Quality Account 2012/13
Our quality performance,
initiatives and priorities
Contents
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Who we are and what we do
Commendations
Part one: our priorities for quality
Joint statement from our Chief Executive and Chair of Trustees
Our vision and values
Our services map
Part two: our priorities for improvement
Our progress against our priorities for improvement 2012/13
Priority 1: Service user experience. To develop tools to measure how
person-centred support is delivered in our services
Priority 2: Service user safety. To manage the risk of harm from medication
Priority 3: Effectiveness. To further develop partnerships in care delivery
Priority 4: Service user experience. To measure the mealtime experience
Priority 5: Service user experience. To ensure service user and staff safety
by reducing the risk of sharps injury
Part three: our priorities for improvement 2013/14
Priority 1: Service user experience. To further develop tools to gain feedback
on how person-centred support is delivered in our services
Priority 2: Service user safety. To manage the risk of harm from medication
by piloting new ways of working with technology
Priority 3: Effectiveness. To further develop our activities programme
Priority 4: Service user experience. To measure our culture for care delivery
and safety using a culture barometer
Priority 5: Service user experience. Ensure learning from complaints and
concerns and publishing this information when it relates to up held
complaints regarding care delivery
Priority 6: Service user experience. To measure the effectiveness of new
equipment for service user and staff safety following the introduction
of ‘safer sharps’
Part four: indicators
Part five: annexes
Annex 1: Legal requirement
Annex 2: Statement from Lead Commissioning Primary Care Trusts (PCTs),
the Overview and Scrutiny Committee (OSC) and Local Improvement
Networks (LINks)
Who we are and what we do
Sue Ryder provides care and support for people living with
complex, end of life and specialist palliative care needs.
We are a large national charity in England and Scotland. We aspire
to create a world where everyone has access to personalised and
compassionate care.
We deliver services within local communities through our day care,
respite care, hospices, specialist palliative care, community nurse
specialists and Hospice at Home. As well as long-term residential
care, extra-care housing support, homecare in Scotland and
community integration.
This year we’re celebrating 60 years of providing care. The aim of
Sue Ryder from the outset was to provide care and support where
it is needed most. Today we still operate on the same principle.
This document, the Sue Ryder Quality Account, demonstrates our
continued commitment to quality improvement. It outlines our
quality improvement measures over the last year and our priorities
for the year ahead.
Our approach to quality is shown below
Commendation
Organisational
values
“I was very impressed with everything at
the hospice from the doctors to the
cleaners. I don't think anyone could wish
for more. Excellent in every way.”
Family we supported at one of our hospices
Operational
and clinical staff
Audit
programme
“They treat me as an individual and look
after my needs. I get a say in my care and
sit in on interviews to meet new staff.”
A resident we support at one of our neurological
care centres
“Gave me a break and strength to carry on.”
External
validation
Sue Ryder – Quality Account 2013/14
Participant in one of our community support
programmes
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Part one: our priorities for quality
Position and status on quality
Joint statement from our Chief Executive and the Chairman
of Trustees
Welcome to the fourth annual Quality Account, a summary of our
performance against selected quality measures for 2012/13 and our
initiatives and priorities for 2013/14. We have looked at the learning
from the terrible occurrences at Mid Staffordshire NHS Foundation Trust
outlined in the Francis Report (February 2013), and our Quality Account
this year outlines the actions we intend to take following a comprehensive
review of our own services, as a response to the report. We have
engaged all of our heads of care, service managers and many of our
front line staff, through attendance at a series of local workshops on the
Francis Report in March 2013, ensuring we as an organisation embed
the learning the report highlights.
This Quality Account is produced to inform current and
prospective service users, their families, our staff, supporters,
commissioners and the public, of our commitment to ensure
quality across all our services. The contents have been
influenced by and, have the endorsement of our national
Service User Advisory Group, which is a representative body
of our service users known as ACORNS. As an organisation we
produce this information across all of our services, enabling
us to benchmark our quality standards.
best suit individual needs. Some of the residents took the
opportunity to move to localities closer to their loved ones
and some moved to our care centre, Holme Hall, near York,
which was expanded by three beds. All of the care centre’s
residents have been successfully accommodated in
alternative services. As part of our five year strategy we
will be developing new centres for our complex neurological
care, the first of which is planned to open in 2015, and we
also aim to expand our end of life care provision.
We keep the service user at the centre of our thinking with
the development of our services. We have delivered the Royal
College of Nursing (RCN) Clinical Leadership Programme for
the third consecutive year resulting in a number of initiatives
which ensure continued development of our staff and
measurable outcomes for the people we support. Examples
of the service improvement projects have been embedded
throughout this year’s account.
The closure of Hickleton also saw us move our continuing
health care service to our offices in Doncaster. After a short
period of time, the service was not attracting enough people
to remain cost effective and at a break-even level, despite
numerous efforts to make the service work, and the service
was closed. The community based services run from Hickleton
were re launched at the end of 2012 and we have seen an
increase and fresh interest in the support they provide to
people with complex needs living within the local community.
In September 2012, we closed our Hickleton Hall care
centre in Doncaster after successfully finding alternative
accommodation and care arrangements for its 27 residents.
The decision to close the care centre was taken after personal
care plans developed for each resident showed a clear wish
to be closer to their families and amenities. This coupled with
no referrals from local commissioners for some time clearly
showed that Hickleton Hall was not best suited to providing
care that its residents and the local population wanted.
Over a period of 12 months we had in-depth discussions
with residents and their families and loved ones, as well as
commissioners and staff, about what models of care would
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Sue Ryder – Quality Account 2013/14
We have also expanded our community support projects,
specifically within Suffolk and Aberdeen. In Suffolk, working in
partnership with Age UK Suffolk and Suffolk Family Carers, we
successfully gained funding to develop services for people
with dementia and their family carers. In September 2012, we
launched a dedicated helpline, advisor service and localised
dementia projects. In Aberdeen, we work with four other
charitable organisations, and Aberdeen Council of Voluntary
Organisations, to provide a service across Aberdeen city for
adults over the age of 55. The service was launched in January
2013 and has over 100 referrals for support.
Working with each of our centres and hospices we have
shaped our five year plan (2013-2018) to help us provide
more incredible care.
We hope you find our Quality Account useful. We welcome
suggestions for future accounts. This Quality Account and the
information it contains is accurate and has been reviewed via
our internal governance structures.
1. We will deliver an increased range of high-quality and
2.
3.
4.
5.
6.
responsive care services, and give those we care for
more choice and control over how and where they
are supported
We will use the experiences of people who are touched
by our care to develop our national voice and campaign
to improve the lives of everyone living with end of life
and long-term neurological conditions
We will support our international partners to continue
their care provision and build their capacity to become
self-reliant
We will develop and use our networks to inspire and
engage our supporters to grow our income so that we
can meet the aspirations of Sue Ryder
We will be a great place to work with an environment
in which our people can flourish, live our values and deliver
our strategy
We will ensure all our systems and processes are effective
and efficient to support the delivery of our strategy
Paul Woodward
Chief Executive
Roger Paffard
Chairman of Trustees
Our vision
We aspire to create a world where
everyone has access to personalised
and compassionate care.
Our values
At Sue Ryder we’re passionate about
giving people the care they want,
that’s why we always aim to:
• do the right thing
• push the boundaries
• make the future together
Sue Ryder – Quality Account 2013/14
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Our service map
Head Office
1. Central Office, London
Registered Office
2. Sudbury Office, Sudbury
Extra Care
3. Sue Ryder – Heyeswood, Merseyside
Aberdeen
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4.
5.
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9.
10.
Palliative Care
Sue Ryder – Manorlands Hospice, West Yorkshire
Sue Ryder – Wheatfields Hospice, West Yorkshire
Sue Ryder – Thorpe Hall Hospice, Peterborough
Sue Ryder – St John’s Hospice, Bedfordshire
Sue Ryder – Nettlebed Hospice, Oxfordshire
Sue Ryder – Leckhampton Court Hospice, Cheltenham
Sue Ryder – Duchess of Kent House, Reading
11.
12.
13.
14.
15.
Complex Needs
Sue Ryder – Dee View Court, Aberdeen
Sue Ryder – Holme Hall, East Yorkshire
Sue Ryder – The Chantry, Suffolk
Sue Ryder – Stagenhoe, Hertfordshire
Sue Ryder – Cuerden Hall, Lancashire
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Elderly & Dementia
16. Sue Ryder – Birchley Hall, Lancashire
Homecare services (in Scotland)
17. Angus Homecare
18. Stirling Homecare
Supported Living
19. Supported living unit, Suffolk
20. Supported living unit, Aberdeen
Leeds
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5
21.
22.
23.
24.
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Liverpool
16
3
21
Other services
Befriending schemes (dementia & volunteer), Doncaster
Befriending Scheme for older people, Aberdeen
Dementia Helpline and localised projects, Suffolk
PEPS service, Bedfordshire
Nottingham
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Birmingham
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7
9
14
Oxford
London
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Sue Ryder – Quality Account 2013/14
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Part two: our priorities for improvement
Our priorities for 2012/13 have been influenced by service
user experience and involvement, national standards and
learning from enhanced quality performance data.
Over the course of the last year a number of projects
have culminated in improved information relating to user
experience, incidents, complaints and compliance with
Sue Ryder policies and procedures.
The priorities for 2012/13 were:
Priority 1
Service user experience
To develop tools to measure how
person-centred support is delivered
in our services
Priority 2
Service user safety
To manage the risk of harm from
medication
Priority 3
Effectiveness
To further develop partnerships in
care delivery
Priority 2
Service user safety
To manage the risk of harm from
medication by piloting new ways
of working with technology
Priority 3
Effectiveness
To further develop our activity
programmes
Priority 4
Service user experience
To measure our culture for care
delivery and safety using a culture
barometer
Priority 5
Service user experience
To share learning from complaints
and concerns, and publishing this
information when it relates to up held
complaints regarding care delivery
Priority 6
Service user experience
To measure the effectiveness of new
equipment for service user and staff
safety following the introduction of
‘safer sharps’
In November 2012, we published a new report, The Forgotten
Millions: reforming social care services for people living with
Priority 4
To measure the mealtime
neurological conditions. It presents an in-depth analysis of the
Service user experience
experience
strengths and weaknesses of Local Authority neurological care
provision. It was compiled following freedom of information
Priority 5
To ensure service user and staff
requests issued to Local Authorities in England to determine if Service user experience
safety by reducing the risk of
sharps injury
there were sufficient strategies, resource allocation and data
collection processes in place to plan appropriate services for
people with neurological conditions. The report found out that
only 5% of 131 responding Local Authorities know how many The priorities for 2013/14 are summarised below:
individuals with any neurological condition they care for. The
Priority 1
To further develop tools to gain
report highlights that there must be improved choice, and
Service user experience
feedback on how person-centred
services should be provided in an integrated way by working
support is delivered in our services
with health services where possible.
At Sue Ryder, we reviewed the key findings and learning
from the Francis Report with each service area and with our
service user group; ACORNS; looking at the implications for
Sue Ryder from this national learning and how the service
user experience can continue to be enhanced.
We continue to improve service user and family experience in
our care, both on a local and national level. The priorities for
2012/13 and 2013/14 do not fully represent all that we are
doing, but they give an indication of particular areas of focus.
Our quality strategy focuses on the same three overarching
key areas identified in previous Quality Accounts and
these are:
• service user experience
• service user safety
• effectiveness
These priorities have been approved by ACORNS (our Service
User Advisory Group), the Executive Leadership Team (ELT)
and our Board of Trustees.
Sue Ryder – Quality Account 2013/14
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Priority 1: Service user experience
Progress made in 2012/13
Standards fo
r
For people we person-centred planni
ng
support
To develop tools to measure how person-centred
support is delivered in our services
✓ We said, we would review the finding from the Think

