Enclosure C
Paper WL1856
Annual report 2009/2010
Page 1
Cover
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Our vision and values
This year we have involved people who use our services, carers, our staff and external stakeholders in a far-reaching cultural change project. This is important to us, because we want our staff to have aclear and united sense of our purpose, and of the valuesand behaviours we aim to live by.
Based on extensive consultation and validation, we have agreed our desired organisational values. By embedding these in our policies, processes and systems, we will create a culture that enables us to realise our strategic goals. Accordingly the values will underpin service standards and practice to help us deliver a consistently high quality experience for patients, their carers and the public.
Our strategic aims are:
To provide a safe and effective service
To provide a positive and consistent patient experience
To become a provider of choice
To build a reputation for excellence in forensic and high secure services
To build an engaged and patient focussed workforce
And these are the distinguishing, organisation-wide values which will help us to achieve our aims:
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Togetherness
Responsibility
Excellence
Caring
We will find practical ways to measure ourselves and each other against these values by building them into our recruitment processes, induction and development initiatives and staff appraisals. As well as working with stakeholders to design and develop more effective systems, managers and leaders at the Trust will need to role model the desired behaviours associated with our values and inspire colleagues to do the same.
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Contents
Page 4 Message from the Chairman
Page 5 Message from the Chief Executive
Highlights of the year
Page X - X Improving our environments
Page X - X Improving the pathways for people using our services
Page X - X A focus on physical healthcare
Page X - X Involving patients in our services
Page X - X Leading our field
Page X - X Providing safe services
Page X - X Forward plans
Quality Account
Pages X - X
Finance
Pages X – X
Who runs the Trust
Pages X - X
Page 4
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Message from the Chairman, Nigel McCorkell
I have much appreciated the warm welcome and support I’ve had during this my first year as Chairman. I’m really positive about all that West London Mental Health Trust does for its communities and it’s a privilege for me to be a part of it.
This year, much of our effort has focussed on learning the lessons from the Care Quality Commission’s investigation, and absorbing the recommendations made by an independent inquiry into the care and treatment of two patients in BroadmoorHospital. These reports were published last summer, and have presented us with many challenges, resulting in significant change.
We’ve seen change right at the top of the organisation, with the appointment of a number of new directors including Peter, our Chief Executive. With five new non-executive directors, the leadership team is very different compared to a year ago. As a board, we are developing so that we can play our part in promoting a dynamic, innovative culture that encourages staff to be enthusiastic, up to date with current practice and highly motivated.
It’s heartening to confirm that we are seeing positive change in a number of areas, and this report gives you some of the detail on this. I believe that if we continue to work enthusiastically and at this pace, we will achieve the high quality of care within safe environments that we so desire.
We’re seeing and hearing about staff taking personal responsibility for driving through the changes. We’ve seen this at ward level for example, with staff supporting our new, improved standards of ward cleanliness, with attendance at mandatory training improving and staff now looking out for the physical health care of their patients, as well as looking after their mental health needs.
So for us as leaders, we have to immerse ourselves in the real front-line challenges that come with the change that is happening here at West London Mental Health by getting out and talking to people. This way we can steer the organisation, confident that we are in touch with what is happening at the front line of care and support our colleagues to achieve the new levels of excellence they crave.
SIGNATURE GOES HERE
Nigel McCorkell
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Message from the Chief Executive, Peter Cubbon
It's been a busy and challenging time for me since arriving at West London Mental Health Trust last August. I've been made to feel very welcome and have been impressed by the many talented and committed staff I've met during my time here.
We’ve embarked on a journey of positive change, but we’ll still need clear direction, increased patient focus and a great deal of hard work to get us back on track as a provider of quality mental healthcare. Feedback from both staff and people who use our services tells me that we are making progress, but we still have much work to do which includes sustaining the changes we’ve made so far.
In recent months we've had frank conversations with many of our service users, carers, partner organisations and our staff through our values project. They reinforced the view that a change in culture is needed. To help us get from here to where we all want to be, we’ve now agreed a clear set of values that we want to see all of us embracing and which, when lived daily as behaviours, will help us to meet our objectives and continue to improve.
