CQC Inspection Kathryn Singh Kathryn Singh Chief Executive
What I will cover • Understanding our history & our services • Our ratings • What the CQC said we do well • What the CQC said we must improve • Our approach and response • Our governance arrangements • Support with our action plan
Understanding our history … 2015 North Lincolnshire School Nursing Service 2011 Doncaster and Rotherham Community Health (TCS) 2010 Doncaster Tier 2 & 3 CAMHS 2008 North Lincolnshire Mental Health 2007 Foundation Trust Status Manchester EI 2002 Rotherham Mental Health Services 1999 Doncaster and Scunthorpe Health Care Trusts Merge
The image cannot be displayed. Your computer may not have enough memory to open the image, or the image may have been corrupted. Restart your computer, and then open the file again. If the red x still appears, you may have to delete the image and then insert it again. Our services in 2016 … The services we provide in the different localities are presented in this map .
Facts about RDaSH … Circa 4,300 (3,700 WTE) Employees Volunteers Circa 200 Annual budget £155 Million • Clinical Commissioning Groups (CCGs) Commissioners • Local Authorities • Others, e.g. Drug Treatment Agency • NHS England
RDaSH facts continued… Locations 240 across 5 regional areas Number of beds 347 beds on 21 wards Community Teams 89 across 5 localities Learning Disability Domiciliary Services in Doncaster Adult Social Care and Rotherham Learning Disability Registered Homes: 88 Travis Gardens, Danes Court and Station Road In 2014/15 Patient contacts • 82,356 people accessed our services • 912,409 face to face contacts • A further 143,363 non face to face patient contacts
Our overall rating …
What the CQC said we do well … Learning Disability • Solar Centre - commended by patients and carers • 88 Travis Gardens – Outstanding for Caring Services • Mental Health Crisis Teams – Rated Outstanding Overall by CQC Adult Mental Health • Mulberry House – Introduction of the ‘Perfect Week’ • Doncaster Perinatal Service Services • Rotherham dedicated service for deaf patients with mental health problems • Safeguarding Advisor in post and training at a high level across all services Children & Young People’s • Out of hours duty system provides excellent coverage of emergency/crisis calls Mental Health Services • Peer Support Workers assist with transition to adult mental health services • Peer Mentor Scheme developed, including training packages to provide service users with the skills and knowledge to become Peer Mentors Drug & Alcohol Services • Peer Mentors from New Beginnings worked across the services in Doncaster and three had progressed into paid employment • Telehealth Services developed to respond to the needs of patients with long term conditions • Specialist Falls Service facilitates a Falls and Balance Group that has received positive Adult Community Services patient feedback • Dietetics Service innovative use of the MUST Tool to support community nurses offering ‘Food First’ advice
What the CQC said we do well … • Caring and compassionate staff End of Life Services • Patients and relatives were empowered and supported to manage their own health • Evidence of Lessons Learnt • Implemented Fall Safe • Care records are comprehensive Community Inpatient Services • Staff were caring and respectful of patients privacy and dignity, patients were involved in decision making • Rated Overall by CQC as Outstanding Community Health for Children, • Development of local education and health aids Young People and Families Young People and Families • Development of ‘Roots of Empathy’ to prevent bullying, funded by NHS England • Reducing Restrictive Interventions training introduced to assist patients to develop Forensics positive ways to manage their aggression, resulting in a 50% reduction in physical interventions • Community-based services for Older People rated as Outstanding for Caring • Young Onset Dementia Day Care offering carer respite and patient engagement Older People’s Mental Health • Male Carers Support Group for patients with Huntingdon’s Disease Services • Cognitive Stimulation Programme – support patients with cognitive functioning • Kings Fund advice and guidance to make wards Dementia Friendly
Our approach and response… September 2015 - Immediate actions were taken and action plan drafted September 2015 - Immediate actions were taken and action plan drafted following initial feedback from CQC following initial feedback from CQC November 2015 - Trust Quality Improvement Plan developed following November 2015 - Trust Quality Improvement Plan developed following receipt of draft CQC reports receipt of draft CQC reports December 2015 - Executive director leads identified for all quality December 2015 - Executive director leads identified for all quality improvement actions improvement actions December 2015 - New Governance structure agreed (part of Well Led) December 2015 - New Governance structure agreed (part of Well Led) January 2016 - Executive Director of Health Informatics post approved January 2016 - Executive Director of Health Informatics post approved - BoD approved our Listening into Action application - BoD approved our Listening into Action application (next cohort will start April 2016) (next cohort will start April 2016)
Our action plan … Safe: Community mental health services for people with learning disability or Safe: Community mental health services for people with learning disability or autism autism Action already underway: Action already underway: • • Ironstone Centre - our Trust has provided non-recurrent funding for additional staff Ironstone Centre - our Trust has provided non-recurrent funding for additional staff and a business case has been submitted to North Lincolnshire CCG to request and a business case has been submitted to North Lincolnshire CCG to request additional staff resource. An external review of community LD services has been additional staff resource. An external review of community LD services has been commissioned. commissioned. • • Learning Disability Services – we have undertaken a review of the completion of Learning Disability Services – we have undertaken a review of the completion of risk assessments across all learning disability community services and have risk assessments across all learning disability community services and have implemented a revised monitoring, escalation and audit process. implemented a revised monitoring, escalation and audit process. • • Rotherham Community Learning Disability Team - clinical environment assessed Rotherham Community Learning Disability Team - clinical environment assessed and actions taken to ensure the safety of people who use services and staff. and actions taken to ensure the safety of people who use services and staff. Psychiatry consulting rooms made safe by removing non-essential equipment and a Psychiatry consulting rooms made safe by removing non-essential equipment and a clinical consulting room has been identified. clinical consulting room has been identified. • • Learning Disability Services – personal audible alarms provided to all staff working Learning Disability Services – personal audible alarms provided to all staff working in learning disability consulting rooms in Doncaster, Rotherham and North in learning disability consulting rooms in Doncaster, Rotherham and North Lincolnshire. Lincolnshire.
Safe: Community based mental health services for working age adults Safe: Community based mental health services for working age adults Action already taken: Action already taken: • • Mandatory/statutory training compliance – fortnightly monitoring of Mandatory/statutory training compliance – fortnightly monitoring of training compliance by team implemented and monitored by Assistant training compliance by team implemented and monitored by Assistant Director Director • • Access to Patient Information – training needs analysis underway to Access to Patient Information – training needs analysis underway to provide targeted focused training based on individual staff competencies provide targeted focused training based on individual staff competencies using IT Systems. Training to be completed during March/April 2016. using IT Systems. Training to be completed during March/April 2016. using IT Systems. Training to be completed during March/April 2016. using IT Systems. Training to be completed during March/April 2016. • • Medication Management – implementation of standard operating Medication Management – implementation of standard operating procedures across adult mental health services to standardise recording of procedures across adult mental health services to standardise recording of medication in relation to storage, prescribing, administration and recording medication in relation to storage, prescribing, administration and recording of medicines. of medicines.
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