Supporting people to be Safe, Well and at Home
Annual Report and
Quality Accounts for 2013/14
Supplier of services to
Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Annual Report and Quality Accounts
2013/14
1
Introduction
Our vision, values and aims
Services provided by Plymouth Community Healthcare CIC
Statement from Chief Executive and Chairman
2
3
Priorities for improvement 2014/15
Statements of assurance relating to quality of services
1
Annual Report and
Quality Accounts 2013/14
1.1 Introduction
Welcome and thank you for reading our combined annual report
and quality accounts for the year 1 April 2013 to 31 March 2014,
we hope you find it interesting.
Our combined report sets out our vision, values and aims and
provides us with an opportunity to tell you about what we have
achieved in the past 12 months and about the challenges we
have overcome.
You can use the report to understand:
• What we are doing well.
• Where we need to make improvements.
Review of services
Aim 1 A recognised employee-led organisation
Aim 2 Based around local people and communities
Aim 3 Providing seamless system leadership
Aim 4 Where experience exceeds expectations
Aim 5 Sustainable, successful and admired
Quality indicators
Statements from third parties
• What our priorities for improvement are for the coming year.
• How we have involved staff, people using our services, carers and others to decide those priorities.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
1.2 Our vision, values and aims
Our aims
Our vision
• A recognised employee-led
organisation
To work together with others to help the local population to stay
physically and mentally well, to get better when they are ill, and
to remain as independent as they can until the end of their lives;
supporting people to be safe, well and at home.
• Based around local people and communities
Our values
• Where experience exceeds expectations
Involvement
• Sustainable, successful and admired
We will always involve the adults, children, and young people
we care for in deciding how we can provide our services to best
meet their needs.
Collaboration
We are committed to working collaboratively with other organisations
to achieve improved health outcomes for the local population.
Delivery
• Providing seamless system leadership
1.3 Services provided by Plymouth
Community Healthcare CIC
Plymouth Community Healthcare is one of more than 600
not for profit companies working in the UK’s health and social
care arena. We provide 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,
Cornwall and beyond.
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:
We 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.
Various Units at Mount Gould Hospital and the Local Care Centre
Empowerment
Syrena House
We 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.
Plym Bridge House
Think Family
We understand that offering services across the age range offers opportunities to develop a ‘Think Family’ approach to the care that we deliver.
Cumberland Centre
Glenbourne Unit
Lee Mill Hospital
The Thornberry Centre
Westbourne
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
1.4 Statement from the Chief Executive
and Chairman
Glowing report
from inspectors
The Care Quality Commission (CQC) carried out
an inspection of Plym Bridge House in Derriford in
December 2013. This was a routine and scheduled
but unannounced inspection to check that essential
standards of quality and safety were being met. Plym
Bridge House also received a positive report at the
previous CQC inspection in early 2013.
Welcome to our combined annual report and quality accounts
for Plymouth Community Healthcare CIC (PCH). These
accounts report back on our priorities for improvement from
our 2012/13 Quality Accounts, our key achievements and
improvements throughout the year and highlight our priorities
for improvement for the coming year.
This report is divided into three sections. Part one provides an
introduction to the organisation, part two sets out our priorities
for 2014/15 and includes statements of assurance, and part
three reviews our progress over the past year against our five aims.
The CQC announced that the service met all of the five
areas that were audited, which were;
• Consent to care and treatment.
• Care and welfare of people who use the services.
• Cleanliness and infection control.
• Supporting workers.
• Record keeping.
The inspectors spoke to staff, young people and their
families and carers in the unit.
The CQC quoted comments that included “The staff
really do care about you”; “It’s not that they are caring
for their job, it’s that they really, really care for you”;
“Staff will miss going home on time, to make sure we are
ok, they genuinely care” and, “When staff notice you are
feeling low, staff will sit with you until they know you
are ok, until you are smiling and happy again, they
will make you laugh”.
Chief Executive, Steve Waite said: “Plymouth
Community Healthcare is delighted to receive a
second very positive report from the Care Quality
Commission. We place the highest of priorities in
ensuring that our services are delivered to a high
standard. This report provides a very clear example
of the commitment, professionalism and caring
support of all staff at Plym Bridge House has been
recognised by the external inspection by CQC.”
People using our services and their carers deserve the highest
quality of care we are able to provide and as the health
environment becomes more competitive, quality is becoming
more important in everything we do.
Our staff are committed to improving quality and through their
continued dedication and commitment we have maintained a
very high standard of care.
Patient experience is a vital component to help improve our
services and relates directly to the Francis Report (2013) which highlighted the failings at Mid Staffordshire NHS
Foundation Trust. Plymouth Community Healthcare is
committed to ensuring that the support and care we offer is
of the highest quality. We will use every opportunity to learn
from the experiences of people using our services as well as
listening to colleagues in ensuring we continue to improve the
quality and outcomes for all our services.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
1.5 Who’s who?
I would also like to take this opportunity to thank our staff,
statutory partners, communities of interest, people using our
services and their carers who have helped us to focus on the
areas that are important and make a difference.
To the best of our knowledge the information contained within
this annual report and quality accounts is accurate.
Stephen Waite Chief Executive Plymouth Community Healthcare CIC
Duncan Currall Chairman Plymouth Community Healthcare CIC
1 Stephen Waite
1
Chief Executive
2
3
5
6
8
9
2 Duncan Currall
Chairman
3 Dr Andrew Sant Medical Director
4 Daniel O’Toole
4
Director of Finance & Deputy Chief Executive
5 Michelle Thomas
Director of Operations
6 Geoff Baines
Director of Professional Practice, Safety & Quality
7
7 David Ratcliffe
Non-Executive Director
8 Clare Tanner
Non-Executive Director
9 Morris Watts Non-Executive Director
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
2
2.1 Our priorities for quality
improvement 2014 to 2015
This year we have grouped our quality priorities under our five
aims. Together the aims address whether people who use our
services feel ‘cared for, safe and confident in their treatment’.
To help us compile our priorities we reviewed data collected
during 2013/14 from a number of different areas. These included
complaints and concerns, patient satisfaction surveys, service
user involvement groups, incident reports, staff workshops, our
commissioner’s intentions and the statements from our statutory
stakeholders from last year’s quality accounts.
We consulted with our stakeholders and asked them to
comment on the priorities we identified. The final stage of our
consultation process was to issue our annual report and quality
accounts to our statutory stakeholders and their statements are
published in the final chapter of this document.
Plymouth Community Healthcare CIC would like to thank
stakeholders for their involvement in the production of the
priorities for improvement and the supporting statements.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Priority
Aim
How will we
achieve this?
