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Mersey Care NHS Foundation Trust: Annual Report and Accounts 2018/19

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Mersey Care NHS Foundation Trust: Annual Report and Accounts 2018/19 Mersey Care NHS Foundation Trust Annual Report 2018/19 Quality Report 2018/19 Annual Accounts 2018/19 Striving for perfect care and a just culture Page 1 of 284 [page left intentionally blank] Page 2 of 284 Mersey Care NHS Foundation Trust Annual Report and Accounts 2018/19 Presented to Parliament pursuant to Schedule 7, paragraph 25(4)(a) of the National Health Service Act 2006 Page 3 of 284 Copyright © Mersey Care NHS Foundation Trust, 2019. All Rights Reserved. Page 4 of 284 Contents Page Annual Report – 2018/19 7 Quality Report – 2018/19 133 Annual Accounts – 2018/19 217 Page 5 of 284 [page left intentionally blank] Page 6 of 284 Mersey Care NHS Foundation Trust Annual Report 2018/19 Annual Report and Accounts 2018/19 Presented to Parliament pursuant to Schedule 7, paragraph 25(4)(a) of the National Health Service Act 2006 Page 7 of 284 Contents Chapter Page Foreword 9 PART A OVERVIEW 11 1 Introduction 11 2 Risk Management 19 PART B PERFORMANCE REPORT 21 3 Executive Performance Report 21 4 Environment and Sustainability 24 5 Equality, Diversity and Human Rights 27 6 Complaints and Compliments 28 7 Freedom to Speak Up (Whistleblowing) 29 8 Emergency Planning, Resilience and Response 31 9 Finance Director’s Report 32 PART C ACCOUNTABILITY REPORT 37 10 Director’s Report 37 11 Statement of the Chief Executive’s Responsibilities as 60 the Accountable Officer for the Trust 12 Audit Committee 62 13 Remuneration Report 65 14 Staff Report 78 15 Single Oversight Framework 90 16 Annual Governance Statement 94 APPENDICES App A Attendance at Council of Governor Meetings 127 App B Attendance at Board of Directors / Board Committee 129 Meetings Page 8 of 284 FOREWORD Welcome to our annual report covering the financial year 2018/19. As ever, this report gives us a great opportunity to celebrate the many achievements that we have made this year. It also offers a great opportunity for us to showcase our activity and performance across the Trust as Mersey Care strives for perfect care delivered through a just and learning culture. 2018/19 has seen Mersey Care continue to embed community physical health services acquired from the former Liverpool Community Health NHS Trust (LCH) over the last 20 months. We have also taken over responsibility for the mental health services at HM Prison Liverpool. Given the CQC’s historical concerns about these prison services prior to Mersey Care becoming their responsible provider, the CQC inspected these services in October 2018. In its report following this inspection, the CQC noted the excellent progress and improvements that had been made to the prison services, whilst still recognising that further work would be necessary to bring these services up to the very best standard in the future1. As we noted in last year’s annual report, the former LCH services have been subject to a critical external review by Dr Bill Kirkup2 due to concerns about the historical delivery of services before being acquired by Mersey Care. This has meant that we have given a high degree of focus to help support theses services to be as safe and effective as possible moving forward. Taking responsibility for these former LCH services has meant that Mersey Care has been at the forefront of providing responses to a range of questions raised by NHS Improvement in respect of recommendations 6.6 (serious incidents) and 6.7 (whistleblowing and other HR issues) of the external review, a task that, given the complexity of services, has taken the Trust a year to complete. At the end of 2018 the CQC inspected a range of the Trust’s other services, culminating in a well-led inspection at the end of December 2018. At the beginning of April 2019 the CQC published its inspection report3. Although the Trust retained its overall good rating, what is most pleasing, from this the Trust’s third CQC inspection since 2015, is the shift from a requires improvement to a good rating for the safe domain together with an improvement from a good to an outstanding rating for the well-led domain. On behalf of the Board of Directors we would like to thank staff across the whole of the organisation for their dedication and hard work in achieving these ratings - but given our objective of striving for perfect care delivered through a just and learning culture this is only the start and not the end of this journey. Increasingly Mersey Care is helping to shape the future of health services across Liverpool and Sefton. Mersey Care has a strong focus on how we can support the system to integrate local health and social care services. We now lead the Provider Alliances - comprising local NHS providers, GPs, local authorities and the voluntary sector - across Liverpool and Sefton. Given the direction of the NHS Long Term Plan4 the integration of services will be an 1 This report, published December 2018, is available on the CQC’s website by clicking here. 2 The independent Report of the Liverpool Community Health Independent Review, examining the failures at LCH between 2010 and 2014, was published in February 2018. The review is available on NHS Improvement’s website by clicking here. Following its publication NHS Improvement asked a number of questions of all those providers who had taken responsibility for the former LCH’s services. 