We’re just beginning to embed these values into every aspect of what we do here. We'll be measuring ourselves against them through our performance development review processes and we'll be rewarding staff who live these values in our staff award schemes. We’ll seek to recruit people who share these values, and develop our managers’ skills in using them to lead the organisation. The results of this will be evident in improved patient care and recovery and it’s my priority to ensure that our values-based cultural change programme makes a difference.
Another area of focus for the year ahead will be enabling greater involvement of people who use our services and their carers in our planning, decision making and daily operation. There are already many service users who are working closely with us and we’re grateful for their open feedback and positive encouragement. I'll be aiming to make their roles far more meaningful and include them in many more areas, so that we can be confident that we're moving things in the direction they want us to go. We'll also be re-launching our bid to become a Foundation Trust equivalent this coming year which will mean building an active membership base. We’ll be inviting service users and their carers to become involved in this, too.
Like all NHS organisations, we'll be working to achieve our objectives against a backdrop of significant public sector financial challenge. We're already seeking ways of delivering our services more efficiently, and using the opportunity to do so more effectively for local communities, too.
So the year ahead will be one of more change and challenge. To support this, the Trust has produced its first Quality Account, which you will see in section x of this report. The Quality Account presents the targets we have set for ourselves and our plans for achieving them.
We know that we have a long way to go, but we are making improvements day by day, and I’m confident that people using our services will soon see and feel that progress for themselves.
SIGNATURE GOES HERE
Peter Cubbon
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Highlights of the year
SUBHEADING
Improving our environments
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This year all of our domestic staff have been trained to the new National Standards of Cleanliness. We’ve invested in improved equipment and we’ve changed the cleaning products to ensure high standards are maintained. We’ve also been working with an external agency to deep clean all of our inpatient areas. Barbara Wood, Director of Estates and Facilities says: “Both domestic and clinical staff are taking a real pride in their improved environments and estates and facilities staff have never been busier! Our focus is now on maintaining the high standards we now set for ourselves. We’ll be doing this through continual monitoring and auditing of the cleanliness of the environments in which our patients live. We’ll be displaying the audit results in each ward and actively encouraging patients and staff to report issues if they see standards slipping.”
Bright new facilities at the Limes
At the Limes in Ealing, our patients are benefiting from their recently refurbished unit. John Nursimooloo, manager of the Limes says: "Patients in the Assessment Unit now have better standards of privacy because they now have individual rooms. For our women patients, we have developed a new unit complete with lounge area where they can relax, as well as a new kitchen and dining room. These bright new facilities will help us to continue to provide excellent care to patients, allowing them to develop their independence and improve the quality of their lives."
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Wards and other areas in the Hammersmith & Fulham Mental Health Unit have been completely refurbished and decorated to make them cleaner, safer and more pleasant.
The new older people’s ward feels open and inviting, with improved lighting and bright living areas contributing to a dramatic transformation.
As part of the improvement works, the child visiting and tribunal rooms have also been refreshed. The vibrant, family-friendly new child visiting suite was opened in March 2010, with an integrated kitchen area, baby changing facilities, TV, toys and games. As well as making visiting less stressful for both children and parents, family contact has been proven to have a positive impact on mental health recovery.
Redeveloping BroadmoorHospital
This year the re-development planning process for BroadmoorHospital has moved ahead at a steady pace.
We were asked by the Department of Health to revisit our Outline Business Case in light of the High Secure Commissioners' review of high secure hospital services for the whole of the UK. This review stipulated a smaller number of beds than we had previously planned for, and this meant that we needed to adjust the scale of our plans and costs accordingly. These plans have been approved by NHS London. Approval by the Department of Health and Treasury is our next goal.
User groups are now being set up to take forward the design development and enable a planning application to be submitted in early 2011. Meantime, Bracknell Forest Council are proceeding with their consultation process for their Local Development Framework (LDF) and have already announced this to the local community. The Broadmoor re-development is part of this as it would provide some of the land needed to improve local housing and amenities.
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SUBHEADING
Improving pathways for people using our services
Community services in Hammersmith & Fulham have been transformed to make sure that people receive the same high level of care no matter where they live. Services that were based on geographic boundaries have been replaced with teams who focus on specific levels of need, working together to provide comprehensivemental health care.
