Priory Healthcare Quality Account 20 13-14 PROVIDING QUALITY INSPIRING INNOVATION DELIVERING VALUE Contents Part 1 Statement from the Chief Executive 03 Statement from the Chief Executive 04 Quality statement from the Director of Corporate Assurance and Chief Nursing Officer Part 2 Priorities for improvement 05 Summary of progress against 201 3-14 Quality Performance Indicators 06 Detailed review of performance against 201 3-14 Quality Performance Indicators 10 Priorities for improvement 201 4-15 12 Our statements of assurance from the Board Part 3 Additional information 14 Service user satisfaction – delivering value through clinical excellence 16 Outcomes – the success of our service users 20 Participation in clinical audits 21 The Commissioning for Quality and Innovation (CQUIN) framework 22 Continuous improvement in the delivery of our services 23 Staff opinion 23 Investing in staff, education and training 24 Regulatory compliance 25 Focus sites during 201 3-14 25 Improving safety for our service users Part 4 Appendix 26 Statement of assurance from our lead commissioner 27 Working in partnership with the NHS 28 Statement of Directors' responsibilities in respect of the Quality Account 29 Independent Limited Assurance Report to the Board of Directors of the Priory Group’s No. 1 Limited on the annual Quality Account 32 Format of this Quality Account 33 Scope of data inclusion 2 Part 1 – Statement from the Chief Executive Welcome to the latest Priory Group • across all 58 registered healthcare sites Healthcare Quality Account. In publishing nationally not a single service was placed an annual set of Quality Accounts for our under any form of embargo throughout Healthcare Division our aim is to be fully the whole year. transparent and accountable for the services we provide. The account provides Of course, none of these results are a summary of the achievements of our achievable without the ongoing dedication Healthcare business during 2013-14 and hard work of our staff. Our 2013 staff and outlines our priorities for further survey showed that 8 9% of Priory Healthcare improvements in the year ahead. Delivering employees felt that they were able to good care to our service users cannot be contribute to the success of their team and done in isolation and we work in a close 81% felt that they were able to do their job partnership with our staff, service users, to a standard that they were proud of families, Commissioners and Regulators. compared to the NHS benchmark of 7 7%. I was delighted to celebrate our staff In April 2013 we set ourselves ambitious achievements this year with our first ever Quality Improvement Indicators. Of the eight Priory Group “PRIDE” awards where staff were indicators set, I am proud to say we have individually recognised for their care, hard achieved or mostly achieved seven. These work and achievements in underpinning our remain our key priorities for the coming year core values of delivering value, providing as we strive for excellence against a backdrop quality and inspiring innovation. of ever increasing acuity of our patients and continued regulatory changes. I am therefore Throughout all of this however our absolute pleased to outline some of the key highlights: focus remains on service user safety, clinical effectiveness and the service user experience. • 100% Commissioning for Quality and Innovation (CQUIN) targets achieved for Learning from serious incidents and the year complaints is also hugely important to us as • 93% of all outcomes were judged to be met we strive for continued improvement and by the Care Quality Commission at their excellence in care delivery and outcomes. My last inspection aim is to ensure that the safety and wellbeing • 97% of service users surveyed in acute of service users is protected and the highest mental health services would recommend quality standards are upheld whilst further Priory developing integrated care pathways. • 98% of service users felt safe during their stay • 83% of service users in secure services felt I am proud of Priory’s performance over the engaged in their own recovery last quality year and, to the best of my • 75% of young people in Child and knowledge, the information contained in this Adolescent Mental Health Services report is a true and accurate reflection of the (CAMHS) showed an improvement services and outcomes that we have delivered . in their overall wellbeing • 100% of service users in our neuro- rehabilitation service believe they were well cared for and supported • 100% of service users in our specialist Tom Riall autism service felt that they were able to Chief Executive Officer make suggestions about their own care June 2014 3 Quality statement from the Director of Corporate Assurance and Chief Nursing Officer The Priory Group is focused on delivering “There have been significant improvements safe, compassionate, effectively regulated in the way in which the Group governs for care, that strives for good clinical and manages quality, providing a better outcomes. The focus remains on providing balance of focus across financial, operational excellence in mental healthcare across and quality performance.” the communities we serve. “The creation of a Head of Quality During 2013 the Priory Group benchmarked role within each division has itself against all the recommendations from allowed for a much greater degree the Francis inquiry and delivered on a number of focus on quality and has provided of key areas such as encouraging openness an improved level of capacity to and transparency, focus on safer staffing and manage quality improvement.” improving the service user experience. The PricewaterhouseCoopers external review focus has been to enhance and further raise care standards. Delivery of high quality care remains the priority against a backdrop of high acuity and We continue to invest in our staff through significant challenge. If at times we fall short education and training. In 2013 The Priory of delivering the high standards that we Group launched its Nursing Strategy which expect, we take immediate and robust focuses on delivering compassionate care in remedial action and learn lessons. a consistent manner. A new competency framework has been developed to further There is no room for complacency and we drive up professional standards. In addition, continue to be passionate about the care we are offering apprenticeships which include that we deliver. We proactively seek out the the Diploma in Health and Social Care to areas for improvement and continue to have Healthcare Assistants in some key hospitals. a dedicated arms-length internal inspection We are proud to report that 99% of service team that proactively highlights areas for users in acute mental health services felt they improvement. This assists us in ensuring that were treated with dignity and respect. our services continue to be well-led, safe, effective, caring, responsive and provide good Our ultimate objective is to be world class clinical outcomes. We look ahead to 201 4-15 and a beacon of good practice for other with enthusiasm and focus and continue to health and social care providers. In July 2013, put quality at the heart of everything we do. PricewaterhouseCoopers returned to undertake a further review of our governance processes: “We are proud to report that 99% of service users in Siân Wicks acute mental health services felt they were treated Director of Corporate Assurance and Chief Nursing Officer with dignity and respect.” June 2014 4 Part 2 – Priorities for improvement Summary of progress against 201 3-14 Quality Performance Indicators In 201 2-13, our Quality Account incorporated the feedback from service users, Priory staff, Commissioners and other external stakeholders, to identify three priority domains and eight priorities for improvement in 201 3-14 as our Quality Performance Indicators (QPI’s). In this section we will summarise our achievement against these priorities. We have used baseline indicators from the 201 2-13 Quality Account where possible to ensure the evaluation of our objectives is as accurate and effective as possible. QPI Service and Priority Domain Outcome number PRIORY HEALTHCARE DIVISION All service users to have their physical healthcare needs assessed and a plan put in Clinical effectiveness 1 Mostly achieved place to address areas of physical health need and service user safety Ensure that unmet need is recorded for all service users to assist in the CPA and Clinical effectiveness 2 Mostly achieved discharge planning process and service user safety CHILD AND ADOLESCENT MENTAL HEALTH SERVICES Service users to be more involved and to participate in the planning and review of 3 Service user experience Partially achieved 1 safe, sound, and supportive services EATING DISORDER SERVICES 4 Increase family and carer engagement and wellbeing Service user experience Achieved SECURE SERVICES 5 Service users to participate in recruitment across all our secure sites Service user experience Achieved COMPLEX CARE SERVICES Increase service user involvement and engagement in meaningful activity to support 6 Clinical effectiveness Achieved their recovery and rehabilitation ACUTE MENTAL HEALTH SERVICES Ensure that the service user is signposted to appropriate support services in the event 7 Service user safety Mostly achieved of a crisis upon discharge from acute services SECURE SERVICES 8 Increase service user satisfaction in relation to care planning and communication Service user experience Achieved Table 1: Summary of progress against 201