Healthwatch Annual Richmond Report
2014/2015 Contents
Chair’s foreword 4 Chief Officer’s foreword 5 About Healthwatch 6 Highlights 7 Engaging with people who use health and social care services 8 Young people (under 21) 8 Older people (over 65) 9 People volunteering or working in Richmond 9 People who are seldom heard 10 Disadvantaged or vulnerable People 10 Public engagement events 11 Networking 11 Enter and View 12 Nightingale House 12 Recruitment 13 Enter and View Authorised Representatives 13 Providing information and signposting 14 Influencing decision makers with evidence from local people 16 GP visits 16 Inpatient mental health services in South West London 18 WMUH transaction with Chelsea and Westminster NHS Trust 19 Quality Accounts 19 Conflict of interest 20 Residential care 20 Communications 22 Public events 23 Participating in boards 25 Boards and committees 29
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33 Group Sharing Information Quality the and reports Sharing
31 House Chudleigh
27 Board Wellbeing and Health the with Working
21 House Nightingale
17 Hospital University Middlesex West
13 practices GP
11 Act Care The
8 fair freshers Mary’s St
Case Studies Case
us Contact 38
information Financial 37
2014-15 for board Our 36
activities Healthwatch in volunteers Involving 36
activities Healthwatch about decisions Making 36
making decision and governance Our 36
future the for work Planned 34
future the for challenges and Opportunities 34
2015/16 for plans Our 34
Requests for information for Requests
32
standards Quality 30
House Nightingale 30
services local improve to others with Working 30
= Chair’s foreword
It’s been a busy and services. These substantial projects, fascinating year for however, represent just a small cross- the Board and the section of how we are engaging with and team, with many representing the community’s views to opportunities for us ensure that health and social care know to get involved and and respond to patients’ views. engage the community on their experience of This will (probably) be the last annual health and social care report that I introduce. As Healthwatch in the borough. The Richmond has been growing over the past feedback you give us year, we have reviewed how we operate is making a difference. and how we can engage more people more effectively in our work. So we will We are delighted as a result that our shortly be creating a new Healthwatch contract to deliver Healthwatch Richmond Richmond Committee, and appointing has been extended by the London Borough someone to chair that committee. This of Richmond upon Thames Council until will be separate from the Board of M arch 2017. Richmond Health Voices - the body that has the contract to deliver Healthwatch We’ve taken forward our work on GP Richmond. practices in the borough, undertaking Enter and View visits to several different There will be opportunities for new practices. We’ve started work on social volunteers to join the Healthwatch care, visiting some residential care homes Committee. If you would like to be and undertaking a consultation on the involved with this, or any other of our implications of the Care Act for the activities, please do get in touch. The Council. more people who get involved, the more we can achieve. We’ve engaged young people on health and social care issues, and begun a new project on children’s mental health
Amanda Brooks, Chair
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Mike Derry, Chief Officer Chief Derry, Mike
our work. our
interest to get in touch and take part in in part take and touch in get to interest
support. We encourage anyone with an an with anyone encourage We support.
for their commitment and for their their for and commitment their for
new to Healthwatch. We are truly grateful grateful truly are We Healthwatch. to new
predecessor Richmond LINk and of people people of and LINk Richmond predecessor
of people continuing the legacy of our our of legacy the continuing people of
and our Board. Both retain a good mix mix good a retain Both Board. our and
skill and hard work of our volunteers volunteers our of work hard and skill
success has been due to the dedication, dedication, the to due been has success
As well as the hard work of our staff, our our staff, our of work hard the as well As the coming year. year. coming the
people and make a bigger difference over over difference bigger a make and people
people to find the information they need. they information the find to people
communication to help us engage more more engage us help to communication
decisions, listens to people and has helped helped has and people to listens decisions,
in Healthwatch. We’ll also develop our our develop also We’ll Healthwatch. in
social services services social
volunteers and how we involve people people involve we how and volunteers
say in NHS and and NHS in say
improving the way we support our our support we way the improving
a meaningful meaningful a
governance, revisiting our strategy, strategy, our revisiting governance,
gives local people people local gives
To do so we will be reviewing our our reviewing be will we so do To
nationally, that that nationally,
care locally and and locally care over the coming year. year. coming the over
difference to to difference look forward to meeting these challenges challenges these meeting to forward look
further growth and development and we we and development and growth further a makes that
champion for Richmond. There is room for for room is There Richmond. for champion organisation
to an effective and performing consumer consumer performing and effective an to an become
have grown from an ambitious start-up start-up ambitious an from grown have have we year
This report covers a period over which we we which over period a covers report This past the Over
foreword Chief Officer’s Officer’s Chief
= About Healthwatch
Healthwatch Richmond exists to make health and social care better for the local community. Our role is to ensure that local health and social care services, and the local decision makers, put the experiences of people at the heart of local care. We believe that the best way to do this is by designing local services around people’s needs and experiences. Everything we say and do is informed by our connections to local people and our expertise is grounded in their experience. Healthwatch is the only body looking solely at people’s experience across NHS and social services. We are uniquely placed as a network, with a local Healthwatch in every local authority area in England and Healthwatch England, supporting our voice at a national level. We’re set up by government as an independent statutory watchdog for NHS and social care. This gives us powers to enter places where care is provided, to request information and to get responses to our reports.
63 and Admit 4 giving 1000 People Outreach One Events their say sessions Visits to West visiting 6 Wards Improved Middlesex local care 34 University 2 Patients homes Hospital 116 Bulletins 10 Visits to 67 75 Boards and local GP 220 Opportunities committees practices promoted
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A resident’s advocate resident’s A
improvement”
Chudleigh house and there was notable notable was there and house Chudleigh
“Staff are spending more time at at time more spending are “Staff
local care homes care local access and information. and access
Our work led to improvements at two two at improvements to led work Our local practices leading to improvements in in improvements to leading practices local
general practice by making 10 visits to to visits 10 making by practice general
nationally
We responded to the local interest in in interest local the to responded We
Improving care locally and and locally care Improving
General Practice General
Healthwatch.
practice to support the work of other other of work the support to practice provide a formal response to this. to response formal a provide
way we work is used to demonstrate good good demonstrate to used is work we way Westminster on their planned merger and and merger planned their on Westminster
quality standards for Healthwatch. The The Healthwatch. for standards quality to quiz West Middlesex and Chelsea and and Chelsea and Middlesex West quiz to
reviewing the performance of and setting setting and of performance the reviewing We also ran an event for our volunteers volunteers our for event an ran also We
in to two national research projects projects research national two to in
patients. Healthwatch England and we took part part took we and England Healthwatch
change including bringing nurses closer to to closer nurses bringing including change as an example of good practice by by practice good of example an as
to turn their experiences into meaningful meaningful into experiences their turn to Healthwatch Richmond was identified identified was Richmond Healthwatch
over 100 patients and worked with staff staff with worked and patients 100 over
Identified as best practice best as Identified Middlesex University Hospital we spoke to to spoke we Hospital University Middlesex
Through 34 visits to 6 wards at West West at wards 6 to visits 34 Through
decision makers. decision
committees where they spoke directly to to directly spoke they where committees Hospitals
supported to sit on 75 external external 75 on sit to supported
Members of the community were were community the of Members
Government and Care Partnerships Care and Government
opportunities to have their say. their have to opportunities
Director General of Social Care, Local Local Care, Social of General Director
giving people information on 220 220 on information people giving
Department in relation to this.” to relation in Department We sent 67 bulletins and newsletters newsletters and bulletins 67 sent We
provide personal care and talking to the the to talking and care personal provide
Healthwatch.
