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Quality Account 2017/18 Our Vision to Deliver Innovative, High Quality Specialist Mental Health Services Through Compassion, Collaboration and Community

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Quality Account 2017/18 Our Vision to Deliver Innovative, High Quality Specialist Mental Health Services Through Compassion, Collaboration and Community Quality Account 2017/18 Our Vision To deliver innovative, high quality specialist mental health services through compassion, collaboration and community. Our Mission In a beautiful setting, we promote and support the well-being of people affected by mental ill-health, working with them to nurture their unique potential so that they can have a life worth living. Care for the environment Honesty and Hope Integrity The Retreat Courage Peace Equality and Community Registered address: Heslington Road, York YO10 5BN Contact details: Main switchboard 01904 412551 Referrals 01904 420910 Safehaven fax 01904 430906 Email [email protected] Website www.theretreatyork.org.uk Twitter @theretreatyork Facebook www.facebook.com/theretreatyork Contents Part One Statement on Quality from the Chief Executive and Statement of Assurance from the Board 4 Part Two Care Quality Commission (CQC) Inspection November 2017: Results 6 Priorities for Improvement 2018/19 7 Review of services / External accreditation 10 Participation in Clinical Audits 11 Commitment to Research as a driver for improving the quality of care and patient experience 12 Commissioning for Quality and Innovation (CQUIN) 14 Information Governance and Data Quality 15 Part Three Review of Quality performance 2017/18 17 Complaints Report, including patient safety incident data 22 Compliments Report 24 Patient and Carers Experience 25 Patient Friends and Family Test 27 Part Four Statement of Directors’ Responsibilities for the Quality Report 28 Statement from Healthwatch York 29 Statement from our NHS Commissioners 30 For ease of clarity, any reference to service user, patient or inpatient refers to an individual who is currently using our services at The Retreat York (this means The Retreat York, The Tuke Centre, the Autism and ADHD Service and The Retreat Living Ltd). Quality Account 2017/18 | 3 Part One Joint Statement on Quality and Assurance from the Chief Executive and the Board This Quality Account is our annual report to the public and to people who use our services about the quality of the care we deliver. It includes examples of improvements we have already made to the quality of the services we provide and our plans to make further improvements. It also describes some of the systems we have in place to measure quality. The Retreat is a not-for-profit provider of specialist raised in the inspection report. We developed a clearly mental health services. We work closely with the defined Quality Improvement Plan that systematically NHS to provide services for people with complex addressed every aspect of care delivery, including and challenging needs. The Retreat was established measures to ensure that quality was embedded into over 200 years ago by Quakers and was the first place everything that we do. This resulted in us receiving a where people with mental health problems were rating of ‘Good’ in January 2018 from the CQC with treated humanely, with dignity and respect. We are positive feedback about how much we had learned proud of our long-standing reputation for excellence and listened through this process. and for providing care of the highest quality. We are committed to working with those who use our services Over the last few months, we have undertaken to improve the quality of the services we deliver and a strategic review of our services and our future enable us to evidence that quality improvement. direction. The organisation has been facing significant financial challenges and reducing occupancy. The The Retreat has seen significant changes over the last two years, with major changes in the Leadership review included detailed internal analysis of our Team. We have seen the departure of a Director of finances and operations, and detailed market analysis Operations, a Director of Finance and two Medical to highlight the impact that national policy drivers, Directors, and have welcomed a new Director of such as the Government’s Five Year Forward View, Finance. We have also supplemented the team with are having on commissioning intentions and ongoing two interim Directors within Human Resources and demand for our services. We have also had many Operations. face-to-face meetings with our current commissioning During 2017/18 we closed our satellite service at The customers and key stakeholders. This work has clearly Retreat Strensall, recognising that the facility was no demonstrated the drive for community based, locally longer fit for purpose for providing the complex care delivered care with a move away from inpatient required by this cohort of patients. All patients were services. successfully transferred to appropriate care facilities in We have therefore recognised that we need to change the area. our operating model. It is clear that the Government’s With the changing requirements for different Five Year Forward View is