Barchester Independent Hospital Services Quality Account 2014
Transcription
Barchester Independent Hospital Services Quality Account 2014
F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 BARCHESTER HEALTHCARE’S INDEPENDENT HOSPITAL SERVICES QUALITY ACCOUNT 2014–2015 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Introduction Barchester Healthcare is pleased to report back on the 2013 to 2014 Quality Account from our independent hospital services, and to set new targets for 2014 to 2015. This document provides a basis for all stakeholders involved with our hospitals to look back over and reflect upon the quality improvements we have made over the past year, and to plan actions for the improvements we have set ourselves going forward into next year. I want to ensure that Barchester delivers the very best in quality care. Our independent hospital’s Quality Account for 2013 to 2014 was an important contribution to positive change. Though we did not meet all our targets we made significant progress in all areas – and we are increasingly focused on what we need to do to achieve targets in the future: we know where more work is needed and what kind of approach we need to take to make sure targets are delivered upon. Much of the value of a Quality Account is the help they offer services in measuring progress objectively, identifying problems, thinking through and planning new approaches. They are iterative, too, which is to say that we get better at them as we repeat and review the processes involved over time. Moving forward to the Quality Account for 2014 to 2015, we have identified five areas of improvement that we believe will improve quality within our services, based on discussions with the individuals we support, their families and carers, our staff and other stakeholders as well as on Department of Health guidance. It is not always easy to involve stakeholders. Some of the people we offer services to do not find it easy to communicate, for example. Some of the health professionals who commission those services struggle to find the time to be involved with the Quality Account planning process. For 2014 to 2015 one of the challenges we have set ourselves is to increase stakeholder involvement by taking advantage of meetings with commissioners and medical personnel to discuss Quality Accounts rather than expecting attendance at formal Quality Review panels, though these will continue. We are committed to open and transparent working practices, reporting on what we do, and on where we need to improve. Quality is always evolving, responding to changes in values, expectations and perceptions. We are committed to measuring and reviewing our planned outcomes regularly, to adapting them wherever necessary, and ensuring that the service given to the individuals we support, staff and other stakeholders is based on best practice. 2 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 As a result, planning for improvements on the basis of working with a Quality Account is a useful and natural approach for our organisation. I can confirm that the content of this report has been reviewed by the Barchester Operations Board in June 2014 and to the best of our knowledge the information contained in it is accurate. I would like to take this opportunity to thank all those involved in providing feedback, ideas or actions for our Quality Account. This includes the individuals we support, relatives, friends, our staff and internal and external stakeholders, particularly commissioners and visiting care professionals. Without their input the progress we have made towards our aims and objectives would not have been possible. Dr Pete Calveley Chief Executive Officer, Barchester Healthcare F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Statement of Accuracy of our Quality Account Directors of organisations providing hospital services have an obligation under the 2009 Health Act, National Health Service (Quality Accounts) Regulations 2010 and the National Health Service (Quality Accounts) Amendment Regulation 2011 to prepare a Quality Account for each financial year. Guidance has been issued by the Department of Health setting out these legal requirements. In that context we need to formally record that over the period covered by the Quality Account for 2013 to 2014 Barchester Healthcare provided NHS mental health services within its seven independent hospital sites. 100% of the total income generated by these services was procured through Barchester providing care and treatment to those in need on behalf of the NHS. Monitoring and reporting progress The Barchester Board sub-committee for Quality and Clinical Governance Committee meets every month. It regularly reviews the quality and risk profiles covering all service provision, including mental health service provision. The committee identifies any areas of care practice that need improvement. It links with the Hospital Quality and Governance Committee to make sure that action plans are put in place to improve service delivery and maintain safety. The committee also reviews reports on progress and challenges to these action plans. As Barchester’s Director of Quality and Clinical Governance I am responsible for its link to the sub-board Quality and Clinical Governance group. The Hospital Quality and Governance Committee is the key body for driving quality improvements across all our independent hospitals. Our meetings are quarterly and there are a number of sub-work groups to the main committee, which drive forward quality and governance projects in between the national committee meetings. Over the last two years we have redeveloped our hospital clinical governance reporting metrics and Key Performance Indicators to ensure that we are collecting relevant and accurate data that can drive practice and quality development. We have introduced new reporting metrics for the hospital services. Examples include: • risk registers for the use of physical intervention • monitoring and reporting against the use of anti-psychotics, and psychotropic medications. 