regulating supported living services that that services living supported regulating
people a say in local care and promoted promoted and care local in say a people
“reviewing how to improve its approach to to approach its improve to how “reviewing
and 4 public events we gave over 1000 1000 over gave we events public 4 and
Through 63 outreach sessions and visits, visits, and sessions outreach 63 Through
the way it regulates supported living. supported regulates it way the
and social care care social and level with the CQC committing to improve improve to committing CQC the with level
Giving people a voice in the NHS NHS the in voice a people Giving We also made a difference at national national at difference a made also We Highlights
= Engaging with people who use health and social care services
During 2014-15 we delivered an Healthwatch Kingston on: Joint extensive programme of work to ‘‘ Youth Engagement obtain the views and experiences Staff at Twickenham Academy of the community about NHS ‘‘ and social care services through As a result of this we: visiting community groups, events Engaged with almost 200 young and places. Our visits promoted ‘‘ people Healthwatch Richmond, supported Developed strong relationships people to access our services and ‘‘ with the key organisations that will brought our signposting service to support future engagement with the community. children and young people Identified the need to develop We used what people told us to set ‘‘ a work stream with Child and our work priorities, to shape our Adolescent Mental Health Services responses to consultations and to make Supported the development of the recommendations for local and national Local Offer for children and young statutory partners. ‘‘ people as part of the Children and Healthwatch Annual Reports are Families Act required to explain how we gathered the experiences of the following groups: Young people (under 21) St Mary’s University freshers fair Our work to engage children and young In September 2014 we visited people saw us participate in an average of St Mary’s University to speak to one session a month with young people, students about their health and either directly or by engaging with the provide signposting information. groups that support them, including the To engage students in our work following: and encourage them to sign up to hear more from us, we asked Richmond Youth Council students “Where would you go if ‘‘ Paernts Self Advocacy Group you suspected a broken bone?” We signed up over 150 students, ‘‘ Parent and Toddler Group St Mary who we continue to engage with. Magdalene’s Church ‘‘ Of those that we spoke to, only 7% Freshers Fair St Mary’s University knew where to go if they thought ‘‘ Children’s Centre Managers they had broken a bone. Many ‘‘ Children’s and Families Act Local were not aware of local services ‘‘ Offer Working Group or did not know the difference Meeting parents and organisations between a Walk-in Centre and ‘‘ concerned with CAMHS Accident and Emergency.
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‘ ‘ gathering.
Mulberry Centre Christmas Christmas Centre Mulberry ‘ ‘
to prioritise our work. our prioritise to
RUILS Advocacy Support group Support Advocacy RUILS ‘ ‘ experiences that we’d collected to help us us help to collected we’d that experiences
views were considered alongside the wider wider the alongside considered were views Visits to Kingston Hospital’s A&E Hospital’s Kingston to Visits ‘ ‘
with some GPs in the borough. These These borough. the in GPs some with Worked with pharmacists with Worked
University Hospital and high satisfaction satisfaction high and Hospital University
‘ ‘
Community Healthcare Health Fair Health Healthcare Community
expensive parking at West Middlesex Middlesex West at parking expensive
Hounslow and Richmond Richmond and Hounslow
between different healthcare services, services, healthcare different between
‘ ‘
borough
group related to poor transport links links transport poor to related group
Weekly stalls at libraries across the the across libraries at stalls Weekly
The most common themes from this this from themes common most The
‘ ‘
Network Network
Deer Park View Care Centre Care View Park Deer ‘ ‘ ‘ ‘ Patient Participation Group Group Participation Patient
Richmond Synagogue Richmond Visits to GP practices and the the and practices GP to Visits
‘ ‘ Consultation the atrium atrium the
‘ ‘ Older Peoples Mental Health Health Mental Peoples Older ‘ ‘ staff events and monthly stalls in in stalls monthly and events staff
West Middlesex Hospital public and and public Hospital Middlesex West Ethnic Minority Advocacy Group Advocacy Minority Ethnic ‘ ‘
Age UK Whitton UK Age ‘ ‘ including: including:
Hands Help A Neighbour in Distress in Neighbour A Help Hands ‘ ‘ 2 activities taking place each month month each place taking activities 2
220 people with an average of just over over just of average an with people 220 Linden Hall Linden ‘ ‘
Our work over the year reached around around reached year the over work Our
Stroke Clubs in Hampton and Sheen and Hampton in Clubs Stroke ‘ ‘
Barnes Green Centre Green Barnes ‘ ‘ people. people.
care volunteers, to engage this group of of group this engage to volunteers, care Full of life fair life of Full
NHS employees and health and social social and health and employees NHS
events and organisations including: organisations and events attended public events and meetings of of meetings and events public attended
over 65 through outreach to around 12 12 around to outreach through 65 over We held pop-up stalls in public places, places, public in stalls pop-up held We
We engaged with around 300 people aged aged people 300 around with engaged We
Richmond
Older people (over 65) (over people Older People volunteering or working in in working or volunteering People
= Disadvantaged or vulnerable As a result of our engagement with people learning disability support organisations, we identified concerns with a local We identified disadvantaged and care provider. Our work in this area led vulnerable people as: homeless people, to improved care locally and created people with learning disabilities and those an impact at national level. See the who support them, people with physical Chudleigh House Case study on page 31. disabilities and carers. We reached over 125 people across 14 different groups including:
SPEAR Homelessness support group People who are seldom heard ‘‘ SPEAR women’s group ‘‘ Vineyard Homelessness support We defined people who are seldom heard ‘‘ groups as: Richmond Homelessness Forum People with Learning Disabilities ‘‘ Riverbank Trust ‘‘ Homeless people ‘‘ Carers support group ‘‘ Children and Young People ‘‘ Caring at a Distance group ‘‘ People who are frail and elderly ‘‘ Early Intervention Dementia Carers ‘‘ People living in deprivation ‘‘ Support Group All ‘of‘ these groups overlap with either Richmond Carers Centre the disadvantaged and vulnerable, people ‘‘ Caring cafe under 21 or people over 65. Our work with ‘‘ Parents Self Advocacy Group seldom heard people is described under ‘‘ Mencap Carers support Group the relevant headings above to avoid ‘‘ double counting our work. ‘‘ Learning Disability Provider Forum ‘‘ RUILS advocacy meeting
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The importance of personal contacts was consistently repeated. consistently was contacts personal of importance The
‘ ‘ uncertainty about eligibility criteria eligibility about uncertainty
Mixed views on funding care by renting out homes, and high levels of of levels high and homes, out renting by care funding on views Mixed
‘ ‘ contact
Providing better access to information, with one professional as the main main the as professional one with information, to access better Providing ‘ ‘
Improving access to services for social interaction and recreational activities recreational and interaction social for services to access Improving ‘ ‘
Need for more support services for carers and service users service and carers for services support more for Need
Our published reports on this work identified key issues including: issues key identified work this on reports published Our
level.
the national consultation so that the community’s views were heard at a national national a at heard were views community’s the that so consultation national the
the way that the Care Act was implemented in Richmond. They were also fed into into fed also were They Richmond. in implemented was Act Care the that way the
The responses received were sent to Richmond Council who used them to shape shape to them used who Council Richmond to sent were received responses The
people. people.
which were sent to our mailing lists and those of 26 organisations supporting older older supporting organisations 26 of those and lists mailing our to sent were which
individuals. We also produced two newsletters to inform people about the Act, Act, the about people inform to newsletters two produced also We individuals.
