DRAFT Nurse Staffing Review

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DRAFT Nurse Staffing Review
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
Board Paper - Cover Sheet
Date: 27th
January 2016
Lead Director
Report Title: PLACE 2015
Report
Author
Classification
Mr R Sanderson, Chief Building Officer
Purpose (Tick
one only)
Approval
Links to
Strategic
Objectives
Links to CQC
Domains/
Fundamental
Standard(s)
Identified
Risk? (If yes,
risk
reference)
Resource
Implications
Legal
implications
and equality
and diversity
assessment
Benefit to
patients and
the public

Putting patients at the heart of everything we do

Regulations 9, 10, 12, 14, 15
Agenda Item A7(i)
Mrs H Lamont, Nursing & Patient Services Director
NHS Unclassified / NHS Protect / NHS Confidential
Discussion
For
Information 
N/A
Some Estates impact
N/A
Safe, clean, comfortable environment; appropriate nutrition and
hydration
Report
History
Executive Team 11th November 2015
Next steps
Board to consider and endorse action plan, for implementation
Agenda item A7(i)
THE NEWCASTLE UPON TYNE HOSPITALS NHS FOUNDATION TRUST
PATIENT-LED ASSESSMENT OF THE CARE ENVIRONMENT (PLACE) 2015
1.
INTRODUCTION
The PLACE audits were undertaken during the months of February and May 2015
with 41 areas being assessed, (including external and communal areas on all
three sites), with the involvement of 10 Patient Assessors.
As in previous years, feedback from the assessment teams during the inspection
process was that standards remained high across the Trust. It is to be noted that
the assessment teams were very complimentary with regards to our staff stating
that they “provide a calm and caring atmosphere with attention to detail and
individual patient care and that they appear to take pride in their work and to be
proactive in promoting change”.
2.
METHODOLOGY
The aim of PLACE assessments is to provide a snapshot of how an organisation is
performing against a range of non-clinical activities which impact on the patient
experience of are. The non-clinical areas of scrutiny are:





Cleanliness
Food and Hydration
Privacy, Dignity and Wellbeing
Condition, Appearance and Maintenance of healthcare premises
Dementia (whether the premises are equipped to meet the needs of the
dementia sufferers against a specified range of criteria).
The criteria included in PLACE are not standards but do represent aspects of care
which patients and the public have identified as important. It also represents good
practice as identified by professional organisations whose members are
responsible for the delivery of these services. In the case of Dementia they draw
heavily on the work of The King’s Fund and Stirling University.
As with the 2014 assessment, the 2015 assessment required 25% of wards and a
similar number of non-ward areas to be visited by teams of assessors comprising
50% of patient assessors (minimum of two).
Staff Assessors comprised representatives from Patient Services, Estates and
Hotel Services.
The assessment tools have either questions requiring a yes/no answer, or a pass,
qualified pass or fail judgment is required.
Elements are passed if they meet the required definition. A qualified pass would
be awarded if most, but not all items meet the definition and there are no serious
issues such as contamination with body fluids. A rough guide is if 20% failed to
1
meet the definition then a qualified pass would be awarded, however this is at the
discretion of the assessment team.
An element would be a Fail if greater than 20% did not reach the required
standard or there was body fluid contamination on just one item/area.
Trust and site level scores also include organsational level assessments in
facilities and food; therefore the total sites scores will not reflect the total Trust
scores.
3.
RESULTS
Appendix 1 shows the number of points available for each component and the
score achieved for each Hospital site. The Trust results for 2014 and 2015 and
comparison with the national average can be seen in appendix 2; appendix 3
details the results by site, including the full food results. Appendix 4 shows
comparison of the Trust scores against the Shelford Group, the NUTH position for
each domain for 2014 and 2015 and comparison with local Trusts. A summary of
elements that were scored as fails, qualified passes or no’s can be seen in
appendix 5.
The Newcastle Hospitals scored well again this year against the national average.