Local, Act Personal benchmarking audit to change our
policies and procedures to reflect the person-centred
approach to all our care and support activities.
We have worked with our national and local service user groups
to review our support planning records. As a result of this we have
developed individual support plans that are person-centred and
support ‘no decision about me without me’. Whilst reflecting
support needs, these plans also highlight an individual’s wishes,
preferences and aspirations. Our support planning and review
policy has also been revised to reflect the changes in services’
approach to supporting individuals.
Through national and local user groups we have agreed a
service user charter. The charter sets out service user and
organisational expectations through engagement.
We have also worked with our service users to develop a
set of person-centred standards for service users, staff and
volunteers. A volunteer at one of our hospices supported the
development of these by producing some hand-rendered
illustrations for the document, which were welcomed by
staff and service users.
Sarah, a ward sister at St John’s
Hospice, introduced a pre-admission
checklist to aid the inpatient admission
process. This was designed to identify
requirements a patient may have prior
to their admission. As well highlighting
the potential need for specific
equipment (i.e. oxygen therapy,
appropriate bed and mattress type,
bed rails & moving and handling
equipment), it also considered the
patient’s condition & ability (i.e. mobility,
skin condition, infection risk and safety
considerations). The completion of
a checklist helps ensure that
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Sue Ryder – Quality Account 2013/14
As an organisation, for the past three years, we have held the
Information Standard. It is our way of ensuring the information
we produce for the people we support is clear, accurate and
can be trusted. In August 2012, we reviewed our service user’s
views of the standard, and one comment that came back
was about having a quality mark that clearly shared their
involvement. This has now been developed and appears on
the publications developed in conjunction with service users
and/or service user champions.
appropriate information is cascaded
to the inpatient unit, allowing staff to
identify any specific needs, allocate a
suitable bed space and prepare the
environment accordingly.
This work was enhanced by Suzanna, a
ward sister also at St Johns Hospice who
developed a pre-admission information
leaflet, designed for community settings
and for those coming to the hospice.
The leaflet was developed and circulated
to key colleagues and the hospices user
group to ensure it contained the right
information. It has now been shared
within the wider community, increasing
understanding of the hospice, facilities,
what we do and what people can expect
from a stay with us, making them better
prepared prior to admission.
Cheryl, a sister at Manorlands Hospice,
took on a project as part of her Clinical
Leadership Project to review the
information leaflets available to
patients and families in the inpatient
unit. A survey was conducted collecting
the views and ideas of patients and
their families, as well as staff comments
by email. New materials were
developed. The hospice now has
more readily available and pertinent
information, which is easily accessible,
helping communication with patients
and families.
introduced, designed to aid
communication. They would all form
part of a welcome pack available to
patients and families on admission.
Susan, a ward sister at Thorpe Hall, took
Having separate leaflets on specific
on a similar project following feedback
areas lets patients and families only
from a patient that during their stay who read what they need to, as well as
said they hadn’t received any information ultimately increasing confidence in
before or on admission. The current
our service by having information
information materials were reviewed
readily available.
and a series of new leaflets were

✓ We said, we would measure personalisation in practice
by looking at observations of care, reviewing how staff
demonstrate empathy and compassion in care delivery.
Processes
These outcomes relate to experiences that individuals have
when using our services, and if process outcomes are not
embedded then this can have a significant negative impact
on achieving quality or life and or change outcomes.
We have carried out a number of quality audits focusing on
user experience and observations in practice. These audits
Service users told us
were conducted in and out-of-office-hours, to allow us time
to accurately review user experience within a 24-hour period. “They treat me as an individual and look after my needs. I get
a say in my care and sit in on interviews to meet new staff.”
We developed an audit tool to measure services person“It's like a family, if I want anything they come straight away.
centred planning. The audit has been completed for all
I get the best attention; it's like home in a way.”
services’ using our new records.
“I attend another day service but you don’t get the personal
touch like you do here.”
“I like going horse riding and spending time in the activity
room with the team.”
comment from one of our service users
“I can do what I like, like having a room on my own.”
We shared the learning from each of the audits with service
leads, these findings were incorporated into local quality
improvement plans in response to identified areas of
improvement. Learning was shared across the organisation
through our quality action group meetings.
✓ We said, we would measure personalisation in practice

by conducting detailed service user surveys.
The surveys focused on what it feels like to be treated as an
individual and actions from care-givers which illustrate this.
We mapped these to the following outcomes:
Quality of life
These may be referred to as maintenance outcomes, as they
reflect aspects of a person’s whole life that they are working
to maintain or achieve. These outcomes are balanced across
all services that interact with users and can be reflective of
integrated working.
Sue Ryder – Quality Account 2013/14
“I couldn't fault the services provided by you.”
“Please keep up the good work, your help, kindness and caring
helped me to understand and know what exactly was going
on, thank you.”
“Excellent support –
always someone
available to talk to”
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Priority 1: Service user experience
Progress made in 2012/13

✗ We said, we would measure personalisation in practice,
using our volunteers as mystery shoppers in questioning
staff attitudes and values towards compassion, dignity and
person-centred approaches to care.
Our ACORNS members asked to be better informed
inbetween meetings. We introduced an ACORNS newsletter
to update ACORNS members as well as those not involved
within the meeting. The newsletter includes topics such as
workstream updates, opportunities for members to develop
content or share a story, and in each edition we feature a
staff and trustee profile, so our service users get a better
insight into the background of those that support the
organisation and their motivations. We have received really
good feedback from service users and a member of the
ACORNS group co-edits the content for each edition.
We did not implement this fully, but used this as a tool for
reviewing our Scottish homecare services, which was a very
paper based approach that did not reflect in real time an
individual’s experience of our service. The value placed
on the interpersonal relationship between our care staff
and the individual receiving care was critical to measuring
personalisation in practice. Moving forward we aim to capture
service user experience as an ongoing process utilising
Personalisation goes deeper than having person-centred
hand-held devices.
plans and understanding an individual’s needs and wants. It’s
about actively listening and making the changes needed to
✓ We said, we would engage further with ACORNS

enable people to live their lives the way they want to, it tends
and our 2012/13 Clinical Leadership Programme leads in
to be the small things that make a difference. The projects
developing evidence based tools, and refining and adjusting
undertaken as part of the Clinical Leadership Programme
these based on feedback and observations of care delivery.
have been evidence of this, and examples of these have
been included within our Quality Account for this year.
Lesley, head of care at Dee View Court care
centre, undertook a project entitled ‘hear me’.
The aim of the project was to improve service user
involvement at the centre, allowing the residents
to be involved in the service’s decision making
process. Lesley consulted with the residents and
as a consequence the residents’ meetings were
altered to focus more on resident issues –
‘no decision is made about me, without me’.
Residents now feel able to talk about real issues
affecting them, and not just listen. A resident now
chairs the meetings; they feel more valued and
have a clearer insight into some of the challenges
faced within the service.
Lesley also looked at other ways residents could be
involved within the centre. Residents are now active
members of interview panels for new staff, hold
menu meetings to liaise with the chefs about what
food is provided and have recently renamed the
recreational therapy group, the ‘sunshine group’.
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Sue Ryder – Quality Account 2013/14
Varsha, a nurse at our neurological centre near
York, undertook a project looking at end of life
care in a neurological setting. Varsha initiated the
project by identifying the areas of care that were
non-existent or those that required improvement.
Varsha talked with residents about their priorities
of care, collated this, and cascaded the information
which included relative and staff feedback of
past experiences of supporting individuals at the
end of life, into staff training. There is now a better
understanding of end of life care, thus enabling
a better service to be offered.

