Provide
Quality Account
2013-14
1
Contents
Section 1





Statement from Chief Executive
Statement from Chairman
Statement from Executive Director Clinical and operations Health and Social
care
Quality first
Clinical strategy 2013-16
Section 2










Clinical strategy priorities for 2013-14
Priorities for clinical improvement in 2014-15
Review of clinical performance in 2013-14
Commissioning for Quality and innovation (CQUINS) 2013-14
Quality and safety matters
Quality and safety summary 2013-14
Audits
o National
o Local
Research
Organisational inspections
Data Quality
Section 3



Patient experience
Staff Awards
Organisation Awards
2
Section 1
 Statement from Chief Executive
 Statement from the Chairman
 Statement from Executive Director Clinical and
operations, Health and Social care
 Quality
 Clinical Strategy 2013-216
3
Statement from Chief Executive
This Quality accounts is an important part of the overall commitment Provide have made in
relation to the quality of the services we deliver. All Health care providers have a duty to
produce an annual Quality account which provides all members of the public with clear and
concise information about how safe the organisation is.
Within Provide our service users are the main focus of all we do and we continually work to
develop the best patient experience possible. During executive walk abouts we see
committed and dedicated staff delivering the very best of care to all client groups and we
encourage staff at all levels to have a voice and join in the debate about quality and safety.
This account provides information about the quality delivered over the past year as well as
our plans for 2014-15, we also include areas where we need to focus and plan
improvements for future delivery of care. We have a clinical strategy which was approved
by the organisations Board and which includes the areas of improvement identified as being
required across all Healthcare organisations in the Francis report, following The Mid
Staffordshire Public enquiry in 2009.
Over the last year we have made considerable progress in looking at how efficiently we
work and how we can improve this in order to be able to commit clinical time appropriately
and in a way that is cost effective while maintaining standards of care. We have listened to
what patients tell us about their care and have made changes in line with this, we use the
important information that our service users provide to improve quality and change to meet
our client’s needs. We publish the outcome from patient surveys on our web site so that we
can share with all members of the public what our service users think about our services and
how we act in relation to our service user’s opinions.
Our organisation aims to deliver quality services which are effective and safe and I am
delighted to share this account with you and confirm that to the best of my knowledge the
information contained is an accurate reflection of quality and performance during 2013-14.
I look forward to the continuation of quality across all areas of Provide.
4
Statement from Chairman
The Board within Provide see the quality and safety of the services delivered as a priority
and we work to ensure that all systems and processes are in place to enable staff to deliver
the care we feel our service users deserve at a standard that we as an organisation will not
compromise on.
The Board reviews comprehensive patient safety and quality information at every Board
meeting and this is a priority item on the agenda. We gain assurance about clinical quality
from the Executive Director Clinical Operations for Health and Social care who provides
quality reports which include Safeguarding, Infection prevention, Medicines Management
and all data in relation to our Key performance indicators.
During 2013-14 a new Quality and Safety Board report has been implemented which
provides greater clarity around any incident in relation to quality and safety. We have
approved a clinical strategy which sets out our clinical vision up until 2016 and includes
plans for improvement. The strategy’s focus is the provision of competent compassionate
nurses who are supported by strong leaders and a commitment to transparency in all we do.
The Board members take part in executive walk rounds where they are able to talk to both
service users and staff and see the delivery of care at all levels and in various areas across
the organisation.
This Quality Account shows that the organisation is fully committed to quality and safety
and that during 2012-13 we performed at a consistently high level.
5
Statement from Executive Director of
Clinical & Operations, Health and Social Care
Achieving quality is all about ensuring that we get it right for our patients and staff every
time. It is about making the experience of receiving care in all of our settings meaningful and
to a standard that we would expect if we were to access health care ourselves.
I am proud to be able to work in 'Provide' and to be able to reflect on last year’s
