Web viewto carers and easy-read proposals shared with clients within TRC’s. ... for carers who want to engage with the Media through press releases or radio and TV interviews

Paper No. SET/33/13

South Eastern HSC Trust Personal & Public InvolvementBi-Annual Summary Report to Trust Board

Reporting Period 1 September - 31 March 2013

The Personal and Public Involvement Strategy – Involving You, describes key strategic aims that will be delivered by the Trust over the period 2012-2015, in respect to its engagement process. As part of the monitoring process a template has been completed to highlight the PPI activities being pursued, their impact and future proposed PPI activities. This report is a summary of the monitoring templates and provides an overview of the best practice that is ongoing throughout the various Directorates in order to fulfil the aims laid out in Involving You.

Case studies have been included to provide additional qualitative information on how Personal and Public Involvement has made in order to offer staff an opportunity to reflect on their practice and provide more detail on some of the activity undertaken.

Contents

Page Number

Primary Care, Older People, AHPs and Nursing 2-6

Children’s Services 7-11

Mental Health 12-17

Adult Disability 18-26

Hospital Services 27-32

HR & Corporate Affairs 33-36

Corporate Response to Aim 4 37

Case studies

- Adult Services 38- Older People’s Services 41

Primary Care, Older People, AHPs and NursingAim 1 Involve people in the decisions we makeThis is the main purpose of our personal and public involvement process. We believe involving people in our decisions is a basic requirement in developing, planning and delivering the best services. This aim focuses on the way in which involvement happens and the methods we will use to involve individuals, service users, specific groups and communities in making decisions about their care and delivering services.

Level PPI Activities to date Impact on service – How has this work improved services for clients?

Proposed PPI activities

Individual Service users are represented on the Lisburn PCCC Project team to develop a Strategic Service Model and a business case for the Primary and Community Care Centre for Lisburn.

User satisfaction surveys were carried out as part of the Primary and Community Care Service rolling programme within Sexual Health and Tissue Viability.

The questionnaire aimed to gauge awareness of the following aspects of the care and service provided: -

Respect Attitude Behaviour Communication Privacy and dignity On discharge from the service

Patient Client Council completed a face-to-face patient survey across dermatology outpatient clinics on a range of Trust sites as part of the dermatology pathway design group/PCP74 questionnaires have been completed to date and the survey has also been circulated to those listed on the PCC membership scheme.

It is important to involve service users from the outset in developing a future model which meets the needs of the population.

Once data collection is completed a report will be produced and the data can be analysed by Trust site. Feedback to date has been very positive although issues have been highlighted in relation to waiting time for an appointment and in some cases waiting time at clinics

Service users will continue to be included in all stages of the project and information also evidenced through Patient participation groups within the GP Practices.

Service Users and Interest

Groups

All stakeholders have been included in the Project Board or Project Team.Larger stakeholder meeting was held to discuss the Strategic Service Model and the future development of the model of care for the Lisburn locality.The Trust has been working with community

The proposed Model of Care has been circulated to all stakeholders including the spoke Practices.

This has ensured that there is local and political support.

HSCB are leading discussions with spoke GP practices to confirm their requirements in line with TYC.

Supported housing model will be progressed 2

Primary Care, Older People, AHPs and NursingLevel PPI Activities to date Impact on service – How has this work

improved services for clients?Proposed PPI activities

and elected representatives in Kilcooley to develop options for the replacement of Ravara EPH. The Trust proposes to consult publically in late 2012 and has begun pre-consultation with residents of Ravara, their families, staff and local representatives with meetings held on 29th August to discuss the options and what will happen next.

Residents’ views have been gathered and the consultation document will be developed to take these into account. Consultation resulted in five responses, with political and community backing.

alongside and service user representatives.

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Primary Care, Older People, AHPs and NursingAim 2 Make sure that people have the information they need to contribute to decisionsInvolving people in a meaningful way is possible when we share information with an appropriate audience in a context and a format that they will understand.



Individual Development of a drop in clinic for clients who have a pre and post diagnosis of dementia to ensure that relevant information is available and questions answered. The need for this service was identified by service users and the carers’ groups. The service is advertised in GP surgeries and Outpatients departments.

New patient / carer leaflets have been developed for the District Nursing service, Social Work and Social Care for Older People.

Leaflets explaining procedures carried out in Treatment Rooms are also being developed. Leaflets are in an ‘easy to read’ format and service users were involved in their production.

