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Trust Board Papers for 6 November 2019

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Trust Board Papers for 6 November 2019 Torbay and South Devon NHS Foundation Trust Public Board of Directors Meeting Board Room, Hengrave House, Torbay Hospital, Torquay, TQ2 7AA 6 November 2019 09:00 - 6 November 2019 11:30 Overall Page 1 of 295 Overall Page 2 of 295 AGENDA # Description Owner Time In case of fire - if the fire alarm sounds please exit the Board Room immediately in a calm and orderly fashion. On exiting, turn left, exit the building through the sliding doors and assemble in Hengrave House Car Park. User Experience Story Information 1 Board Corporate Objectives Information Board Corporate Objectives.pdf 7 2 PART A: Matters for Discussion/Decision 2.1 Apologies for Absence Ch Note 2.2 Declaration of Interests Ch Note 2.3 Minutes of the Board Meeting held on the 2nd October Ch 2019 and Outstanding Actions Approve 19.10.02 - Board of Directors Minutes Public.pdf 9 2.4 Report of the Chairman Ch Note 2.5 Report of the Chief Executive CE Review Report of the Chief Executive.pdf 25 2.6 DTP/DoF/DW Integrated Performance Report - Month 6 OD Receive and Note Integrated Performance Report - Month 6.pdf 37 Overall Page 3 of 295 # Description Owner Time 2.7 Operational Accountability and Governance Framework CS Approval Operational Accountability and Governance Frame... 105 2.8 Winter Plan COO Information Winter Plan.pdf 127 2.9 Clinical Services Transformation Progamme MD Approval Clinical Services Transformation Programme.pdf 163 2.10 Care Quality Commission Update CN Receive and Note Care Quality Commission Update.pdf 173 2.11 Emergency Preparedness Responsibilities Assurance DECD Report Approval Emergency Preparedness Responsibilities Assuran... 183 2.12 Freedom to Speak Up Guardian Six Month Report DWOD Receive and Note Freedom to Speak Up Six Monthly Board Report.pd... 187 2.13 Audit Committee Annual Report CS Receive and Note Audit Committee Annual Report.pdf 253 2.14 Audit Committee Terms of Reference CS Approve Audit Committee Terms of Reference.pdf 261 2.15 People Committee Terms of Reference CS Approval People Committee Terms of Reference.pdf 273 Overall Page 4 of 295 # Description Owner Time 3 PART B: Matters for Approval/Noting Without Discussion 3.1 Reports from Board Committees 3.1.1 Finance, Performance and Digital Committee - 29th Ch October 2019 Information 2019.10.29_FPD_Cttee_Report_to_Board.pdf 281 3.1.2 Audit Committee - 30th October 2019 Ch Information 3.1.3 People Committee - 24th October 2019 Ch 3.2 Reports from Executive Directors 3.2.1 Safe Staffing and Nursing Work Programme CN Information Safe Staffing and Nursing Work Programme.pdf 283 4 Compliance Issues 5 Any Other Business Notified in Advance Ch 6 Date of Next Meeting - 9.00 am, Wednesday 4th December Ch 2019 7 Exclusion of the Public Ch Overall Page 5 of 295 INDEX Board Corporate Objectives.pdf.....................................................................................................7 19.10.02 - Board of Directors Minutes Public.pdf...........................................................................9 Report of the Chief Executive.pdf...................................................................................................25 Integrated Performance Report - Month 6.pdf................................................................................37 Operational Accountability and Governance Framework.pdf..........................................................105 Winter Plan.pdf.................................................................................................................................127 Clinical Services Transformation Programme.pdf..........................................................................163 Care Quality Commission Update.pdf............................................................................................173 Emergency Preparedness Responsibilities Assurance Report.pdf................................................183 Freedom to Speak Up Six Monthly Board Report.pdf....................................................................187 Audit Committee Annual Report.pdf...............................................................................................253 Audit Committee Terms of Reference.pdf......................................................................................261 People Committee Terms of Reference.pdf...................................................................................273 2019.10.29_FPD_Cttee_Report_to_Board.pdf..............................................................................281 Safe Staffing and Nursing Work Programme.pdf.............................................................................283 Overall Page 6 of 295 BOARD CORPORATE OBJECTIVES Corporate Objective: 1. Safe, quality care and best experience 2. Improved wellbeing through partnership 3. Valuing our workforce 4. Well led Corporate Risk / Theme 1. Available capital resources are insufficient to fund high risk / high priority infrastructure / equipment requirements / IT Infrastructure and IT systems. 