How will we
measure this?
Aim 1 A recognised employee-led organisation
Improving staff attitude
towards people who use our
services, relatives and carers
through customer service
training.
To ensure people
who contact our
organisation, or access
our services, have a
positive experience.
By evaluating customer
care training across
the organisation
and addressing any
inconsistencies that
have been identified.
Priority
Aim
How will we
achieve this?
How will we
measure this?
Aim 3 Based around local people and communities (continued)
Monitoring patient
feedback to assess
staff attitude towards
people in contact with,
or using our services.
Improving recovery from
stroke.
To offer a community
focussed approach and
rehabilitation.
To develop the Early
Supported Discharge
pathway.
By the percentage of
time that people who
use our services spend
in a stroke unit.
Aim 4 Where experience exceeds expectations
Aim 2 Providing seamless system leadership
Ensuring that records of
people who use our services
are held electronically.
To improve quality and
safety by enabling
health professionals to
share information more
easily.
There is a project plan
in place to roll out the
new patient electronic
system across the
organisation which will
involve both staff and
people who use our
services.
Outcomes will be
measured through
health record audits,
feedback from health
professionals and
people who use our
services.
Asking friends and families
whether they would
recommend our services to
a friend or relative based on
their treatment.
To improve the
experience of people
who use our services by
acting on their feedback.
Over the next year this
question will be included
in all patient surveys
and rolled out across all
services.
Response rates will be
monitored and reviewed
through our Safety,
Quality and Performance
Committee in order to
improve the experience
of people who use our
services.
Aim 5 Sustainable, successful and admired
Aim 3 Based around local people and communities
Improving dementia care
by increasing engagement
with carers of people with
dementia.
To support dementia
carers.
By developing a
dementia framework
and support network.
Patient feedback
will be monitored to
identify any comments
and concerns which
are raised regarding
support for dementia
carers.
To improve waiting times for all
of our services.
To reduce waiting times,
regardless of what is set
nationally, in order to
improve the experience
of people who use our
services.
By engaging staff and
people who use the
services.
Feedback from people
who our services will be
assessed and monitored.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Table 1
2.2 Statements of assurance relating
to the quality of services
This section of the document contains nationally mandated
statements of assurance and the purpose is to ensure that PCH
has considered quality of care across all the services it delivers.
Audit or
Enquiry
Eligible to Actually
participate participated
in
in
Data collection
completed
No. of cases
submitted
Actions
identified
Sentinel Stoke
National Audit
Programme
Yes
Continuous
data collection
which started
in January
2013, ending
early in 2015.
Between 1 April 2013 and
31 March 2014:
First quarterly set of audit
results is in the process of
being reviewed, including
development of actions
to raise standards, where
necessary.
Yes
Between 1 April 2013 to 31 March 2014, PCH provided 55
NHS services.
Plymouth Community Healthcare has reviewed all of the data
available to them on the quality of the care for all of these NHS
services.
The income generated by the NHS services reviewed in
2013/14 represents 92% of the total income generated from the provision of services by PCH for 2013/14.
2.2.1 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.
During 1 April 2013 to 31 March 2014, PCH participated in two
national clinical audits and one national confidential enquiry, for
which it was eligible; the details are set out in Table 1. Both of the
national clinical audits included questions against the National
Institute for Health and Care Excellence (NICE) guidelines.
The reports of 21 local clinical audits were reviewed by PCH in
2013/14. Four of these local clinical audits were against NICE
Mount Gould
Hospital Stroke
Rehab submitted
160 cases,
and the Early
Supported
Discharge (ESD)
Team submitted
209 cases, to
the audit. Note:
some cases are
for patients who
have been cared
for by both the
Rehab team and
the ESD team.
National Audit of
Schizophrenia
Yes
Yes
October 2013
90 cases
Awaiting report from Royal
College of Psychiatrists.
National
Confidential
Inquiry (NCI)
into Suicide
and Homicide
by People with
Mental Illness
Yes
Yes
Quarterly
returns made
Nine
questionnaires
sent to clinicians
regarding
suicides.
Quarterly returns enable
PCH to review the data
and identify individuals who
have had contact with our
Mental Health Services in
the 12 months prior to the
event. Consultants/clinicians
complete questionnaires which
are submitted to the Inquiry.
No homicides.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
guidelines. For every local clinical audit undertaken, where
appropriate, an action plan is created for the teams involved.
Each audit has an identified lead and the action plans are
monitored within operational and governance meetings.
Further details of the agreed goals for 2013/14 and the
forthcoming 12 months are available on request from daniel.otoole@nhs.net.
2.2.2 Participation in clinical research
2.2.4 Care Quality Commission (CQC) views
Plymouth Community Healthcare recognises the importance
of involving people who use our services in clinical research.
Using their direct experience helps us to provide better services
and improve overall quality.
We continue to run genetic trials looking into the prevention
of stroke and have completed the rehabilitation trial known
as ‘TWIST’. This involved using the Wii™ as a therapy and
rehabilitation aid in peoples’ homes to help recover strength in
their arms after a stroke. Results of the trial will be available
soon.
The number of patients receiving NHS funded services provided
or sub-contracted by PCH for the period 1 April 2013 to 31
March 2014, that were recruited during that period to participate
in research approved by the National Institute of Health
Research was 148.
2.2.3 Goals agreed with
Commissioners
A proportion of PCH’s income from 1 April 2013 to 31 March
2014 was conditional on achieving quality improvement and
innovation goals agreed between PCH and the NHS Northern,
Eastern and Western Devon Clinical Commissioning Group
through the Commissioning for Quality and Innovation (CQUIN)
payment framework.
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 2013/14.
Plymouth Community Healthcare is subject to periodic reviews
by the CQC and the last published review was in February
2014 at the Cumberland Centre. The CQC’s assessment of the
Cumberland Centre following the review was that all standards
assessed had been met.
Plymouth Community Healthcare has not participated in
any special reviews or investigations by the CQC during the
reporting period.
Full reports of CQC reviews are available at the following link:
www.cqc.org.uk/public.
2.2.5 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 people who use our services’ and our
community involvement.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
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.
2.2.6 Secondary uses service
Plymouth Community Healthcare submitted 1,553 inpatient
and 2,957 outpatient records between 1 April 2013 to 31
March 2014 to the Secondary Uses 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:
98.6% for admitted patient care (national average 99.1%)
2.2.7 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:
99.9% for admitted patient care (national average 99.9%)
100% for out patient care (national average 99.9%)
To improve data quality PCH will be setting 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.