achievements. We have delivered effective and good quality care that patients themselves
have told us about, and this account highlights those successes in 2013/14.
In the coming year, I look forward to working with the team to continue our journey on
improving quality and our priorities are aimed at achieving key areas that are important to
patients, and will enhance the patient’s experience of their care.
6
Quality First
Vision
“Being a leading provider of integrated health and social care
delivering quality services that are effective and safe whilst providing
good quality patient experience and value for money”
Provide are a Community Interest Company who delivers a combination of
both specialist and local healthcare services. Services are provided in a variety
of settings which includes patients’ homes, clinic settings, GP surgeries as well
as three community hospital wards.
At all times we strive to deliver high quality services which recognise patient’s
individual needs. Our patients are the focus of our service delivery which
supports our vision of “being a leading provider of integrated health and social
care delivering quality services that are effective and safe whilst providing
good quality patient experience and value for money”.
Provide take quality and safety very seriously and it is monitored very closely
by the organisations Board. The Board requires regular updates on quality
standards in place and how all service areas are meeting both national and
locally agreed quality and safety standards.
We have processes in place to monitor all complaints as well as collating our
compliments; we also have an established programme in place to survey our
patients about their experience within our services.
We have systems in place to monitor all incidents that staff report whatever
the severity; we have robust well established systems for investigation
incidents.
We have patient forums where patients can talk to us about their care and
help us to change and develop our services in a way that will meet patients
need. We listen to our patients and use the valuable information to progress
service delivery.
7
Board Assurance
The Board closely monitor quality and safety indicators which have been set
both nationally and locally and demonstrate the organisations commitment to
patient safety.
 Bi monthly quality and safety reports are sent to the board to inform
them of key areas across services with clear indications of performance
at the appropriate level and that resources are available to enable
clinicians to work at the required standards.
 Falls are monitored closely and reported to the Board
 Pressure ulcer prevention is monitored and reported to the Board
 Any significant event within a clinical setting is reported to the Board
which would include any serious incident which required investigation.
 The Board receive specialist reports in relation to safeguarding, Infection
prevention, medicines management and patient safety.
Patient safety Executive walkabouts
The Board regularly take part in patient safety walkabouts; this is a proactive
way of developing discussions between Executive Directors, Non-Executive
Directors and front line staff. The outcome of the patient safety walkabouts
allows structured discussions at the Board meetings around patient safety.
The key aim of the walkabouts is:
 Demonstration of the Boards commitment to patient safety and quality
 Allows front line staff and patients to express their views to the Board
members and allows Board members to have an accurate view of safety
across the organisation
 Encourages and fosters a culture of reporting and openness
 Provides local solutions to minimise risk
 Allows staff at all levels and patients to share experiences and examples
of good practice
For 2014-15 we will continue to put patient safety and quality first and at the
heart of everything we do. We will continue to listen and learn from what
patients tell us about our services. We will continue to listen to all stakeholders
and act on what they tell us.
8
Clinical Mission
“Deliver integrated services that will enable and support people to live the
best lives possible”
Clinical strategy 2013-16
During 2013 a clinical strategy was developed and agreed at Board level. The
strategy was developed in line with recommendations made in the Francis
report which followed a public enquiry following the failings of the Mid
Staffordshire NHS Trust. The clinical strategy takes the recommendations from
the report into account in the key themes and objectives set out to be
achieved up to 2016.
The five key themes from the Francis Report were:
 Standards and methods of compliance: the report highlighted that there
was not sufficient clarity around standards on safety and patient care.
 Openness transparency and Candour: the introduction of candour into
the NHS contract
 Improved support for compassionate nursing
 Strong patient centred leadership
 Accurate relevant and useful information: everything we know we will
