are not initially entered. The clinical systems team will be responsible for the monitoring of these data items.
Clinical coding
Plymouth Community Healthcare was not subject to the Payment by Results clinical coding audit that took place between 1 April 2012 to 31
March 2013 by the Audit Commission.
Information governance
Plymouth Community Healthcare’s score for
1 April 2012 to 31 March 2013 for Information
Quality and Records Management assessed using the Information Governance Toolkit (IGT) was 66%, and graded as ‘green’ (satisfactory).
PCH has significantly improved its score against the IGT from last year which was 38% and graded as ‘red’ (not satisfactory).

Plymouth Community Healthcare chose to survey a random sample of its workforce with questionnaires sent to 750 employees, of which 337 responded.
Overall there has been a significant increase in the positive message coming back from staff about the organisation, including:
Staff are largely enthusiastic about their work and draw a direct link between their work and helping patients.
Over half of staff would recommend
PCH as a place to work (up from below half last year).
An increase in staff who stated that essential infection control materials are available when needed.
However, there are areas that we need to improve:
Less than a third of staff think that internal communications are effective.
Only 1 in 4 staff believe that management listens to them.
Consequently we will be undertaking a review of our internal communications, and we will be exploring how management interacts with staff.

Progress against our priorities for improvement in 2012/13
In our 2011/12 Quality Account we pledged to make improvements in four key areas identified by our stakeholders. The next two pages shows the progress we have made on these priorities.
Provide more information about the services we provide in ways that people can understand.
Examples of progress during 2012/13 include the introduction of quarterly public board meetings, a programme of events to promote PCH services across Plymouth, developing a range of service information leaflets for our six localities.
We continuously measure what people have said through Patient Opinion, patient surveys, recorded interviews with people who use our services, board discovery interviews, suggestion boxes, customer services data, locality forums and our website.
Improve the way we involve people using our services and carers.
To help us gain feedback in a timely way we’ve introduced a variety of feedback mechanisms: The National Patient Opinion website; capturing continuous feedback in our
‘inpatient’ areas via tablet computers and kiosks; one - one meetings with our Chief Executive; working with Plymouth LiNK (now Healthwatch) to gather feedback; users of our services and carers participating in recruitment interviews.
We will continue to assess how successful we are with regard to involving people who use our services, and this will be measured using their feedback gathered via the mechanisms listed above.

Continue to develop and build on partnerships in order to deliver a seamless care pathway for people using our services.
During 2012/13 we introduced a new pilot scheme - Improving Customer Experience (ICE) which focuses on rapid response, crisis support and reablement. The aim is to have a single point of access so that when you visit your GP with a different problem you can be referred to a rapid response team which will make your care as fast and as thorough as possible; social care and health services are working on this together. People who have used the service have expressed their liking for the service, and PCH is receiving daily positive feedback from referers.
Introduce an ’Information Prescriptions’ web page that contains a series of links and signposts to guide people to sources of information about heath and care.
An Information Prescriptions web page has been developed signposting to a list of clinical services. It’s too early to say how effective the web page has been as it was only launched earlier this year. However, to date the Information Prescriptions and Clinical Services pages have received 3,304 visits. We will continue to monitor usage and customer service feedback described above.

I write to record my sincere appreciation, thanks and respect for the support I received from the ICE Team following my recent accident.
Starting with the Assessment Team who came to my home immediately upon my discharge from Derriford, continuing with the Nursing/Physio support and the daily Carers visits; throughout I received the very best of attention from Professionals who truly demonstrated their commitment to compassionate support.
Your Team worked flawlessly, a testament I feel to the concept of integration of services to provide a flexible and seamless package of support delivered by committed People. Thank you for assembling a
Team who truly understand the real meaning of Humanity and please extend to all its members my enduring thanks.