We conducted two self-completion surveys and held a public event engaging 65 65 engaging event public a held and surveys self-completion two conducted We
feedback on the consultation questions. questions. consultation the on feedback
what the Act would mean for people and their families as they aged and to gather gather to and aged they as families their and people for mean would Act the what
In partnership with Richmond Council, we engaged the community to explain explain to community the engaged we Council, Richmond with partnership In
The Care Act Care The
‘ ‘ Middlesex University Hospital, South South Hospital, University Middlesex
NHS Providers (including West West (including Providers NHS ‘ ‘
’ section, page 30. 30. page section, ’ services
Local Authority Authority Local the ‘ the Working with others to improve local local improve to others with Working
‘ ‘ Group this report, particularly those presented in in presented those particularly report, this
Richmond Clinical Commissioning Commissioning Clinical Richmond ‘ ‘ us to achieve many of the outcomes in in outcomes the of many achieve to us
stakeholders’ networks. This work helped helped work This networks. stakeholders’ Local and national Healthwatch national and Local ‘ ‘
us to reach the community through our our through community the reach to us
The voluntary sector sector voluntary The
receptive to our messages and helped helped and messages our to receptive
stakeholders we met with: met we stakeholders these organisations and made them more more them made and organisations these
To develop our relationships with key key with relationships our develop To helped us to coordinate our work with with work our coordinate to us helped
This helped us to promote Healthwatch, Healthwatch, promote to us helped This
Networking
‘ ‘
section, page 24. page section,
Care Quality Commission Quality Care ‘ ‘
’ ’ ‘ the in detail more in
Communications
NHS England England NHS
and social care. This work is described described is work This care. social and
and social care providers) providers) care social and events focussing on key issues in health health in issues key on focussing events
Richmond Community Health Trust Trust Health Community Richmond or supported four large public engagement engagement public large four supported or
Foundation Trust and Hounslow and and Hounslow and Trust Foundation As well as promoting Healthwatch we held held we Healthwatch promoting as well As
Health Trust, Kingston Hospital NHS NHS Hospital Kingston Trust, Health
Public engagement events engagement Public West London and St Georges Mental Mental Georges St and London West
= Enter and View
Healthwatch Organisations have the power to Enter and View premises where NHS care or social care are provided so that we can observe care being delivered and to report on what could or ought to improve. To ensure that we are using this power effectively, we carefully select providers to visit, based on a range of evidence. Primarily we collect information from patients and the public about their experiences of care, but we also look to existing sources of information to support this. Some sources of information are publicly available such as the national GP Patient Survey, others require us to make requests for information such as performance data. We hold quarterly Quality Information Sharing Group (QISG) meetings with Richmond Council, Richmond CCG, Care Quality Commission and NHS England to share intelligence, to review our plans and to ensure that our planned visits do not overlap with the work of other agencies. You can read more about these meetings on page 33. All Enter and View visits are planned with a team of volunteers including Enter and View Representatives who form Project Groups. Project Groups are open to all with an interest in the area of work and are publicly advertised via our Newsletter. Planned visits are scrutinised by our Board who are responsible for authorising the use of our powers. Nightingale House Nightingale House was selected as a priority for review because of its lack of engagement with the Local Authority and refusal to accept visits from a peer review scheme. Read more about the visit and the report on page 20. Following the visit we shared our findings with the CQC and Local Authority. We also shared the findings of our work with the Healthwatch organisations that covered areas where the owner operated other homes.
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‘ ‘ ‘ ‘
Yvonne Lincoln Lincoln Yvonne ‘ ‘ ‘ ‘ Maureen Chatterley Chatterley Maureen ‘ ‘
Mike Derry Mike Grootoonk Sylke ‘ ‘ ‘ ‘ Liz Grove Grove Liz ‘ ‘
Mary McLaren McLaren Mary Hempel Sandra ‘ ‘ ‘ ‘ Linda Nelhams Nelhams Linda ‘ ‘
Keisha Forteau Forteau Keisha Hussain Rasha ‘ ‘ ‘ ‘ Julie Risley Risley Julie ‘ ‘
Louise Smith Smith Louise Hughes Perin ‘ ‘ ‘ ‘ Jan Marriott Marriott Jan ‘ ‘
Yvonne Peel Peel Yvonne Alexander Penny Batcho Notay Notay Batcho
Enter and View Authorised Representatives Authorised View and Enter
successfully trained and recruited 14 volunteers and 4 members of staff. of members 4 and volunteers 14 recruited and trained successfully
to provide support and supervision for our Enter and View volunteers. Over 2014/15 we we 2014/15 Over volunteers. View and Enter our for supervision and support provide to
knowledge and experience. All project groups have regular planning and debrief sessions sessions debrief and planning regular have groups project All experience. and knowledge
meetings for all of our volunteers to identify training needs, offer support and share share and support offer needs, training identify to volunteers our of all for meetings
undertake Enter and View visits before being able to take part in visits. We hold quarterly quarterly hold We visits. in part take to able being before visits View and Enter undertake
checks. All of our volunteers complete training in safeguarding adults and in how to to how in and adults safeguarding in training complete volunteers our of All checks.
application, attend an interview and we seek satisfactory references and enhanced DBS DBS enhanced and references satisfactory seek we and interview an attend application,
meets the requirements of the Health and Social Care Act. Volunteers submit a written written a submit Volunteers Act. Care Social and Health the of requirements the meets
representatives are recruited through a careful selection and training process that that process training and selection careful a through recruited are representatives
Before they are eligible to take part in Enter and View visits, our Enter and View View and Enter our visits, View and Enter in part take to eligible are they Before
Recruitment
practice environment. practice
that they would make a range of improvements to both their communications and and communications their both to improvements of range a make would they that
Surgery, Lock Road Surgery. GP practices responded to our reports to confirm confirm to reports our to responded practices GP Surgery. Road Lock Surgery,
website: Vineyard Surgery, Woodlawn, Oak Lane Medical Centres, Seymour House House Seymour Centres, Medical Lane Oak Woodlawn, Surgery, Vineyard website:
Reports have been published for the practices visited and can be viewed on our our on viewed be can and visited practices the for published been have Reports
‘ ‘
Improvements that patients would like to see to like would patients that Improvements ‘ ‘
Overall satisfaction satisfaction Overall ‘ ‘
Quality of care of Quality ‘ ‘
Access to services to Access
specifically focussing on: focussing specifically
patients and staff questions based on the previously gathered patient feedback feedback patient gathered previously the on based questions staff and patients
The visits aimed to identify good practice and drive improvements. We asked asked We improvements. drive and practice good identify to aimed visits The
CQC inspections. inspections. CQC
during the year and a further 4 postponed until early 2015 to avoid clashing with with clashing avoid to 2015 early until postponed 4 further a and year the during
that we had received from the community. Of these practices, 5 were visited visited were 5 practices, these Of community. the from received had we that
national GP Patient Survey, comments left on NHS Choices patient and feedback feedback and patient Choices NHS on left comments Survey, Patient GP national
We identified 9 high and low performing practices according to data from the the from data to according practices performing low and high 9 identified We
formed the basis of our visits. our of basis the formed
where residents had concerns about the care that was available to them and and them to available was that care the about concerns had residents where
meetings that concluded in March 2014. This work identified a number of areas areas of number a identified work This 2014. March in concluded that meetings
We decided to visit GP practices following public engagement activity and public public and activity engagement public following practices GP visit to decided We GP practices GP
= Providing information and signposting
We began the year viewing By networking with other organisations we signposting as a standalone activity, have reached vulnerable people, helping separate from our engagement them get what they need from local activity and generally carried out health and social care services. when people contacted Healthwatch asking for support, and driven Whilst inbound calls and outreach are through by our marketing activity. equally valuable pathways for accessing our signposting service, we had not Whilst inbound contact is a substantive routinely recorded signposting activity area of work for us, we recognise that arising from our outreach work. We’re providing information and signposting trialling the new Healthwatch CRM people to sources of support runs through database to help us to capture our wider all of our public facing work. signposting activity. At each of our outreach and engagement sessions we promote the signposting service, but also provide signposting services directly to the community. We have also produced bulletins and newsletters that promote opportunities for people to engage, and also provided information on issues such as the Care Act.
“It is reassuring to know there is an organisation and people like your good self available to listen and offer guidance to the public in situations like mine. The details you have provided are very helpful and much appreciated.”
A Healthwatch Richmond signposting service user
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2% Children’s care Children’s
2% Accessing records Accessing
2% 5% Acute care Acute Regulator or professional body professional or Regulator
6% Patient/service user rights user Patient/service Ombudsman
3% Parliamentary Health Service Service Health Parliamentary 8% Mental health Mental
9% NHS England NHS 9% Dentistry
9% NHS Choices NHS 9% Community services Community
12% NHS provider organisations provider NHS 11% Help with making complaints making with Help
13% NHS 111 NHS 12% Adult social care social Adult
16% Voluntary sector support sector Voluntary Dentist
13% 16% Local authority Local or GP a with Registering
23% 20% NHS Complaints Advocacy Complaints NHS GP’s
Query % Query %
people to in 2014/15 in to people 2014/15? in about
The places that we signposted signposted we that places The us ask people did services What
= Influencing decision makers with evidence from local people
We produce reports with recommendations that we use to influence decision makers in health and social care. Our reports are based on evidence in the form of experiences gathered through engagement, observations and feedback from Enter and View visits and the findings of wider research. We also support people to engage directly through promoting opportunities via our communications and through taking seats on committees within commissioners and providers. Over the past year we have had successes in this area, the key successes are described below:
GP visits One of the recommendations made to all practices was to explore extended Extensive outreach and engagement into weekend and evening opening hours. experience of GP services identified a The CCG has since been awarded a significant variation in patient satisfaction. grant to pilot weekend GP services in Through cross-referencing these the borough. Individual practices also experiences with the national GP Patient agreed to improve their signage, display Survey and comments on NHS Choices, information regarding their opening we identified the practices that appeared times and facilities, make arrangements to have the highest and lowest levels of to improve confidentiality at reception patient satisfaction and arranged Enter and to improving the promotion of their and View visits to these. online booking services. During the year we completed ten visits We’ll write back to GP practices after across five locations. Each practice was six months to ask them to confirm sent a report with recommendations based what actions have been taken and on the findings from our visits and asked which remain outstanding following our to respond explaining what actions they reports. would take as a result. These responses were included in the final report.