4 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 We have introduced early warning systems to monitor for increases in the use of anti-psychotic medication and increases in the use of restraint. We review data to look for patterns that alert us to a change in patient status. Our strategy is based on national policy initiatives, internal regulatory compliance and Quality Account priorities. Our committee reviews and plans its performance to meet the requirements of NHS commissioning bodies. Plans are to some extent shaped by Commissioning for Quality and Innovation (CQUIN) standards and its agreed priorities. Barchester’s independent hospitals work hard to continually improve patient experience through monthly clinical governance meetings, patient forums, input from clinical review teams and quality improvement initiatives. As with Barchester’s corporate clinical governance more generally, local governance committees are made up by multi-disciplinary representatives. Throughout 2013 to 2014 the independent hospitals ran monthly clinical audits as part of quality checks based on our Quality Account. We have seven independent hospitals based primarily in the north of England. They are: Arbour Lodge in Stockport, Billingham Grange in Billingham, Castle Care Village in Hull, Forest Hospital in Mansfield, Jasmine Court in Waltham Abbey, Hazeldene Unit at South View in Billingham and Windermere House in Hull. Our hospital services are commissioned by the NHS and we work closely with our commissioners to deliver local services for people with mental health needs that provide a care pathway into the community. We have collaborative partnerships with NHS mental health foundation trusts who we, in turn, commission through a service level agreement contract for the provision of psychiatry and other clinical services into our hospitals. We value our shared working relationships with our partners in the NHS and appreciate the contribution that accurate reporting through our Quality Account makes to it, and to the quality of the services we offer. Trish Morris-Thompson Director of Quality and Clinical Governance On behalf of Barchester Healthcare 5 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Part One How we performed last year (2013 to 2014) This section of the Quality Account for Barchester's independent hospitals reviews our performance over the last year, running from March 2013 to March 2014 but reported on in June, following Department of Health guidelines. Overall, we worked hard to meet the targets we set ourselves. Comparing the 2014–2015 Quality Account to its predecessors shows that we have met more targets, that we are better focused on the issues and that our reporting has improved. There is still progress to be made, however: Quality Account meetings need to become part of our routines and to be linked informally to all meetings with commissioners and medical staff, Quality Groups need to establish themselves as forces for change and our reporting and monitoring must become more focused. Nonetheless, for 2013 to 2014 our hospitals achieved their goals. The Department of Health’s Quality Account guidance required that we identify at least three priorities for improvement from the Department of Health’s ‘No Health without Mental Health’ initiative. This encompasses a list of priority areas for improvement, which for 2013 to 2014 involved working towards: • Good mental health • Recovery • Positive experience of care • Reduction in avoidable harm • Reduction in stigma The hospital group also believe that goals, action planning and targets should take account of coming legislation on the Duty of Candour and of CQC’s ‘five questions’, which give the basis to their fundamental principles. We used these principles as the starting point for consultations with the people we support, relatives, staff and other stakeholders, the independent hospitals’ Managers’ Forum and Barchester’s Mental Health Clinical Governance Group. The consultations resulted in targets for improvement and associated aims set out over the remainder of this section. 6 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 “I go out with staff all the time. It’s the best place ever.” F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Based on the Department of Health’s ‘No Health without Mental Health’ initiative, priority 2: Recovery: 1. To develop Barchester Recovery Star models for older people living with dementia and dementia with challenging behaviours and for younger people with mental health needs. To achieve this we agreed we would: • Form a sub-committee working group • Involve service users and carers through Quality Review Panels • Review best practice and develop models specific to each group • Approve models through the Hospital Clinical Governance Quality Committee • Review the effectiveness of the new models with service users, carers and other stakeholders through Quality Review Panels reporting back to the Hospital Clinical Governance Quality Committee Our targets: • By six months we would develop outcome models for people living with dementia with challenging behaviours and for younger people with mental health needs • By nine months we would pilot the outcome models • By twelve months outcome models would be fully operational • By twelve months we would plan review of outcome models Did we achieve our target? A working group was formed and work was commenced, involving review and quality review panels, reporting to the Hospital Clinical Governance Committee. The idea of utilising a universal electronic tool was impractical, as the model is a poor fit for people living with dementia; there are also licensing cost