share – so the public have better information about what is going on.
Provide are committed to developing clinical services where staff are
compassionate, professionally competent, and communicate well, who
challenge poor behaviour and practice and are committed to continual service
improvement.
Provides clinical strategy echo’s the national message on nursing, support staff
and allied health professionals and to achieve our objectives we will invest in
our clinical workforce at all levels.
9
Provide Clinical Strategic Objectives 2013-16
The objectives within our clinical startegy echo the national message on nursing,
support staff and allied health professionals. We will invest in our clinical workforce
at all levels to ensure that they are able to deliver high standards of care to meet
patients needs and have strong capable Leadership.
To do this we will:
1. Helping People to stay independent, maximising wellbeing and
improving health outcomes
We will achieve this by creating a culture of across the organisation which is
based around the values behavious of the 6C’s.
2. Working with people to provide a positive experience of care
We will work with our customers, listening to what they tell us about the
services we deliver.
3. Delivering high quality care and measuring impact
We will develop quality metrics that demonstrate impact on service user’s
outcomes
4. Building and strengthening leadership
Develop the role of the Clinical Professional Forum; develop leadership
capacity and confidence using the improved motivation to improve outcomes
for service users.
5. Ensuring that we have the right staff, with the right skills in the right
place
We are agreeing new staffing levels across clinical areas using evidence based tools
and by assuring the competence of all clinical staff.
6. Supporting positive staff experience
We are working with local universities and Health Education England to
develop opportunities for frontline staff and managers.
10
Section 2
 Review of clinical performance 2013-14
 Priorities for clinical improvement 2014-15
 Commissioning for Quality and innovation
(CQUINS) 2013-14
 Commissioning for Quality and innovation moving
into 2014-15
 Quality and Safety matters
 Quality and Safety summary 2013-14
 Audits
o National
o Local
 Research
 Data Quality
11
Review of clinical performance 2013-14
For 2013-14 our priorities for Quality improvement were:
What we said we would do
Frailty: working with other
organisations to develop a holistic and
truly integrated frailty pathway and
identifying people that would benefit
from being cared for on such a
pathway, (the most frail and
vulnerable patients in our community)
How we got on
We are now working with local GPs
and commissioners of health care
services as well as the acute hospitals
to ensure that the frailty pathway is
implemented and making a difference
Pressure ulcers: Improve risk
assessments in service areas and our
focus on prevention of ulcers
including a robust system of review.
Where we provide 24 hour care ,
apply a zero tolerance model for
avoidable pressure ulcers
We have established a forum which
very closely monitors this important
area of care and ensures that practice
across the organisation is of a high
standard. We work closely with our
local commissioners to implement
quality initiatives in this area and have
reduced the incidents of pressure
ulcers across our organisation.
Infection prevention: Maintain MRSA We have maintained excellent
AND Clostridium Difficile performance standards in this area with no cases of
in line with contracts
MRSA or Clostridium Difficile acquired
in our care.
Customer Engagement: Building on
our pilot approach and running
another event
We continue to run customer
engagement events where we listen
to what patients tell us about our
services.
Children’s Diabetes: continue our
work towards meeting all the best
practice standards in relation to
children with type one diabetes in
partnership with Mid Essex Hospital.
We have established high practice
standards in this area and ensure that
children who are seen within our
services
12
During 2013-14 we also
 increase the numbers of Health Visitors we employ
 Rolled out the Friends and Family Test into our community wards and
assessment areas. This will tell us more about what our service users
think about the care they receive.
 Committed to train District Nurses and are working with local university to
develop this
 Implemented Competency framework for Band 2 -3 nurses
 We have further embedded clinical supervision into the organisations
culture
 Expanded the role of clinical facilitators to ensure front line staff are
clinically supported
 Staffs have an annual performance and development review which
includes review of clinical competence and clinical supervision as well as
setting out the development needs of all staff.
 Increased the amount of clinical skills training provided to front line
clinicians
Priorities for quality 2014-15

