Experience of NHSLA RMS

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Experience ofNHSLA RMS

• Lynn Pearl
• Risk Manager

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• What do we do?
• Deliver Mental Health Learning Disabilities
  health and social care services to
• Diverse communities over large geographical area
• Population base of 550,000
• Budget of 120 million
• Work from 120 sites
• 2,700 staff
• 302 beds
• 5000 service users

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• Staff
• 1496 Care
• Nursing, Health Care Assistants, Community
  Support Workers
• 79 Medical
• Consultants, Doctors
• 137 Allied Health Professionals
• Psychology, Therapists, Occupational Therapists,
  Physiotherapy
• 339 Estates Facilities
• Hotel Services, Maintenance, Catering, Patient
  Transport, IT Information, Property
• 563 Support
• Admin Clerical, Finance, Personnel, Management

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Care Groups
Service Delivery
Older Peoples Mental Heath
Adult Mental Health
Learning Disabilities
Forensic
Child Adolescent Mental Health
Substance Misuse
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• Historical Assessments in BDCT
• 2003 - CNST Passed
• 2005 - RPST Passed
• - CNST Failed
• 2007 - CNST Passed

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• Misplaced confidence
• 100 in 8 Standards
• Perception - pilot should not be too hard
• We were so wrong!
• Changes in minimum data requirements meant
  re-writing 99 policies
• New Policies to produce
• Old Policies disappeared

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• Project Plan for Pilot and Future
• Organisational Objective Level 3 by 2010
• Level 1 2007/08 (Pilot Site) Nov 2007
• Level 2 2008/09
• Level 3 2009/10

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• Three Heads are better than one
• Worked with SWYMHT LPFT
• Jointly Identified 9 standards as difficult
• 1.1.2 Policy on Procedural Documents 1.1.7
  Responding to External Recommendations1.2.5 Risk
  Management Training1.1.3 Secure
  Environment1.3.5 Slips, Trips and Falls1.4.1
  Identification of Service Users1.4.3 Management
  of service Users with Dual Diagnosis1.5.8 Best
  Practice NICE, NCEs National Guidance1.5.9
  Best Practice NSFs high level enquiries

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• In-House Process
• 50 criteria Allocated Responsibilities
• Director Lead
• Responsible Officer
• Implementation Officer
• Action plans covering all criteria all levels
• Monthly Meetings

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• Supporting the Process
• Provided the LAs scoring
  template to those responsible
• Used available Policy Templates from NHSLA
  Website
• Offered support in interpreting the standards -
  Time consuming and difficult
• Open to interpretation not always right
• Linked with other pilot sites

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• Issues
• Time scales
• Clarity of lead officers Trust wide Role
• Right people producing Policy/procedure
• Multi-agency Policies
• Day job
• Inconsistent commitment
• Lack of knowledge/understanding of new standards
• Quality Assurance
• Approval of documentation
• Gathering Evidence best method

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• Assessment Day
• 9.30am 19 criteria not compliant
• Lunch time gained 7 criteria
• 2.30pm 41 criteria compliant

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• Non Compliant
• 1.1.10 Employment Checks Technicality
• 1.2.5 Risk Management Training Difficult
• 1.2.6 Training Needs analysis Difficult
• 1.3.4 Moving Handling Vacant Post
• 1.3.5 Slips, Trips Falls Clinical and Non
  Clinical
• 1.3.6 Inoculation Incident Technicality
• 1.4.2 Information from Service Users
  Technicality
• 1.4.5 Observation of Service Users Perception
• 1.5.7 Improvement Implementation
  Effectiveness

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• Next Considerations
• Strategy
• Time
• Resource
• Templates
• Policy/procedure
• Implementation and Effectiveness
• Non Compliance

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• Conclusion
• Journey
• Hard Work
• Trust Board and Senior Management Commitment
• Good Basic Framework
• Improvement on CNST