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understand that work is underway to move nurses’ stations into each bay. bay. each into stations nurses’ move to underway is work that understand
Early indications suggest that long-term change is taking place, for example we we example for place, taking is change long-term that suggest indications Early
at the end of the year, approximately 12 months after we first visited the Hospital. Hospital. the visited first we after months 12 approximately year, the of end the at
To ensure that the changes are made and to see their effect, we will review them them review will we effect, their see to and made are changes the that ensure To
‘ ‘ disturbed.
Reminding staff to be considerate of noise at night so that patients are not not are patients that so night at noise of considerate be to staff Reminding ‘ ‘
Piloting a patient diary to improve communication between staff and family and staff between communication improve to diary patient a Piloting
sample needs to be collected as soon as possible as soon as collected be to needs sample
‘ ‘ alerts other patient wishing to use the toilet, and reminds staff that the the that staff reminds and toilet, the use to wishing patient other alerts
Introducing a notice to indicate that a sample has been left in a toilet. This This toilet. a in left been has sample a that indicate to notice a Introducing
‘ ‘ can focus on providing meals to patients to meals providing on focus can
Ringing bells to alert all staff to the start of mealtimes and ensure that staff staff that ensure and mealtimes of start the to staff all alert to bells Ringing ‘ ‘
Implementing volunteers to assist with discharge with assist to volunteers Implementing
less likely that patient needs would not be met be not would needs patient that likely less
reduce the time that patients need to wait when they need care, and make it it make and care, need they when wait to need patients that time the reduce
‘ ‘ spend more time close to the patients that they’re caring for. This in turn will will turn in This for. caring they’re that patients the to close time more spend
Moving nurses’ stations from the corridors into bays, to ensure that staff staff that ensure to bays, into corridors the from stations nurses’ Moving
Improvements arising from this included: this from arising Improvements
over the actions with staff taking responsibility for implementing the actions. the implementing for responsibility taking staff with actions the over
identified in collaboration. Collaborative planning created a sense of ownership ownership of sense a created planning Collaborative collaboration. in identified
report, actions that the hospital could realistically take to improve care were were care improve to take realistically could hospital the that actions report,
with hospital staff and management. Based on the recommendations from the the from recommendations the on Based management. and staff hospital with
The action planning meeting brought together Healthwatch staff and volunteers volunteers and staff Healthwatch together brought meeting planning action The
partnership with the hospital. the with partnership
these recommendations into changes, we held an ‘action planning’ meeting in in meeting planning’ ‘action an held we changes, into recommendations these
We produced a report of our findings and a set of recommendations. To turn turn To recommendations. of set a and findings our of report a produced We
communication.
from hospital, at mealtimes, and problems with the environment and with with and environment the with problems and mealtimes, at hospital, from
needs were not being met. Patients also told us about problems with discharge discharge with problems about us told also Patients met. being not were needs
Most people viewed the care at the hospital positively but some patients’ patients’ some but positively hospital the at care the viewed people Most
observing the care and the environment. the and care the observing
a broad range of questions about their experience of care at the hospital and and hospital the at care of experience their about questions of range broad a
to six wards over a period of three weeks. We spoke to over 100 patients, asking asking patients, 100 over to spoke We weeks. three of period a over wards six to
a better understanding of patient experiences at the Hospital. We made 34 visits visits 34 made We Hospital. the at experiences patient of understanding better a
to work undertaken by Richmond LINk in 2011. This gave us an opportunity to gain gain to opportunity an us gave This 2011. in LINk Richmond by undertaken work to
West Middlesex University Hospital invited us to audit their services as a follow up up follow a as services their audit to us invited Hospital University Middlesex West West Middlesex University Hospital University Middlesex West
= Inpatient mental health services community and mental health settings in South West London and promoted the consultation through community and church networks. A local consultation about the future location of inpatient facilities for people Healthwatch attended the local in southwest London, was conducted by consultation events including a meeting Kingston CCG on behalf of the 5 boroughs organised by the Friends of Barnes that receive care from the local mental Hospital to enable older people and their health trust. The consultation proposed carers to voice their specific needs and reducing the number of hospitals within views. We supported the voices of local the area from 3 to 2, which meant that people, reflecting these in the formal inpatient care would be provided further written response. away for some patients and that visitors As well as a formal written response we would face an access issue due to the presented our views to the CCG Board distance and traffic problems. There were emphasising the importance of investing in also clear ramifications for community community services and of the trust acting services that were not addressed by the to mitigate the impact of the changed consultation. in-patient locations by introducing more We identified a low awareness of the flexible visiting hours. consultation amongst the community and Richmond CCG is developing an outcomes publicised the consultation widely. To based commissioning approach for reach a wider audience, we encouraged community mental health services. our networks and supporters to To ensure the changes that we have promote the consultation through their championed take place, we will request a websites and newsletters. Our trustees seat on the strategy implementation group and volunteers also put up posters in when it is set up.
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the upcoming year. upcoming the
as commenting on the priorities set for for set priorities the on commenting as
priorities set for the previous year as well well as year previous the for set priorities
achievements of providers against the the against providers of achievements
statutory consultation about merger. about consultation statutory
co.uk) gave an independent view on the the on view independent an gave co.uk)
formal submission in March 2015 to the the to 2015 March in submission formal
our website, www.healthwatchrichmond. website, our
Based on our discussions we made a a made we discussions our on Based
accounts. Our commentaries (available on on (available commentaries Our accounts.
about the merger. the about from the community to comment on the the on comment to community the from
new organisation and answered questions questions answered and organisation new asked board members and volunteers volunteers and members board asked
trusts. The trusts set out the vision for the the for vision the out set trusts The trusts. and St Georges Mental Health Trust. We We Trust. Health Mental Georges St and
integration and transformation of the two two the of transformation and integration Foundation Trust and South West London London West South and Trust Foundation
Middlesex Hospitals to hear about the the about hear to Hospitals Middlesex Hospital NHS Trust, Kingston Hospital NHS NHS Hospital Kingston Trust, NHS Hospital
from Chelsea and Westminster and West West and Westminster and Chelsea from NHS Trust, West Middlesex University University Middlesex West Trust, NHS
Healthwatch volunteers to meet with leads leads with meet to volunteers Healthwatch and Richmond Community Healthcare Healthcare Community Richmond and
We invited board members and and members board invited We four major local providers: Hounslow Hounslow providers: local major four
comment on the Quality Accounts of of Accounts Quality the on comment
and Westminster NHS Trust NHS Westminster and
We were given the opportunity to to opportunity the given were We
Hospital transaction with Chelsea Chelsea with transaction Hospital
West Middlesex University University Middlesex West Quality Accounts Accounts Quality
= Conflict of interest Residential care We wrote a letter on 9th February 2015 Concerns were raised to us at the Quality to the Chief Officer of Richmond CCG Information Sharing Group (QISG, page asking about the commissioning of services 33), a meeting set up by Healthwatch from the newly formed GP Alliance and Richmond to enable Richmond Council, the management of conflicts of interest. Richmond Clinical Commissioning Group, We have pointed out that the real and NHS England and the Care Quality perceived conflicts need to be carefully Commission (CQC) to share information and transparently managed to ensure about local health and social services, fairness between providers and so that about the lack of engagement from the CCG is able to deliver innovative and Nightingale House. patient centred solutions to care. The CCG responded to us with clarification about how these conflicts are managed but the issue remains open. In addition we have faced challenges to our own management of perceived conflicts. We are taking an assertive approach to managing these to ensure perceived conflicts do not inhibit the vital patient and public representation and oversight of key issues such as the commissioning of services from general practice.