✓ We said, we would use quality-themed visits to explore The ACORNS group was made aware of and supported our
and report on the service user experience of care and support, approach to themed quality visits and it was through these
visits that we identified that a greater focus needs to be given
and plan to focus on this within our planned visits.
to the provision of meaningful activities for service users in
our residential neurological care centres. It was for this reason
Throughout the year, all services had a themed visit that
that we identified the development of this work as a priority
focused on person-centred care carried out by the Clinical
for 2013-2014.
Quality Team. These visits focused on the involvement of
service users in planning their own care, and evidence of
responses to points made within surveys and complaints.
There was a review of the information readily avaliable to
service users in public areas and at least three service users
were interviewed during the visits and asked:
• what is going well?
• what is not going so well?
• is there anything you would want to see changed?
Any actions identified were then reported to the
service manager for incorporation into their Quality
Improvement Plan.
The visit was also used to find out whether service users
had noticed a change since the ‘Our Mealtimes’ standard
had been introduced.
Sue Ryder – Quality Account 2013/14
Service user comments
One service user reported that the food was good. She liked
the fact that there was no longer a four week rolling menu
and she was asked each day what she would like to eat.
One patient who has coeliac disease talked about how the
hospice had consulted her and ensured she had a wide
variety of menu choices. The patient compared this to her
experience in hospital where she said she got the same
meal every day for 3 weeks.
One patient said “you can have whatever you want, when you
want”. She went on to say how staff had made her cheese on
toast at 3am because it was what she wanted.
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Priority 1: Service user experience
Progress made in 2012/13
Johanna, day services manager at Thorpe Hall Hospice
undertook a project to look at introducing personalisation
and person-centred planning within the service. The work
was to ultimately identify and work towards the personal
goals and objectives of the individuals attending the day
service, by having a greater awareness of these. Johanna
started by organising a series of workshops with service
users and staff to discuss themes such as ‘what is important
to me?’, ‘If I could I would’.
From this a pilot group of six service users was set up,
with one-to-one meetings held with all participants,
Johanna worked with each individual in developing their
own monthly activity plans. Staff and volunteers worked
together in supporting individuals to achieve what they
had set out in their plans. The progress of the pilot group
was discussed as an agenda item at monthly staff meetings,
to ensure it remain active and a live piece of work and to
gain feedback. Through working in this way, service users
have become more active in the community by accessing
additional services, having the confidence to do more things
or activities they thought they could no longer do, such as
rowing or swimming. It has also had positive effects on staff
with increased morale, highlighting the importance of roles
such as volunteers in the delivery of support by utilising
their strengths, skills and past experience.
Ruth, a unit lead at Stagenhoe, our neurological centre set
within rural Hertfordshire took on a project to improve the
surrounding areas to improve access to the gardens for
residents. The aim of the project was to facilitate an area
where residents could walk, sit and generally enjoy the
outside area without risk of wandering into unsafe areas.
“Whilst working as unit lead, I was caring for a client with
Parkinson’s who was on half-hourly checks as he wandered.
I observed the reaction of a staff member who noticed that
the client was ‘missing’. When checked, he was found only
moments later in the garden, but the staff member was very
unsettled that the client had ‘got out’. The area of garden was
not enclosed and as the home stands in eight acres of
parkland surrounded by farm and woodland it was not safe
for the clients to be outside unattended.”
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Sue Ryder – Quality Account 2013/14
Some quotes from service users involved in the
personalisation project:
“Everyone seems to be on a computer nowadays, I don’t want
to be left behind. It also helps me keep in touch with my
friends and family. I am going to buy my own computer.”
“I used to sail, it’s great to have control of a boat again, it’s so
peaceful out there on the water.”
“I want to learn more about baking for myself. I really enjoy it.
Having the cake stall gave me a lot of confidence and I
wanted to raise some money and give something back.”
“My French is going well, I have a great teacher. Everyone
should speak at least one other language. I hope to go to
France one day.”
Ruth in conversation with the management team determined
a budget for fencing and resources. A volunteer group from
a local pharmaceutical company offered their services and
the work was undertaken to make the area safe for residents.
Staff and residents assisted with the task. Residents are now
able to enjoy a safe outside area, where they can sit and enjoy
their surroundings, without staff becoming anxious about
their safety.
The resident with Parkinson’s who prompted the idea for
the service improvement project is reported to have many
more ‘on’ days where he can enjoy the fruits of his labours.
No longer a contained client, now a contented gardener.
Priority 2: Service user safety
Progress made in 2012/13
To manage the risk of harm from medication
✓ We said, we would ensure 100% of medicine related

incidents were overseen by a member of the Clinical Quality
Team (CQT), and that medicines management incidents
are a standing item on every centre’s Quality Improvement
Group (QIG).
100% of medicine related incidents have been reviewed by a
member of CQT and audit results demonstrated that medicine
management incidents are a standing item on every centre’s
QIG. In addition we audited compliance against our medicines
management policy, which encompassed all aspects of
medicines management, from prescribing, ordering and
supply through to storage and administration, staff training
and disposal methods. The hospices have additional standards
to meet regarding the accountable officer role for controlled
drugs, which was part of the audit.
Bi-annual education and review of medicines competencies
are in place for all registered nursing staff. Our audit and
subsequent action plan demonstrated that all centres
have robust staff training plans in place for this aspect of
care delivery.
The medicines policy for homecare (Scotland) and social care
(including extra care and Birchley Hall) has been updated.
All services that have non-medical prescribing in place
(Duchess of Kent House and Wheatfields Hospice) have
this detailed within the service risk register and actions and
support (as detailed in the policy) are in place to support
clinical practice.
✓ We said, we would ensure that the recording of ‘other’ as

a subcategory within our electronic incident reporting system
(Datix) is reduced by 75%. This will help us to better analyse
incident trends. There are configuration changes required to
our system to enable additional categories to be added.
We have ensured that the recording of ‘other’ as a sub category
within medicines errors was reduced to zero. We have achieved
this by better educating our staff and responding to incidents
immediately.
Sue Ryder – Quality Account 2013/14
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Priority 3: Effectiveness
Progress made in 2012/13
To further develop partnerships in care delivery
Working together, Sue Ryder – Thorpe Hall Hospice and
Cruse Bereavement Care run Charlie Chimp’s Club, a support
In our last Quality Account we talked about the different
group for bereaved families. The club is open to anyone living
initiatives that had taken place throughout the year, with lots
in and around Peterborough with children and young people
of examples of working in partnership. This year is no different. aged 7-14 years, following an initial assessment of their needs.
In September 2012, we launched a Dementia Helpline that
The club helps children and young people to:
has already received over 300 calls from people living within
• make friends and support each other
the local community who were worried about memory
• remember the person who has died
loss or dementia. We work with Age UK Suffolk and Suffolk
• learn about death and bereavement
Family Carers to offer a collective service, supporting the
• express and understand their feelings
Helpline with a local Dementia Advisor service, that visits
• find ways to cope with their loss
people at home or in their place of choice and provides them • strengthen their emotional muscles
with a single point of contact as their condition progresses,
“What helped me the most was talking to new friends
as well as advice and information on support available to
who shared the same sadness.”
them. We have also launched two dementia village projects
within very rural areas of Suffolk. Operating within a four-mile Emma, 6 years
radius, we are running a number of workshops, events and
“The first time I went, I felt relaxed, because someone
focus groups to map out the local needs and work with
else was in my situation.”
local people to develop these, meeting the needs of the
Warren, 11 years
local community.
By working in partnership, we aim to:
• raise awareness and understanding of dementia
across Suffolk
• increase early diagnosis rates, access to treatment and help
to enable those affected by dementia to manage and live
well with the condition and be able to plan what future
support will be needed
• identify the gaps in local provision and ensure we have
the right services in place for the future
“What helped me the most was not being judged and being
with people my age because they understand me.”
Harriet, 12 years
There is also an informal support group for parents and carers,
while the children and young people take part in the club,
they benefit from the mutual support of other parents and
carers who have also recently experienced an bereavement.
“Knowing that we were not the only family that was grieving so
badly really helped me.”
Our Synergy Café supports people with dementia and their
Kabira, mum
carers in a relaxing and safe environment. The café has
received interest from Orbit Housing, who have replicating
“What helped me the most was being able to chat about many
the model and in March 2012 launched a new service in
Newmarket, in partnership with us. We are also expanding this subjects, pitfalls, and finding common ground, also similarities
in how you cope.”
as part of the work we have been doing with developing
Steph, mum
dementia-aware communities. This will see a Synergy Café
being run in four different locations within Suffolk, in addition
“He has definitely benefited from the club – meeting children
to those run in partnership with Orbit.
that have been through bereavement and understanding
feelings.”
In 2011/12 we launched a MND (Motor Neurone Disease)
Tom*, dad
Coordinator role within one of our hospices and due to the
success of this it has been further extended, and now delivers
essential coordinated care to more people locally. We also run
a clinic from the hospice on a weekly basis.
*name has been changed
12
Sue Ryder – Quality Account 2013/14
In January 2013, in partnership with British Red Cross, Bethany
Christian Trust, The Living Well Project, and Parish Nursing, we
launched a Befriending service in Aberdeen, titled ‘Aberdeen
City Befriending Partnership for older people’. The Befriending
Partnership is funded by the Aberdeen City’s Reshaping Care
for Older People Change Fund.
Within the first year of service, we had 1051 patients registered
on our system. 40% of these were from relatives or carers
of a patient, with 18% from community district nurses or
Macmillan nurses, and the remainder from other healthcare
professionals, including on call doctors (7%). 620 of these
patients had died, 65% of these died at home, which was
where they wanted to be supported and eventually die.
Only 11% died in an acute hospital, the percentage was
greater prior to PEPS.
The charities have come together to provide a service across
the city, with Aberdeen Council of Voluntary Organisations
(ACVO) as the lead partner responsible to the Change Fund
for the delivery of the service. The aim of the service is to help We are working to improve the time when a person is referred
people achieve a good quality of life and give them the added to the service to identify real savings in hospital admissions,
confidence they need to remain independent in their own
but indications to date have showed that when a person was
home. It is early days but we have already received some
admitted to hospital their length of stay was reduced through
really positive feedback on the service. As our contribution,
working with the PEPS service.
we have taken the lead in producing all the marketing
“the time I had left with him, I was able to be his wife,
materials for the service, as well as developing a contact
not his carer.”
system and evaluating the service as it progresses.
✓ We said, we would review our service evaluation in