2.2.8 Clinical coding
Plymouth Community Healthcare was not subject to the
Payment by Results clinical coding audit that took place
between 1 April 2013 to 31 March 2014 by the Audit
Commission.
99.4% for out patient care (national average 99.3%)
2.2.9 Information governance
Plymouth Community Healthcare’s score for 1 April 2013 to 31
March 2014 for Information Quality and Records Management
assessed using the Information Governance Toolkit (IGT)
was 68%, and graded as ‘green’ (satisfactory). This is an
improvement from last year which was 66%.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
3
Review of our services
2011/12
I would recommend this organisation as a
place to work (results in %)
2013/14
45
40
In this section we look at our progress against priorities identified last year
and our current position. Our progress has been grouped under our five
strategic aims and together they address whether people who use our
services feel ‘cared for, safe and confident in their treatment’.
35
30
25
20
15
Aim 1 A recognised employee-led organisation
Staff Survey
Earlier this year PCH asked a random selection of 750 employees the
following two questions:
10
5
0
5
5
Strongly
disagree
12
13
Disagree
30
23
Neither
agree nor
disagree
40
40
Agree
If a friend or relative needed treatment I would be
happy with the standard of care (results in %)
14
19
Strongly
agree
2011/12
2013/14
60
• Would you recommend this organisation as a place to work - agree or disagree?
50
• If a friend or relative needed treatment I would be happy with the standard of care – agree or disagree?
30
422 employees responded to the survey and the results are shown in the
graphs. The results to the first question show that 59% of staff in 2013/14
would agree or strongly agree to recommending the organisation as a place
to work compared to 54% in 2011/12. This shows a 5% increase compared to
the previous year.
40
20
10
0
2
3
Strongly
disagree
8
8
Disagree
22
18
Neither
agree nor
disagree
50
44
Agree
18
27
Strongly
agree
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
The results to the second question show that 71% of staff in 2013/14 would
agree or strongly agree with the standard of care if their friend or relative
needed treatment compared to 63% in 2011/12. This shows an increase of 3%
compared to previous year.
Our Voice – the staff engagement council
The purpose of Our Voice is to enable staff to influence the future direction of the organisation and debate current issues that affect the business it is
engaged in.
Our Voice ensures that, through its membership, the views of staff are used
to help shape the business and strategy of PCH and the services it provides,
thereby giving those staff a voice.
It will continue to improve quality and levels of service to the community we
serve and as a Community Interest Company, look to re-investing any surplus
into the community.
The aims for the forum are:
• To help improve the health and wellbeing of the local community.
• To help contribute to the improvement of staff satisfaction and experience.
• To contribute to improving our organisation.
Improving staff attitude
Excellent customer care is a key priority for PCH. Last year we introduced
customer services training to both our induction and staff annual updates.
The training has been well received and provides staff with the principles and
skills to enhance the patient experience in every day practice. The training
programme is reviewed and evaluated regularly and we will continue to monitor
feedback to ensure that we continue to deliver high quality services. This
remains a priority for 2014/15.
Apprenticeship Week
Plymouth Community Healthcare supports Apprenticeship Week by participating
in a variety of activities. Every year National Apprenticeship Week increases
in popularity, the seven day celebration is packed with activities and
interactive careers events designed to encourage more people to sign up for
apprenticeship schemes and motivate employers to recruit more apprentices in
their workplace.
Plymouth Community Healthcare is supported by the Wider Workforce and
Apprenticeship Lead at Health Education South West and the National
Apprenticeship Service to provide apprenticeship opportunities for both new and
existing employees.
Michelle Thomas, Director of Operations said: “As an organisation we want to
help prepare the future workforce of Plymouth for roles in healthcare. Our aim
is to be an employee led organisation and to help us achieve this it is important
that people from our communities have opportunities to work with us. We are
integrated into the communities of Plymouth and employing local people is very
important to us an organisation.”
Sophie Rowntree, recently qualified Finance Apprentice said: “After completing
my A Levels, I thought this role would be a great opportunity to train to be
an Accounts Assistant through the Association of Accounting Technicians
qualification, whilst gaining practical experience of using skills within the finance team.
“Since completing my apprenticeship in July 2013, I have filled the Management
Accounts Assistant vacancy within finance, meaning my involvement within
the team has expanded. I have been given more challenging responsibilities in
order to coincide with the more in depth knowledge I am learning through my
accounting course.”
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Mount Gould Plymouth care workers say team work is key to their success
If variety is the is the spice of life then porter Shaun Craddock and matron Sue
Goodman have plenty to keep them motivated.
For Mr Craddock, one minute he can be greeting a patient as they step-off the
ambulance, the next he can find himself transporting life-saving blood or oxygen
to another.
Every day at Mount Gould Hospital is different as the team support their patients
to full-health and independence.
“I enjoy helping out in the community and being part of a team,” said the
23-year-old porter. “It is a nice place to work and a friendly environment. I feel
like it’s good work and I feel needed.”
Mr Craddock and Mrs Goodman have very different jobs but the colleagues say
it is all about coming together to achieve the best results.
Mrs Goodman, who oversees two of the six hospital wards, said: “I work as
part of a team and everything I do is reliant on the rest of the team being as
committed as I am. We help people get as much independence as they can and
live as full a life as they can, wherever they want to live it.”
Some patients have even compared the experience to being in a hotel, said the
former John Kitto pupil, Mr Craddock.
“There is a lot of time for patients here and they always come first,” he
explained. “I know a lot of people do not like coming into hospital but I have
seen people crying when the ambulance comes to pick them up because they
don’t want to leave. They make friends with the nurses and they sometimes pop
in to say hello afterwards.”
Aim 2 Based around local people and communities
Improving communication and information
Part of our commitment was to develop three easy-read documents for three
of our key services. To date we have developed policy guidance for staff which
focuses on producing information for patients and the public. It contains a useful
checklist that services can use to help them develop a leaflet that can help
reach their target audience.
A new easy read guide to methods of contraception and information on local
Sexual Health Services has been created for those working with people who
have a learning disability. The information is presented in mostly pictorial form
and has been designed to help initial discussions before referring on to a
specialist service for further advice.
Jenny Hoare, from Harbour Drug & Alcohol Services, said, “Having worked in
and around the sexual health field for 10 years with both young people and
adults, I was pleased to hear that some guidance has finally been written and
produced with a view to supporting people with learning disabilities.
Plymouth has a wide variety of services that support young people and young
adults with their sexual health needs, but I believe there was a gap for both
service users and practitioners in delivering accessible information in an
understandable way. I am impressed by the way it has been put together as a
very accessible tool for professionals and I look forward to putting it into use.”