20
21
and the Council. Council. the and
recommendations made in our report and we remain in close contact with the CQC CQC the with contact close in remain we and report our in made recommendations
We will return to Nightingale House to check on the progress of implementing the the implementing of progress the on check to House Nightingale to return will We
’. ‘ as rated being home the in Requiring improvement Requiring
forward a planned inspection following our feedback. The CQC inspection resulted resulted inspection CQC The feedback. our following inspection planned a forward
Richmond Council have had increased contact with the home and the CQC moved moved CQC the and home the with contact increased had have Council Richmond
have improved access to the home’s complaints policy. complaints home’s the to access improved have
all staff issued with identification and all visitors required to sign in. Residents also also Residents in. sign to required visitors all and identification with issued staff all
As a result of our recommendations, security has been improved at the home with with home the at improved been has security recommendations, our of result a As
Richmond Council and Richmond CCG. Richmond and Council Richmond
the final report. The final report was then shared with NHS England, the CQC, CQC, the England, NHS with shared then was report final The report. final the
with the management of Nightingale House whose response was included within within included was response whose House Nightingale of management the with
Following the visit, a report of our findings and recommendations was shared shared was recommendations and findings our of report a visit, the Following
suitability of the home for people with accessibility issues. accessibility with people for home the of suitability
management, the effectiveness of policies and procedures in the home and the the and home the in procedures and policies of effectiveness the management,
Our Enter and View visit raised questions and concerns about the registration of of registration the about concerns and questions raised visit View and Enter Our
activities and the home’s policies and procedures. and policies home’s the and activities
residents. Staff and residents were asked about care needs and assessments, assessments, and needs care about asked were residents and Staff residents.
observations on the care provided, the interaction and activities available for for available activities and interaction the provided, care the on observations
and View visit to Nightingale House in December 2014. The team made general general made team The 2014. December in House Nightingale to visit View and
Four Authorised Representatives (including one staff member) carried out an Enter Enter an out carried member) staff one (including Representatives Authorised Four
covered areas where the owner operated other homes. other operated owner the where areas covered
also shared the findings of our work with the Healthwatch organisations that that organisations Healthwatch the with work our of findings the shared also
Following the visit we shared our findings with the CQC and Local Authority. We We Authority. Local and CQC the with findings our shared we visit the Following
review scheme. scheme. review
engagement with the Local Authority and refusal to accept visits from a peer peer a from visits accept to refusal and Authority Local the with engagement
Nightingale House was selected as a priority for review because of its lack of of lack its of because review for priority a as selected was House Nightingale Nightingale House House Nightingale
= Communications and public engagement
We promoted over 220 opportunities for local people to engage with the commissioning, provision and management of local health and social care services through 67 Newsletters and Bulletins and daily social media activity. The tables below show the volume of our communications and the opportunities that we have promoted. E-Bulletins and newsletters
Healthwatch mailing list Social Care bulletin Subscribers 640 Subscribers 227
Mailouts 14 Bulletins 10
Mental Health bulletin Children and Young People’s Care bulletin Subscribers 204 Subscribers 62
Bulletins 11 Bulletins 14
Healthcare bulletin
We sent 67 bulletins and newsletters in 248 Subscribers 2014/15, nearly twice as many as 2013/14, giving people information on around 220 ways they could have their say.
Bulletins 18
22
23
s r visito Female
49% s r visito g turnin Re
39%
s r visito Male
51%
s n Mentio
180 New sessions New
s w vie ofile Pr 61%
1,700
s r Followe
1,096
s User
2,917
s eet Tw
827
this was not an effective format for us. for format effective an not was this
engagement and our trial proved that that proved trial our and engagement
s view age P
using Facebook as this produced little little produced this as Facebook using
the public. We chose to discontinue discontinue to chose We public. the
12,839
to be a useful platform for engaging engaging for platform useful a be to
social media. This trial proved Twitter Twitter proved trial This media. social
A key aim from last year was to trial trial to was year last from aim key A
Twitter Website
0 08 07 06 05 04 03 02 01
43
Other
Healthwatch Mailing List Mailing Healthwatch
l ta To
Healthcare Bulletin Healthcare
57
Consultations Care Bulletin Care ’ eoples P
l ta To
oung oung Y and Children
Social Care Bulletin Care Social 16
Committee places/board positions places/board Committee
l ta To Mental Health Bulletin Health Mental
68
Public Meetings and Event and Meetings Public s
l ta To
36
participate
lunteer Opportunitie lunteer Vo s
l ta To Promoted opportunities to to opportunities Promoted
= Public events Care Act phase 2 In addition to promoting opportunities In partnership with Richmond Council we for people to get involved, we held, held an event engaging around 60 carers, or supported, four large public events service users, members of the public, providing 240 people with an opportunity voluntary representatives, and provider to influence the commissioning, provision organisations. Richmond Council presented and management of local health and social their plans for implementing the Care care services. The table below gives an Act. We facilitated round table discussions overview of these and case studies are focussing on the prevention strategy and provided below for further information. on the financial support and advice people would need to enable them to arrange Event Attendees care and support at home. Care Act 65 The feedback from these discussions was Outcomes Based 70 shared with Richmond Council directly to Commisssioning shape the Council’s Prevention Strategy Care Act Phase 2 60 and inform their plans for providing Health and Wellbeing Board financial information and advice. 45 Engagement 77.3% of returned feedback forms rated the event as good or very good. Outcomes Based Commissioning Event “The event was well organised and very We brought together 70 carers, patients well attended” and health professionals to hear from Richmond CCG about their plans to Anonymous Feedback Form commission community services through Outcomes Based Commissioning. Presentations from Richmond CCG, including from Chief Officer, Jacqui Harvey were followed by a question and answer session.
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25
Programme Board. Programme
role within the South West London 111 111 London West South the within role on our website. website. our on
We continue to undertake the same same the undertake to continue We Read more about this work on page 24, or or 24, page on work this about more Read
borough basis across south west London. London. west south across basis borough for people to question Richmond CCG. CCG. Richmond question to people for
111 is now being commissioned on a six six a on commissioned being now is 111 understanding and provide an opportunity opportunity an provide and understanding
Group in the interests of the patient. NHS NHS patient. the of interests the in Group we supported a public event to promote promote to event public a supported we
monitoring the Joint Clinical Governance Governance Clinical Joint the monitoring CCG for verification. Alongside this work work this Alongside verification. for CCG
Since that time we have been guiding and and guiding been have we time that Since the next actions to recommend to the the to recommend to actions next the
the current joint provision with Kingston. Kingston. with provision joint current the considered and decisions were made for for made were decisions and considered
Implementation Board, which selected selected which Board, Implementation groups and workshops involved was was involved workshops and groups
of Urgent Care. We sat originally on the the on originally sat We Care. Urgent of body at which all information from other other from information all which at body
The NHS 111 service is a key element element key a is service 111 NHS The Programme Board was the overseeing overseeing the was Board Programme
in Richmond from 1st April 2016. The The 2016. April 1st from Richmond in
NHS 111 NHS
commissioning NHS Community Services Services Community NHS commissioning
the basis of the revised contract terms for for terms contract revised the of basis the
of Hours GP services. GP Hours of
components of the Outcomes, which form form which Outcomes, the of components
improved publicity of the provision of Out Out of provision the of publicity improved
reference group assembled the key key the assembled group reference
ensured independent monitoring and and monitoring independent ensured
Group and Programme Board. The The Board. Programme and Group
outcome of this work is that our presence presence our that is work this of outcome
participant in the Outcomes Reference Reference Outcomes the in participant
the Strategic Resilience Group. A major major A Group. Resilience Strategic the
Healthwatch Richmond was a key key a was Richmond Healthwatch
Care Committee and latterly within within latterly and Committee Care
has taken place within the CCG Urgent Urgent CCG the within place taken has programme
Urgent Care within the Borough. This This Borough. the within Care Urgent Outcomes Based Commissioning Commissioning Based Outcomes
improvements in the provision of of provision the in improvements
and monitored Richmond CCG on on CCG Richmond monitored and and key providers. key and
Throughout the year we advised advised we year the Throughout comprising the Council, Richmond CCG, CCG, Richmond Council, the comprising
group, the Integrated Partnership Group Group Partnership Integrated the group,
Urgent care Urgent
at meetings of the relevant working working relevant the of meetings at
consultation and input patient views views patient input and consultation
Richmond. We have encouraged public public encouraged have We Richmond. reduced as a consequence. a as reduced
planning for the Better Care Fund in in Fund Care Better the for planning that waiting times were dramatically dramatically were times waiting that
From the outset, we participated in the the in participated we outset, the From Therapy. Considerable evidence existed existed evidence Considerable Therapy.