problems. Each hospital is using established and appropriate models. It was agreed that hospitals will work towards a research project on core elements and validation for variants over 2014 to 2015. This target was met. 8 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Based on the Department of Health’s ‘No Health without Mental Health’ initiative, priorities 3 and 4: Positive experience of care and reduction in avoidable harm: 2. Develop risk models at all hospitals, using models currently used in the hospital services with links to NHS Mental Health Hospital Trusts (e.g. GRIST, FACE and TARA). To achieve this we agreed we would: • Pilot GRIST at Windermere and Castle Care Village • Pilot FACE at Billingham Grange and South View • Pilot TARA at Forest Hospital and Arbour Lodge • Pilot Sainsbury Model at Jasmine Court • Review the effectiveness of the new models with service users and relatives where appropriate Our targets: • By three months models would be piloted in hospitals as above • By six months models would be fully operational • By twelve months models would be reviewed with stakeholders through Quality Review Panels Did we achieve our target? Pilot projects were carried out and appropriate models were selected (GRIST and Sainsbury), though there are some problems with divergent commissioning requirements for the individuals we support from different geographical areas. All homes have risk models in place, reviewed with service users where appropriate. It was agreed that hospitals will look at proactively providing information to commissioners based on improved electronic data collection rather than simply responding to requests. This target was met. 9 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Based on the Department of Health’s ‘No Health without Mental Health’ initiative, priority 4: Prevention of avoidable harm: 3. To accredit all methods of physical intervention. To achieve this we agreed we would: • Apply for accreditation of General Services Association and National Association for Psychological and Physical Intervention training Our targets: • Accredit General Services Association and National Association for Psychological and Physical Intervention within three months • Report back on accreditation to all Quality Review Panels within six months Did we achieve our target? This target was partially achieved and will be fully achieved over 2015–2015. Reporting processes will be improved over 2014 to 2015. This target was met. “I am involved in decisions regarding my relative every step of the way.” 10 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Based on the Patient Inclusion and Involvement Strategy and the Department of Health’s ‘No Health without Mental Health’ initiative, priority 3: Positive experience of care: 4. To develop one user-led customer satisfaction and feedback survey that can be used universally across all hospital services, ensuring that alternative formats exist for all methods of communication. To achieve this we agreed we would: • Form a sub-committee working group • Involve service users and carers through Quality Action Planning groups and Quality Review Panels • Develop a customer satisfaction and feedback survey • Evolve strategies for survey use involving alternatives to speech • Review the effectiveness of the new survey for service users, carers and other stakeholders through Quality Review Panels reporting back to the Hospital Clinical Governance Quality Committee Our targets: • By six months we would develop an agreed customer satisfaction survey • By nine months we would pilot the satisfaction survey • By twelve months the survey would be fully operational Did we achieve our target? A format has been approved through the agreed channels, including easyread, pictorial and audio versions. Its early version was piloted in two hospitals. The various formats are awaiting circulation and further testing. This target was met. 11 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Based on the Experts by Experience initiative and the Department of Health’s ‘No Health without Mental Health’ initiative, priorities 3 and 5: Positive experience of care and reduction in stigma: 5. Develop an Experts by Experience programme, based on real inclusion and designed to involve Experts in business planning and design and delivery of services, to be piloted at two hospitals. To achieve this we agreed we would: • Establish a project group in two hospitals to deliver Experts by Experience, involving all stakeholders through Quality Action Groups and Quality Review Panels • Agree and develop a series of half-day workshops on Experts by Experience for users of services (including potential Experts), staff, relatives and carers (including potential Experts), and managers • Review progress with all stakeholders through Quality Review Panels • Implement pilot Expert by Experience schemes at two hospitals Our targets: • By six months we would develop an Experts by Experience project group and appropriate half-day workshops • By nine months we would deliver the half-day workshops • By twelve months pilot schemes would be established in two hospitals Did we achieve our target? Project groups met and work on half-day workshops begun. This target lost momentum as the result of a number of management changes. Progress will be reviewed and alternatives considered, including an inter-hospital patient council. This target was partially met. 12 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Based on the Department of Health’s ‘No Health without Mental Health’ initiative, priority 3: Positive experience of care: 6. Introduce a training package for staff, which will facilitate a better understanding of personal needs, culture and diversity, linked to the introduction of Equalities Impact Assessments for all policies and all major service changes. To achieve this we