Develop minimum standards for prevention and intervention for falls across
the entire organisations.

Agree standardised information and develop an admission pack for patients to
inpatient units.

Agree standardised information and develop a discharge pack for patients on
discharge from inpatient units.

Implement the revised policy on End of Life Care to include a focus on why
patients were unable to achieve their preferred place of care.

Undertake a focused piece of work to consider the patient / carer experience
on the palliative care pathway.

To expand the Friends and Family Test to include identified specialist
services.
13

Evaluate the process for ‘recruiting for compassion’ to all clinical posts across
the organisation to ensure candidates are assessed for their values, attitudes
and behaviours towards the well-being of patients and their basic care needs.

Develop a Clinical Research Group as a sub-group of the Clinical Forum
consider this development with other health providers.

Establish lunch and learn sessions to develop staff knowledge of clinical
quality tools and how these support care quality.

Establish the ‘Harm Free Care Forum’ to focus on all high impact areas in the
Safety Thermometer.

Agree and implement a clinical quality dashboard for all business units.

Continue to develop the Clinical Forum as a focus for enhancing clinical care
across Provide and explore how aspects of the forum could be widened into a
virtual medium.

Develop a competency framework for band 6 and 7 nurse leaders in adult
services and provide establish learning action set.

To review the role and function clinical facilitators in Provide to ensure that
front line staffs are clinically supported in practice.

Building on recruiting for compassion develop a model for recruiting for
leadership

Ensure that nurses in Provide are equipped and informed in for the
revalidation process to be implemented in 2015 by NMC.

Be creative within the workplace to build in time to learn for clinicians across
Provide.

Agree a strategy to support the expansion of non-medical prescribers within
Provide that will enhance clinical services.

E-Rostering pilot to be mainstreamed and rolled out across all adult services
to support effective use of resources.

To develop a methodology for community healthcare workforce modelling and
agree clinical staffing levels to meet the dependency and acuity needs of
patients cared for by Provide.

To ensure full engagement with the HCA competency programme across all
clinical Band 2/ 3 staff.

Support 4 community nurses to undertake the District Nursing Programme.
14

Be creative within the workplace to build in time to learn for clinicians across
Provide

Implement safeguarding supervision for paediatric allied health professionals.