“It puts trust back in the hospital environment. It is the small things we have like
the free parking, free TV, good food and time with the patients.”
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Implementation of the NHS Safety Thermometer
Urinary catheter related infections
A priority from last year was the NHS Safety Thermometer which allows teams
to measure harm and the proportion of patients that are ‘harm free’ during their
working day. The following has been introduced over the last year to measure,
assess, learn and improve the safety of the care provided:
Catheter related infections can be caused by a number of factors and they can
all cause considerable pain and discomfort to the sufferer.
•
Collecting data regarding falls, pressure ulcers, Venous Thromboembolism (VTE) and urinary tract infections in patients with catheters.
•
Targets linked to reducing the number of pressure ulcers.
An audit performed in September 2012 identified that there were 416 patients
with a catheter. Of these, 52 were found to have an infection relating to the
catheter.
•
Learning being shared with care homes and outside agencies to reduce further harm therefore improving service provision and safety.
•
Publicising results to teams and monitoring trends.
Our three Professional Leads were used to provide expert professional advice
to operational managers regarding practice issues, performance, quality
standards and workforce planning.
One of the many key areas which have benefitted from the involvement of
the Professional Leads is that of Harm-Free Care, incorporating issues such
as Falls, Catheter Associated Urinary Tract Infections (CAUTI) and Pressure
Ulcers. The Leads have engaged with PCH services, as well as those from
the wider health community, implementing new incident reporting processes
and providing training to staff as well as designing and producing all of the
supporting materials required, such as the Catheter Passport (now in use not
only by PCH but also in care homes across the region).
These areas of work under the Harm-Free Care agenda are recorded via the
Safety Thermometer - the data is then used to evidence good practice.
Nurses from PCH and the private sector have introduced new ways of working
resulting in a reduction in the numbers of people with urinary tract infections
relating to their catheters.
An audit performed in September 2013 identified that this figure was reduced
to just 20 patients with an infection, this equates to a 50% reduction in catheter
associated urinary tract infections.
The biggest reduction of catheter usage was in Nursing Home’s and Community
Hospital settings – with instances of catheter associated urinary tract infection
reduced to nil. The reduction in infections was achieved following a continued
effort by District Nurses, hospital ward staff and staff in Nursing Homes.
Electronic patient records
A priority from last year was to implement a system to record and store patient
records electronically. Electronic records will help improve quality and safety by
enabling health professionals to share information more easily.
A project lead and team have been appointed to implement the new system. In
December 2013, the system was launched at the Minor Injuries Unit - the first
service to use the new system. The implementation is still in its early stages
and will remain a priority for 2014/15.
Linda Badcock, Senior Nurse Practitioner said “Initially I was very excited about
electronic patient records as they have been promised for many years, and it
was good to hear it was finally happening.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
“The main advantage is the potential for sharing of patient information between
healthcare professionals. Instead of relying on patients to know the names of
their medication and drug allergies, once the system is live across PCH we will
be able to view their GP records for current medication once consent is gained.”
“This makes it so much safer for patients and for us as professionals. Another
advantage is that we don’t struggle to read people’s handwriting anymore! It
will be great when it goes live all the way across PCH and other healthcare
providers.”
Improving how we inform people about possible side effects
Over the past year PCH has been working with many groups and committees
across the organisation to promote greater awareness of improving how we
inform people of possible side effects. This includes:
•
Prescribers are always encouraged to comment on any side effects when initiating therapy.
•
Patient Information Leaflets (PILs) added to every supply.
•
A greater range of ‘patient friendly’ information on medicines is available and encouraged.
•
Our website now having links to NHS Choices, Patient.co.uk (medical information and support) and the Maudsley Hospital, all of which are sources of useful information.
•
Many wards, for example the Glenbourne Unit having these leaflets ready printed to give to patients.
Awareness raising will continue over the next year, and improvement will be
monitored through our patient satisfaction surveys.
Livewell
The Livewell team was established in April 2013. The Livewell team is set
up to provide support and advice about healthy lifestyles to the people of
Plymouth. Livewell provides a number of services including a 12 week weight
loss programme and a stop smoking service. The team also attends events
throughout the City offering advice about different ways to improve health such
as sun safety and knowing your limits for alcohol.
Since the launch of Livewell thousands of people have taken advantage of the
support and advice.
Plymouth Dad kicks the habit
A father of two from Plymouth has successfully stopped smoking with the
Livewell Stop Smoking Service after he became worried that his 25 a day habit
would mean he’d not be able to give his children an active childhood.
Andrew Pearse 41, had been smoking since he was 18 years old and had tried
to quit several times before.
Following a recommendation from his doctor, Andrew got in touch with Livewell
Stop Smoking Service. “I met the adviser and was really impressed by how
much she listened and understood my problems without being judgemental. The
ongoing support from Livewell was great. It was invaluable to be touching base
with someone outside your working or private life. It felt like I was really working
with somone to overcome my addiction rather than facing it alone.”
Living life to the max
“I was referred to the 10% Club following a Hearty Lives health check as my
BMI was in the overweight category. I made a phone call and got signed up on
the January programme run at Activ8 Community gym, Scott Business Park.
I learned a lot and found it very informative and interesting. I learnt about portion
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
sizes, label reading and the importance of reducing salt in my diet. I found the
traffic light labelling system very useful. Also not to believe all the health claims
made on the packaging!
I’m not quite as breathless now, and I do a lot more walking! I have regular visits
to my chiropractor and he was very pleased when he saw me. I usually need to
have manipulation on my back, but it wasn’t necessary this time, and he is in no
rush to see me again.
My blood pressure has also reduced, and I have stopped taking one of my BP
tablets.”
Senior health minister visits Plymouth to open new doctors’ surgery
A senior Government health minister visited the City to officially open the new
Cumberland GP Practice.
Dr Daniel Poulter MP, Parliamentary Under Secretary of State for Health, visited
the Peninsula School of Dentistry’s Devonport Dental Education Facility, as well
as Derriford Hospital to meet staff and see the services provided.
Dr Poulter has worked as an NHS hospital doctor specialising primarily in
obstetrics, gynaecology and women’s health. He continues to practise medicine
as an NHS hospital doctor on a part-time basis as well as serving as an MP and
minister.
Celebrating its first anniversary, the Cumberland GP Practice currently provides
NHS care to 800 local patients.
Aim 3 Providing seamless system leadership
Safeguarding adults, children and young people
In September 2013, PCH developed the role of Integrated Safeguarding Lead
for adults and children which provides assurance around safeguarding the
people who use our services. As part of this new arrangement, PCH developed
an Integrated Safeguarding Committee which brings key people within PCH
with key partners in working together to safeguard people at both a practical
and strategic level.