agreed we would: • Agree an Equalities Impact Assessment format • Agree a training package with Barchester Business School, incorporating training on Equalities Impact Assessments • Review the training packages with all stakeholders through Quality Review Panels • Deliver the agreed training packages • Review the effectiveness of the training packages with Quality Review Panels Our targets: • By three months we would develop an Equalities Impact Assessment format • By six months we would develop and agree a diversity training package incorporating training on Equalities Impact Assessments • By nine months we would deliver a diversity training package incorporating training on Equalities Impact Assessments • By twelve months we would review and evaluate the effectiveness of our diversity training and Equalities Impact Assessment Did we achieve our target? An Equalities Impact Assessment format was agreed and is in use for our Quality Account. A diversity training package has been agreed and tested. It was well received by staff in its test site and has been the subject of presentation and review at the Hospital Clinical Governance Committee. Roll out across all sites is planned. This target was met. 13 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Part Two Identified priorities for clinical improvements in 2014–2015 Based on the Department of Health’s ‘No Health without Mental Health’ initiative, priority 3: Positive experience of care: 1. To improve review of data and Quality Account planning for the Hospital Quality and Clinical Governance Committee. To achieve this we agreed that: • All hospitals will send clinical governance data to the responsible Regional Director two weeks prior to the Hospital Quality and Clinical Governance Committee meeting • The Regional Director will circulate a digest version of the data, matching it to relevant policy and regulatory initiatives and picking out important areas for service improvement for discussion, review and action planning Our targets: • Establish a pattern of data management and digest format within six months • Establish at least two action points for service improvements arising from review of data and stakeholder involvement, to be actioned or carried forward into the 2015–2016 Quality Account • Demonstrate service improvements or change towards service improvements within 12 months 15 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Based on the Department of Health’s ‘No Health without Mental Health’ initiative, priority 2: Recovery: 2. To establish a reporting framework on relevant data that involves commissioners and drives forward recovery wherever appropriate. To achieve this we agreed we would: • Form a sub-committee and agree a core report for commissioners on recovery statistics and information, with explanatory narratives where required • Ask individual hospitals to agree additional information specific to commissioner requirements with the sub-committee • Individual hospitals to review information produced (with commissioners if possible) and link to recovery-based action planning Our targets: • To produce an agreed core report for commissioners with ‘bolt-on’ information required by commissioners for particular hospitals within three months • To review recovery statistics (with commissioners if possible) and to agree revised recovery plans for individuals who require it within six months • Identifying a set of outcome-based benchmarks within 12 months “Through informed choice, individuals can access the therapies and activities they feel benefit them.” 16 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Based on the Department of Health’s ‘No Health without Mental Health’ initiative, priority 4: Reduction in avoidable harm: 3. To improve the review of data based on physical restraint, formulating a strategy for best practice in each hospital. To achieve this we agreed we would: • Form a sub-committee to agree new methods of recording restraint, utilising a grading system’ • To agree methods of recording that improve clarity and transparency and have a narrative explanatory element • Ensure that the Regional Director is aware of training records on restraint for all staff members at each hospital individually • Ensure the Regional Director can review all incidents, request multi-disciplinary meetings and increase numbers of staff with formally accredited restraint training Our targets: • Agree a new method of incident recording including grading, with clarity, transparency and relevant narrative within three months • Ensure all serious untoward incidents (SUI)s are reviewed by the Regional Director, beginning after three months and ongoing • Facilitate multi-disciplinary meetings and action planning for incidents that require it after three months and ongoing • Increase the numbers of staff with accredited restraint training within 12 months 17 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Based on the Department of Health’s ‘No Health without Mental Health’ initiative, priority 4: Reduction in avoidable harm: 4. To improve screening for physical health, review and improve well-being. To achieve this we agreed we would: • Form a sub-committee and agree a format for physical health reviews • Review the physical health of all the individuals we support who do not refuse consent • Based on physical health reviews, agree action plans for the individuals we support to increase well-being Our targets: • An agreed format for physical health reviews after three months • Have systems in place to support all individuals with regard to physical health and to promote their well-being “The staff are all wonderful. They show particular love and attention and nothing is ever too much trouble.” 