2012/13, and look at satisfaction levels amongst service
users and their families, satisfaction levels amongst
staff, achievement of key outcome measures and
stakeholder engagement.
Comment from a lady we supported as part of the PEPS service
We continually evaluate all our services. We have set
measures to evaluate the services outlined above at key
points over 2013/14. We continue to explore partnership
working and approaches to our care delivery when we
develop new services.
In December 2011, we launched a new service, coordinating
24-hour palliative care and support. Bedfordshire Partnership
for Excellence in Palliative Support (PEPS) is an integrated
partnership of 15 organisations from the health, social care
and voluntary sectors, which have come together to form a
central Coordination Centre, hosted by Sue Ryder. Through
working together, across a diverse range of providers, we have
been able to achieve cross-boundary working in practice,
instigating a true culture change for the benefit of the patient.
The PEPS service brings together a shared electronic
patient record for the first time. PEPS supports the local
implementation of the national quality standards for
Electronic Palliative Care Coordination Systems, as well as
putting into practice the End of Life QIPP programme. In
October 2012, it was featured within the Department of
Health’s End of Life fourth annual report as an example of
good practice, and the service was also a finalist in the
Patient Centred Care, Health Service Journal awards.
Sue Ryder – Quality Account 2013/14
“There is someone
to call at night; don’t
feel alone, people
appear when they
say they will”
Comment from a relative we support
13
Priority 4: Service user experience
Progress made in 2012/13
To measure the mealtime experience
✓ We said, we would extend the Service User Nutrition

and Eating Experience project to embed the ‘Our Mealtimes’
standard.
The ‘Our Mealtimes’ standard was launched in June 2012,
where we brought together cooks from our services to share
ideas for applying the ‘Our Mealtimes’ standard in practice.
This was the first time this staff group had met together
and one of the aims of the day was to help reinforce the
importance of our catering teams in providing a good
experience for our service users.
The job descriptions of cooks and other members of the
catering team working within our care centres and hospices
were reviewed, to ensure consistency and reflect the activities
they were carrying out. This has helped us to recruit a number
of new cooks who collectively bring a wealth of experience
and enthusiasm into the organisation.
The cooks were brought together again in April 2013 to
share the excellent things they have done locally to embed
the ‘Our Mealtime’ standard. There were examples of new
menus presented in ways that ‘would rival a first class
restaurant’ and a tasting session of sweet dishes prepared
by the cooks that was very well received and prompted an
exchange of recipes. One care centre was working with
residents to grow vegetables for use in the kitchen and
another had re-decorated the dining area in consultation
with service users. The cooks who attended the day shared
ideas with regard to how to get real time feedback about
the mealtime experience, and how they could become
more involved in discussing preferences with service users
and their families, and working with nursing staff to support
nutritional assessment.
✓ We said, we would analyse the success of the

‘Our Mealtimes’ standard using a themed survey.
A survey was circulated during February 2013 and examples
of some of the comments are below:
“We have lovely place mats and cruet sets which brighten up
the café and make it more homely. The addition of comfy
seats has also made mealtimes better for some residents.”
“The dining room has been painted, and we have chosen new
curtains and there are now plants to decorate the room.”
Our survey indicated that in some services we need to make
our snack menu more visible as not all service users who
responded were fully aware of the range of snacks available.
The introduction of new ways of obtaining real time feedback
will enable us to further improve the mealtime experience and a
review of the ‘Our Mealtimes’ standard is planned for 2013/14.
✓ We said, we would look to find a way to incorporate

a review of compliance with the revised Nutrition and
Hydration Policy into our themed quality visit process.
We ensured that a section was incorporated into the ‘Person
Centred’ themed quality visit that assessed each service’s
approach to meeting the ‘Our Mealtimes’ standard and to
assess their compliance with policy by checking records to
see how nutritional needs were being assessed and managed.
In one of our hospices a patient said that although she had a
small appetite, staff had been happy to provide her with little
snacks that she had fancied at any time of the day.
The dining room expe
rience
Our mealtimes
designed by people
A series of standards
s with the aim of the
who use our service experience for all
me
best possible mealti
Where we choose to
eat in a designated
dining
area we would like:
• the choice of where
to sit (where possible)
and who
to sit with
• designated dining areas
to be clean and tidy
• the option to have our
food plated or served
at the
table from serving dishes
• tables to be wheelchair
friendly where appropriate
Special consideratio
ns
For those of us who
have to have our food
specially
prepared we would
like:
• these to be prepared
to meet our specific dietar
y needs
• soft food presented
in an appetising way
• nutritional supplemen
ts served in a way that
is attractive
• referral to a dietician
for advice and support
if we have
special nutritional needs
Involvement
From the outset, we wou
ld like the
opportunity to tell staff
what our special
preferences regarding
mealtimes and
diet are.
We would like to be able
to speak with the cook
or catering assistants
so that
about the range of menu we can give feedback
options and the qualit
y of
service and food.
Where we are in a reside
ntial care setting we would
like to have the oppor
tunity to have our own
‘food
group’ where we can
discuss and influence
menu
options, the mealtime
experience and other
related
factors.
Other consideratio
ns:
We would like:
• hot and cold beverages
available 24 hours a day
• biscuits and fresh fruit
availa
• a choice of snacks availa ble 24 hours a day
ble for out of normal
kitchen operating hours
• locally grown fruit and
vegetables where possib
le
• the chance to take part
in some home growing
of
produce where we are
in a residential care centre
and where there is the
facility to do so
14
Sue Ryder – Quality Account 2013/14

✓ We said, we would continue to consult with our
national service user advisory group on nutrition and
mealtime priorities.
The ACORNS group have been updated at each meeting
about the progress in introducing the ‘Our Mealtimes’
standard and have enthusiastically supported the project
having been influential in initiating the project in the first
instance. At the meeting in March 2013 there were reports
from two of our care centres that residents were starting to
grow vegetables and herbs to support the production of
meals within the care centre kitchen. This demonstrated
further progression towards the ‘Our Mealtimes’ standard.
✓ We said, we would review the food safety procedures.

There is a new Food Safety Policy and supporting guidance
documents for ‘food handlers’. To test compliance with food
safety principles we used an external company to carry out
inspections in all of our kitchens. The Health and Safety
Team have provided assurance to the Health and Social Care
Governance Committee that any identified actions have been
addressed, and there will be an annual audit reporting to our
Health and Social Care Governance Committee.
Myla, a unit lead nurse from one of neurological centres,
looked at the development of a clinical skills competency
assessment for staff and student nurses for Percutaneous
Endoscopic Gastrostomy (PEG) feeding as her RCN Clinical
Leadership Project. Myla wanted to address the nutritional
needs of service users needing PEG feeding as well as
increasing the knowledge of guidelines around PEG feeding
amongst staff, especially new starters. Myla created a
competency assessment to demonstrate learner knowledge
and skills for safe and effective practice, with staff having an
increased understanding and skills, improving the overall
experience of care for the people we support.
Sue Ryder – Quality Account 2013/14
15
Priority 5: Service user experience
Progress made in 2012/13
To ensure service user and staff safety by reducing
the risk of sharps injury
✓ We said, we would adhere to the European Union

directive to standardise sharps assessments and increase
awareness for all front line staff on better sharps
management by May 2013.
The Infection Prevention and Control Lead has worked
alongside heads of care and health and safety in identifying
the risky procedures carried out in our services. Each service
was asked to identify what equipment could be replaced with
safety engineered alternatives or a sharp not to be used at all.
We have issued a ‘Learning for Safety’ memo on sharps
injuries and are producing procedures on better sharps
management.
✓ We said, we would hope to have all our staff suitably