Patient survey & results 2012/13 Your experiences - putting customer satisfaction at the heart of what we do
At Plymouth Community Healthcare (PCH) we take feedback very seriously because it’s one of the best ways to learn about how we are doing, and where we can improve. We encourage everyone who uses our services to let us know how we’ve done, and we are continually looking for ways to make it easier for people to share their experiences with us.
The main aim of the survey is to ensure people who use our services within Plymouth, have the right opportunity to give their views on their experiences of accessing PCH services, and to ensure these views are used to improve patient care in the future.
Real improvement at the point of care
PCH, in collaboration with Plymouth University, has been running a number of leadership and development programmes.
We need to know when we have, and haven’t
One of the successful projects arising from the delivered exceptional levels of service, and we always take appropriate action to improve things leadership programme focused on implementing when we let people down. a system to capture ‘Real Time’ feedback from patients. Patients are now asked to complete
There are a number of ways people can share their feedback with us: via our website, by a questionnaire directly into a tablet computer.
The data is downloaded as soon as the speaking to a member of staff, filling out a paper questionnaire has been completed and the information is then instantly available to all staff.
survey or even using of our new tablet pads that are pre-loaded with surveys that can be completed,
It has enabled services to see what patients are uploaded and seen by staff straight away. happy with and areas they need to improve upon
and take action.

Complaints, Concerns & Compliments (the 3 Cs)
PCH actively reviews all the feedback we receive on the services we deliver. The chart below shows the ratio of the 3 Cs. As an organisation we log when patients feedback positively regarding their care, and in
2012/13 we received:
79 Concer ns
728 Compliments

And if it goes wrong...?
Our complaints procedure has been established in line with NHS best practice guidance and our aim is to deal with complaints quickly and efficiently by those who have been involved in delivering the patient’s care.
The NHS Constitution makes clear what people should expect when they complain and the
Care Quality Commission requires registered providers of services to investigate complaints effectively and learn lessons from them.
The Duty of Candor will also become a contractual requirement for NHS organisations and providers of NHS services. This means that PCH will be required to tell patients if their safety has been compromised, apologise and ensure that lessons are learned to prevent them from being repeated.
Over the last few years PCH has shown an improvement in the number of incidents reported demonstrating an increasingly open and learning culture that aligns well to the Duty of Candor and willingness to acknowledge when things go wrong.
Being open with people about what has happened and discussing incidents quickly, fully and compassionately can help patients and staff to cope better with the after effects of patient safety incidents.
When PCH talks about being open we mean:
Acknowledging, apologising and explaining when things go wrong.
Conducting a thorough investigation and reassuring patients, their families and carers that lessons learned will help prevent the incident happening again.
Providing support for those involved to cope with what happened.

Promoting a responsive learning culture
Plymouth Community Healthcare recognises the value and importance of ensuring all lessons from incidents are embedded within the organisation. To this end, work of the Serious Incidents Requiring Investigation
(SIRI) Panel continues in order to implement and embed lessons learnt from SIRI’s. The group is led by the Director of Governance and provides assurance that quality improvements are being made as a result of incident learning.
An example which demonstrates learning from SIRI’s driving change is the positive work that has been undertaken regarding tissue viability:
Implementing mandatory pressure ulcer training for all registered nurses and health care professionals involved in pressure ulcer management.
Developing a patient leaflet which is given to all patients at risk of developing pressure damage.
A group of health care professionals meet monthly to discuss any areas of concern and ways in which to improve practice.
We have a robust reporting system in place for all grade 2, 3 and 4 pressure ulcers (grade 4 being the most severe).
Our pressure ulcer guidelines have been reviewed in accordance with the new policy for pressure ulcers.
All grade 3 and 4 pressure ulcers are seen by the tissue viability team within 3 working days.
Incident reporting
Staff are actively encouraged to report incidents of all types, and our web-based reporting system has been well received by staff and has led to improved quality in the reported incident information. This system allows for better monitoring of incidents across the organisation.