Although some of our positions are lower than last year it is fair to say the
differentials between many of the scores are relatively small.
In 2015 the scoring methodology for Food and Hydration was altered to weight the
food taste section and to increase the range of option for answering this question
from three to five. Additionally, the options for answering the food temperature
question reduced from three to two. This change has contributed towards the
decrease in ward food scores which in turn offset an increase in the organisation
food section, leading to an overall decrease of 0.3% in the food scores.
The Dementia component of the assessment was undertaken and scored for the
first time in 2015. The Dementia assessment focused on flooring, décor and
signage but also included such things as availability of handrails and appropriate
seating and, to a lesser extent, food. The items included in the assessment do not
constitute the full range of issues requiring assessment which, in total, are too
numerous to include in these assessments. However, they do include a number of
key issues and organisations are now encouraged to undertake more
comprehensive assessments using one of the recognised environmental
assessment tools available.
4.
ACTION PLAN
The training for PLACE includes the requirement for development of a Trust Action
Plan. The purpose of this action plan is to focus upon the standards of PLACE
which cannot be achieved in the organisation without further actions/expenditure.
2
5.
CONCLUSION
The purpose of this paper is to advise Directors of the 2015 PLACE programme,
share results and request endorsement of the Action Plan.
Once again the results for the Newcastle Hospitals are positive. However,
improvements can and will be made to improve standards and achieve another
successful year in 2016.
6.
RECOMMENDATION
To receive the briefing and note the satisfactory outcomes of the 2015 PLACE
programme.
Rob Sanderson
Chief Building Officer
18th January 2016
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Appendix 1
POSSIBLE SCORES/ACTUAL SCORE ACHIEVED
Condition,
Privacy
Appearance
&
&
Dignity
Maintenance
440.00
838.00
FH
Cleanliness
Possible
Score
Actual
Score
Shortfall
2058.00
719.98
2047.00
660.97
413.33
789.00
583.96
11.00
59.01
26.67
49.00
371.33
Food
Condition,
Privacy
Appearance
&
&
Dignity
Maintenance
632.00
1166.00
Dementia
955.29
RVI
Cleanliness
Possible
Score
Actual
Score
Shortfall
2886.00
681.08
2872.00
623.17
573.83
1100.00
557.96
14.00
57.91
58.17
66.00
475.33
CAV
Possible
Score
Actual
Score
Shortfall
Cleanliness
Food
Condition,
Privacy
Appearance
&
&
Dignity
Maintenance
134.00
294.00
Food
Dementia
1015.29
Dementia
566.00
222.03
566.00
211.27
126.00
275.00
251.29
0
10.76
8.00
19.00
62.00
4
313.29
APPENDIX 2
NUTH PLACE SCORES 2014 AND 2015
COMPARISON WITH THE NATIONAL AVERAGE 2014
APPENDIX 3
5
PLACE SCORES BY SITE
FOOD RESULTS
6
APPENDIX 4
COMPARISON WITH SHELFORD GROUP
TRUST
Gateshead
Guy’s & St Thomas’
Oxford
Northumbria
Newcastle Hospitals
Sheffield
Imperial
University Hospital Birmingham
Cambridge & Peterborough
Central Manchester
County Durham & Darlington
King’s College Hospital
South Tyneside
TRUST
University Hospital Birmingham
Sheffield
Northumbria
Oxford
Central Manchester
Newcastle Hospitals
Guy’s & St Thomas’
Gateshead
Cambridge & Peterborough
County Durham & Darlington
King’s College Hospital
Imperial
Cleanliness
TRUST
99.78%
99.75%
