Agenda item
Patient Led Assessments of the Care Environment (PLACE) Scores 2015-2017
The report provides an update on scores for Patient Led Assessments of the Care Environment (PLACE) at local hospitals.
Minutes:
Yvonne Smith (Head of Facilities at London North West Healthcare National Health Service (NHS) Trust) introduced herself and provided background information about the Patient Led Assessments of the Care Environment (PLACE) (page 79 to the Agenda pack).
Ms Smith said that assessments were carried on an annual basis between February and June. They were unannounced with the Trust, apart from the assessment team members, and were overseen by NHS Digital. It was important to note that each assessment concentrated on the care environment and did not look at staff behaviours or clinical care provision, with decisions being based entirely on the observations made at the actual time of the assessment. The Committee heard that the 2018 process was due to start on 1 February and recruitment of patient assessors was ongoing.
Members referred to section 2 of the report (page 81 to the Agenda pack), which provided an overview of scores in 2015, 2016 and 2017, and asked questions related to the Trust’s attitude towards cleanliness, standards and patient food at hospitals as well as actions taken by its leadership to address issues. Simon Crawford (Director of Strategy at London North West Healthcare NHS Trust) said that the Trust took patient experience very seriously and leadership had been disappointed with the food scoring at Northwick Park Hospital. Mr Crawford said that the low score could be due to the fact that not all patients liked the food choices available on wards and there were issues around meal times which had been addressed by the introduction of a Patient Protected Mealtimes and Beverages Policy, ‘weight-day weekends’ and the standardisation of the nutritional screening tool and food charts. In addition, a Trust Nutrition and Hydration Study Day would be held annually, following a successful pilot in September 2017 and external reviews related to nutrition and hydration had been undertaken by Healthwatch Brent. Ms Smith reassured the Committee that patient concerns had been addressed – in addition to the Patient Protected Mealtimes and Beverages Policy, a letter had gone out to consultant teams to encourage them to organise visits and diagnostic tests outside the protected times and patients who may need additional support would be identified.
The Committee noted that the hospital cleaning service had been outsourced to Compass Group and enquired if the Trust communicated with other hospitals using the same provider. Ms Smith responded that the service provided by Compass Group would be specific to London North West Healthcare NHS Trust as outlined in the contract between the two parties. However, monthly performance meetings took place and these were attended by representatives from Infection Control and Corporate Nursing. In addition, a Director at Compass Group attended a meeting every quarter and the Managing Director for healthcare attended a meeting annually. Ms Smith considered the contract to deliver good value for money and acknowledged that Compass Group had inherited a number of challenges which it had managed to overcome via regular training and support provided to staff. Mr Crawford added that an essential part of achieving a good value for money was holding the provider to account. For instance, a system which allowed issues at ward levels to be escalated to Ms Smith’s team and the monthly meetings with Compass Group had been put in place.
The Chair invited Julie Pal (Healthwatch Brent) to comment on the report. Ms Pal said that despite the fact that Healthwatch Brent had been pleased to be involved with the Trust, there were a number of issues that required attention. She noted that the report was high level and did not provide segmented data to enable readers to understand the experience of Brent patients and learn more about the way they use various facilities. Ms Pal highlighted that Healthwatch Brent was disappointed by the low score for food provision. She informed the Committee that Healthwatch Brent had conducted a visit and had produced a report which had been presented to the Brent Clinical Commissioning Group in March 2017. Some of the key recommendations of that report included:
· Identifying patients who needed assistance at meal times;
· The provision of red trays for vulnerable patients;
· Making the 6 am tea and the meals through the day accessible to everyone;
· The temperature of the food;
· Asking staff to monitor patients’ food and drink intake as there had been concerns about nutrition and hydration.
Ms Smith confirmed that these recommendations had been taken into account when a new facilities management contract had been commissioned. Its key features were:
· Investment in the patient food service, including the provision of a full range menu at both lunch and supper times;
· 24/7 helpdesk to report any problems with the estates;
· An improved assessment tool, with inspections carried out every four months by another Head of Facilities which allowed good practice to be shared;
· The Perfect Ward application which enabled matrons to report any issues related to the environment in the ward, its cleanliness and the food delivered to patients;
· The setting up of a Patient Experience Task and Finish Group to monitor service provision.
The Committee heard that the scores for privacy, dignity and wellbeing had been significantly lower than the national average and asked for an explanation of the main reasons for the low scores. Ms Smith said that there were a number of measures that had been implemented to improve performance. For example, staff and patients were briefed on how to fit the new modesty gowns correctly, curtains had been checked to ensure that they had been hung properly, staff had been reminded that sensitive conversations should not take place in public areas and nurses had been asked to ensure that patients could open the new type of sanitising wipes. Moreover, Mr Crawford said that as part of the estate refurbishment programme, wards had been designed and colour-coded in such a way that they were dementia-friendly.
Co-opted Observers asked questions that related to the frequency of assessments and capturing the experience of young people on wards. Members heard that peer mock inspections were conducted in areas of weak performance, examples of good practice were shared and Healthwatch Brent had been invited to visit the Trust. Ms Smith confirmed that children’s impatient area was visited as part of assessments and questions related to the nutrition and hydration of children and the facilities for social interaction were asked. The new paediatric menu had been patient-led as a group of children from the ward had been asked to contribute.
RESOLVED that:
(i) The contents of the Patient Led Assessments of the Care Environment (PLACE) Scores 2015-17 report, be noted;
(ii) More detail on patient experiences be incorporated into next year’s Quality Account produced by the London North West Healthcare Trust.
(iii)The input and experiences of young people be included more in the PLACE assessments by the Trust in future.
Supporting documents:
- 07. PLACE Scores Covering Report, item 9. PDF 80 KB
- 07a. PLACE Report Brent Community Wellbeing Scrutiny Committee paper, item 9. PDF 473 KB