Infection prevention & control
Keeping patients and wards infection free is a key priority for PCH. During the last year PCH has had one case of hospital acquired Clostridium difficile (healthcare-acquired infection) and no cases of MRSA
(Meticillin-resistant Staphylococcus Aureus). This achievement is the result of hard work of staff throughout the organisation, and the support of people and visitors who use our services.
Healthcare-associated infections remain one of the health service’s biggest challenges. Plymouth Community
Healthcare is determined to minimise the risk of any infection and is committed to having the highest possible standards of hygiene and infection prevention and control. We achieve this through:
Our annual infection prevention control audit programme;
Infection Prevention Control Liaison Practitioners who act as a advisory and information resource for the organisation;
Provision of infection prevention control training, support and training for care homes and primary care;
Raising awareness through healthcare events.
In November 2012, we brought together staff from across the health sector to look at urinary infections, and see how we could reduce urinary infections related to catheters by 50 percent by July 2013.
Representatives from companies who supply medical equipment were also on hand to showcase a variety of products that could be used to reduce urinary infections.
We have decided to take a holistic community approach and bring healthcare providers together to achieve a reduction in urinary infections related to catheters. More than 50 staff from a variety of care settings were brought together to agree a way forward for reducing catheter infections in Plymouth.
Over the next 12 months we are looking to collaborate with other healthcare providers and organise seminars from acute care, community care, and care homes; working together to ensure that patients receive high quality care.
This is the start of many collaborative events related to the South West Quality and Patient Safety
Improvement Programme for our patients in Plymouth. In the future we will be looking at other areas such as falls, pressure ulcers and how we can reduce their occurrence and improve the lives of people in the City.

City clinical care being recognised internationally. More patient care together with more face-to-face contact is being delivered by our district nursing teams across the City.
District nursing is at the forefront of our community-based services, allowing local people to receive the care they need whilst staying in their own homes.
Following a comprehensive review looking at working practices and clinical environments, we set up a new programme, called the ‘Productive Series’, to enable our district nurses to spend more time with patients as possible, but also manage to keep on top of a wide range of other activities including; travelling, equipment and staffing organisation, and maintaining excellent patient care.
Good ideas and new initiatives are being shared with other teams, so that we can spend more time out with our patients. The ‘Productive Series’ has given staff the opportunity to review the way we organise our work place and working practices.
Since Plymouth Community Healthcare was created in October 2012, staff attitude surveys undertaken throughout the year have shown a significant increase in our staff feeling supported as well as increased team morale.
We asked staff to reassess how they worked and look at problems on the frontline in order to identify and implement new solutions. We can now see that the considerable effort our district nurses put in is now having a very positive effect on patients and other staff.
The Productive Series work carried out by the district nursing teams in Plymouth has been recognised not only locally, but nationally and internationally. The teams’ work is being used positively to embarked on the ‘Productive Series’.
demonstrate what can be achieved to clinical teams in Australia and New Zealand, who have just

Child and Adolescent Mental Health Services (CAMHS) is giving children and young people a significant voice in its services.
Facilitated by local charity Routeways, ‘In Other Words’, is a group of young people aged 11 and over who currently access, or are previous service users of CAMHS in Plymouth.
They meet twice a month to contribute to issues affecting them, and to make sure that people who make decisions about CAMHS in Plymouth know – from the right people – what is important, and what it is like to access and use CAMHS. Members sit on interview panels or supply interview questions – they were key in the shortlisting process for the new clinical director.
The group is involved in a variety of projects such as ‘Mental Health 5 A Day’, for which they created a leaflet for use in schools, and a drawing competition for Targeted Mental Health in Schools.
They were responsible for the naming of the new CAHMS building: decorated suggestion boxes were place in the CAMHS area, and the subsequent suggested names became part of a survey which was sent to schools and staff. Members of ‘In Other Words’ critiqued the recently refurbished buildings, which they found a little clinical, making it possible for further work to be done to make the rooms friendlier.
Individuals can attend CAMHS business meetings to explain what ‘In Other Words’ is achieving and how it is helping them as individuals, for example in terms of improved self-confidence. The group level and is fundamental to the aims of CAHMS.
is meeting with Chief Executive Steve Waite in June. The input of ‘In Other Words’ is at a very high