99.75%
99.74%
99.50%
99.31%
98.60%
98.55%
98.25%
98.22%
97.69%
97.23%
95.11%
Northumbria
University Hospital Birmingham
Gateshead
Guy’s & St Thomas’
County Durham & Darlington
Newcastle Hospitals
Central Manchester
Oxford
Cambridge & Peterborough
King’s College Hospital
South Tyneside
Imperial
Sheffield
Condition, Appearance &
Maintenance
TRUST
98.31%
97.65%
96.44%
95.96%
95.15%
94.23%
93.57%
93.13%
91.99%
91.16%
87.62%
86.76%
Northumbria
University Hospital Birmingham
Newcastle Hospitals
Guy’s & St Thomas’
Cambridge & Peterborough
Central Manchester
Oxford
Country Durham & Darlington
Gateshead
South Tyneside
Sheffield
King’s College Hospital
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Food
97.11%
94.39%
93.47%
92.61%
92.21%
91.72%
90.62%
89.76%
88.92%
88.86%
88.74%
86.07%
84.87%
Privacy, Dignity & Wellbeing
95.33%
93.34%
92.58%
90.43%
89.09%
88.45%
86.39%
86.16%
84.61%
83.53%
83.33%
79.14%
South Tyneside
86.68%
Imperial
TRUST
78.39%
Dementia
Northumbria
Oxford
University Hospital Birmingham
Central Manchester
Guy’s & St Thomas’
Cambridge & Peterborough
South Tyneside
King’s College Hospital
Imperial
Gateshead
Newcastle Hospitals
County Durham & Darlington
Sheffield
95.41%
91.09%
84.44%
83.67%
82.18%
79.09%
73.15%
71.21%
67.60%
64.93%
58.57%
47.88%
00
It should be noted that Northumbria Healthcare NHS Foundation Trust have made a large investment in new
infrastructure which will have had an effect on their PLACE results.
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POSITION IN EACH DOMAIN IN THE SHELFORD GROUP 2014 AND 2015
Domain
Position 2014
Position 2015
Cleanliness
1st
5th
Food
4th
6th
Condition, Appearance &
Maintenance
7th
6th
Privacy, Dignity & Wellbeing
3rd
3rd
Not previously scored
11th
Dementia
COMPARISON WITH LOCAL TRUSTS (%)
120
100
80
60
40
20
0
Condition,
Appearance
&
Maintenanc
e
Dementia
Cleanliness
Food
Privacy,
Dignity &
Wellbeing
Gateshead
99.78
93.47
84.51
93.13
64.93
Northumbria Healthcare
99.74
97.11
95.33
96.44
95.41
South Tyneside
95.11
88.74
83.53
86.68
73.15
County Durham & Darlington
97.69
92.21
86.16
91.16
47.88
City Hospitals Sunderland
99.51
96
89.93
95.76
76.34
South Tees Hospitals
98.59
85.23
83.07
93.19
72.69
The Newcastle upon Tyne Hospitals
99.5
91.72
92.58
94.23
58.57
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APPENDIX 5
SUMMARY OF ELEMENTS THAT WERE FAILS, QUALIFIED PASSES OR NOs
Failed Elements
Condition/appearance:
Secure storage of personal
possessions
Ward/Dept
where Failed
All in-patient
wards
Qualified Pass (QP)
Elements
Ward/Dept
where QP
Condition/appearance:
Toilet area – scuff marks
RVI
Breast
Assessment
Bath/toilet very dated –
needs redecoration.
Ward 33
Bath/toilet – recently used
required attention.
Ward 48
NO Elements
Ward/Dept
where No
recorded
Flooring not to dementia
standard
All areas
Condition/appearance:
Ward requires complete
refurbishment.
FH
Ward 3
Condition/appearance:
Linen delivered in bags and
stacked on shelves – 21
pillows stored in small room
FH
Ward 29
Décor not to dementia
standard
Most areas
Condition/appearance:
Door frame damaged.
RVI
Breast
Assessment
Condition/appearance:
Woodwork/framework of
doors marked with chlorine
residue.
RVI
Ward 11
Signage not to dementia
standard
Most areas
Condition/appearance:
Seal on toilet floor damaged.
Toilet seat cracked.
RVI
Breast
Assessment
Condition/appearance:
General storage –
Emergency Retrieval
Equipment stored in
corridor.