Building on the success of the ‘mock inspection’ support visits, initiate a
programme of quality support visits to clinical teams.
CQUINS, Commissioning for Quality and Innovation 2013-14 and extension
of National CQUIN IN 2014-15
The commissioning for quality and innovation (CQUIN) exists to encourage NHS
organisations to sharpen their focus on quality. Since its introduction in 2010/11
the importance of CQUIN schemes has increased in importance and Provide
have regularly taken part in the CQUIN schemes and for 2014-15 will be
extending the work already in progress in relation to Friends and Family Test and
Pressure ulcer prevention.
Mid Essex CCG have reported, that they are assured Provide have quality
improvement as an integral part of the organisations Clinical strategy and overall
ambition for patient care.
Patient Experience
Friends and Family Test
We always listen to what service users tell us about the services that we are
delivering and we use this information to improve or change what we do.
The friends and family test allows the organisation to monitor how highly service
users rate our services and allows service areas to improve in response to this
quality measurement.
WE have now implemented the Friends and Family Test in all three community
wards and two assessment units. During 2014-15 this initiative will be extended
into specialist services which will further inform how we are able to monitor
quality and safety within the organisation
Venous thromboembolism (VTE, blood clots) risk assessment
We have continued to monitor how many of our patients have a risk assessment
carried out for thromboembolism risk (blood clot) and have maintained an
excellent service to our patients in this area. We have maintained accurate risk
15
assessments and provided medication to prevent this consistently across our
community hospital wards.
NHS Safety thermometer
We continue to collect data via the safety thermometer which is a national
initiative and allows us to see how many people in our care have pressure ulcers,
falls, urinary tract infections and VTEs. This data is collected every month and
allows the organisation to closely monitor patient safety.
Reduction of pressure ulcers acquired in our care. We closely monitor all
pressure ulcers that develop in our care and have over the last year reduced the
incidents in relation to pressure ulcer development.
Developing District nurse pathways
We have worked with local university to develop a programme to train District
Nurses across community service. We have committed to train 3 nurses per
intake to provide the very best community based care possible for patients.
Frailty pathway
We have worked with local GPs to identify those patients who are frail and
vulnerable and need to be close support by community services; we meet with
local GPs regularly to identify the frail patients to ensure they receive the care
they need when they need it.
Quality and safety monitoring
Over the last year we have improved the quality of the data we collect which is
able to show the organisation and external bodies and most importantly our
patients and service users that we are meeting the quality and safety standards
that we should in all areas.
The Board are aware of the standards across the organisation in relation to
quality and safety and a report is presented at each Board meeting which is
prioritised as the initial agenda item. This demonstrates the commitment the
organisation makes to the quality of standards.
We see that this is essential if we are to encourage and expect staff working for
the organisation to mirror this example and put safety and quality first.
16
We have robust electronic systems in place for staff to report any incident that
may have caused or had the potential to cause harm. This system allows the
organisation to track all incidents and actions required to prevent further
occurrence.
We have an open and honest culture around reporting and staff across all areas
report incidents responsibly and so contribute to the improvements that take
place from learning from incidents.
Serious incidents 2013-14
All serious incidents are reported as soon as possible after the event. A serious
incident is an incident which occurred in relation to NHS funded services and has
resulted in harm to one or more patients. All serious incidents are investigated
fully and the finding from the investigations shared with the commissioners of the
Health care service involved and with the patient and family involved. Provide
are open and honest with patients and their families following and incident.
During 2013-14 we reported and investigated 17 serious incidents across different
services. All investigations were completed and action plans put in place to make
sure we prevent further incidents of the same nature in the future and to ensure
we continue to improve constantly and learn from any adverse event.
service
Community hospital wards
Integrated care teams
Incidents in relation to information
Consent issues
Numbers
8
5
3
1
Pressure ulcers grade 3 and 4
All healthcare organisations are required to report and investigate all grade 3 and 4
pressure ulcers that develop in their care. Pressure ulcers are debilitating and largely
preventable and so there is very close monitoring within Provide in relation to this
issue. We hold regular meetings where pressure ulcers are discussed and plans
made when required to improve our process.
During 2013-14 there were 41 grade 3 pressure and 4 grade 4 pressure ulcers
reported and investigated. 7 of the grade 3 pressure ulcers were declared as
avoidable and actions taken to improve services. The Care Quality Commission
reported in 2013-14 as part of a full inspection that, “ the providers rates for new
pressure ulcer cases for all patients and for patients over 70, is generally
below the national average”
17
Falls
All patient falls that occur in Provide are closely monitored and on admission to our
hospital wards there are assessments carried out to as far as possible prevent
patient falls. The organisation has invested in patient safety providing equipment