An information pack is currently being developed for services users and families to explain the financial information and processes on entering Residential or Nursing Home care.

User satisfaction surveys as part of the Primary and Community Care Service rolling programme – we now produce posters reporting the findings which are displayed in waiting areas.

To support the developing procurement exercise for community meals and domiciliary

The service provides easy access with no appointment required. It is informal, confidential and a one-stop shop and allows sign posting to other services or further information. Advice is given on benefits, health issues, counselling, support, medication, expectations and financial / legal issues. Service user feedback has been very positive, with a high usage of the service.

All service users receive a copy at the point of admission to the service. Service users and carers feel more informed about the services.

As part of a Lean Financial Pathway process it was identified that clearer, more robust and updated financial information be given to service users and families.

1. Allows the public see the findings of our surveys and hopefully encourages them to participate.

2. It lets them see that each service picks up on the comments provided.

This gave staff the opportunity to think a bit differently about how they get feedback and also encourage PPI within their services

The service specifications are being developed to take these views into account.

Service users have been able to inform the development of the service.

Proposed developments include having a carer on the team at Drop In centre, greater advertising of the service and future development of an outreach model.

It has been suggested that the services devise some key service questions that can be asked by someone external to the service.

Final returns and analysis will inform future activity.

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Primary Care, Older People, AHPs and NursingLevel PPI Activities to date Impact on service – How has this work

improved services for clients?Proposed PPI activities

care, questionnaires have been developed. For the meals service 250 questionnaires were issued with 149 being returned. For domiciliary care 400 were issued, the final return position is still awaited.

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Primary Care, Older People, AHPs and Nursing

Aim 3 Increase feedback from people, use this to shape and improve services and make sure people know about outcomesFeedback from service users is crucial to developing improvements and allowing resources to be prioritised. It is also vital in making sure energy is directed to those areas that are of most importance to those that use services and the public.



Individual Clients and families are involved in individual person centred assessment using NISAT and care planning.

Patient satisfaction surveys are completed as part of a rolling programme.

Flowline Group – Continence ServiceBreathe Easy Groups – Respiratory ServiceDiabetes Support Group – LisburnCommunity Dental ServicesCommunity Stroke Team

Clients and families have opportunities to feedback during assessment, monitoring visits or reviews and other regular communication and work with staff to shape their care requirements.

Feedback is used to address any issues and improve services.

Review of what patient information leaflets are given to patients and their content to ensure that patients can understand them. Balance class time changed meet patient’s requirements.

To continue to improve in this process.

Development of other methods to gather the views of service users including patient stories, staff have been identified for this training.


GroupsConsultation through monthly meetings held with carers of dementia clients.

Carers Implementation Group

Personal development Carers Course

Opportunity to support carers, but also listen to their views to improve service provision.

Carers participate in setting the agenda for this group.

Carers have an opportunity to develop themselves and their own interests to help them cope with their caring responsibility and to build confidence and skills.

Monthly meetings continuing.

Meetings continuing

Course has been positively evaluated and is continuing to run.

CommunityPartnership working with Community groups to undertake surveys of Local Communities to identify the needs of Older People.

Ongoing projects include Colin Neighbourhood Partnership health check project and Older People’s survey in Kilcooley.

Colin project ongoing.

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Children’s Services

Aim 1 Involve people in the decisions we makeThis is the main purpose of our personal and public involvement process. We believe involving people in our decisions is a basic requirement in developing, planning and delivering the best services. This aim focuses on the way in which involvement happens and the methods we will use to involve individuals, service users, specific groups and communities in making decisions about their care and delivering services.

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Individual / Service users

A Children in Care Council is being established which will help give children in care a greater voice in the issues and concerns which affect them.

Buy-in from voluntary groups and children in care has been secured.

The first meeting will be held in February to set out plans.

Service Users/Interest group

16 Plus/Homeless Accommodation

The Trust is also in a joint commissioning process with the NIHE and Supporting People which aims to develop a new model of service accommodation for those 16 plus population who are Looked After as well as 16-21 year olds who present as homeless.

A stakeholder engagement and communication group has been established to both identify and engage with a range of stakeholders who will have a vested interest in the development in the supported housing project. To date the group have targeted 3 of the main political parties and VOYPIC. The stakeholder strategy is targeted at politicians, community groups and statutory bodies such as the PSNI.

Advance plans are underway to complete the first phase of this development by 2013. The completion of the project will result in the development of three 8/9 bedded units throughout the Trust. The engagement strategy has been successful in enlisting the support of the political parties. A project for Downpatrick has been submitted for approval.