18 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Based on the Department of Health’s ‘No Health without Mental Health’ initiative, priority 3: Positive experience of care: 5. To broaden the experience and training of Mental Health Act Administrators, improving and strengthening services to and relationships with service users. To achieve this we agreed we would: • Review the training records of all Mental Health Act Administrators • Agree training plans with all Mental Health Act administrators, working towards acquiring the Certificate of Mental Health Law and Practice • Agree ongoing supervision with all Mental Health Act Administrators incorporating reviews of training progress • Facilitate the formation of a group meeting for peer support for all Mental Health Act Administrators • Agree a resource section to be placed on the intranet for Mental Health Act Administrators and deliver it through the peer group meeting Our targets: • All Mental Health Act Administrators training records reviewed after three months and training plans agreed • At least 70% of Mental Health Act Administrators to be awarded the Certificate of Mental Health Law within the specified training period • All Mental Health Act Administrators to have regular supervision incorporating review of training progress after three months and ongoing • At least three monthly peer group meetings to take place for Mental Health Act Administrators, commencing after three months • An agreed resource section to be placed on the intranet after six months • Robustness of reporting mechanisms to be improved and discussed with the individuals we support and at Quality Review meetings within 12 months 19 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Part Three About Barchester Healthcare – Funding, Registration, Research, Staffing and Commissioner’s Comments Funding: Barchester Healthcare provides services to almost 11,000 people in over 200 service sites. Our commissioners are the individuals we support, who fund their choices through personal budgets, private income or resources provided by local authorities, Clinical Commissioning Groups and the NHS Commissioning Board. Our overall health income fluctuates on a daily basis because most of it comes through individual nursing or continuing healthcare funding. In developing this account we have specifically reviewed the Quality Accounts of our seven independent hospitals, reporting back as a composite. Their income represents approximately 3% of the total income for Barchester generated from the provision of NHS services over 2013 to 2014. Over the course of 2013 to 2014 we have met requirements for being an approved provider for 'locked and unlocked' rehabilitation services for Yorkshire and Humber strategic health authority, which included an element of Commissioning for Quality and Innovation (CQUIN) payment1. Patients in our hospitals are funded through individual contracts. Some commissioners have set broad targets to be achieved in relation to CQUIN, which is now part of the standard mental health contract. Barchester Healthcare was not subject to the Payment by Results clinical coding audit during 2013 to 2014. Registration: Barchester Healthcare is licensed by Monitor, the health service regulator with particular responsibility for patient welfare, value for money and financial oversight. Barchester Healthcare is required to register with the Care Quality Commission (CQC). The range of services Barchester provides is subject to different registration for different regulated activities. For our independent hospitals our current registration status is in respect of: ‘Regulated Activity: Accommodation for persons who require nursing or personal care’ and ‘Regulated Activity: Assessment or medical treatment for persons detained under the Mental Health Act 1983’. This covers assessment and treatment of disease, disorder or injury; diagnostic and screening procedures. 1 ‘The Commissioning for Quality and Innovation (CQUIN) payment framework enables commissioners to reward excellence by linking a proportion of providers’ income to the achievement of local quality improvement goals.’, Department of Health website, 2008, http://www.dh.gov.uk 21 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Barchester Healthcare’s Independent Hospital Services, Quality Account 2014–2015 Barchester Healthcare has not participated in any special reviews or investigations by CQC during the reporting period. CQC have issued no warning notices of action against Barchester Healthcare’s independent hospitals during 2013 to 2014. Research: We are a pilot site for the 'Think Local, Act Personal' initiative. We have participated in national audit work, though not directly connected to delivery of mental health hospital services. Barchester Healthcare did not submit records during 2013 to 2014 to the Secondary Uses service for inclusion in the Hospital Episode Statistics. Staffing: Barchester Healthcare’s excellent service quality was recognised by our shortlisting for ‘The Health Investor Award for Best Residential Care Provider’ in 2014. Barchester Healthcare featured in ‘The Sunday Times Top 25 Best Big Companies to Work For’ for 2014, the only care organisation to feature in this list. The list is based on confidentially researched employee feedback. “The management and staff are wonderful and they have sorted all of the concerns I had.” Barchester Healthcare would like to thank everyone who has contributed to this Quality Account. We look forward to working with all stakeholders over the coming year to deliver the improvements to which we are committed. 