which alerts nurses when patients at risk are trying to move unaided. The Care
Quality Commission reported in 2013-14 as part of a full inspection that, “the
providers rate for falls with harm has been below or equal to the national
average for most of 2013.”
Infection prevention
Provide have an excellent record in relation to MRSA and C Difficile and there have
been no cases of MRSA and C Difficile that were acquired in Provides care.
All incidents reported across the organisation are seen by the organisations Head of
Quality and Safety as well as senior managers in the services involved. The
organisation also has a Quality and Safety Committee where all issues in relation to
quality and safety are discussed and decisions taken to assure maintenance and
improvement is core business of the organisation in every service area.
Confidential enquiries and Audit 2013-14
The following information gives details in relation to activities in Provide with
reference to confidential enquiries and audits for 2013-14.
The report of one national audit was reviewed during 2013-14 and actions will be
taken as described below following full analysis of the recommendations
The reports of 14 local audits were reviewed during 2013-14 and all actions required
are now being acted upon, see details below of a selection of Provide medicines
management and clinical audits. The organisation also has a full programme of
monthly infection prevention audits which constantly review High impact
interventions.
Confidential enquiries
During 2013-14 there were no national confidential enquiries covered in relation to
the services that the organisation Provide.
18
Audit
National Audit
Provide took place in the national intermediate care audit, this involved all integrated
care teams working with the elderly and vulnerable within domiciliary care settings.
The results of this audit have been released and the findings and recommendations
are being reviewed to determine actions required for the organisation and the
delivery of intermediate care services. This national audit will show what good looks
like in relation to intermediate care and help us in planning care for the future.
Local Audit
Medicines management
During 2013-14 a number of audits were carried out in relation to medicines
management, an area closely scrutinised both locally and nationally to ensure
medicines management is optimal across all service areas.
Medicines management Annual Audit; undertaken for all services areas and
assures the organisation that we are compliant with CQC outcome 9, Medicines
management. The full report will be completed at the end of April 2014.
Injectable medicines audit; undertaken against NPSA guidance in Community
hospitals, Intermediate care teams, children’s and adult community nursing teams,
Assessment services and Physiotherapy teams. There is a high compliance across
all services and Head of Medicines management will be working on a Standard
operating procedure to enhance the current policies in this area.
Cold Chain audit; carried out in all relevant areas across the organisation where
drug fridges are in use. The audit indicates excellent compliance across all services
with some very minor recommendations made in relation to equipment servicing.
Clinical audits
The clinical audit programme is devised each year to look at areas of high risk or
areas where we as an organisation have questions in relation to services being
delivered and the need to assure The Board that standards are being maintained at
acceptable levels.
Clinical record keeping audit
The audit was completed in line with national recommendations and to assure the
organisation that we meet the requirements of the CQC outcome 21. A total of 1,482
records were audited, 1,236 electronic records and 246 paper records. The audit
outcome shows significant improvements on last year’s audit with a 22%
improvement in compliance and many improvements in all areas. Records are being
completed safely with relevant safety details, allergies, and date of birth, NHS
number and contemporaneous record keeping.
19
An action plan held within Information Governance is being worked through and
each area involved in the area are having individual goals set as required to make
improvements as identified in the audit.
Resuscitation audit, DNAR and recognising the deteriorating patient
Provide are committed to an annual resuscitation audit to ensure that staff work
within Provide policy, national guidance and within individuals professional guidance
and scope of practice. The audit also assures that all equipment in use is safe and fit
for purpose.
There is a resuscitation trolleys located in all Provide community wards, in outpatient
area at St Peters hospital and within assessment areas.
The audit outcomes were positive in relation to the correct equipment in place and fit
for purpose as well as regular checking of the equipment as required with Provide
policy which is based on National guidance. There is a good compliance with
resuscitation training and competencies within clinical staff groups and a good
understanding is evident about the actions required should a patient require
resuscitation.
DNAR form completion had improved since the previous audit carried out in 2012-13
although a recommendation to use carbonated DNAR pads was made and is now
being implemented.
Recommendations were made in relation to documentation required for use in
assessing and recognising a patient who is deteriorating and additional training has
been carried out in all clinical areas where this is relevant. New paperwork is under
development to complement patient safety in this important area.
Central Alert System Audit; A national system the CAS system is in place to
ensure that all organisations carrying out healthcare are alerted to any issues that
may affect patient safety. Once an alert arrives at the organisation there is a system
of cascade that ensures all relevant staff are made aware of issues. This is closely
monitored and internally we make checks to ensure compliance with alerts. An
annual audit which looks at this system as a whole tells us that:



Equipment in use is safe and fit for purpose
Staff are aware of roles and responsibilities in relation to alerts
Actions are taken in timely manner
For 2014-15 the organisation has a full programme for audit which will enable the
assessment of services being delivered and guide plans for improvement and
learning. The programme will include;

Medicines audits

Infection prevention audits

Audits in relation to falls prevention
20

Record keeping audit

Diabetes care for inpatients
Research
Participation in clinical research
During 2013-14 three research proposals were agreed through Provide
committees after scrutiny at ethics and research committee. This research is
currently being undertaken.
Registration with Care Quality Commission
Provide are now registered under new identity although were recently inspected
as Central Essex Community services C.I.C. The organisation is registered for
Nursing care, surgical procedures, treatment of disease disorders or injury, family
planning and diagnostic and screening procedures. The organisation has no
current conditions on registration other than those pertaining to location which is
standard for all organisations. The Care Quality Commission has not taken any
enforcement actions against the organisation during 2013-14.
Information Governance
The information Governance toolkit is an online system introduced by the
Department of Health, which allows organisations to assess themselves against the
standards required in relation to the processes in place to protect all patient related
information.
For 2013-14 our information governance toolkit scoring was 73%. This overall rating
equates to 8 requirements scored at level 3, 29 requirements scored at level 2 and 2
requirements scored as N/A, this is out of a total of 39 requirements. This represents
the first year that Provide have reached level 2 or above on all requirements of the
tool kit and an overall satisfactory score.
Our score this year of 73% represents a consistent improvement in our overall score
from 10/11(60%), 11/12 (69%) and 12/13 (72%) and we will continue our work during
2014-15 to ensure that we improve further.
21
Statement from The care Quality Commission
From report published following latest inspection from January 2014.
We chose to inspect Central Essex Community services C.I.C as part of the first pilot
of the new inspection process we are introducing for the community health services
We found that central Essex community services C.I.C was providing safe care and
saw some good examples of caring and compassionate care. Staff spoke with
passion about their work, felt proud and understood the values of the organisation.
22
Section 3
 Patient experience
 Staff achievements
23
Patient experience
We wanted to thank you for the very good advice you gave
[patients name] in regard to controlling the bladder. Since your first
visit the change has been amazing after following tips given and it
has literally changed our lives.
Continence Service October 2013
We have a customer experience team who deal with all concerns and complaints,
manage the process and act as a central conduit in ensuring that the process is
carried out in a professional and timely manner in line with our policies and in the
best interest of those concerned. .
We know sometimes patients feel services were not delivered in the best way and
we work with people to make sure we get it right in the future and that we develop
services with services users views in mind.
A huge thank you for the kindness shown to me during my stay here and
the time and thought spent on the healing of my leg has produced a good
result, to a level I hardly dared hope for.
The level of care here has been excellent and everyone has been
absolutely wonderful, I am very grateful.
St Peters Ward and Tissue Viability October 2013
We are committed to actively seeking and responding to the views of our patients.
Listening gives us the opportunity to understand what we already do well so that we
can keep doing it.
It also gives us the chance to learn from customers and improve what we do.
Our Customer Experience Strategy already includes feedback via compliments,
complaints and a programme of customer surveys across our services. However, we
also want to look at some care pathways in a more in-depth way, so we have
introduced Customer Engagement Group events to do this.
We will be running at least one event every year.
24
Stroke Service Users
You said...
“
The therapy assessment process was too long and repetitive
”
We did...
We revised our assessments, now one assessment is shared
across all our teams.
You said...
“
Six weeks' support after discharge isn't long enough
”
We did
We increased the discharge support to 12 weeks
Leg Ulcer Service Users
25
You said...
“
Due to lack of space in clinic, sometimes you can be overheard
”
We did….
Moved waiting chairs away from the reception area
Placed a playing radio near to the waiting area
Arranged for a private room to be available if/when required
Informed patients about the room via appointment letter and signs in clinic
You said...
“You’d like us to improve communication with GPs”
We did….
Introduced letters to GPs/referrers following Assessment
Informed patients about the room via appointment letter and signs in clinic
At the end of July this year my husband had an aortic -bifemoral
by-pass graft at Broomfield hospital. Before the operation the
big toe on his right foot developed an ulcer and dying tissue, an
indication of the circulation problem.
For the last five weeks my husband's toe has been treated at
BCH. The podiatrist dealing with him is Louise Hinds. We are
impressed by her professionalism and expertise. She has
liaised with the GP's surgery and the consultant’s team at
Broomfield hospital. Thanks to her care and dedication, my
Informed
patients about the room via appointment letter and signs in clinic
husband’s condition has improved
dramatically.
We want you to know how grateful we are to Louise.
Podiatry September 2013
Awards and Achievements
26
Staff achievements
Two Provide nurses were shortlisted
for a national nursing award.
Their initiative means a clear pathway
for managing wound infection is now
in place across Provide and is
already delivering results.
The pathway is being used by our
community paediatric teams, in our
tissue viability service, on our
community hospital wards and in our
integrated care services – as well as
by many local practice nurses.
Early evidence suggests the initiative
is having a positive impact on the
management of challenging and
chronic wounds at high risk of
recurring infection – as well as cutting
down on unnecessary spending.
A team of children's speech and language
therapists from Provide have won a national
innovation award for contribution to their