Our Director of Professional Practice, Safety and Quality is the Executive
Director for Safeguarding and represents PCH on the local safeguarding
children and adults boards and is the vice chair of the safeguarding children
board. Within PCH the safeguarding children team work with staff to provide
safe services and also train staff in the practice of safeguarding children.
Similar training exists for those staff working with adults. PCH also collaborates
with other agencies to investigate adult safeguarding alerts and we are an
important part of the health and social care network that collaborates together
every day in keeping people safe.
Improving dementia care
An executive lead and operational lead have been identified to take forward the
dementia framework and support network across the organisation. To improve
the overall experience of people using our services the following has been
implemented over the last year:
• Identifying dementia champions in all inpatient ward areas who undertake a proactive role in promoting dementia awareness, developing training and facilitating learning within every day practice.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
• Implementing dementia education workshops for staff, carers and patients.
Integrated health care
• Continuously reviewing the dementia pathway by working closely with the community and other stakeholders to stop crisis prevention admission (stopping people from coming into hospital when it is not appropriate).
Plymouth dementia care pilot has helped to halve the number of hospital
admissions and enabled more dementia patients to be treated in, or close to,
their own homes has been highly commended in the 2013 NHS Innovation
Challenge Prize for Dementia.
The following work is planned for 2014/15:
• Reviewing the dementia pathway model to include a nurse triage assessment at the point of contact; this will improve efficiency and unnecessary delays to treatment.
• More targeted educational workshops for staff to ensure they have the right skills and relevant training in place.
• Patient’s diagnosed with dementia will be offered a two hour post diagnosis information training session with their carer and the service; offering further support to help identify what else can be put in place to support them.
• A holistic care plan which will follow the patient throughout their care.
• Implementing the ‘Dementia Friends’ initiative to raise basic awareness of dementia across the organisation.
• Existing nurse medication clinics will work closer with GPs to improve partnership working and care for people who use our services.
• Our memory service and complex care team are undertaking a separate piece of work which is focusing on supporting carers when diagnosis has been received.
• Having a dedicated sensory room for people with dementia.
This will remain a priority for 2014/15.
Councillor Sue McDonald, Cabinet member for Public Health and Adult Social
Care, said: “‘We are very proud of our social care and health staff who, in a time
of great pressure, have managed to focus on the needs of people with dementia
and have demonstrated such fantastic innovation in the way they work.”
Over a 19 week period the Plymouth Care Co-Ordination Team (run jointly
by Plymouth City Council and Plymouth Community Healthcare), operated a
centralised dementia hub in one area of the city, taking referrals from a wide
range of health and social care professionals.
Using a new joined-up approach, the team made detailed health and lifestyle
assessments before working with patients, their families and local health
services to devise targeted care plans designed to meet the specific needs of
each individual. As a result, the number of people with dementia needing to be
referred to hospital during the pilot almost halved from a baseline of 29 per cent
to just 15 per cent.
Steve Waite, Chief Executive of Plymouth Community Healthcare, said: “I am
delighted that our integrated approach, developed by the team members, has
been so successful. It is a new approach which is being rolled out across the
city, a reflection of our ethos of supporting people to be safe, well and at home.
Plymouth Community Healthcare, as a social enterprise, provides a range of
integrated services for people with physical and mental health problems, this
development was a natural and welcome progression for us to support.”
Improving recovery from stroke
This was a priority identified from last year. An Early Supported Discharge Team
(ESDT) for Stroke began originally as a pilot in May 2012 and became a service
in October 2012.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Since the service began in October 2012, it has provided
a seven day a week service with patients being seen
by a team member within 24 hours of discharge from a
care setting. The team consists of a manager, dedicated
stroke co-ordinator, physiotherapists, occupational
therapists, speech and language therapy, rehabilitation
assistants and access to neuropsychology and stroke
medical consultant.
Each patient’s therapy consists of a session as and when
required and is supported by rehabilitation assistants,
with the aim of supporting a person for six weeks after
discharge. The team works with carers, GP’s, District
nurses, community therapy teams, hospital settings and
care homes.
Strong links have been formed with teams both locally
and regionally, such as the Stroke Association, Stroke
Co-ordinators for Cornwall and neuro community teams
for Devon areas. This helps with signposting and
referring people who use our services onto more local
teams when their ESDT therapy/care has concluded.
Aim 4 Where experience exceeds expectations
An educational lead for stroke supports ongoing training
for staff and care settings when required.
Patient experience
Improving recovery from stroke has been identified as a
priority for 2014/15.
At PCH we take feedback very seriously because it is 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 have done, and we
are continually looking for ways to make it easier for people to share their
experiences with us.
We need to know when we have, and have not delivered exceptional levels of
service, and we always take appropriate action to improve things when we let
people down.
We have introduced several mechanisms to involve people who use our
services and their carers to provide feedback. Some examples include our
annual patient survey, the National Patient Opinion website, the use of tablets
and kiosks to gather feedback, via our website, by speaking to a member of
staff, working with Plymouth Healthwatch, digital recordings of the patient’s
experience, patient stories to the board, patients sitting on recruitment panels,
user groups, attending local health events and feedback via our localities.
Recommending our services
Plymouth Community Healthcare is now asking people who use our services
whether they would recommend it to their friends and family.
From June 2013 to March 2014 our Minor Injury Unit (MIU) and inpatient areas
asked patients if they would recommend their service to friends and family.
2495 people from the MIU fed back their views and 95% said that they would
recommend our services to friends and family.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Over the next year we will be rolling this question out to all our service areas
and it will remain a priority for 2014/15.
Patient survey 2013/14
The main aim of the survey is to ensure people who use our services, 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. Questionnaire responses have increased year on year as more services
are routinely carrying out surveys.
What people say about our services
“Just a quick note to express our gratitude for the outstanding care you
provided. We feel we couldn’t have done this without you. In his last few days
before passing away, the standard of care and compassion exceeded our
expectations. All the staff helped to make his last few days special as he was
treated with respect and dignity. This helped make his last few days with us
comfortable and took the worry away from us as the care was exceptional. We
couldn’t have asked for more.”
“I felt I had to write to you with words of praise for your
support team. I have suffered from anxiety depression
for a number of years now, and some time ago I was
invited to go along to Innes House on a Tuesday
afternoon to a support group. I very often felt quite low
when I arrived - but always now I leave feeling much
better - and smiling!”