having a significant impact treatments, we made the decision to close our on commissioning intentions which has moved Therapeutic Community (The Acorn Programme), towards reducing inpatient beds, length of stay and with service users moving to a range of different care out of area placements. At the time of writing, we options at the beginning of April 2018. are now in the process of beginning consultation In 2017, following a significant safeguarding challenge, with staff about our future operating model, with a we received an ‘Inadequate’ rating from the Care proposed move away from the provision of inpatient Quality Commission (CQC), so a major focus of our beds and growing and developing into outpatient and work during 2017 has been to address the issues community based models of care. 4 | Quality Account 2017/18 Part One Joint Statement on Quality and Assurance from the Chief Executive and the Board We have also commenced an options appraisal to look We know that 2018/19 is going to be a challenging at our current environment and how we can maximise year for The Retreat, but we are positive and confident its potential. Our priorities for improvement in 2018/19 that we can achieve great things through working as a will therefore reflect what we have learned over the cohesive and committed team. last year and how we can ensure that this learning On behalf of The Retreat, we affirm our commitment shapes our future service provision. to providing high quality services and confirm that, to Inevitably, the degree of change and level of the best of our knowledge, the information contained uncertainty has impacted on our staff, and we are in this report is accurate. extremely grateful for the huge efforts that they have demonstrated in maintaining ‘business as usual’ during this challenging time. We have made some significant progress in 2017/18, particularly given the Cathy Waters Jennifer Barraclough impact that the CQC inspection inevitably had on the Chief Executive Clerk to the Board organisation earlier in 2017. We do recognise that we of Trustee Directors still have a lot of work to do. 07 June 2018 07 June 2018 As an organisation with Quaker origins we have strong values that we work to. Our values are of key importance to the way we work and deliver care to our patients and service users. We are also working hard to raise awareness of our audit and research activities, which we use to improve the quality of care and patient experience. Quality Account 2017/18 | 5 Part Two CQC Inspection November 2017: Results We had a CQC Inspection in November 2017, with the report published in January 2018. The results are below. Statements from the Care Quality Commission …they told us that The Retreat is required to register with the Care Quality Commission staff saw them as and its current registration status is in respect of: individuals and • Assessment or medical treatment for persons detained under the people not as a Mental Health Act 1983 condition. • Diagnostic and screening procedures • Treatment of disease, disorder or injury • Personal care • The diagram below outlines the results of the CQC’s comprehensive inspection in November 2017. Overall Inadequate Requires Good Outstanding rating improvement Safe Effective Caring Responsive Well led Overall Wards for older people with mental health problems Good Good Good Good Good Good Unit staff strongly We received positive upheld the values of feedback from the organisation and external stakeholders regarded them as including advocacy, central to the way in commissioners and which they worked. local authorities. 6 | Quality Account 2017/18 Part Two Priorities for Improvement 2018/19 We have spent a lot of time considering our priorities for 2018/19 and embarked upon a programme of consultation with staff, patients and carers to ensure that our priorities are meaningful and supported by all. In pulling together the priorities we reflected on our successes and what could have gone better in 2017/18 and the outcome of our CQC Inspection Report. We feel confident that as these priorities have the full support of our staff, patients and carers they are both achievable and SMART (Specific, Measurable, Assignable, Realistic and Time- related) and will help us to grow and develop our services together. Progress on achievement of these priorities will be reported back in next year’s quality account. Patient Safety Objective Rationale 2018/19 Activities Indicators for success To improve the We have a system that is • IT and Governance • Compliance with procedures and efficiency and not currently fully utilised colleagues are working procedural change will provide effectiveness or understood by all staff. with our system provider tangible evidence of success which we of our Incident We will also improve to maximise the available will monitor monthly. Management our reporting processes programmes within the • Supervision with staff, competency System. to better inform our system. assessments and associated records governance framework. • Training of our IT and will provide internal evidence of Governance team who will cultural change and of increased staff then cascade training to the understanding.
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