3 This latest report is available on the CQC’s website by clicking here. 4 Further information on the Plan is available by clicking here. Page 9 of 284 increasingly important objective for the local health and social care systems in the coming years. Our ambition to re-shape the Trust’s estate has also continued apace and this is clearly evident with the successful build of our new 40-bed inpatient hospital / community hub in Southport. We have named this new facility The Hartley Hospital it is scheduled to open by the end of 2019. We also continue to be on track with building our new 123-bed mental health and learning disability medium secure unit in Maghull, now named Rowan View and this impressive facility is scheduled to open in September 2020. Our three Life Rooms - at Walton, Southport and Bootle - continue to be at the heart of our services for learning, recovery, health and wellbeing as well as a base for our Recovery College and Social Prescribing Services. Over the next 12 months we are planning to develop a Life Rooms in Ashworth Hospital as well as make our Life Rooms offer more accessible to the people of central and south Liverpool. Despite these and many other achievements we continue to face a range of challenges in the coming year: • although overall Mersey Care has been rated as good by the CQC, for the services we have acquired LCH (that now make up our Community Division), the CQC has provided a rating of requires improvement, with three of the five domains being rated as requires improvement (safe, effective and well-led) and the other two domains rated as good (caring and responsive). As we have only recently assumed responsibility for these services, the CQC has used its permitted discretion not to use these service ratings to affect the overall Mersey Care rating, but nonetheless we will continue our hard work to consistently and sustainably improve these services through 2019/20 and beyond; • in light of NHS England’s decision in 2016/17 to no longer commission learning disability services at our Whalley site, we have worked hard with partners at NHS England and NHS Improvement to obtain clarity from commissioners on the future of the low secure unit and non-secure inpatient services at this site. This has been a passionate focus for the Board of Directors who have maintained a strong focus on the development of these services in order to assure the safe transfer of services into the community and to new secure facilities as they come on stream. The safety and dignity of these vulnerable service users will therefore continue to be a key priority for the Trust. Finally, as part of our zero suicide ambition, and in conjunction with the Zero Suicide Alliance, we continue to work together to prevent the 6000 deaths that we see annually from suicide. If you only take one thing from this report please take just 20 minutes to save a life and take the training at www.zerosuicidealliance.com. Beatrice Fraenkel, Chairman Joe Rafferty, Chief Executive 22 May 2019 22 May 2019 Page 10 of 284 PART A – OVERVIEW CHAPTER 1 – INTRODUCTION 1. Mersey Care is a community mental health and physical health provider which provides a wide range of community health services across Liverpool, Sefton and Kirkby together with specialist mental health services across North West England and beyond. Our vision is be an organisation that is striving for perfect care and a just culture to the people we provide services to, their carers and our staff. 2. For the people of Liverpool, Sefton and Kirkby we provide specialist mental health inpatient services and community physical health, mental health, learning disabilities, addiction services together with acquired brain injury services. We also provide secure mental health services for the North West of England, the West Midlands and Wales and specialist learning disability services across Lancashire, Greater Manchester, Cheshire and Merseyside. We are one of only three trusts in the country that provide high secure mental health services. 3. Following the acquisition of the former Liverpool Community Health NHS Trust, since 1 April 2018 we have provided community services for South Sefton and Liverpool.
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