providers of Podiatry and Musculoskeletal Musculoskeletal and Podiatry of providers
and Integrated Partnership group Partnership Integrated and
successful introduction of schemes for new new for schemes of introduction successful
Better Care Fund development development Fund Care Better
this work we guided the Board towards the the towards Board the guided we work this
Wandsworth. Through our involvement in in involvement our Through Wandsworth.
this work has had. has work this
we undertook jointly with Healthwatch Healthwatch with jointly undertook we
provided below of the impact that that impact the of below provided
Board for Any Qualified Provider, a role role a Provider, Qualified Any for Board
influence directly. Examples are are Examples directly. influence
Our representatives sat on the Programme Programme the on sat representatives Our
number of Boards where they exert exert they where Boards of number
Any Qualified Provider Qualified Any We support volunteers who sit on a a on sit who volunteers support We Participating in boards in Participating
= Care and Support partnership South London Education and Training Board This group were concerned with how the Care Act extends coverage to those who We made a number of contributions to currently fund their own care. As part this Board in relation to its strategy and of this board we actively and efficiently its investments in education, training and stressed the crucial need for clear development. In addition, we highlighted information on the changes as early as the specific role of councils in contributing possible. Leaflets were produced for this to the Board’s work and the importance to be distributed locally to a wide variety of the ability and opportunity of individual of potential users of social care. We made Council Members to engage with this and a number of key adaptations to improve contribute. the leaflets through this group. A survey of Council Members was carried Hounslow and Richmond out by the Board, and whilst it is hard to Community Healthcare NHS Trust claim that this resulted entirely from our work, the Board acknowledged the value Our representatives sat as observers on of our involvement. both the Public Board meetings and the Patient and Public Involvement Group, and ensured patient interests were considered in the development and prioritisation of “Incredibly useful feedback, which I will the values of the Trust. In addition the bring to the attention of my colleagues Trust took up evidence-based approaches here and at the Health Innovation to staff motivation and learning as a result Network”. of our involvement. Communications and Stakeholder Recruitment Engagement Lead, South London Education and Training Board Healthwatch Richmond were invited to, and participated in, the recruitment and selection panels for senior staff within local providers including the CCG Chief Officer and Director level staff working at local providers and commissioners.
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27
through the Healthwatch Committee. Healthwatch the through
future, our governance review (see page 36) may allow us to provide support support provide to us allow may 36) page (see review governance our future,
Trustees and so our representatives are supported through the Board. In the the In Board. the through supported are representatives our so and Trustees
At present our representatives on this board were all drawn from the Board of of Board the from drawn all were board this on representatives our present At
conclusions reached can be taken forward in the coming year. year. coming the in forward taken be can reached conclusions
discussions. We are discussing with the Health and Wellbeing Board how the the how Board Wellbeing and Health the with discussing are We discussions.
well attended with over 50 people participating in a lively series of round table table round of series lively a in participating people 50 over with attended well
held at Richmond College, on public health issues facing the Borough. This was was This Borough. the facing issues health public on College, Richmond at held
engagement. Recently, this included promoting and participating in an event, event, an in participating and promoting included this Recently, engagement.
We also continue to support the Health and Wellbeing Board in its public public its in Board Wellbeing and Health the support to continue also We
board members have attended our events to hear patients’ views first hand. first views patients’ hear to events our attended have members board
programme and have been delighted when Health and Wellbeing Board and CCG CCG and Board Wellbeing and Health when delighted been have and programme
to champion the interests of patients. We keep the Boards updated on our work work our on updated Boards the keep We patients. of interests the champion to
in these Boards, we are drawing on our projects and feedback from the community community the from feedback and projects our on drawing are we Boards, these in
as an observer on Richmond’s Clinical Commissioning Group (CCG). By participating participating By (CCG). Group Commissioning Clinical Richmond’s on observer an as
Healthwatch have a statutory seat on the Health and Wellbeing Board and also sit sit also and Board Wellbeing and Health the on seat statutory a have Healthwatch Working with the Health and Wellbeing board Wellbeing and Health the with Working
= Boards and committees
In addition Healthwatch Richmond also ensures community representation through seats on more than 75 boards and committees across NHS Health and Social Care.
Richmond Clinical London Borough of Commissioning Group Richmond upon Thames (our local Council) Richmond Clinical Commissioning ‘‘ Group Board Health and Wellbeing Board Strategic Resilience Groups ‘‘ WHB Engagement group ‘‘ Integrated Partnership Board ‘‘ London and SWL Healthwatch ‘‘ OBC Programme Board ‘‘ Forums ‘‘ OBC Outcomes reference Group LBRuT Disability Equality Access ‘‘ OBC Communications Group ‘‘ Partnership ‘‘ MH OBC Programme Board Users and Carers Group - Adult ‘‘ Community Involvement Group ‘‘ Partners Public Information Group ‘‘ Whole Systems Transformation ‘‘ Local Strategic Partnership ‘‘ Board ‘‘ Engagement Working Group Urgent Care Committee Adult Safeguarding Board ‘‘ Adult Mental Health Strategy ‘‘ Richmond Partnership Community ‘‘ Group ‘‘ Engagement Working Group Older People Mental Health Emotional Wellbeing and Mental Strategy Group ‘‘ Health Children’s and Young ‘‘ People’s Board Pharmaceutical Needs Assessment Integrated Partnership Group ‘‘ Community Ward Project Board - ‘‘ ‘‘ Out of Hospital Patient Reference Group GP Patient Participation Group ‘‘ reps Forum Kingston and Richmond 111 ‘‘ Governance Meeting ‘‘ SWL NHS111 Programme Board
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29
‘ ‘
‘ ‘ Richmond Stakeholder meeting Stakeholder Richmond Board
‘ ‘ Whole system transformation transformation system Whole ‘ ‘ – Carer Member Carer –
Carers, Families and Friends Group Group Friends and Families Carers, Healthwatch liaison group liaison Healthwatch
Trust Foundation Trust Foundation
St Georges Mental Health NHS NHS Health Mental Georges St Kingston Hospital NHS NHS Hospital Kingston
South West London and and London West South
‘ ‘
Equality and Diversity Committee Diversity and Equality
‘ ‘
Patients Forum Patients
‘ ‘
/ PLACE committee PLACE /
London Ambulance Service Users/ Service Ambulance London
Patient Environment Action Team Team Action Environment Patient ‘ ‘
‘ ‘ networks
Patient Experience Committee Experience Patient Cardiac & Stroke and Cancer Cancer and Stroke & Cardiac
‘ ‘ Workshops
(WMUH) Primary Care Transformation Transformation Care Primary
University Hospital NHS Trust Trust NHS Hospital University
‘ ‘ Steering Group Steering
West Middlesex Middlesex West
Patient and Public Engagement Engagement Public and Patient ‘ ‘
Joint Commissioning Collaborative Collaborative Commissioning Joint
‘ ‘
Collaborative
‘ ‘
South West London Commissioning Commissioning London West South
St Mary’s University University Mary’s St
‘ ‘
and North Central and East London East and Central North and
Organisations
Health Education South London London South Education Health
Other Statutory Statutory Other
‘ ‘ Network (AHSN) Network
S London Academic Health Science Science Health Academic London S
‘ ‘ Training Board Board Training
South London Education and and Education London South
‘ ‘ Committee
HRCH Integrated Governance Governance Integrated HRCH Education and Training and Education
‘ ‘ Ambulatory Care Steering Group Steering Care Ambulatory
HRCH CQUIN Paediatric Paediatric CQUIN HRCH
‘ ‘
Advisory Committee Advisory
‘ ‘
Mental Health Network Health Mental
Teddington Memorial Hospital Hospital Memorial Teddington
Public Health England London London England Health Public
‘ ‘ Involvement Group Involvement
local pharmacists local
HRCH Patient and Public Public and Patient HRCH
‘ ‘
Pharmaceutical Committee and and Committee Pharmaceutical
shortly)
Kingston and Richmond Local Local Richmond and Kingston ‘ ‘
‘ ‘
Scrutiny Group (to be formed formed be (to Group Scrutiny
South West London Network London West South ‘ ‘
HRCH PALS and Complaints Complaints and PALS HRCH ‘ ‘
Quality Information Sharing Group Sharing Information Quality
HRCH Board HRCH
‘ ‘ Communications Working Group Working Communications
Healthwatch England England Healthwatch
Trust (HRCH) Trust
Community Healthcare NHS NHS Healthcare Community
Healthwatch Hounslow and Richmond Richmond and Hounslow
= Working with others to improve local services
Nightingale House Healthwatch Richmond appears as a case study in the Quality Standards as good Our Enter and View visit raised questions practice in three areas; choosing priorities and concerns about the registration and deciding when to instigate a project, of management, the effectiveness of our signposting activity and working with policies and procedures in the home and volunteers. the suitability of the home for people with accessibility issues. We shared As a result, the way we work is used to these concerns with the Care Quality demonstrate good practice supporting Commission, LBRuT, and with Healthwatch other Healthwatch to improve. Buckinghamshire who cover an area where the company also operates a home. Following our feedback, the CQC moved forward a planned inspection at “Many local Healthwatch could Nightingale House. The home was rated as describe clear process that they used “Requires Improvement”. Communication to determine when to conduct a more between Richmond Council and detailed investigation. Healthwatch Nightingale House identified training needs Richmond identifies an issue from for management and a need for policies the range of information provided, and procedures to be updated. picking out where the evidence is strongest. Outcomes are defined Quality standards then a standard project management Healthwatch Richmond was identified process completed which is taken to as an example of good practice by the Board for a decision.” Healthwatch England and engaged in research leading to two national Extract from Healthwatch Quality publications during the year. Standards
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31
Care Partnerships Care
Jon Rouse, Director General of Social Care, Local Government and and Government Local Care, Social of General Director Rouse, Jon
this.” this.”