22 Ensure implementation and evaluate Action plan: None expected Ensure implementation and evaluate Action plan: None expected Negative impact: Better monitoring of quality, improved service quality and greater involvement Better monitoring of quality, improved service quality and greater involvement Negative impact: Positive impact: Positive impact: 1. To improve review of data and Quality Account planning for the Hospital Quality and Clinical Governance Committee Gender issues Age issues Action plan Ensure implementation and evaluate Action plan: None expected Negative impact: Better monitoring of quality, improved service quality and greater involvement Better monitoring of quality, improved service quality and greater involvement Ensure implementation and evaluate Action plan: None expected Negative impact: Positive impact: Religious or belief issues Positive impact: Disability issues Ensure implementation and evaluate Action plan: None expected Negative impact: Better monitoring of quality, improved service quality and greater involvement Positive impact: Sexual orientation F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Ensure implementation with planning for Quality Accounts exploring age issues and evaluate Action plan: None expected Ensure implementation with planning for Quality Accounts exploring gender issues and evaluate Action plan: None expected Negative impact: Greater involvement of commissioners, better focused and more outcomebased care Greater involvement of commissioners, better focused and more outcomebased care Negative impact: Positive impact: Positive impact: 2. To establish a reporting framework on relevant data that involves commissioners and drives forward recovery where appropriate Gender issues Age issues Action plan Ensure implementation with planning for Quality Accounts exploring disability issues and evaluate Action plan: None expected Action plan: Ensure implementation with planning for Quality Accounts exploring orientation issues and evaluate Ensure implementation with planning for Quality Accounts exploring religious and belief issues and evaluate None expected None expected Action plan: Negative impact: Negative impact: Negative impact: Greater involvement of commissioners, better focused and more outcome-based care Greater involvement of commissioners, better focused and more outcomebased care Greater involvement of commissioners, better focused and more outcomePositive impact: care Positive impact: Sexual orientation Positive impact: Religious or belief issues Positive impact: Disability issues F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Negative impact: Physical intervention might be inappropriate if it does not respect gender issues Negative impact: Physical intervention might be inappropriate if it does not take account of age and disability Ensure physical intervention takes account of age and disability Ensure physical intervention takes account of potential gender issues Action plan: Better management of physical intervention Better management of physical intervention Action plan: Positive impact: Positive impact: 3. To improve review of data based on physical restraint, formulating a strategy for reduction and improving response in each hospital Gender issues Age issues Action plan Ensure physical intervention takes account of age and disability Action plan: Physical intervention might be inappropriate if it does not take account of age and disability Ensure physical intervention takes account of religious issues Action plan: Physical intervention might be inappropriate if it does not take account of religious issues Ensure physical intervention takes account of orientation issues Action plan: Physical intervention might be inappropriate if it does not take account of orientation issues Negative impact: Negative impact: Negative impact: Better management of physical intervention Better management of physical intervention Better management of physical intervention Positive impact: Sexual orientation Positive impact: Religious or belief issues Positive impact: Disability issues F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Evaluate available options Action plan: Screening can be difficult to manage effectively for people living with dementia None required Action plan: None expected Negative impact: Better screening and improved well-being Better screening and improved well-being Negative impact: Positive impact: Positive impact: 4. To improve screening for physical health, review and improve well-being Gender issues Age issues Action plan Evaluate available options Action plan: Screening can be difficult to manage effectively for people with sensory deficits None required Action plan: None expected None required Action plan: None expected Negative impact: Negative impact: Negative impact: Better screening and improved well-being Better screening and improved well-being Better screening and improved well-being Positive impact: Sexual orientation Positive impact: Religious or belief issues Positive impact: Disability issues F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 Negative impact: None expected Negative impact: None expected Training must acknowledge dementia issues Training must acknowledge gender issues Action plan: Improved services to all service users Improved services to all service users Action plan: Positive impact: Positive impact: 5. To broaden the experience and training of Mental Health Act Administrators, improving & strengthening services to and relationships with service users Gender issues Age issues Action plan Positive impact: Improved services to all service users Negative impact: None expected Action plan: Training must acknowledge religious and belief issues Improved services to all service users Negative impact: None expected Action plan: Training must acknowledge gender issues Religious or belief issues Positive impact: Disability issues Training must acknowledge orientation issues Action plan: None expected Negative impact: Improved services to all service users Positive impact: Sexual orientation F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 F_BAR_7588 Barchester Healthcare’s Independent Hospital Services Quality Account May 2014 V13_Layout 1 06/10/2014 1 www.barchester .com