“My mother who has medium to severe Alzheimers had
to be admitted to the Edgcumbe Unit to be assessed
as it has become increasingly hard to care for all of her
needs at home. From the first day we took mum into the
unit all of the staff have been so caring and kind, not
only to her but to us as a family. Mum has been there for
almost nine weeks and is now waiting for a space in a
nursing home.”
“At all times the OT staff were patient, professional,
supportive and caring. I am also grateful to the OT
department for offering “Saturday sessions”. I am due to
be discharged tomorrow, much better than when I came
in. With many thanks once again.”
“To everyone who helped, just a quick card to say thank
you for all your help. You have given me the ability to
carry on and for that, I really thank you. I hope you all
enjoy the cakes”.
“Thank you for being there for us when we most needed it. It was such a
frightening time in a world that seemed so dark at that time and you brought
clarity. Thank you so much, with love…..”
“We are writing to commend one of your staff, who has been our support
over the past few months. Her pleasant, relaxed and helpful approach and
demeanour has greatly assisted in what could have been a far more difficult
time. She has been there to offer us options and let us make our own decisions
and has been fully behind and supportive of us.”
“I am writing to you to say a big thank you to your team for the fantastic support
they have given to our mum since her discharge from hospital in September.
We feel her remarkable progress, at the age of 94, has been down to the
wonderful help and encouragement she has been given by your visiting
professionals. “
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Some examples of what we have put in
place as a result of concerns raised:
Complaints, concerns and compliments
Plymouth Community Healthcare welcomes and
encourages feedback from people who use our services,
carers, family members and the public about the services
we provide. Based on the feedback we received in
2013/14, we know that most people who use our services
are happy with the care and treatment provided by PCH.
However, sometimes this care and treatment falls short of
the high standards people deserve. When this happens
it is very important that we hear about it so we can learn
from that experience and improve in the future.
Our complaints procedure has been established in line
with NHS best practice guidance and our aim is to address complaints and concerns quickly and efficiently. All complaints that PCH received in the reporting period
were acknowledged within three working days.
160
135
Being open with people who use our services about what
has happened and discussing incidents quickly, fully and
compassionately can help all those involved cope better
with the after effects of safety incidents.
We listened and acted
People who use our services felt that they were not
being treated appropriately e.g. they had concerns
about treatment provided and issues about their
assessments.
Face to face meetings are now offered to
complainants at the acknowledgement stage.
Putting appropriately constructed care plans in
place.
Raising awareness of where staff can locate
relevant up to date policies and procedures.
1196
During the reporting period PCH received the following
number of complaints, concerns and compliments.
The duty of candour is a contractual requirement for PCH.
What this means is that we are required to tell people who
use our services if their safety has been compromised,
apologise and ensure that lessons are learned to prevent
them from being repeated.
Issues identified
Complaints
Concerns
Compliments
Staff being insensitive, condescending,
unprofessional and lacked compassion.
Introduction of customer services training for all
staff, including standards of behaviour.
Disclosure of personal identifiable information and
concerns about sharing information with other
agencies.
Refresher training provided to teams regarding
documentation, care plans and information sharing.
Letters forwarded to patients containing errors and
inaccuracies.
Guidance produced regarding the process for
checking, signing and sending letters.
Obtaining consent to share information.
New process implemented to improve
communication with another agency regarding
consent to share.
Making clients aware of the remit of confidentiality
and when information should be shared.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Eliminating mixed sex accommodation and maintaining
privacy, dignity and respect
We believe that people who use our services have the right to receive
high quality care that is safe and respects their privacy and dignity. We are
committed to providing every patient with same sex accommodation, to
protect their privacy and dignity during their inpatient stay. Over the last year
all inpatient areas have been compliant with Department of Health guidance
and we have not had any breaches reported. Our declaration of compliance is
published on PCH’s web pages and also published in each inpatient ward so
that people who use our services and visitors are made aware.
We have also introduced an ‘Eliminating mixed sex accommodation’ policy
which is designed to provide guidance to PCH staff to enable them to provide
care and treatment to people who use our services in a way which maintains
their right to privacy and dignity. To continue improving our services we have
in place an eliminating mixed sex accommodation delivery plan and several
methods in which people who use our services can feed back their experience.
Reducing the number of medication incidents
Plymouth Community Healthcare continues to adopt an open culture where it
is normal practice for staff to report medication incidents without fear of being
criticised or reprimanded. This includes learning from incidents, sharing good
practice and examining how incidents have been dealt with. All medication
incidents reported are sent to the Chief Pharmacist by email who takes any
immediate action required and then forwards to any individuals or outside
organisations for further information or investigation. Plymouth Community
Healthcare’s Medicines Governance Group meets monthly to review medication
incidents and any learning is shared across the organisation to help improve
medication errors.
reporting culture within the organisation (it is recognised nationally that many
medication errors are never reported). For the period January to December
2013 we had 409 medication incidents reported compared to 365 in 2012. The
increase reflects more activity, greater transfers of care, incidents reported
by PCH staff which relate to other organisations and an increased reporting
culture.
Learning and progress will continue to be recorded and monitored through
PCH’s Safety, Quality and Performance Committee on a monthly basis. We will
be participating fully in the Medicines & Healthcare Products Regulatory Agency
(MHRA)/NHS England Patient Safety Alert “Improving medication error incident
reporting and learning” from March 2014.
Incident reporting
Plymouth Community Healthcare recognises the value and importance of
ensuring all lessons learned from incidents are shared across the organisation.
In 2013/14, 4783 incidents were reported of which 4475 resulted in no harm or
were categorised as a minor injury requiring first aid. This is an increase of 679
incidents which were reported in the previous year. The increase is attributed
to our web based reporting system which was introduced in 2011 and has
enabled staff to improve both reporting and monitoring of incidents across the
organisation. Staff are also actively encouraged to report minor and near miss
incidents as evidence has shown that learning from these has helped reduce
incidents with more serious outcomes.
We have an average rate of reporting of medication incidents, 95% of which are
‘no harm’ incidents and this is regarded as good as that demonstrates an active
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Aim 5 Sustainable, successful and admired
Infection prevention and control
Keeping patients and wards infection free is a key priority for PCH and we are
committed to having the highest possible standards of hygiene and infection
prevention and control. During the last year PCH has received one case of
hospital acquired Clostridium Difficile (healthcare-acquired infection) and for
the third year running there has been no cases of MRSA (Methicillin Resitant
Staphylococcal Aureus Bacteraemia). This fantastic achievement is the result
of the hard work of staff right across the organisation and the support of people
who use our services and visitors.
Healthcare-associated infections remain one of the health service’s biggest
challenges and although we have an excellent track record we are not
complacent and continue to work hard to eradicate all hospital acquired
infection.