Plymouth Community Healthcare’s tent saved lives in first weekend in March, after carrying out over 120 tests for high blood pressure and diabetes.
In total, 5 people were diagnosed with high blood pressure which has been nicknamed ‘the silent killer’ by leading professionals, as there are no visible symptoms. Around 30% of people in England have high blood pressure, although many may not be aware of it. High blood pressure puts danger on an individual due to an increase in the risk of a heart attack or stroke. Smoking, obesity, the contraceptive pill and poor diet can all contribute to increasing a person’s risk.
The nurses from Plymouth Community Healthcare also referred 2 people for having high blood sugar levels, which may mean they are in danger of having un-known diabetes. District nurses from the local care provider were part of the event ‘Kick Yourself Fit’ which was organised between Devon
FA and Plymouth Community Healthcare.
The event not only provided healthcare for free, but provided a spectacle of football talent on the
Piazza. The event inspired the city to have fun whilst being active.
Over a thousand people got involved with activities on the day, which included demonstrations by international and regional football players. The pitches were open to all ages, which allowed anyone to turn up and kick about with some professional football and street soccer players.
The event was also supported by the Lord Mayor, who took his time to interact with the health exhibitors which was provided by Tavistock Community Sports Centre.
and members of the public. Getting into the spirit of the event he had a go on the exercise bike,

Quality indicators
Plymouth Community Healthcare is required to report on the following quality indicators which are relevant to the services we provide. These are provided below.
2011-12
Plymouth Community Healthcare intends to take the actions set out below to improve its performance, trend action to improve performance and so the quality of its services. indicator
Percentage of patients on Care
Programme Approach who were followed up within 7 days after discharge from psychiatric inpatient care during the reporting period.
Percentage of non detained admissions to acute wards for which the Crisis Resolution Home
Treatment Team acted as a gatekeeper during the reporting period.
Percentage of staff during the reporting period who would recommend the PCH as a provider of care to their family or friends.
target 2011/12 2012/13
95
60
95 99 99
.3
%
81
.2
91
.1
68 68 stable
Increase stable
PCH will continue to monitor this through its contract performance meetings.
PCH is reviewing how it collates the data for this indicator. Appropriate changes will be made to improve reporting for next year.
PCH is reviewing its employee engagement and will be developing a strategy and a 12 month work programme to help improve results.
Community Mental Health services: How patients felt about their overall experience of care over the last 12 months.
Excellent Good Fair Poor
30% 51% 9% 10%
12% 9%
2012-13
29% 50%

Plymouth Community Healthcare is leading the way in collaboration events, bringing together other health providers to promote health issues.
Working in collaboration with other health professionals is becoming increasingly recognised as playing an important role in providing good quality healthcare services. In coming together to share experiences we are able to learn from each other and find solutions to common problems faced by people accessing health services. Here are some of our stories...
Devonport residents are getting access to new health services, thanks to a new partnership agreement between Plymouth University and Plymouth Community Healthcare.
The partnership heralds the start of a new relationship where the two organisations are working closely across education, research and innovation to improve access to health services in the city.
Steve Waite, Chief Executive of Plymouth Community Healthcare said: “This forward thinking partnership is particularly fitting as Plymouth University is the first in the world to achieve the Social
Enterprise Mark, and we are delighted to be working with them to increase health services available in the Cumberland Centre.
“By opening the new Cumberland Surgery we have increased access to services where people can get advice, care and support. What’s more medical and health profession students are working alongside our practising GPs and nurses to get first-hand experience while they train to the highest levels. In turn, the University offers training and research opportunities to our health professionals.
So it’s win, win all round!”
Both the partners are excited by the new academic health partnership in terms of the increased local healthcare needs and the city and the future possibilities it will bring. choices it provides local residents, the opportunities for students to build empathy and respect for

A member of our Plymouth Options team has devised and implemented a training scheme aimed at helping individuals with a disability to get into employment.
Plymouth Options is a city-wide service for adults in Plymouth with common mental health problems such as anxiety and depression. Its Paid Training Placements model recently received funding from
South West Development in order to promote wider take-up across the City.
The Paid Training Placements Model provide disabled people with six month placements in ring-fenced jobs with employers making reasonable adjustments to help them. After the employees have completed their 6-month placements, they are guaranteed an interview for the post if their position becomes available.
Adjustments may include providing time for individuals to take medication; allowing extra time to complete training or even additional resources; providing flexible working hours for individuals who would otherwise find it difficult to cope in a standard working environment; or even accepting references from someone other than a previous employer.
Our Options Service, based in Exeter Street, has already taken on two disabled workers under the scheme and we are looking at rolling it out across Plymouth Community Healthcare in the coming year.
Tracy Clasby, is an interim service manager with Plymouth Options, and is overseeing the work of the two employees on the scheme.
Tracy said: “I found using this process of employment to be smooth and quick. It was not any different than when we hire able bodied staff.
“We have a role to play, as a group that works with people with learning difficulties and mental health issues, in getting people jobs and not just stopping at treating them. Knowing they can get barrier to employment.” employment will hopefully give them that extra incentive to get well – being disabled or ill is not a