skilled and equipped with the right tools to minimise the
risk of needle stick injury.
Working closely with local NHS care providers, each service
has identified the locally favored safety equipment, purchased
the new equipment and initiated staff training, either through
medical equipment representatives or through the ‘train the
trainer’ approach. Ensuring that each service uses equipment
familiar to community and acute local services will minimise
the risk of incorrect usage by intern, bank and agency staff.
All services have been provided with small sharps boxes in
order to ensure any sharp/needle is safely disposed of at
the patient’s side.
Needle stick and sharps reporting has shown that a higher
number of staff are being treated correctly following an
incident and being immediately assessed by a doctor either
via accident and emergency or by the in-house doctor.
16
Sue Ryder – Quality Account 2013/14
✓ We said, we would aim to assess the risk of sharps injury

in every centre.
Every incident reported through our electronic reporting
system, Datix, is monitored by the Infection Prevention and
Control Lead. Each service is contacted after the event and
offered support, suggestions and guidance about responding
to the incident but also looking at ways to minimise the risk
of this incident, happening again. A support staff member
is identified to offer support to any staff member who is
required to give a blood sample to test for any acquired
blood borne virus acquired during this exposure.
There are no reports of any staff member acquiring a blood
borne virus whilst working in our centres this year.
There have been 15 needle stick incidents this year, 12 in
palliative care services and three in our neurological services.
The higher number from palliative services reflects the high
use of equipment in these clinical care environments.
✓ We said, we would identify safer sharps equipment

and clinical practice to minimise injury.
We have reviewed our sharps materials and equipment and
are standardising safer sharps procurement. Each service area
has a comprehensive list of safer sharps equipment and has
reviewed practice regarding sharps management.
✓ We said, we would aim to offer consistent teaching