Hygiene Award for Sister Val
Sister Val Radmore, who works in infection prevention and control, received
a ‘highly commended’ in the national schülke Hand Hygiene Champions
of 2013 awards. The three judges praised Val and commented: “This is a
very impressive entry. Val has certainly gone the extra mile to promote hand
hygiene.”
Val was nominated by Sister Deborah Pudner, who said: ‘I think Val deserves
a hand hygiene champion award as she has been educating and encouraging
individuals to implement good standards of HH for over 15 years.”
Val has helped devise hand hygiene posters, patient leaflets, which include
hand hygiene techniques and made a hand hygiene video which can be found
on YouTube.
Improving the waiting times for Child & Adolescent Mental
Health Services (CAMHS)
This was a priority set last year and we have improved the way that we engage
with young people to better understand their views on CAMHS. We have set
up focus groups to ensure that we ask young people about the specific care
pathways they are on to support redesign and development. We are also
improving our website with the help of our young people and their families and
providing further opportunities for them to give us their views. The service is
also distributing a regular newsletter to our stakeholders so that are kept up to
date on progress.
We have recently made changes to the way children and young people access
the service to help improve waiting times. Part of this change involves better
integration of CAMHS within the PCH locality framework, and although CAMHS
is a city wide service it is hosted by the North West Locality. This has benefitted
the service and people who use the services by providing a more joined up
approach to effective care.
National Institute for Health and Clinical Excellence
The National Institute for Health and Care Excellence (NICE) is a nondepartmental public body that provides national guidance and advice to improve
health and social care. Implementing NICE guidance helps ensure that people
who use our services receive best practice that is based upon evidence based
research and recommendations.
During 2013/14 83 pieces of new NICE guidance have been reviewed to
determine if they are relevant to our services. A baseline assessment of
compliance is completed for all new NICE guidance that are relevant to our
services.
Monitoring the implementation of NICE guidance is a continuous process
and any issues are fed back to individual localities at our Safety, Quality and
Performance Committee. This ensures:
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
• Compliance with national standards in respect of the delivery and monitoring of NICE guidance.
has seen the initiative expand to children’s centres
throughout the city.
• Effective audit and monitoring arrangements are in place for NICE guidance.
• Results and findings of clinical audit and clinical effectiveness projects are reviewed.
• Progress of action plans arising as a result of NICE clinical audits, NICE baseline assessments and NICE guidance implementation/workshops.
Partnership working success
The city’s antenatal programme has gained national recognition at the British
Journal of Midwifery Awards in London.
The Great Expectations (GE) team represents a partnership between Plymouth
Community Healthcare, Plymouth City Council, local children’s centres and
Plymouth Hospitals NHS Trust.
The team have been responsible for redesigning the antenatal course in line
with Department of Health quality standards, for example NICE, and ensuring
that parents-to-be are offered first class parenting education wherever they live
across the city.
Great Expectations is a free six-week parenting programme, delivered in all
Plymouth Children’s centres. Parents-to-be learn about positive lifestyle choices
for a health pregnancy, how to connect and communicate with their baby and
how to understand and respond to their baby’s needs.
Jan Potter, a Public Health improvement Manager for PCH said “We were
thrilled that Great Expectations has received this award. Our team has worked
incredibly hard to ensure that pregnant women, their partners and supporters
are offered the highest standard of antenatal education.”
Councillors Sue McDonald, Cabinet Member for Public Health and Adult Social
Care and Nicky Williams, Cabinet Member for Children and Young People,
congratulated the dedicated team on their hard work and commitment, which
Glenbourne award
The Glenbourne Unit’s ECTAS Accreditation has been
rated as ‘Excellent’ by the Royal College of Psychiatrists’
Special Committee for Professional Practice and Ethics.
The ECT Accreditation Service (ECTAS) works with
ECT services to assure and improve the quality of
administration of electroconvulsive therapy, and
Glenbourne was one of the first services nationally to
put their service forward for accreditation. Accreditation
is a long and demanding process with plenty of audit
work completed in preparation. There are three phases
to the process - Self-Review, followed by a Peer Review
visit by an external team (which comprise a Lead ECT
Nurse, Lead ECT Consultant Psychiatrist and Lead ECT
Anaesthetist). Information from both the self and peer
review is then submitted to the Accreditation Committee
who make a recommendation about the service’s
accreditation to the Royal College of Psychiatrists Special
Committee for Professional Practice and Ethics.
“This is a fantastic achievement which recognises the hard
work of our staff, not only during the accreditation process
but every day that they come to work, and highlights their
commitment to providing safe, quality care in a first-class
service.”
Dave McAuley, Central & North East Locality Manager,
said: “We are delighted that the service has once again
been accredited with excellence by ECTAS. This is a
credit to the team and a reflection on the excellent care
they provide.”
To achieve ‘Excellent’ status, services have to
demonstrate that they have not only met the standards
for that level, but for all levels.
Carole Love, Lead ECT Nurse at the Glenbourne Unit,
said: “We are thrilled with the excellent accreditation
awarded to Glenbourne’s ECT service, as this means
that not only do we adhere to the very high and
demanding standards of the Royal College, but we can
also demonstrate our excellent quality of care to service
users, carers, and commissioners.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
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 in the table.
Plymouth Community Healthcare intends to take the action
set out below to improve its performance and quality of its
services
1
2
3
4
5
6
Indicator
Target
2011/
2012
2012/
2013
2013/
2014
Trend
Action to improve performance
Percentage of patients on Care Programme
Approach who were followed up within 7
days after discharge from psychiatric in-patient care during the reporting period.
95%
99%
99%
98%
Stable
PCH will continue to monitor this through its
contract performance meetings.
Percentage of admissions to acute wards
for which the Crisis Resolution Home
Treatment Team acted as a gatekeeper
during the reporting period.
95%
81%
91%
83%
Decreased
Reduction in gatekept admission % due to use
of beds by out of area emergency patients (bed
shortages in other areas) thus not controlled by
‘our’ Home Treatment Team.
Percentage of patients readmitted to hospital within 28 days of being discharged from a hospital.
New indicator for 2013/14
3.2%
-
PCH are reviewing the needs of individuals who
have required readmission to acute mental health
services within 28 days of discharge. We are
developing individualised care plans to address
identified areas of need with the aim of building
resilience to enable people who use our services
to be more supported when they are at home.
The number and, where available, rate of
patient safety incidents reported within the
organisation.
New indicator for 2013/14
18%
-
1%
-
PCH will continue to deliver staff training to assist
with the accuracy and timeliness of reporting
incidents, use the duty of candour to identify
areas of learning and continue to monitor and
review progress.