We recently shared almost £40,000 with nine community organisations working to improve the wellbeing of the people of Plymouth.
As a community interest company, any profits we make have to be reinvested into the organisation or shared with the community and we were delighted to be able to share some of the surplus we made in our first year, and support community health activities and projects across the City.
This year, nine groups were each been awarded a Community Development Grant after a rigorous selection process that saw 35 community groups and not for profit organisations operating within the
City of Plymouth boundary submitting an application.
With just eight grants available, the selection process was challenging for the judging panel, all members of Plymouth Community Healthcare’s Board.
Director of Finance Dan O’Toole explained: “The applications were of an exceptional quality. The winners were those that best met our three criteria; benefitting the community of Plymouth, with a clear link to health and wellbeing and alignment to our core objective to ‘support people to be safe, well and at home’.”
Although there was a total of eight grants on offer, one grant of £5,000 was split between two organisations, The Red Cross and the African Women’s Association. With very similar aims, the two are being encouraged to work together to make best use of their windfall.
Awards have also been earmarked for the Devon and Cornwall Food Association, Elder Tree
Befriending Support Service, rehabilitation unit Trevi House, Plymouth YMCA, community art project
Oasis and community support groups Memory Matters and Tamar View.
“It is fitting that the winners include small and large groups, with some new and other well-established projects,” commented Dan.
“Every one of the successful applicants clearly showed that their focus is on the health and wellbeing of the diverse groups that make up the population of Plymouth, and we are delighted that these grants will assist them with their vital work,” he added.
In total, the funds released by Plymouth Community Healthcare amount to £38,268.40. And there’s more still to come, as further grants of £5,000 will be awarded later in the year to the two groups who safer, happier and healthier Plymouth. can demonstrate that their use of the initial grant has had the most significant impact in achieving a

As part of the process for developing this document, we have shared the initial draft with our statutory stakeholders; Caring Plymouth’s Scrutiny Panel, Healthwatch Plymouth and our lead commissioner.
They were offered an opportunity to comment ahead of publication, and below are the statements that we received.
Caring Plymouth’s Scrutiny Panel
Unfortunately due to a conflict between the deadline set by the Department of Health for the submission of Quality Accounts and the Council’s municipal calendar the Caring Plymouth Scrutiny
Panel has been unable to consider these Quality
Accounts as part of a standard committee meeting.
However, the Chair and Vice Chair of Plymouth
City Council’s Caring Plymouth Scrutiny Panel have prepared this statement following consideration of the Quality Accounts of Plymouth
Community Healthcare (PCH).
We are assured that the priorities for the forthcoming year are appropriate. We are pleased to see that improvement in the Child and
Adolescent Mental Health Service, which has previously been subject to monitoring by the City
Council’s Scrutiny function and highlighted in last year’s statement attached to quality accounts, is identified as a priority.
The Improving Customer Experience scheme
(ICE), which has been developed in partnership with Plymouth City Council alongside Health services in the City is an excellent example of how health and social care can work together to deliver improved outcomes for patients. It is the
Improving Customer Experience scheme (ICE), which has been developed in partnership with
Plymouth City Council alongside Health services in the City is an excellent example of how health and social care can work together to deliver improved outcomes for patients. It is clear that the approach will aid integration across the whole of the local health, public health and social care system.
The Chair and Vice Chair wish to congratulate
Plymouth Community Healthcare for providing a document which aimed to be clear and easily understood by members of the public.
Healthwatch Plymouth
Healthwatch Plymouth aims to work closely with Plymouth Community Healthcare over the coming year, to ensure that the patient voice is heard consistently across the organisation.
Healthwatch Plymouth will also be looking to be actively involved in monitoring quality and safety of services, sharing the views of the public at executive level.
We look forward to strengthening our relationship with Plymouth Community Healthcare through representation on key committees / boards and by further collaborative working to benefit local people.