programmes, identifying those at risk and ensure they are
offered appropriate immunisation.
By the end of 2013 we will be offering immunisation within
all our neurological, homecare and palliative care services
for blood borne viruses. The infection prevention and control
training is mandatory and provided annually to all staff.
Our education staff have been supported by the Infection
Prevention and Control Lead to ensure this is consistent
across the organisation.
Part three: our priorities for improvement 2013/14
Priority 2: Service user safety
Priority 1: Service user experience
To further develop tools to measure how personcentred support is delivered in our services
To manage the risk of harm from medication by
piloting new ways of working with technology
In 2013/14 we will:
In 2013/14 we will:
• explore and embed the use of hand-held devices in
hospice settings to gain feedback in real time
• review current systems available electronically in hospices
for prescribing and administration
• develop electronic tools for capturing feedback
consistently across all hospices
• raise awareness about medicines risk for all staff by
including case studies in the two-yearly competency review
• expand the skills and commitment of our volunteers by
piloting a development programme to equip them to
gain feedback from patients and carers outside of the
professional workforce
• review the medicines competencies and ensure all
education leads receive reports on incidents, and include
this information as standard in training
• continue specialist review of all medicines incidents
• enhance links with volunteer coordinators in each hospice
to deliver local education and support programmes to help
us capture user experience
Executive Leadership Team (ELT) Sponsor
Steve Jenkin, Director of Health and Social Care
Executive Leadership Team (ELT) Sponsor
Steve Jenkin, Director of Health and Social Care
Implementation Lead
Sue Hogston, Head of Clinical Quality and Nurse Lead
Implementation Lead
Sue Hogston, Head of Clinical Quality and Nurse Lead
Programme Manager
Angela Kilip, Quality Manager and Service User
Experience Lead
Mark Woodfield, IT Systems Manager
Programme Manager
Helen Press, Quality and Risk Manager
Mark Woodfield, IT Systems Manager
Sue Ryder – Quality Account 2013/14
17
Priority 3: Effectiveness
Priority 4: Service user experience
To further develop our activity programmes
To measure our culture for care delivery and safety,
using a cultural barometer
In 2013/14 we will:
In 2013/14 we will:
• review service user survey results for activity groups that
run at our neurological and palliative care centres
• work with service users to develop a standard, which
reflects our approach to person-centred care and support
for meaningful activities and pursuits
• ensure there is a launching of the standard, bringing
together staff and volunteers who facilitate activities
and pursuits
• have a facilitated self assessment workshop and action plan
for each centre, working with their linked quality manager
• report on the overview of safety culture maturity to be
presented at Health and Social Care Governance Group
• monitor service actions via local Quality Improvement
Groups and assess through quality visits and audits
• measure progress through existing surveys, audits and
the ACORNS group
Executive Leadership Team (ELT) Sponsor
Steve Jenkin, Director of Health and Social Care
Executive Leadership Team (ELT) Sponsor
Steve Jenkin, Director of Health and Social Care
Implementation Lead
Sue Hogston, Head of Clinical Quality and Nurse Lead
Implementation Lead
Sue Hogston, Head of Clinical Quality and Nurse Lead
Programme Manager
Rudo Nyakuhwa, Quality Manager Education and Training
Programme Manager
Helen Press, Quality and Risk Manager
18
Sue Ryder – Quality Account 2013/14
Priority 5: Service user experience
Priority 6: Service user experience
To share learning from complaints and concerns and
publishing this information when it relates to up held
complaints regarding care delivery
To measure the effectiveness of new equipment for
service user and staff safety following the
introduction of ‘safer sharps’
In 2013/14 we will:
In 2013/14 we will:
• revise the Complaints Policy and associated templates
(following national recommendations from the Francis
Report 2013)
• conduct a specialist review of all sharps injuries
throughout the year
• revise the information for service users on how to express
a concern or make a complaint
• monitor compliance against national standards for
availability of equipment and staff attendance at our
vaccinations programme
• provide multiple ways through which concerns regarding
care delivery can be raised and ensure these are published
widely in our centres and central offices
Executive Leadership Team (ELT) Sponsor
Steve Jenkin, Director of Health and Social Care
Executive Leadership Team (ELT) Sponsor
Steve Jenkin, Director of Health and Social Care
Implementation Lead
Sue Hogston, Head of Clinical Quality and Nurse Lead
Implementation Lead
Sue Hogston, Head of Clinical Quality and Nurse Lead
Programme Manager
Helen Press, Quality and Risk Manager
Programme Manager
Lesley Bates, Quality and Effectiveness Manager
Sue Ryder – Quality Account 2013/14
19
Part four: indicators
1. Service user experience – all services
Service user experience is measured within the annual service user surveys in the following ways:
• percentage of service users who rated overall care as ‘Good’ or ‘Excellent’
• percentage of service users who responded ‘Yes, completely’ or ‘Yes, mostly’ that overall they were treated
with respect and dignity
Neurological care
Palliative care
l 2011/12*
l 2012/13
l 2011/12
l 2012/13
Rated overall care
Rated overall care
Treated with respect and dignity
Treated with respect and dignity
0
10
20
30
40
50
60
70
80
90
100 %
90
100 %
*2011/12 results for neurological care included Hickleton Hall
Community support and homecare services
l 2011/12
l 2012/13
Rated overall care
Treated with respect and dignity
0
20
10
20
30
40
50
60
70
Sue Ryder – Quality Account 2013/14
80
0
10
20
30
40
50
60
70
80
90
100 %
In 2012/13 we introduced the NHS Net Promoter Score to our hospices which measures how likely service users are to
recommend the service to family and friends. Our overall hospice score = 95
The response rate to our surveys is dependent upon those who are willing or able to complete the survey and therefore does
not necessarily represent the experience of all.
1.1 Neurological care 2012/13
Survey
Centre
Birchley Hall
The Chantry
Cuerden Hall
Dee View Court
Holme Hall
Stagenhoe
Percentage of service users
who rated overall care as
‘Good’ or ‘Excellent’
Percentage of service users
who responded ‘Yes, completely’ or
‘Yes, mostly’ that overall they were
treated with respect and dignity
93%
85%
95%
93%
95%
76%
100%
95%
95%
87%
95%
83%
Percentage of service users
who responded ‘Yes, completely’ or
‘Yes, mostly’ that overall they were
treated with respect and dignity
Those likely to
recommend the service
(Net Promoter Score)
100%
100%
99%
98%
98%
99%
98%
100
94
89
n/a
94
100
100
Percentage of service users
who rated overall care as
‘Good’ or ‘Excellent’
Percentage of service users
who responded ‘Yes, completely’ or
‘Yes, mostly’ that overall they were
treated with respect and dignity
81%
100%
96%
94%
95%
97%
1.2 Palliative care 2012/13
Survey
Hospice
Percentage of service users
who rated overall care as
‘Good’ or ‘Excellent’
Leckhampton Court
Manorlands
Nettlebed
St Johns
Thorpe Hall
Duchess of Kent House (West Berkshire services)
Wheatfields
100%
99%
99%
99%
98%
98%
100%
1.3 Community support and homecare services 2012/13
Survey
Service
Angus Homecare
Heyeswood
Stirling Homecare
Sue Ryder – Quality Account 2013/14
21
1.4 Person-centred care audit
In 2012/13 we developed a set of person-centred standards for our service users in neurological care. As part of an audit of
these standards we interviewed 21 service users across our centres to measure how well we are meeting these standards.
We measured the percentage of service users in the sample who responded ‘Always’ or ‘Sometimes’ to the following questions.
We felt this was a better means of applying the principles of a ‘net promoter’ type score within neurological care provision.
Survey
Responded ‘Always’
or ‘Sometimes’
Feel involved in writing their support plan
Feel they are treated with privacy and dignity
Feel confident that their support plan will be changed to reflect their needs and wants changing
Feel they have the opportunity to influence menus
Feel they have the opportunity to eat where and with who they want to
Feel listened to
Feel confident that they can talk to any staff member
The service provides activities that are meaningful to you
86%
100%
85%
86%
95%
95%
95%
95%
1.5 Formal complaints
We define a formal complaint as ‘an expression of discontent to which a response is required’. With reference to our
Complaints Policy, the complaint is considered formal when it is received orally, in writing or electronically and cannot be
resolved within 24-hours of receipt.
40% (n=10) of our services had no complaints between April 2012 and March 2013.
The target in the Complaints Policy for the initial holding response to complaints is three working days. Where the complaint
was initially received by a service, and where the complaint was by a named complainant 100% were acknowledged within
the timescale. This is an improvement on last year when 76.4% of complaints were acknowledged within three days.
The target in the Complaints Policy for the final written response to a complaint is 20 working days, however the policy does
acknowledge that in some instances this is not possible. This would usually be where the investigation is complex. In these
cases all services aim to maintain contact with the complainant, giving a report of progress. Of those complaints where the
complainant gave their name and where they requested a formal response, in 17 out of 18 instances the 20 working day
target was met. Where the target time was not met the complainant was sent a holding letter to explain the delay. All complaints
were resolved locally. These figures are comparable with last year’s data.
22
Sue Ryder – Quality Account 2013/14
The tables below show formal complaints figures for all services for April 2012-March 2013:
Neurological care