2. Failure to achieve key performance / quality standards. 3. Inability to recruit / retain staff in sufficient number / quality to maintain service provision. 4. Lack of available Care Home / Domiciliary Care capacity of the right specification / quality. 5. Failure to achieve financial plan. 6. Care Quality Commission’s rating ‘requires improvement’ and the inability to deliver sufficient progress to achieve ‘good’ or ‘outstanding’. Board Corporate Objectives.pdf Page 1 of 1 Overall Page 7 of 295 Overall Page 8 of 295 MINUTES OF THE TORBAY AND SOUTH DEVON NHS FOUNDATION TRUST PUBLIC BOARD OF DIRECTORS MEETING HELD IN THE BOARD ROOM, TORBAY HOSPITAL ON WEDNESDAY 2ND OCTOBER 2019 PUBLIC Present: Sir Richard Ibbotson Chairman Professor C Balch Non-Executive Director Mrs V Matthews Non-Executive Director Mr R Sutton Non-Executive Director Mr P Richards Non-Executive Director Mrs S Taylor Non-Executive Director Ms L Davenport Chief Executive Mrs L Darke Director of Estates and Commercial Development Dr R Dyer Medical Director Mrs J Falcao Director of Workforce and Organisational Development Mr J Harrison Chief Operating Officer Ms A Jones Director of Transformation and Partnerships Mr D Killoran Interim Director of Finance In attendance: Mrs J Downes Company Secretary Mrs S Fox PA to Chief Executive Ms J Gratton Joint Head of Communications Mrs J Phare System Director of Nursing and Professional Practice Governors: Mrs W Marshfield Mr M Birch Mr G Goswell-Munro Mrs A Hall Mrs L Hookings Mrs M Lewis Mr P Lilly ACTION 153/10/19 Board Corporate Objectives The Board noted the Trust Corporate Objectives. 154/10/19 User Experience Story The User Experience Story was presented by Ms Julie Kemmner and Mr Dave Reddaway from the Community Dietetics Team. The story concerned a young man suffering from muscular dystrophy who had swallowing difficulties. He was referred to the Dietetics Team from the Page 1 of 16 Public 19.10.02 - Board of Directors Minutes Public.pdf Page 1 of 16 Overall Page 9 of 295 Speech and Language team. When he was first visited his weight was stable, but earlier this year it dropped significantly until the young man had a BMI of 12.4 and was frail and very poorly. The Team discussed with the young man and his family the option of a PEG tube so he could be fed directly into his stomach and this was something they wanted to try. However because he was so malnourished he needed to gain weight before that procedure could take place. The young man therefore had a NG tube (down his nose) fitted in a short space of time and as a result he gained weight very quickly and was able to go on a family holiday to Florida. On his return he started to have feeding/swallowing difficulties and again the tube needed to be replaced. Since then he has been able to manage and now has a much better quality of life at a stable weight and was now waiting to have the PEG tube fitted. Ms Kemmner and Mr Reddaway wished the Board to be aware of how quickly this young man was able to be assessed and treated because they were called in once his problems with swallowing were recognised. It also meant the young man was able to be treated at an outpatient without the need for any hospital admissions. It was noted that the Community Dietetics team were a small team, but they were keen to ensure that teams in the community were aware of the service they provided and they were trying to raise awareness of malnutrition and their role in supporting patients because very often teams missed the opportunity to call in the Dietetics team when they could have made a difference to a patient’s well-being. The Chief Executive reflected on the need for patients to have access to high quality food and how the team had made such a positive impact on this young man’s life. Mrs Matthews queried the missed opportunities and Ms Kemmner explained that the team was small (3.7 whole time equivalents) and was based at Torbay Hospital, but provided a service across the Trust’s whole footprint. She said that the team worked hard to raise awareness, however they were not always called in to support other teams when earlier intervention could have made a difference. Ms Kemmner added that the team had a year’s funding to support the teams in Newton Abbot and Torquay, but this was not equitable as the same funding was not provided for the other localities. In addition, the team have put in a bid for winter pressure funding to work with the CCG around hydration in care homes, as it was known that good hydration contributed to the prevention
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