The number and percentage of such
patient safety incidents that resulted in
severe harm or death.
Percentage of staff during the reporting
period who would recommend PCH as a
provider of care to their family and friends.
60%
68%
68%
71%
Increased
PCH will continue to review its employee
engagement strategy to help improve results on a
yearly basis.
Patient’s experience of contact with a
health or social care worker in Community
Mental Health Services who felt that they
were definitely, or to some extent treated
with respect and dignity, had confidence in
the person treating them and given time to
discuss their condition or treatment.
n/a
94%
95%
94%
Stable
PCH takes part in the annual Care Quality
Commission Community Mental Health survey.
The survey helps us find out about people’s
experiences of using our services. PCH will be
taking part in the 2014 survey.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Statements from third parties
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 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 improving dementia care by increasing engagement
with carers of people with dementia is identified as a priority. Review of the
upcoming dementia strategy will form part of this year’s work programme for the panel. The centralised dementia hub, run jointly by Plymouth City Council
and Plymouth Community Healthcare is an excellent example of how health and social care can work together to deliver improved outcomes for patients.
We are however, disappointed that the Child and Adolescent Mental Health
Service (CAMHS), which has previously been subject to monitoring by the City
Council’s Scrutiny function and highlighted in previous statements attached to
quality accounts, has not been specifically identified as a priority. As a panel
we remain concerned about access to CAMHS including waiting times. In
addition, following the panel’s review of the adequacy of mental health services
and support in the city in early 2014, we will also be reviewing the provision
on ‘places of safety’ for vulnerable people in Plymouth as part of our work
programme over the coming year.
The Chair and Vice Chair wish to congratulate Plymouth Community Healthcare
again for providing a document which aimed to be clear and easily understood
by members of the public.
Healthwatch Plymouth
Healthwatch Plymouth has worked collaboratively with Plymouth Community
Healthcare during the last year, most notably in an extensive patient-led
assessment of the care environment process (PLACE). During this process
we observed some excellent care being delivered at many of the Plymouth
Community Healthcare inpatient units. The Quality Account sets out some
tangible priorities for improvement that we hope will improve further the patient
experience in services such as Child and Adolescent Mental Health Services
(CAMHS).
We look forward to working with Plymouth Community Healthcare over the
coming year to monitor progress against the identified priorities, and work once
again on collaborative projects such as Healthy Plymouth.
NHS Northern, Eastern & Western Devon
Clinical Commissioning Group
Introduction
Northern, Eastern and Western Devon Clinical Commissioning Group (NEW
Devon CCG) is pleased to commission services from Plymouth Community
Healthcare. We recognise that the organisation provides valuable care and
support for people with a variety of acute and enduring health conditions.
We look forward to continue working in partnership and developing further
relationships to help deliver our vision of healthy people, living healthy lives, in
healthy communities.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Achievements in 2013-14
Plymouth Community Healthcare makes an important contribution to the health
and wellbeing of the population of Plymouth through the services it provides
and is committed to providing safe, high quality, clinically effective care. The
achievements noted in the quality account for 2013-14 demonstrate this.
Achievements of note which the Trust should be commended include:
Looking forward
NEW Devon CCG agrees with the aims for 2014-2015 highlighted in the quality
account which highlight the organisation’s recognition of the fundamental need
to treat people with dignity and respect. They demonstrate a proactive approach
to engage with service users and their families, support and empower staff and
develop and improve services across whole patient pathways.
• Positive steps to ensure service users with a learning disability have appropriate information relating to contraception and sexual health services.
In particular we welcome:
• Joint working with Plymouth City Council for the development of the integrated dementia hub which has resulted in an impressive reduction of people needing a hospital referral from 29% to 15%.
• The Implementation of a system of electronic records throughout the organisation which we feel will thus enable a seamless approach to care to be delivered.
• The leadership of the Professional Leads in the harm free care agenda, in particular around the reduction of pressure ulcers and catheter acquired infection.
•
• Undertaking a range of National and Local audits and using the outcomes to inform priority work for 2014/14.
• A positive report following the visit by the Care Quality Commission (CQC) to Plym Bridge House which highlighted the value young people placed upon the staff and the service.
•
Robust and thorough complaints and incidents processes that highlight the very positive feedback the organisation has from service users and indicates that lessons learnt from incidents are quickly fed back into the organisation to inform practice and learning.
• The excellent rating of the Glenbourne Electroconvulsive Therapy (ECT) service by the Royal College of Psychiatrists.
The development and implementation of the early supportive discharge pathway for people recovering from stroke enabling them to receive a community approach to rehabilitation within their home environment. This fits well with the national ambition to provide care closer to home.
• Improving dementia care by engagement with carers of people with dementia.
• Improvement of waiting times for all services.
Plymouth Community Healthcare is a responsive, dynamic and innovative
employee led organisation that demonstrates how engagement with the local
community can positively impact upon the development of services to meet the
needs of the local population.
Plymouth Community Healthcare has produced an excellent quality account
which is honest, open and reflects some of the exceptional services provided for
the people of Plymouth. NEW Devon CCG looks forward to continuing to work
with Plymouth Community Healthcare in the coming year.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
Glossary
Care Quality Commission (CQC)
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.
Information Governance Toolkit
Standards by which organisations are assessed to
ensure that information is held, obtained, recorded, used
and shared lawfully.
National Institute for Health Research (NIHR)
A UK government body that coordinates and funds
research for the NHS.
Clinical coding
Translates the medical terminology written by clinicians
to describe a patient’s diagnosis and treatment into
standard, recognised codes.
NHS Number
A unique number which helps healthcare staff and
service providers to help match people to their health
record.
Commissioning for Quality & Innovation Schemes
(CQUIN)
A payment framework which encourages further
improvements in quality and innovation.
Secondary Uses Service
Designed to provide anonymous patient-based data
for purposes other than direct clinical care such as
healthcare planning, commissioning, public health,
medical research and national policy development.
General Medical Practice Code A unique organisation code which helps identify the
organisation and is essential to enable the transfer of
clinical information about the patient from the patient’s GP.
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
A set of indicators which could be used for local quality
improvement and benchmarking.
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Plymouth Community Healthcare Annual Report and Quality Accounts 2013/14
55
How to Feedback
Should you wish to provide feedback on this report
or give suggestions for future reports please use the
contact details below:
Email customerservicespch@nhs.net
Telephone 01752 435201
Customer Services Department
Plymouth Community Healthcare
Local Care Centre
200 Mount Gould Road
Plymouth PL47PY
Supporting people to be Safe, Well and at Home