RVI
Ward 12
Social/Access areas:
Seating provided in
reception/waiting area does
not provide range of heights,
etc.
FH
Ward 38
RVI
Breast
Assessment
Brest Clinic
Main X-Ray
Ward 20
Ward 43
10
Failed elements
Cleanliness
Ventilation/air conditioning
grilles dusty.
Ward/Dept
where failed
RVI
Ward 16
Qualified Pass (QP)
Elements
Ward/Dept
where QP
Cleanliness:
Bedframe dusty.
Floor dusty.
Floor under bed dirty.
RVI
Ward 12
Cleanliness:
Sink/basin – slight stain.
Toilet/sink – stained.
RVI
Ward 12
Ward 23
Cleanliness:
Internal decoration –
decoration to entrance
needs refreshing. Flooring
in ‘bad news’ room requires
replacement.
RVI
Ward 18
NO Elements
Social spaces:
No day room, social/communal
area or play area on Ward.
Ward 31
Social spaces:
Furniture/decoration does not
provide relaxing environment
and does not encourage use.
Social spaces:
Natural light not good.
Privacy and dignity:
No private room on ward
where patients can go for
conversations.
Privacy and dignity:
All rooms on ward are not
single occupancy with en-suite
bath/shower facilities.
11
Ward/Dept
where No
recorded
FH
Ward 31
RVI
Ward 23
Ward 33
Ward 36
Ward 48
RVI
Ward 41
RVI
Ward 41
RVI
Ward 23
Ward 33
CAV
Cherryburn
FH
Ward 3
Ward 5
Ward 11
Ward 19
RVI
Ward 4
Ward 11
Ward 16
Ward 20
Ward 23
Ward 31
Ward 36
Ward 41
Ward 43
Ward 45
12
Failed Elements
Ward/Dept
where Failed
Qualified Pass (QP)
Elements
Ward/Dept
where QP
NO Elements
Privacy and dignity:
Bath/shower visible when door
open – no privacy curtains
installed.
Privacy and dignity:
Patients/families leave
consultation/counselling rooms
via general waiting area.
Privacy and dignity
No separate treatment room
on ward for minor procedures/
wound dressings.
Access:
Handrail not in colour which
contrasts with walls.
Access:
No handrails in corridors within
ward/department.
Access:
No handrails on approach to
bathroom/toilet
Access:
No hearing loop/portable assist
systems at reception desk.
13
Ward/Dept
where No
recorded
CAV
Cherryburn
RVI
Ward 33
Ward 45
CAV
WIC
FH
ENT OPD
RVI
Breast
Assessment
Breast Clinic
RVI
Ward 36
FH
Ward 11
Ward 36
RVI
Ward 45
Ward 48
FH
Ward 3
ENT OPD
RVI
Ward 23
Ward 36
Ward 45
Ward 48
RVI
Ward 23
Ward 45
Ward 48
FH
IOT OPD
MSU OP
Failed Elements
Ward/Dept
where Failed
Qualified Pass (QP)
Elements
Ward/Dept
where QP
NO Elements
Access:
No audible/verbal appointment
alert system for visually
impaired.
Access:
No visual appointment alert
system for hearing impaired.
Access;
No toilet within department big
enough to allow space for
wheelchair and carer (not
nursing staff) to assist when
door is closed.
Access:
No space in reception/waiting
area for wheelchairs and those
accompanying patients to sit
together.
Food tasting:
Meals consisting of more than
one course are not served
separately.
Food tasting:
No separate area away from
bedside where patients can
take their meals.
Food tasting:
Napkins are not provided with
14
Ward/Dept
where No
recorded
FH
IOT OPD
Main OPD
MSC OPD
RVI
COPD
Main X-Ray
FH
IOT OPD
Main OPD
MSU OPD
RVI
Breast
Assessment
Breast Clinic
COPD
Main X-Ray
FH
IOT OPD
RVI
Ward 45
RVI
Breast
Assessment
All areas
Most areas.
All areas
meals.
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