The stakeholder engagement team will continue to meet with the Political parties, community groups, statutory bodies as well as individuals who have a vested interest in the project.

Two additional projects are expected to be developed in Lisburn and Bangor.

Improving outcomes for children

The Family Support and Safeguarding Children Programme has gone through an extensive process with Statutory, Voluntary and Community Groups to develop an action plan to introduce family support schemes that aim to improve the life outcomes for children and young people in the community. The Community groups have identified the local needs in their area and have contributed to the action plan. Community groups were invited to a workshop in January where views were expressed and plans put in place. This work continues under the auspices of the Outcomes

The whole approach centres on improving life outcomes for all of the children within a geographical area. The impact will not only be for individual families but for entire communities. Data is being collected, reviewed and monitored to ensure that schemes commissioned to deliver services to improve life outcomes are meeting effective.

Regular meetings with local communities are planned alongside Trust wide meetings

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Aim 2 Make sure that people have the information they need to contribute to decisionsInvolving people in a meaningful way is possible when we share information with an appropriate audience in a context and a format that they will understand.



Individual / Community

The Health Development Department are currently developing Stop Smoking campaigns in Kilcooley and Old Warren estates in Bangor / Lisburn.

These campaigns, developed in partnership with local community groups, aim to provide information and support to individuals who would like to stop smoking.

This will include providing information relating to the risks associated with smoking and highlighting what support services are available.

A similar campaign in Colin, which included a social marketing campaign, was evaluated. This demonstrated that there was an increase in referrals to Stop Smoking services. In addition, a number of women, who were pregnant, also stopped smoking.

New support groups, that would enable information to be delivered in a more effective way, were also established in the Colin project. These groups had the additional benefit in that they enabled individuals in the community to support each other when stopping smoking.

A similar campaign, held in West Winds, was also very effective in supporting young people to stop smoking. Often smokers minimise the risks involved. Being able to provide information in a way that can be easily understood, can be hugely effective at supporting individuals in changing behaviours.

Once the two new campaigns are evaluated, this local approach to providing individuals in deprived communities with both information and support, could potentially be rolled out to all other areas of deprivation across the Trust, where smoking rates are particularly high.

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Individual / Service Users

Within the Cared for Children Directorate, the Children’s Disability Service recently completed a survey of families to determine their use of and views on respite (short break) services.Completed questionnaires are being used the design of the future short breaks planning for children with disabilities and their carers across the South Eastern (SE) area.

Carer consultation work is now a part of this area of the Trust.

This innovative approach to gaining the feedback of a wide variety of service users will inform further PPI developments within the Cared For Children’s world.

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Aim 5 Evaluate how effective personal and public involvement activity is on planning and delivering servicesTo assess the effect of our activities on involving users and the public involves ongoing evaluation to make sure that services are meeting people’s needs and expectations. We must assess the methods we use during involvement to improve techniques and maintain good practice.



Individual / Service Users /

Community

The development of Family Support Hubs, which co-ordinated a range of support packages for vulnerable families, is ongoing across the SE Trust locality.

Three Family Support Hubs have been established, which meet monthly to review referrals from a range of organisations including schools, GPs, Mental Health teams, Health Visitors etc.

Family Support Hubs include a range of key community and voluntary local family support stakeholders who jointly make decisions with Trust staff as to how to support vulnerable families. Therefore Hubs represent a good example of public involvement in the delivery and design of local health and social care services.

Recently, a detailed evaluation of Hubs were carried out by Safeguarding Children including a range of data gathering techniques and both quantitative and qualitative analysis, such as an independent evaluator talking with a range of stakeholders involved in the process.

This evaluation has demonstrated that the Hubs are very effective at providing timely and flexible support to vulnerable families outside of the statutory social services system. This has included the calculation that the majority of families receiving support do not then require further intervention from social services.

Further work to assess the impact of Family Support Hubs is planned, especially in relation to the outcomes improved for specific families.

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Mental Health




Individual On the inpatient wards the Patient Forums continue to enable patients/Service Users to have a greater say in how the wards are organised. The three mental Health Inpatient Units have access to petty cash to support patient activities. On these wards patients are asked to advise staff which outings/ activities they would like the monies to be spent on.

Training is underway for Community Mental Health Staff on the use of the new care plans which emphasises not only the involvement of the individual in the planning of the care but crucially the involvement of the carer perspective in the assessment and the planning of care

Patients have a greater say in in how the wards are organised and advise on which activities they would like to spend money on.