profession.
The annual Giving Voice awards, run by the
Royal College of Speech and Language
Therapists (RCSLT), highlight the life-changing
work of speech and language therapists and
celebrate the creativity and commitment to the
profession.
The team also had a stand in their local
shopping centre, collaborated with students
from the local university and produced
resources and advice sheets for local parents
and nursery staff.
The chief executive of their service attended one of the events held throughout the
week and described the team as a ‘credit to the profession’.
27
Organisational awards
We are constantly striving
to be a leading provider of
integrated health and social
care, delivering quality
services that are effective
and safe whilst providing a
good patient experience and
value for money.
The good work we do at
Provide is often recognised
with awards and
achievements - both locally
and nationally.
Provide has won the Social
Enterprise category of the
prestigious National Business
Awards.
Judges commended Provide for the
organisation's ability to excel in
every aspect of social enterprise –
from impact and engagement to
leadership and financial
performance
They said: "Strong leadership and a
never-ending procession of
innovations, fuelled by a genuine
desire throughout the organisation to improve care, has proven to be an industry
leader and has bucked the trend in health and social care.
Provide has won a coveted employee-owned organisation award.
The Philip Baxendale Awards have been running for seven years and celebrate
excellence in employee ownership.
Provide has won the Public Service Mutual of the Year category, which is endorsed
by the Cabinet Office.
28
The category celebrates the most impressive group of employees to have spun out
of the public sector into an employee-led mutual organisation, and who are showing
progress in transforming the service to improve outcomes for their users.
The award looks at the progress made in creating a collaborative spirit of partnership
among employee owners, as well as the benefits to service users and social impact.
Statement from other organisations
Statement from The care Quality Commission
From report published following latest inspection from January 2014.
We chose to inspect Central Essex Community services C.I.C as part of the first pilot
of the new inspection process we are introducing for the community health services
We found that central Essex community services C.I.C was providing safe care and
saw some good examples of caring and compassionate care. Staff spoke with
passion about their work, felt proud and understood the values of the organisation.
Health Visiting Review
Provide have recently received a detailed appraisal of Health Visiting Services,
carried out by an independent body (sustain improvement) on behalf of NHS Health
Education East of England. The report indicated that Provide had made significant
improvements in this area with a clear vision and comprehensive plan to support the
change of Health Visitor services. The report recognised the changes that Provide
have made in Health Visiting Services over the past year to improve services.
Sustain said that staff within this service showed strong affiliation to the organisation,
they felt valued and team spirit and peer support is strong.
CQC Children’s Safeguarding Inspection
The CQC reported that “We observes good transfer in arrangements when a family
who has a child on a protection plan moved into Mid Essex , with the allocated
Health Visitor attending the first group meeting planned within the locality and
providing an update to the meeting. This ensured that the child was kept safe”.
Statement from Mid Essex CCG
This is the second year that Quality Accounts are being commented on by Mid Essex Clinical
Commissioning Group (MECCG).
29
MECCG welcomes this Quality Account as a commitment to an open dialogue with the public
regarding the quality of care in Provide (formerly CECS) Services. Assurance from MECCG is required
to ensure that the information in this Quality Account is accurate, fairly interpreted, and
representative of the range of services delivered.
Though MECCG is commenting on a draft version of this Quality Account, it is pleased to be able to
assure the accuracy of the content in general. MECCG is however unable to assure all data reported,
as some data may have been updated prior to publication.
You describe processes to monitor your own progress through the year, these appear robust. In your
account you also celebrate your quality achievements, and working as necessary through any issue
that might arise in relation to delivering against the priorities for the last year. You give an outline
summary of actions taken in the past twelve months and your vision for the year to come. You use
views and comments from users of your services to illustrate areas of good practice.
Your priorities for improvement in 2013 – 2014, have been supported by MECCG through the
agreement of CQUIN schemes which provide financial incentives to improve quality. You have made
clear links between all targets and demonstrated how you have made progress and how this has
been measured. We note your success for a fourth year of 'zero' cases of MRSA bacteraemia.
You give a comprehensive description of your participation in and learning from clinical audit. You
give a summary of findings and learning from all clinical audits undertaken.
In your report there is information about your performance in respect of data quality and the
improvements you have made in the last twelve months, in particular the improvement in data
accuracy. In respect of the information governance (IG) tool kit, you have achieved an improved
score of 73% and are graded as satisfactory.
Your priorities for improvement in 2014 – 2015 are:
1. Falls – develop minimum standards for prevention and intervention across the entire
organisation
2. Standardised Information – inpatient admission and discharge packs
3. End of life – preferred place of care
4. Staff initiatives – to improve recruitment, enhance learning and to support frontline staff
5. Enhance patient/carer experience – expansion of Friends and Family Test, palliative care
pathway.
MECCG supports these as appropriate areas of focus for quality improvement.
In conclusion, Mid Essex Clinical Commissioning Group considers Provide Quality Account for 2013 to
2014 as providing an accurate and balanced picture of key indicators in the reporting period.
MECCG encourages the organisation to continue to implement the multiple and wide-ranging efforts
and initiatives to improve and be innovative in its delivery of quality in the community.
Carol Anderson
Director of Nursing and Quality
Mid Essex Clinical Commissioning Group
30
31