Complaints
Centre
Number of formal
complaints in
2011/12
Number of formal
complaints
2012/13
Percentage of
formal complaints
aknowledged within
3 days
Percentage of formal
complaints responded
to in writing within
20 days
0
2
2
0
0
3
0
1
2
0
0
0
–
100%
100%
–
–
–
–
100%
100%
–
–
–
Number of formal
complaints in
2011/12
Number of formal
complaints
2012/13
Percentage of
formal complaints
aknowledged within
3 days
Percentage of formal
complaints responded
to in writing within
20 days
Upheld/
Not upheld
Leckhampton Court
5
2
100%
100%
1 upheld
1 partially upheld
Manorlands
1
1
100%
Did not want a
formal response
Yes
Nettlebed
3
1 (CNS Service)
100%
100%
Partially
St Johns
2
0
–
–
–
Thorpe Hall
1
2
100%
100%
1 upheld
Duchess of Kent House
(West Berkshire services)
8
10
100%
90%
5 partially upheld
3 upheld
1 not upheld
1 anonymous complaint
with insufficient detail
to be investigated
Wheatfields
0
Birchley Hall
The Chantry
Cuerden Hall
Dee View Court
Holme Hall
Stagehhoe
Upheld/
Not upheld
–
1 upheld
2 partially upheld
–
–
–
Palliative care
Complaints
Hospice
Sue Ryder – Quality Account 2013/14
Where not met a
holding letter of
explanation was sent
1
100%
100%
1 upheld
23
Community support and homecare services
Complaints
Service
Number of formal
complaints in
2011/12
Number of formal
complaints
2012/13
Percentage of
formal complaints
aknowledged within
3 days
Percentage of formal
complaints responded
to in writing within
20 days
Upheld/
Not upheld
Fourways Suffolk
0
0
–
–
–
Angus Homecare
0
3
–
–
2 upheld
1 partially upheld
Heyeswood Extra Care
0
0
–
–
–
Stirling Homecare
8
1
100%
100%
1upheld
Doncaster
Befriending Service
Doncaster
Community Service
0
0
–
–
–
–
0
–
–
–
2. Safety
2.1 Incidents
There have been no incidents that have resulted in the death of service users in 2012/13. There was one incident relating
to permanent harm, for a fracture which occurred following a fall, and was investigated fully with family and commissioners
involved. A like for like comparison of current services shows a small reduction in incidents, however we shall monitor this
and ensure reporting of incidents will continue to be a priority for us in 2013/14.
We commend our staff for ensuring that all accidents, incidents and near misses are appropriately reported so that we can
learn from such incidents and strive to improve our care in order to minimise patient safety issues. The National Patient Safety
Association recognises that high reporting is a mark of a ‘high reliability’ organisation. Research shows that providers with
significantly higher levels of incident reporting are more likely to demonstrate other features of a stronger safety culture.
2.2 Number of incidents affecting service users 2012/13
Indicator
Neurological care
2011/12 2012/13
Number of incidents resulting in death
Number of incidents resulting in permanent or long term harm
Number of service user slips, trips or falls resulting in hospital visit
Number of reports under RIDDOR
–
–
13
1
–
1
2
0
Palliative care
2011/12 2012/13
–
–
1
0
–
–
4
0
Homecare
2011/12 2012/13
–
–
10
0
Within our homecare services, slips, trips and falls have been reported by the service but have not occurred during active
care delivery.
Our health and safety team review all incidents reported by services. They have supported frontline staff to ensure guidance
regarding RIDDOR* reporting is understood.
* RIDDOR – Reporting of Injuries, Diseases and Dangerous Occurrences Regulations
24
Sue Ryder – Quality Account 2013/14
–
–
6
0
2.3 Number of medication incidents 2012/13
Neurological care
Centre
Birchley Hall
The Chantry
Cuerden Hall
Dee View Court
Holme Hall
Stagenhoe
Total
Minimal harm, person required extra
observation or minor treatment
Moderate (short term harm – person
required further treatment)
–
9
1
1
2
6
19
–
–
–
–
–
–
–
There have been no medication incidents causing moderate or severe harm to service users in neurological care. We
encourage reporting of all incidents involving medicines, for example, any issues with late administration or of obtaining
prescriptions to identify trends and learning across care settings. The above represents 38% of all medicine incident
reports in neurological care.
Palliative care
Hospice
Leckhampton Court
Manorlands
Nettlebed
St Johns
Thorpe Hall
Duchess of Kent House (West Berkshire services)
Wheatfields
Total
Minimal harm, person required extra
observation or minor treatment
Moderate (short term harm – person
required further treatment)
1
5
5
3
13
6
6
39
2
–
–
–
1
–
–
3
There have been no medication incidents causing severe harm to service users in palliative care. We encourage reporting of all
incidents involving medicines. These include, for example, any issues with late administration or of obtaining prescriptions to
identify trends and learning across care settings. The above represents 13% of all medicine incident reports in palliative care.
Community support and homecare services
Service
Heyeswood
Angus Homecare
Stirling Homecare
Minimal harm, person required extra
observation or minor treatment
Moderate (short term harm – person
required further treatment)
–
–
–
1
–
–
There have been no medication incidents causing severe harm to service users in homecare but one causing moderate harm,
this incident was reviewed using a root cause analysis approach and we openly communicated with the patient and their
family from the initial incident until resolution, which did require treatment at an acute hospital. We encourage reporting of all
incidents involving medicines, for example any issues with late administration or of obtaining prescriptions to identify trends
and learning across care settings. The above represents 10% of all medicine incident reports in community support services.
Sue Ryder – Quality Account 2013/14
25
2.4 Regulatory inspection results
Neurological care
Centre
Birchley Hall
The Chantry
Cuerden Hall
Dee View Court
Holme Hall
Stagenhoe
Date of last
check from CQC
Standards of
treating people
with respect and
involving them
in their care
Standards of
providing care,
treatment and
support which
meets people’s
needs
Standards of
caring for
people safely
and protecting
them from
harm
Standards of
staffing
Standards of
management
6 March 2013
11 January 2013
17 September 2012
**
4 July 2012
2 November 2012
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
** Dee View Court is inspected by the Care Inspectorate in Scotland
Centre
Dee View Court
Date of last
quality visit
Quality of care
and support
Quality of
environment
Quality of
staffing
Quality of
management
and leadership
17 August 2012
6 (Excellent)
5 (Very Good)
6 (Excellent)
6 (Excellent)
Palliative care
Hospice
Leckhampton Court
Manorlands
Nettlebed
St John’s
Thorpe Hall
Duchess of Kent House
Wheatfields
26
Date of last
check from CQC
Standards of
treating people
with respect and
involving them
in their care
Standards of
providing care,
treatment and
support which
meets people’s
needs
Standards of
caring for
people safely
and protecting
them from
harm
Standards of
staffing
Standards of
management
1 March 2013
4 January 2013
20 February 2013
20 November 2012
13 December 2012
4 January 2013
29 December 2012
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
Sue Ryder – Quality Account 2013/14
Community support and homecare services
Service
Date of last
check from CQC
Standards of
treating people
with respect and
involving them
in their care
Standards of
providing care,
treatment and
support which
meets people’s
needs
Standards of
caring for
people safely
and protecting
them from
harm
Standards of
staffing
Standards of
management
Fourways (supported living unit) 24 November 2012
Heyeswood
2 January 2013
✓
✓
✓
✓
✓
✓
✓
✓
✓
✓
Service
Angus Homecare
Stirling Homecare
Date of last
quality visit
Quality of care
and support,
Quality of
environment
Quality of
staffing
Quality of
management
and leadership
January 2013
May 2013
4 (Good)
6 (Excellent)
Not assessed
Not assessed
4 (Good)
6 (Excellent)
4 (Good)
5 (Very Good)
For more information about our inspection results for our palliative, neurological and community support services in England,
please visit the Care Quality Commission website.
For more information about our inspection results for our services in Scotland, please visit the Care Inspectorate website.
Sue Ryder – Quality Account 2013/14
27
3. Effectiveness
Health Care Acquired Infections (HCAI) and pressure ulcers
The number of infections and pressure ulcers across all neurological and palliative centres reflects the period between
April 2012 and March 2013.
Cases are identified as those which were acquired by the service user whilst under our care, and those acquired prior to the
service user being admitted to one of our services.
Number of HCAI (2012/13)
Neurological care
Health Care Acquired
Infections
Acquired external
to service
Acquired within
own service
Acquired external
to service
Acquired within
own service
Acquired external
to service
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
2
5
6
0
0
0
0
0
0
0
11
7
0
5
5
3
1
2
0
0
23
5
6
0
0
0
0
0
0
0
11
7
0
5
7
3
1
2
0
0
25
Number of HCAI (2012/13)
Health Care Acquired Infections (2012/13)
l acquired within own service
l acquired external to service
Clostridium Difficile
Norovirus
MRSA (infection)
MRSA (colonised)
ESBL (infection)
ESBL (colonised)
Hepatitis (A, B or C)
Tuberculosis
Influenza
28
2
4
6
8
Total
Acquired within
own service
Clostridium Difficile
Norovirus
MRSA (infection)
MRSA (colonised)
ESBL (infection)
ESBL (colonised)
Hepatitis (A, B or C)
Tuberculosis
Influenza
Total
0
Palliative care
10
Sue Ryder – Quality Account 2013/14
new cases
Number of HCAI by service (2012/13)
Neurological care
Centre
Constridium
Difficile
Norovirus
MRSA
(infection)
MRSA
(colonised)
ESBL
(infection)
ESBL
(colonised)
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Constridium
Difficile
Norovirus
MRSA
(infection)
MRSA
(colonised)
ESBL
(infection)
ESBL
(colonised)
4
0
3
0
1
1
3
12
0
1
0
0
0
0
5
6
1
1
2
0
0
1
0
5
4
0
0
0
1
0
0
5
0
1
1
0
0
1
0
3
0
0
0
0
0
1
0
1
Birchley Hall
Chantry
Cuerden Hall
Dee View Court
Holme Hall
Stagenhoe
Total
Hepatitis Tuberculosis
(A,B or C)
0
0
0
0
0
0
0
Influenza
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Hepatitis Tuberculosis
(A,B or C)
Influenza
Palliative care
Hospice
Duchess of Kent House
Leckhampton
Manorlands
Nettlebed
St Johns
Thorpe Hall
Wheatfields
Total