A new assessment and short-term treatment team accepts all new referrals and provides follow-up treatment for people who need support for a limited period. Two recovery teams in the north and south of the borough will focus on people with severe and enduring mental health problems who have more complex needs.
Expected benefits of the new style service include:
- Higher levels of expertise available consistently across the borough.
- Targeted, faster and more responsive care.
- A clearer pathway for GPs and other referrers into the service.
Inpatient wards have also been reconfigured, with a focus on clinical expertise rather than where people live. Targeted resources of a housing and social worker will be attached to the new admission ward so that the practical details of discharge planning can start as soon as people arrive.
People who need a stay of more than two weeks will move to a specialist recovery ward where the environment will be much calmer than a generic acute ward. Planning for those who need extra care and support when they leave the unit can then take place with active service user participation.
Looking after forensic patients in the community
We're proud of the work we've done with colleagues from Central and North West London (CNWL) FT to establish forensic services for community patients. Together, we're providing services in the London boroughs of Harrow, Kensington & Chelsea and Westminster, working to a new and safe model of providing forensic mental healthcare. Dr Nick Broughton, Clinical Director of the service says: "The teams' multidisciplinary and holistic approach is helping re-integrate patients with very complex needs back into the community. They are finding it easier than they might have done to settle back into society and get back to work. Some people can be discharged from hospital earlier than they may have been thanks to the support we can provide in the community. Because they get to know them in their home setting, these teams can now work more proactively with service users to help ensure they continue to live safely in the community. This is aimed at preventing re-admissions to hospital."
Page 9 TEAM PHOTO
Value: EXCELLENCE PHOTO
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Enhanced pharmacy service in the community
This year we've enhanced the level of pharmacy service we provide to our community teams. This was highlighted in our CQC report as an area for improvement. Claire Stanniland, senior pharmacist in Hounslow says: "We've spent a great deal of time with colleagues in the community teams finding out what kind of pharmacy service they need from us. We're now realising a number of benefits of having more pharmacy support for community teams in Hounslow. I visit the teamsmore regularlywhich allows me to complete more regular, detailed medicationhistories for patients. In some community teams I’m asked to meet with individual patients to answer their questions about the medication they are on. Other community mental health teams ask me to deliver teaching sessions to them, so they can more confidently answer questions from patients and carers."
The pharmacy team is also looking forward to the addition of a new Consultant Pharmacist who will work with our local PCT colleagues to develop the opportunities for sharing mental health pharmacy expertise with primary care. This post has been designed in collaboration with the NHS London Consultant Pharmacist panel and our three London Boroughs. It is an innovation which we hope will make a significant impact on the care of people with mental health problems in the community.
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SUBHEADING
A focus on physical healthcare
This year we’ve increased our focus on the physical healthcare of people using our services. With a new physical healthcare strategy in place, easy and timely access to primary healthcare is a priority.
Improved access for forensic patients
In West London Forensic Services we're proud of our new, comprehensive primary health care service, which means our inpatients no longer have to go to EalingHospital for non-emergency assessment and treatment. They can now see the GP in one of the three newprimary care centres. They also have access to the full range of primary care services, as they would if they were living in the community.
An inpatient on one of our forensic wards said: "It's much quicker for us to see a GP. It's saving staff on our wards time too, as they used to have to escort us to the general hospital. This new arrangement is really making a difference to our lives."
Gina Hillis, Senior Nurse Manager says: "We all welcome this new service as our patients need to have easy access to primary care. This is particularly the case because their physical health is often compromised due to the effects of the medicines they are on, the repetitive nature of their diets and a lack of exercise."
Keeping our patients Wii Fit
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Exercise is clinically proven to have a positive effect on physical and mental health. However, as we age, we can become less active, which can lead to a loss of mobility and independence and, potentially, lower levels of emotional and mental wellbeing. To combat this, the Trust’s Older Peoples’ Service at BrentfordLodgeDayHospital promotes physiotherapy through an interesting and varied exercise programme.
The most recent addition to the programme has been the use of Nintendo Wii Fit. The interactive games are encouraging our older patients with a range of cognitive disorders, including Alzheimer’s disease, to become increasingly involved in physical activity, with encouraging results.