Petty Cash for the continuing care wards is to be pursued.

Newly trained Peer Advocate Volunteers have been identified to attend the Patient Forums on each ward with a view to a Peer Advocate Volunteer taking over chairing the Forums and enabling Service Users to contact them directly after the meetings. An Operational Policy to guide the work of the Peer Advocate Development Volunteers has been developed

Peer Advocate Volunteers are to be identified for Down, Lisburn and North Down Ards areas. They will meet with the respective Community Mental Health Teams accompanied by the Peer Advocate Development Officer and office space has been secured in all three areas where they will see Service Users

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Mental Health




Groups

The local CUP groups in Downpatrick, Lisburn and North Down & Ards continue to meet monthly.

Strategic CUP Group continues to meet every three months with an agenda informed by the issues that have Trust wide impact or that cannot be resolved at the local CUP group level.

Database of CUP Members has been set up and each group share the minutes of their meetings with the other two groups.

Service Users or Carer representatives sit on all Selection & Recruitment panels for staff up to and including Band 6 as a pilot

Currently Service Users & carers are involved in : Single Inpatient Project Group; Recovery Working Group; Peer Advocacy Training Development Group ;Borderline Personality Service Steering Group; Home Treatment Services Group and Home Treatment House

Service Users and Carers have availed of the training in meeting procedures and on Chairing Meeting skills

CUP members share information with other groups and strategic CUP meetings escalate issues which don’t have local resolution.

Service Users and Carers report feeling well supported in the Selection & Recruitment process and staff say that their involvement makes these experiences very positive.

CUP meetings will continue to be held every three months.

The presence of Service User or Carer on Selection & Recruitment panels for all bands is being considered once feedback from all the stakeholders has being gathered

Any future groups being set up tasked with designing new services will have Service User and Carer representatives.

Community The links between the CUP Network and World Mental Health Day Events (WMHDE) Committee have been strengthened through more CUP members joining the group and

A greater number of people are involved in marking the events and participating in committee work.

The Mental Health programme continues to provide resources to the World Mental Health Day Events Committee and service Users & Carers will contribute to and benefit from

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Mental Health



influencing the work of WMHDE. these events.

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Mental Health




IndividualNew discharge packs for patients who leave the Mental Health Inpatient Units “Safe Home” have been developed for the three areas.

The pack content are customised based on the age/gender of the patient and enable them to be aware of the services that can support them on discharge particularly at times of difficulty or crisis

The involvement demonstrates the commitment of services and the decision making is enhanced by the differing perspectives that Carers and Service Users bring to the work of these groups.

Any future groups being set up are tasked with designing new services with Service user and Carer representatives.


Groups

Currently Service Users & carers are involved in: Single Inpatient Project Group; Recovery Working Group; Peer Advocacy Training Development Group; Borderline Personality Service Steering Group; Home Treatment Services Group and Home Treatment.

Local CUP groups continue to meet monthly and provide members with news and opportunities to contribute to Trust decisions & plans. Each group send representatives to the Strategic CUP Group.

Local Interest group have been developed for Service Users for:- Bi Polar conditions, Eating Disorder and Borderline Personality

Service Users and carers are appreciative of existing information and booklets but would like to see improvements in the quality and availability of information.

Regular updates on CUP activity are to be provided for the Community of Interest newsletter produced by Health Development.

Work is under way to complete the service information on all Mental Health services for the Trust internet

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Mental Health




Individual Petty cash has been made available to assist Ward staff to supplement the evening and weekend activity programme by helping to provide DVD films, trips to cinema fast food and purchase materials for ward based cookery and crafts.

Over 120 Patient and Carer experience “stories were gathered across Trust departments and facilities as part of the regional “Have Your Say - Mental Health Service User Experience Audit”. The results and report will be available early next year

Feedback from concerns raised on the Mental Health Inpatient wards have resulted in “protected meal times”, increase in the quality and range of patient activities and ongoing improvements to the care environments

Patient satisfaction and Carer satisfaction surveys are to be repeated every three months on all three Mental Health Inpatient Units as part of the “Releasing time to Care” programme.

The regional and local information gained from the “Have Your Say - Mental Health Service User Experience Audit” will be used in improvement of services as indicated.


Groups

The CUP Network ie three local CUP groups and the Strategic CUP group enables people to have their say about local and Trust wide issues.