services that provide personal care and talking to the Department in relation to to relation in Department the to talking and care personal provide that services
“CQC is reviewing how to improve its approach to regulating supported living living supported regulating to approach its improve to how reviewing is “CQC
residents.
approach whilst preserving the choice and control that such services give to to give services such that control and choice the preserving whilst approach
We understand that consideration is being given to strengthening the regulatory regulatory the strengthening to given being is consideration that understand We
CQC and Department of Health. of Department and CQC
national issue and escalated it to Healthwatch England who in turn wrote to the the to wrote turn in who England Healthwatch to it escalated and issue national
premises that CQC or Healthwatch can visit. As a result we identified this as a a as this identified we result a As visit. can Healthwatch or CQC that premises
residence of the people who live there, and therefore outside the scope of of scope the outside therefore and there, live who people the of residence
Chudleigh House is a supported living environment, effectively the private private the effectively environment, living supported a is House Chudleigh
National impact National
“spending more time at the Chudleigh house and there was notable improvement notable was there and house Chudleigh the at time more “spending ”.
An advocate from RUILS told us that new management were were management new that us told RUILS from advocate An
property”
improve staffing levels and made improvements to the living environment in the the in environment living the to improvements made and levels staffing improve
people we support incredibly seriously and have since worked with the council to to council the with worked since have and seriously incredibly support we people
we have acted immediately to rectify these. We take any concerns regarding the the regarding concerns any take We these. rectify to immediately acted have we
“Since concerns over staffing levels and cleanliness were made at Chudleigh House House Chudleigh at made were cleanliness and levels staffing over concerns “Since
who told us that: us told who
Our work led to improvements and a change of management at Chudleigh House, House, Chudleigh at management of change a and improvements to led work Our
concerns to us were invited to a safeguarding meeting to share their experiences. experiences. their share to meeting safeguarding a to invited were us to concerns
helped to arrange care assessments for residents. The people who had raised raised had who people The residents. for assessments care arrange to helped
We reported these concerns to the safeguarding team at Richmond Council and and Council Richmond at team safeguarding the to concerns these reported We
Local Impact Local
‘ ‘
Lack of communication and response when trying to address concerns. address to trying when response and communication of Lack
‘ ‘ engaging with residents with engaging
Concerns about quality of life for residents, lack of activities and staff not not staff and activities of lack residents, for life of quality about Concerns ‘ ‘
leaving leaving ‘ and turnover staff High good carers’ good ‘ ‘
Some residents not receiving appropriate, quality or personalised care care personalised or quality appropriate, receiving not residents Some
about care at Chudleigh House: Chudleigh at care about
In August 2014, Healthwatch Richmond were alerted to the following concerns concerns following the to alerted were Richmond Healthwatch 2014, August In Chudleigh House Chudleigh
= Requests for information
Local Healthwatch organisations have the power to request information from providers and commissioners of local NHS and social care. We also have the power to make reports with recommendations to these organisations about what could or should improve. When providers receive these, they must respond within 20 days. We’re also able to ask providers and commissioners for information and they must respond to our request within 20 days. Below is a table setting out whom we sent reports and requests for information to, and whether they did and did not respond within the 20 day timeframe.
Within 20 Outside 20 Requests Reports Organisation Days Days Richmond CCG 1 0 1 0 Nightingale House 1 1 2 0 Hampton Care 1 0 1 0 Roy Kinnear House 1 0 0 Not Recieved The Vineyard Surgery 1 1 2 0 Woodlawn and Oak Lane Medical 1 2 1 2 Centres Seymour House and Lock Road 1 2 3 0 Surgeries Twickenham Park Surgery 1 0 1* 0 North Road Surgery 1 0 1* 0 Dr Johnson and Partenrs, Sheen 1 0 1* 0 Lane Richmond Green Practice 1 0 1* 0 TOTALS 11 6 14 2
Roy Kinnear House changed ownership shortly after we requested information. We did not receive the requested information from the previous owners, and as a result will request this information from the new owners in due course. Woodlawn and Oak Lane Surgeries were sent our reports on 5th December and asked to respond within 20 days. Having not received their response we made contact with the practices on January 8th. They told us that they had not received these reports and we agreed an extension to January 19th. A further extension was agreed, to 25th January, and a response to the reports and recommendations was received on 27th January. * Whilst requests for information were made within this report’s timeframe, the responses to these requests were received outside this report’s timeframe.
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33
happened. happened.
amount of duplication amongst partner organisations that might otherwise have have otherwise might that organisations partner amongst duplication of amount
schedule work for times that are most mutually beneficial and to avoid a significant significant a avoid to and beneficial mutually most are that times for work schedule
This group has helped us to prioritise our work and to share plans, allowing us to to us allowing plans, share to and work our prioritise to us helped has group This
the Quality Information Sharing Group provides a structure for sharing information. information. sharing for structure a provides Group Sharing Information Quality the
As well as developing relationships between key contacts within each organisation, organisation, each within contacts key between relationships developing as well As
Commission (CQC). Commission
Richmond Clinical Commissioning Group, NHS England and the Care Quality Quality Care the and England NHS Group, Commissioning Clinical Richmond
work, Healthwatch Richmond set up a quarterly meeting with Richmond Council, Council, Richmond with meeting quarterly a up set Richmond Healthwatch work,
To help share information about local health and social services and to coordinate coordinate to and services social and health local about information share help To
Group (QISG) Group Sharing Reports and the Quality Information Sharing Sharing Information Quality the and Reports Sharing
= Our plans for 2015/16
Opportunities and challenges for Planned work for the future the future Child and Adolescent Mental Health Economic Services (CAMHS) We have secured an extension of the We’re working with colleagues from across Healthwatch Richmond contract from the voluntary and education sectors to London Borough of Richmond upon Thames survey parents of children who use CAMHS until 31st March 2017. This provides us and teachers who refer into the service. with security and enables us to invest in Healthwatch for the coming years. We plan to extend this work to include gathering the views and experiences of a The funding however does not come with wider group of children and young people an uplift and we face significant pressures during the year. from increasing costs such as rent and pension liabilities. As a result, we are Discharge from hospital faced with an increasing need to generate Discharge from Hospital was identified additional income to safeguard our vital through our work with West Middlesex work and to ensure the longer-term University Hospital as a key issue for local sustainability for Healthwatch Richmond. patients but we understand that this is a Profile wider issue. Beginning with mapping the discharge system, we aim to understand the Healthwatch is a new brand and coming processes and the relationships between as it does after a series of changes in the many stakeholders. Grounded on this patient and public involvement, there understanding, we aim to design a project is still relatively low awareness of local to identify positive practice and areas for Healthwatch. improvement and ultimately to improve We’re making significant gains in this area discharge locally. however, and the recognisable branding is General Practice a significant strength. We’re continuing with our planned enter With lots of exciting and engaging activity and view visits to four GP practices. These taking place across the organisation visits aim to understand each practice and reasonable stability afforded by the from a patient perspective. Once these are contract extension, we’re now in a position completed, we’ll review our findings and to invest significantly in raising our profile consider further work if applicable. over the coming year. Residential care The biggest challenge that we face to improving our profile is the demand on We will undertake Enter and View visits at our operational time arising from the high Roy Kinnear House and Hampton Care. Any number of significant changes to the NHS further visits to residential care homes will and social care. be informed by a programme of outreach and engagement with care homes and by the Quality Information Sharing Group.