NHS Northern, Eastern & Western Clinical
Commissioning Group (NEW Devon CCG)
Introduction
As a new Commissioning Organisation, NHS NEW
Devon CCG is pleased to support the Plymouth
Community Health (CIC) Quality Account 2012-13.
We look forward to developing further the relationships between the Western Locality, the Partnerships team and the Patient Safety &
Quality team with the CIC in order to help deliver our vision of healthy people, living healthy lives, in healthy communities. Plymouth Community
Healthcare makes a significant contribution to the health and wellbeing of the population through the range of services it provides to adults and children with mental health needs, learning disabilities and long term conditions.
Achievements in 2012-13
Plymouth Community Healthcare (PCH) is committed to providing safe, high quality, clinically effective care to patients and the achievements noted in the quality account for
2012-13 demonstrates this. In addition PCH have forged positive partnerships with the
University of Plymouth and Voluntary Sector
Organisations to improve the health and wellbeing of the population for example helping individuals with disability into employment.
Of note is the increase in the rate of incident reporting, and action taken to embed learning is clear this is evidenced through the work to reduce the number of pressure ulcers. Hospital
Acquired Infection rates are commendable and further work is being undertaken to reduce the rates of catheter acquired urinary tract infections by 50% in 2013-14.
The impact of the introduction of the ‘Productive
Series’ by PCH in community nursing has been recognised internationally, with positive impacts for both patients and staff. The general staff survey results that show staff are largely enthusiastic about their work and over half would recommend PCH as a place to work, this places
PCH in a good position for recruiting and retaining staff.
The CCG would like to acknowledge the participation of PCH in the National Clinical Audit for schizophrenia and look forward to the learning and action plan being shared.
We welcome the work that PCH has undertaken in transferring all patients records to an electronic system and improving data quality; the enormity and significance of this task should not be underestimated and has not been without its challenges. Action has been taken in response to concerns raised by commissioners about the need to maintain a continuous record during the transfer process and further audits are expected imminently to provide assurance on this. The implementation of system 1 in 2013-14 will enable community staff to access records remotely, which will support more timely clinical decision making and promote safer care.
The CCG note the significant improvement in the outcomes of the Information Governance Toolkit
(IGT) from 38% in 2011-12 to 66% in 2012-13 and would expect to see further improvement in
2013-14.

NHS Northern, Eastern & Western Clinical
Commissioning Group (NEW Devon CCG)
(Continued...)
PCH has drawn on a range of methods to gain feedback from people who use their services.
In particular the use of Meridian a system which collects real time information about people’s experiences, this has enabled PCH to take immediate improvement action. The CCG notes the partnership working with Plymouth University to achieve this. The pilot scheme for ‘improving customer experience’ (ICE) has also been well received and the Western Locality is keen to see this rolled out across Plymouth in 2013-14.
For Children and Young people needing mental health services a local charity ‘Routeways’ enables them to have a say in how services are developed and the CCG look forward to hearing more about the impact of this arrangement.
2012-13 was a particularly challenging year for the CAMHS Service. A series of reviews identified that significant actions needed to be taken to strengthen the governance of the service, ensure a single contemporaneous clinical record and that multi-agency processes for safeguarding children were consistently adhered to. Joint work between PCH and the CCG has provided assurance that most of these actions are now complete. The recent appointment of a substantive
Medical Director and Director of Professional
Practice will place PCH in a stronger position moving forward.
The Western Locality has been monitoring the achievement of various performance targets for the services that PCH deliver; however for 2013-14 and beyond we are keen to see improvement in the outcomes demonstrated for people using services and in particular for children and young people and those with a mental health issue.
Priorities for 2013-14
The CCG agrees with the three clear priorities identified through stakeholder consultation in patient experience, patient safety and clinical effectiveness. The priorities demonstrate the organisations recognition of the fundamental need to treat people with dignity and respect and to ensure feedback from service users in regards to the services received.
Patient safety priorities rightly focus on reducing the level of avoidable harm and PCH are making a significant contribution to a whole systems approach across primary and secondary care
(including care homes) to achieve this.
The focus on improving waiting times for
CAMHS, improving support to carers of people with dementia and improving recovery from stroke is in alignment with the priorities of the CCG.
Plymouth Community Healthcare’s response to our statutory stakeholders
We would like to thank our stakeholders for taking the time to comment on the initial draft of our final Quality Account.
Plymouth Community Healthcare welcomes and supports these comments and will use this feedback to help maximise opportunities to improve quality and safety.