1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3.1 Pressure ulcers 2012/13
The number of pressure damage reports has increased over 2012/13. This increase is reflected in both those admitted to our
services with pre-existing pressure damage and reports of pressure damage occurring whilst patients and residents are within
our services. It is important to note that 2011/12 saw a focus on education and recognition of pressure damage across all
services, this has continued into 2012/13. The increase in reporting reflects the overall increase in reporting; all incidents of
pressure damage are investigated. All service users have an assessment of their skin integrity. Pressure relieving equipment is
available in all care settings.
In 2012/13 we had three incidents of grade 3 damage; two of these occurred in our hospice care. We use a root cause analysis
approach (one of the recommended National Patient Safety Agency tools) to review such incidents. In all instances the care
was assessed to be of high quality, with damage directly linked to a pre-existing irreversible condition. These instances are
reported to identify trends and themes and will be one of our priorities for next year.

Pressure ulcers (2012/13)
l acquired within own service
l acquired external to service
Neurological care
Palliative care
0
50
100
150
200
Sue Ryder – Quality Account 2013/14
250
new cases
29
Number of pressure ulcers by service 2012/13 compared with previous year
Neurological care
Centre
2011/12
Birchley Hall
The Chantry
Cuerden Hall
Dee View Court
Holme Hall
Stagenhoe
Total
2012/13
Acquired within
own service
Acquired external
to service
Acquired within
own service
Acquired external
to service
5
4
0
3
3
1
16
–
2
1
4
1
4
12
7
11
0
3
4
4
29
2
2
1
0
1
0
6
Palliative care
Hospice
2011/12
Duchess of Kent House
Leckhampton Court
Manorlands
Nettlebed
St Johns
Thorpe Hall
Wheatfields
Total
30
Sue Ryder – Quality Account 2013/14
2012/13
Acquired within
own service
Acquired external
to service
Acquired within
own service
Acquired external
to service
2
15
14
11
13
2
12
69
11
23
29
9
51
23
14
160
8
17
5
10
18
22
9
89
19
26
19
15
54
47
11
191
Number of pressure ulcers (compared to last year)
(2011/12 adjusted for Hickleton)
Pressure ulcers (acquired within Sue Ryder)
l 2011/12
l 2012/13
Pressure ulcers (acquired external to Sue Ryder)
l 2011/12
l 2012/13
Neurological care
Neurological care
Palliative care
Palliative care
0
50
100
150
200
250
new cases
0
50
100
150
200
250
Neurological care
Palliative care
Pressure ulcers (acquired within Sue Ryder)
l 2011/12
l 2012/13
Pressure ulcers (acquired within Sue Ryder)
l 2011/12
l 2012/13
Birchley Hall
Duchess of Kent House
The Chantry
Leckhampton
Cuerden Hall
Manorlands
Dee View Court
Nettlebed
Holme Hall
St John’s
Stagenhoe
Thorpe Hall
0
2
4
6
8
10
12
new cases
Wheatfields
0
Sue Ryder – Quality Account 2013/14
new cases
5
10
15
20
25
new cases
31
Part five: annexes
Annex 1
There is a legal requirement to report on this section:
• during the period of this report, 1 April 2012 to 31 March
2013 Sue Ryder provided NHS-funded Community Health
Services through its 7 Adult Hospices, 8 Day Hospices,
1 Hospice at Home service, 3 Community Nursing Services,
5 Care Homes with Nursing*. In addition to these services
we also delivered care within 1 Care Home without nursing,
1 Supported Living Service and 1 Extracare Service
• Sue Ryder has reviewed all the data available to it on
the quality of care in all of the services detailed in the
preceding section
• the percentage of NHS funding is variable depending on
the nature of the service and ranges from 35 per cent to
90 per cent of the total cost of providing the service. The
shortfall is met from Sue Ryder charitable income
• the income generated by the NHS services reviewed in the
period 1 April 2012 to 31 March 2013 represents 100 per
cent of the total income generated from the provision of
NHS services by Sue Ryder for the period 1 April 2012 to
31 March 2013
• during the period from 1 April 2012 to 31 March 2013 there
were no national clinical audits or national confidential
enquiries covering the NHS services that Sue Ryder provides
– Sue Ryder sets an annual core audit programme that
runs from April – March each year. The core audit
programme is risk driven, and for hospices and
neurological care centres includes record keeping,
medicines management, falls prevention, manual
handling, pressure ulcer assessment and management,
care at end of life (neurological centres), infection
prevention and control including environmental and
hand hygiene audit
– the monitoring, reporting and actions following these
audits ensure care delivery is safe and effective. Each
service reports audit findings into their local Quality
Improvement Group. The Healthcare Governance
Committee for Sue Ryder receives a twice yearly
overview of audit results and actions taken in response.
Learning from audits is summarised and shared across
health and social care via Learning for Safety Memos
• from 1 April 2012 to 31 March 2013 Sue Ryder was not
eligible to participate in national clinical audits
• the number of patients receiving NHS services provided
by Sue Ryder from 1 April 2012 to March 2013 that were
recruited during that period to participate in research
approved by a research ethics committee was 20 patients
• Sue Ryder income in this reporting period for three hospices
was conditional on achieving quality improvement and
innovation goals through the Commissioning for Quality
and Innovation payment agreed via local commission
groups from PCTs
32
Sue Ryder – Quality Account 2013/14
• Sue Ryder is required to register with the Care Quality
Commission and its current status is registered. Sue Ryder’s
registration is subject to conditions. These conditions
include the registered provider, number of beds for the
following areas: 31 March 2013
– accommodation for persons who require nursing or
personal care
– diagnostic and screening procedures
– nursing care
– personal care
– transport services, triage and medical advice
provided remotely
– treatment of disease, disorder or injury
• Sue Ryder has not participated in any special reviews or
investigations by the CQC during the reporting period
• Sue Ryder did not submit records during the period from
1 April 2012 to 31 March 2013 to the Secondary Uses
service for inclusion in the Hospital Episode Statistics
which are included in the latest published data
• Sue Ryder will be eligible to be scored for the period April
2012 to 31 March 2013 for Information Quality and Records
Management, assessed using the Information Governance
(IG) Toolkit. The eligibility to be scored this year is due to a
change in our organisation type and amendments to the IG
Toolkit. Previously the only option that was available to Sue
Ryder, when first taking NHS services, was as a “Commercial
Third Party”. This did not focus on Information Quality and
Records Management. Last year a new organisation type
within the IG toolkit, “NHS Business Partner”, was introduced
and, since it is applicable to us, we self assessed and
submitted our evidence for level 1 (Amber)
• Sue Ryder was not subject to the Payment by Results
clinical coding audit during the period 1 April 2012 to
31 March 2013 by the Audit Commission
• Sue Ryder will be taking appropriate actions to improve
data quality. We will do this through
– increased awareness in the importance of reporting
– training including how to use our documentation
templates
– identifying trends through our balanced scorecard
reporting system
– ‘learning for safety’ memos for when systems and
processes change
• some of the people we support may be local authorityfunded, dependent on their needs
Annex 2
Statements from Lead Commissioning Primary Care
Trusts (PCTs), the Overview and Scrutiny Committee
(OSC) and Local Involvement Networks (LINk’s)
Feedback from NHS Leeds CCGs
“Leeds South and East Clinical Commissioning Group welcomes
the opportunity to comment on this quality account from
Sue Ryder. Leeds South and East CCG is also providing this
comment on behalf of Leeds North and Leeds West CCGs,
all of whom commission services from Wheatfields Hospice.
We believe the Account to be a fair representation of the
quality of services provided by the hospice. As none of the
information included in the Account is reported to the CCG as
part of the contractual arrangements, we are unable to verify
accuracy, although we have no reason to believe otherwise.
We feel that the Account is concise and readable, and
provides a good overview of quality within the organisation.
With respect to the review of progress against last year’s
priorities, we are pleased to see the progress made in
measuring how patient-centred support is delivered but
note the partial delivery of measuring personalisation of care
through the use of ‘mystery shoppers’. We are pleased to note
the intention to look at the development of technology-based
solutions in the future. It is not clear from the narrative what
progress was made in developing evidence based tools
through engaging with ACORNS and the clinical leadership
programme other than the introduction of a newsletter.
We acknowledge and commend the continued high scores for
patient satisfaction, but feel that combining number
of patients who responded ‘sometimes’ with those who
responded ‘always’ in the neurological centre person centred
care audit could present a misleading position. Showing
percentage of each type of response may have presented
a clearer picture.
We commend the organisation on being open with regard
to the number and types of incidents affecting service users.
We note the significant reduction against the previous year in
reported falls in neurological services and the increase in falls in
palliative care services. We are pleased to note full compliance
with all standards following CQC and Care Inspectorate visits.
We note the general increase in number of service-acquired
pressure ulcers compared to 2011-12. We are supportive of
the proposed priorities for 2013-14 but feel that the inclusion
of proposed actions to reduce the number of pressure ulcers
as one of the priority areas would have demonstrated a clearer
response and commitment to this issue.
We support the organisation in the priority areas proposed
for 2013-14 including the identification of those responsible
for implementation. We are particularly pleased to note the
intention to further develop activity programmes as this is an
issue commonly raised by users. We are also pleased to note
the intention to publish learning from complaints and concerns.
We would like to thank Sue Ryder for providing the Leeds CCGs
We are pleased to note that all services received a visit from the with the opportunity to comment on this Quality Account, and
national Clinical Quality Team focusing on person-centred care, look forward to improvements in service quality and patient
and that as a result the provision of meaningful activities for
care as a result of the priorities outlined within it.”
service users in neurological care centres was identified as an
area requiring improvement.
We are pleased to note the focus on reducing the risk of harm
from medication and the work that has taken place to support
this, including all medicine related incidents being reviewed by
a member of the Clinical Quality Team. We were particularly
pleased to note the sharing and spread of good practice in
relation to the introduction of a pre-admission checklist and
development of an information leaflet. The development of
initiatives in support of those affected by dementia and a club
to support bereaved children is also highly commended.
We also note the progress made in measuring and improving
the meal time experience and the work undertaken in support
of reducing the risk of sharps injury to service users and staff.
Sue Ryder – Quality Account 2013/14
33
Annex 2
Aylesbury Vale & Chiltern Clinical Commissioning
Groups (CCG)
“Aylesbury Vale & Chiltern Clinical Commissioning Groups have
reviewed the Sue Ryder Quality Account against the three
domains of Quality: Patient Experience, Patient Safety and
Clinical Effectiveness. There is evidence that the organisation
has relied on both internal and external assurance
mechanisms an example of such being the Care Quality
Commission reports and the commissioners are satisfied as
to the accuracy of the data contained in the Account.
The report provides a balanced overview of the Trust. It not
only identifies their achievements to date, but also areas
within their service delivery where improvements could be
made. The Clinical Commissioning Group’s (CCG) welcome
the openness and transparency of this approach and are
committed to supporting Sue Ryder in achieving
improvement in the areas identified within the Quality
Account through existing contract mechanisms and
collaborative working.
The key purposes of the Quality Account are to support the
organisation’s Board in assessing quality of the services they
offer and to help patients make choices between different
providers. The report is mainly successful in this area; however
the commissioners would have liked to see some form of
benchmarking against other providers. Whilst we
acknowledge that it is difficult to find peer trusts delivering
the same profile of care, comparisons with other specialist
services would be possible.
The Trust clearly understands the need for integrated
working; this is clearly evidenced within a number of new
initiatives, which have come on line during 2012/13. What
was not clear is whether the initiatives piloted at singular sites,
have or will be rolled out across all Sue Ryder localities.
Patient experience: The Quality Account describes the
commitment of Sue Ryder to use the experiences of people
who are touched by their services to develop their services.
Examples of this is the development of the pre admission
pack for in-patients, their commitment to support patient
centred care through the “No Decision about me, without me”
initiative and the use of Patient Participation Groups
(ACORNS). As commissioners we welcome this approach and
would encourage its continuation.
In the setting in which Sue Ryder operates, it is essential to
ensure the highest standard of patient experience. We are
pleased to see that this is being achieved and where this falls
short, steps are taken to correct.
34
Sue Ryder – Quality Account 2013/14
It was positive to see the survey results for patient experience
had improved from 2011/12. We note a marked
improvement in the neurological setting. The results
highlighting service users views of the Sue Ryder is also to be
commended with nearly all palliative care settings receiving a
100% in the “good to excellent” section, in relation to the
service users overall care.
Patient Safety: The Commissioners wish to commend Sue
Ryder for the continuation of the Clinical Leadership
Programme; this is now in its third year. As commissioners we
see leadership as a key element to the delivery of patient
safety and experience.
The development work in relation to the education for PEG
feeding appears to be a positive step forward in ensuring that
Sue Ryder staff have the knowledge and skills to perform
challenging tasks. This also provided assurance that the
nutritional requirements of patients were being considered as
well as the assurance that patients challenged in this area
were being safeguarded.
The report shows that the number of reportable incidents
reduced from the previous year. The commissioners were
concerned at the proportion of Slips, trips and falls
experienced across the services and would have liked to see
some reassurance about actions planned to reduce this in
2013/14.
We also note that the number of pressure ulcers acquired
whilst in the care of Sue Ryder has almost doubled from the
previous year, the commissioner note the education in
recognising pressure ulcers which took place in 2011/12,
however we are not assured that this alone has been the
primary cause for the increase and would like further
assurance that this area is of the highest priority with an
associated action plan for the 2013/14 year.
Clinical effectiveness: We recognise the commitment to
partnership working as a key tool to enhancing effectiveness,
as commissioners we are reassured to see this commitment
move forward from 2012/13 to the 13/14 year. The work
with Age UK is a good example when setting up the Dementia
helpline. We were unclear however, whether this success
would be shared and replicated to cover Buckinghamshire
patients.
Good nutrition is recognised as a key to promoting health and
wellbeing, Sue Ryder has clearly made a commitment to
increasing the standards in this area and have launched the
scheme known as “Our Mealtime Standards” we welcome this
as a positive step forward.
The Future: The 2013/14 priorities contained in the Quality
Account are consistent with priorities agreed with both
commissioners and those within the Francis Report. We are
particularly pleased with the initiatives, which Sue Ryder has
committed to in order to deliver enhanced quality.
Conclusion: This Quality Account provides a comprehensive
overview of the quality of care within the organisation and
commissioners look forward to continuing to work with the
provider in meeting the quality aspirations of local users,
carers, partners and staff. It is clear that the organisation is
positively embracing an integrated style of working across the
health and social care sectors and welcomes the benefits this
will bring to service users and their families/carers.”
Gloucestershire Clinical Commissioning Group
“Gloucestershire Clinical Commissioning Group is pleased to
have the opportunity to comment on the Sue Ryder Quality
Account. We continue to have an excellent relationship with
our Sue Ryder colleagues in Gloucestershire and are pleased
to see the progress that has been made in a number of areas
over the last year; particularly the focus on patient experience
and patient centred care.
The following organisations received our Quality Account
for 2012/13 but were unable to provide comments or
feedback this year.
• Bedfordshire Clinical Commissioning Group
• Bradford NHS
• Camden Healthwatch
• Central Southern Commissioning Support Unit
• Suffolk County Council
ACORNS
The Quality Account priorities for 2012/13 were agreed
by ACORNS at their meeting in March 2013. The draft Quality
Account was then circulated for comment. A summary version
of the Quality Account will be developed for service users,
their families and for display within our centres, as this has
proved popular.
Sue Ryder is an integral and valued partner in the delivery of
local palliative care services and we are delighted to see the
high levels of patient satisfaction reported in the Account.
There are regular meetings with the local commissioning lead
at which reports and information supporting the delivery of
quality services is shared. While we note the increase in the
numbers of falls and incidence of pressure sores in palliative
care this does not necessarily identify a trend and we believe
Sue Ryder should be commended for their transparency and
honesty in reporting these incidents. We look forward to
working closely with our colleagues to support improvement
and understanding in these areas.
Gloucestershire CCG welcomes the setting of clear priorities
for 2013/14 and looks forward to continuing to work
collaboratively on new initiatives to improve services across
Gloucestershire for patients.”
Our response to the comments we received
The comments we have received from commissioners are
important to us and we value the time taken in reviewing our
performance, initiatives and priorities for the year ahead. Each
of the comments and particularly the areas for improvement
will be factored into our Quality Improvement Plans,
specifically on falls and pressure ulcers prevention. We will
document the progress made and actions taken in next year’s
Quality Account.
Sue Ryder – Quality Account 2013/14
35
Sue Ryder
1st Floor
16 Upper Woburn Place
London
WC1H 0AF
For more information
call: 0845 050 1953
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