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35
candidates
parliamentary parliamentary
local prospective prospective local
Healthwatch through through Healthwatch
Promoting Promoting
of the 2015/16 reporting period. period. reporting 2015/16 the of
newsletter sign-ups during the early part part early the during sign-ups newsletter
our twitter activity, website traffic and and traffic website activity, twitter our
This generated a significant increase in in increase significant a generated This
awareness for Healthwatch Richmond. Healthwatch for awareness
communications in the hope of raising raising of hope the in communications
used this to generate significant electronic electronic significant generate to this used
care. We published the responses and and responses the published We care.
set of questions on local NHS and social social and NHS local on questions of set in early 2015/16. early in
prospective parliamentary candidates a a candidates parliamentary prospective revise our strategic plan for Healthwatch Healthwatch for plan strategic our revise
In the early part of 2015/16 we asked local local asked we 2015/16 of part early the In growth and maintenance. We plan to to plan We maintenance. and growth
to one that we hope will be a phase of of phase a be will hope we that one to
communicate with. communicate
end as we move from a start-up phase phase start-up a from move we as end
the number of people that we regularly regularly we that people of number the
Our initial strategic plan has come to an an to come has plan strategic initial Our
awareness of Healthwatch and to increase increase to and Healthwatch of awareness
year to reach a wider audience to raise raise to audience wider a reach to year Strategy
it will be important over the coming coming the over important be will it
heard.
information. Whilst this is a real strength, strength, real a is this Whilst information.
groups that we have identified as seldom seldom as identified have we that groups
in touch with us with regular and rich rich and regular with us with touch in
We’ll also focus our engagement on those those on engagement our focus also We’ll
Our communications provide those already already those provide communications Our
Centres and groups for young people. people. young for groups and Centres
activity. Children’s to visits and homes care of
Implementing this system will be a major major a be will system this Implementing residents to outreach include will work
commissioned by Healthwatch England. England. Healthwatch by commissioned planned of areas Major engaged. currently
We are testing the CiviCRM system system CiviCRM the testing are We not groups target will outreach Our
also to improve our messaging. messaging. our improve to also engagement.
to reflect our updated contact details and and details contact updated our reflect to most the created have that activities the
communications and marketing material material marketing and communications on focussing by these of effectiveness
of March 2015, we are redesigning our our redesigning are we 2015, March of the increase to but sessions, outreach
Following an office move at the end end the at move office an Following of level high our maintain to plan We
Communications Outreach
= Our governance and decision making
Making decisions about Involving volunteers in Healthwatch activities Healthwatch activities Our Board of Trustees oversees all of the Members of the community are involved work of Healthwatch Richmond. The Board in all of our work. We predominantly is ultimately responsible for making what involve people as volunteers in our are called “relevant decisions”; decisions project groups and as Enter and View about how we perform our Healthwatch representatives. Volunteers in our project work. Trustee roles are filled through groups work in partnership with our staff open recruitment, and we promote vacant to design the activities that discharge our Trustee roles widely, encouraging anyone statutory duties. These project plans are with the right skills and an interest in recommended as activities to the Board. health and social care in Richmond to Volunteers who have been involved in our apply. work are also involved in the production of our reports and recommendations. During 2014-2015 we brought in a consultant to review our governance. As All of our volunteer roles are advertised a result of this, we have decided to set through our newsletters, our outreach and up a Healthwatch Committee to advise through our wider communications. the Board on delivering our Healthwatch role. The Healthwatch Committee will Our volunteers receive training, induction bring Board members and members of and support through group meetings. the wider community together within our These volunteer meetings give us an governance and decision making structure. opportunity to provide supervision for volunteers and to receive feedback to We have also set up a Governance help us to improve the way we involve Committee to review the performance of volunteers in our work. our Board. The Governance Committee includes two non-Trustee members of the public and we have successfully recruited to these posts. Our board for 2014-15 were
Laura Fox, from Chris Manning, from 6 Sheila Mayrhofer, ‘‘ January 2013 ‘‘ June 2013 ‘‘ from 3 October 2013 Paul Brian Pegden Kathy Sheldon, from 6 (Treasurer) ‘‘ Smith, from January ‘‘ June 2013 CJ Hamilton, from 5 2013 Mary McNulty, from 6 ‘‘ February 2014 Philip David Darling, ‘‘ June 2013 Darren Thornton, ‘‘ from 30 January 2013 Peter Hughes, from 6 ‘‘ from 6 June 2013, Andrew Munro, from 6 ‘‘ June 2013 until 6 June 2014 ‘‘ June 2013 (Secretary) Amanda Brooks, from 6 Julie Risley, from 29 ‘‘ June 2013 (Chair) ‘‘ October 2014
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and trustee expenses. trustee and
**Other support and administration costs include the costs of insurance, audit, IT support support IT audit, insurance, of costs the include costs administration and support **Other
volunteers.
through operational activity including projects, engagement, signposting and supporting supporting and signposting engagement, projects, including activity operational through
expenses incurred through running our operational activity. These costs are incured incured are costs These activity. operational our running through incurred expenses
*Operational costs include costs such as meeting costs, travel, print and volunteer volunteer and print travel, costs, meeting as such costs include costs *Operational
Note
Net flow Net 6,983
Total expenditure Total 156,117
6,00 163,10 income Total
Debit £ Debit £ Credit
Total support and administration expenditure administration and support Total 19,328
Other support and administration costs** administration and support Other 4,738
Bookkeeping and accountancy and Bookkeeping 3,900
Office Rent Office 10,690
Support and administration expenditure administration and Support Debit £ Debit £ Credit
Total operational expenditure operational Total 136,789
Operational costs* Operational 16,057
Marketing and promotions and Marketing 1,985
Training 941
Payroll and recruitment and Payroll 1, 6 0 117,8
Operational expenditure Operational Debit £ Debit £ Credit
6,00 163,10 income Total
100 earned Interest
17,000 income Other
146,000 contract Healthwatch
Income Debit £ Debit £ Credit Financial information Financial
= Contact Us
your voice counts
Get in touch Healthwatch Richmond 3rd Floor Regal House 70 London Rd Twickenham TW1 3QS Phone number: 020 8099 5335 Email: [email protected] Website: www.healthwatchrichmond.co.uk Staff Mike Derry, Chief Officer Keisha Forteau, Project, Outreach and Communications Officer Mary Mclaren, Project, Outreach and Communications Officer Louise Smith, Project, Outreach and Communications Officer
We will be making this annual report publicly available by 30th June 2015, by publishing it on our website and circulating it to Healthwatch England, CQC, NHS England, Clinical Commissioning Group/s, Overview and Scrutiny Committee/s, and our local authority.
We confirm that we are using the Healthwatch Trademark (which covers the logo and Healthwatch brand) when undertaking work on our statutory activities as covered by the licence agreement.
If you require this report in an alternative format please contact us at the address above.
© Copyright (Healthwatch Richmond 2015)
Healthwatch Richmond is part of Richmond Health Voices a Registered Company (08382351) and Charity (1152333)
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