Care Quality Commission (CQC)
The Care Quality Commission (CQC) replaced the Healthcare Commission, Mental Health Act
Commission and the Commission for Social
Care Inspection in April 2009. The CQC is the independent regulator of health and social care in England.
Clinical audit
Clinical audit measures the quality of care and services against agreed standards and suggests or makes improvements where necessary.
Clinical coding
Clinical coding translates the medical terminology written by clinicians to describe a patient’s diagnosis and treatment into standard, recognised codes.
Commissioning for Quality & Innovation
Schemes (CQUIN)
A payment framework which encourages further improvements in quality and innovation.
General Medical Practice Code
The General Medical Practice Code (Patient
Registration) is an organisation code. All NHS organisations have a unique code which indentifies the organisation. It is essential to enable the transfer of clinical information about the patient from the patient’s GP.
Health Watch
Health Watch will play a role at a national and local level and will make sure that the views of the public and people who use services are taken into account.
Hospital Episode Statistics
Hospital Episode Statistics is the national statistical data warehouse for England of the care provided by NHS hospitals and for NHS hospital patients treated elsewhere.
Indicators for Quality Improvement
The Indicators for Quality Improvement (IQI) are a resource for local clinical teams providing a set of robust indicators which could be used for local quality improvement and as a source of indicators for local benchmarking.
Information Governance Toolkit (IGT)
The Information Governance Toolkit is a set of
Department of Health standards by which organisatons are assessed to ensure that information is held, obtained, recorded, used and shared lawfully and ethically.
Information Prescriptions
An Information Prescription is a little like a medicines prescription. A medicines prescription tells a patient what drugs they need to take for their condition; an Information Prescription helps patients to learn more about the condition, and how to cope with it on a daily basis.

National Institute for Health Research
(NIHR)
The NIHR is a UK government body that coordinates and funds research for the National
Health Service (England). It supports individuals, facilities and research projects, in order to help deliver government responsibilities in public health and personal social services.
NHS Number
Everyone registered with the NHS in England and Wales has their own NHS Number. It is the only national unique patient identifier, used to help healthcare staff and service providers match people to their health record. It is an important step towards providing safer patient care and improving the quality of NHS number data has a direct impact on improving clinical safety.
Overview and Scrutiny Panel
Since January 2003, every local authority with responsibilities for social services (150 in all) has had the power to scrutinise local health services.
Overview and scrutiny committees take on the role of scrutiny of the NHS – not just major changes but the ongoing operation and planning of services.
Patient Environment Assessment
Team (PEAT) Scores
An annual assessment of inpatient healthcare sites in England that have more than 10 beds. It is a benchmarking tool to ensure improvements are made in the non-clinical aspects of patient care, such as cleanliness, food and infection control.
Secondary Uses Service
The Secondary Uses Service is designed to provide anonymous patient-based data for purposes other than direct clinical care such as healthcare planning, commissioning, public health, clinical audit and governance, benchmarking, performance improvement, medical research and national policy development.

We welcome feedback from staff, people using our services, carers, visitors, commissioners, partner organisations and members of the public to help improve the quality of services delivered.
If you would like to make any comments regarding the services we provide you can do so using the contact details below:
Email: customerservicespch@nhs.net
Telephone: 01752 435201
Or write to:
Customer Services Department
Plymouth Community Healthcare
Room AF3
Local Care Centre
Mount Gould Road
Plymouth PL4 7PY

Mount Gould Local Care Centre
200 Mount Gould Road
Mount Gould
Plymouth
PL4 7PY visit: plymouthcommunityhealthcare.co.uk
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