Sue’s post board blog - July 2017

A blog for our Chair Professor Sue Proctor following the July Trust Board meeting.

Hello, my name is Sue, and welcome to my latest post Board blog following the meeting of our Board of Directors on 27 July 2017.

We discussed a range of important matters concerning the Trust’s services and the papers that informed these discussions can be found on our website.

At each Board meeting we hear about one of our services either from a service user or carer, or from a staff team. At July’s Board meeting we were treated to a fantastic presentation about our Child and Adolescent Mental Health Services based at Mill Lodge in York.

They showcased a brilliant example of service user involvement in the form of a short animation which had been developed and produced by the young people at Mill Lodge (see below). Its purpose is to help prepare prospective service users for an admission and has received excellent feedback so far.

We then heard from a young lady, who (at the time of writing) is an inpatient on the unit. She gave a confident talk where she shared insights into her experiences at Mill Lodge, breaking it down into positives and negatives.

On the negatives, she said:

  • The 16 bed unit felt big and the mix of patients can sometimes mean the loud and disruptive ones get more attention from staff;
  • The food wasn’t good and, for young people there who suffered with an eating disorder, this didn’t help with their recovery; and
  • The use of agency staff could sometimes make young people feel uncomfortable as they were not familiar with them and their backgrounds.

On the positive side, she told us:

  • The staff at Mill Lodge were really good at helping young people to feel well enough to go home. They did this by ensuring they followed a normal daily routine (meals, activities, sleep etc.). She also said there was a wide range of staff who worked there and young people could usually find someone they ‘clicked’ with;
  • Staff make sure young people know what was in their care plan and what treatment and therapies they should be getting, and there were regular check ups; and
  • There are good opportunities for young people to have their voices heard – including daily morning meetings, a weekly Community Meeting and a monthly Young Person’s Council.

These sessions are so important for the Board to learn more about the experiences of staff and service users, and we are extremely grateful for the time and effort that goes into arranging them, and to those who attend the Board.

I am visiting our Deaf CAMHS service soon, which was rated outstanding by the Care Quality Commission (CQC) in November 2016, so I look forward to seeing examples of more good practice there.

CQC action plans

On the subject of the CQC . . .

In the reports we received in 2016, 77% of our services were rated good or outstanding but overall we were rated as requires improvement. This has led to a great deal of work in fulfilling the requirements needed to demonstrate the standards of our services, and how we are improving. In other words, our CQC action plans.

The Board received some disappointing news about progress on our CQC action plans. Whilst there has been some good progress, we’ve had to reopen a number of actions as there wasn’t sufficient evidence in place to show they’d addressed the initial problem or that practice had changed and new ways of working had been embedded.

We also noted the excessive time it had taken to complete certain actions. The process for scrutinising and holding people to account for their actions needs to be more focused and robust so we can confidently demonstrate to each other, our service users and the CQC, that we are improving.

The CQC reports and ratings really matter. They are, ultimately, the way that the public judges us on quality. There will be a great deal of focused work on this issue over the summer and we look forward to receiving an update report, with more evidence of the impact of these actions, in September.

Safe staffing
We receive a report of staffing levels in our inpatient services every month and in June, five out of our 26 inpatient units reported problems with staffing levels.

Our new Assistant Director of Nursing, Nichola Sanderson, is working with our inpatient managers and matrons to get them more engaged with safer staffing and they now receive a weekly report which gives them better staffing data. It’s been successfully trialled in adult inpatients services and we’ll be looking to roll this out further.

We were advised that NHS Improvement are developing guidance on safer staffing in community mental health services and we’ll use this as a guide for assurance about these services in due course.

Equality and diversity

At each Board we also receive a report on wider issues and challenges in our workforce. This month we focused on equality and diversity and considered data on issues such as gender, age, ethnicity, religion, disability and sexual orientation.

Our aim is for our workforce to represent the communities we serve, and looking at this report, we’ve got some work to do. However, it was encouraging to see 15.2% of our staff are from Black, Asian and Minority Ethnic (BAME) communities, which is above the 14.9% from the Leeds Census figures.

We also had a progress report on our compliance against the Workforce Race Equality Standard (WRES). The WRES was introduced across the NHS in 2015 to ensure that employees from BAME backgrounds have equal access to career opportunities and receive fair treatment within the workplace.

Our WRES action plan was developed with staff in 2015/16 and focuses on recruitment and career progression; access to training and development; talent management, and culture and communication.

The report presented a huge volume of data and raised a number of issues which were discussed by the Board, and actions suggested.

Our Director of Workforce Development, Susan Tyler, is currently leading a consultation with staff across the Trust to inform the development of our new Workforce Strategy. Staff can find details of this on Staffnet.

Until next time

Many staff will be taking some annual leave over the next few weeks and if you are one of these lucky people, I hope you have a wonderful and relaxing break.

The Board also takes a break in August so our next meeting will be on 28 September. However, many of the Executive Directors and I will be around, visiting different services across the Trust as usual.

With best wishes

Professor Sue Proctor
Chair