Service Users and Carers are informed and can discuss local and regional plans and developments. Carers and Service Users have been enabled to attend consultation events Conferences & training and feedback to their local groups. CUP members have expressed praise and gratitude for being advised and enabled to attend training such as Applied Suicide Intervention Skills Training (ASIST) and Mental Health First Aid

The Peer Advocate Volunteer Development Officer will actively recruit new members to the local CUP groups in all three areas and, in particular, to invite former members to rejoin.

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Mental Health




Individual The new care plans being used plans have a focus on recovery and clearly demonstrate the individual’s perspectives and their involvement in planning their care. Throughout the development of these care plans Service Users and Carers through the CUP Network were involved in providing feedback and shaping the document.

This approach facilitates more of a focus on solutions rather than problems and helps staff to see each individual as more active participants in their own personal journeys of recovery.

A new cohort of Peer Advocate volunteers is being recruited for the next training course which will commence in January 2013.

Funding has been received for the recruitment of two Peer support Workers. These posts are expected to be filled early in 2013


Groups

Currently Service Users & carers are involved in almost all of the groups that have been set up to plan or redesign services. These include Single Inpatient Project Group; Recovery Working Group; Peer Advocacy Training Development Group; Borderline Personality Service Steering Group; Home Treatment Services Group.Service Users and Carers have also been involved in visiting facilities in other Trusts including those in England to help in the planning of new services here.

The involvement of Service Users and Carers in the groups has brought positive experiences for all involved. The dynamic that is created between Services users and Carers leads to very healthy debate and helps groups arrive at well considered and balanced decisions.

Any future groups being set up tasked with designing new services with Service user and Carer representatives.

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Adult Disability




Individual Clients are involved in assessment and care planning.

Person Centred reviews are being rolled out in Ards TRC.

Clients’ views are central to service provision and the decision making process.

Clients benefit from outcomes which they have identified as important to them.

Roll out of Person Centred reviews across all facilities / teams.

To continue with training of Person Centred Review facilitators - Training arranged in April to increase numbers of facilitators.

Service Users and Interest Groups

Established service user group based at Market Street - regular bimonthly meetings.

Service user meetings have been established in Rowan Centre

Three consultation meetings held with key stakeholders regarding Reform and Modernisation Projects

TILLI Group (Tell it like it is) has been established in Lisburn Sector. The Trust now supports 2 groups- Lisburn and Bangor

Monthly meetings are held with Lisburn Carers Forum.

Monthly Braintime group D/L CBIT service (winner of Chair award in 2011)

Clients and carers contribute / comment on service delivery and development.

Will give service users the opportunity to comment on current service provision and contribute to future planning.

Carers do not have direct link via service user groupDo have input via reviews & contact by professionals

Stakeholders encouraged to contribute at meetings with minutes being forwarded to CEO.

Clients and Carers give ongoing feedback on their views regarding service development

Involves Key Stakeholders in decision making.Enables clients and carers to communicate openly/honestly and have their needs articulated. This promotes the growth of their confidence, independence, Self-esteem and identity and decreases their anxiety, vulnerability, isolation and alienation, and develops

To continue to involve service user group in service delivery / development.

To hold regular service user meetings

Written feedback encouraged / facilitated through dissemination of consultation document.

To continue with partnership approach to decision making.

Currently developments in place to develop more formalised carer support groups in CBIT in NDA sector

Planning for the development of a Carer’s forum in Down Sector has commenced.

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Adult Disability



solutions to problems

Also monthly carer’s group for D/L CBIT service

Exit interviews and patient group meetings take place in Thompson House Hospital

To identify positive and negative views of the service and to take the necessary action to ensure the highest possible patient experience

Continue patient group meetings.

Community Disability Services have established a Physical Disability community of interest for North Down and Ards, Down and Lisburn Sectors.

Encouraging a Partnership approach in working towards improving the health and well being of the local community.

Adult Disability Services, Down sector attend and contribute to the Down Council Disability Forum meetings reviewing key issues for people with a disability within the local area.

Consolidation of Community of Interest.Link with other sector Communities of Interest.

Continue to attend quarterly meetings.Proposed Connect day to be held in Oct 12 – planning ongoing.

Adult Disability Services have established workshop events with relevant stakeholders to review the future provision of day opportunities for people with learning disability and for people with a physical disability in each local sector.

Market Street Day Centre has involved Translink in advising and completing

These inclusive events are identifying what works well, barrier and challenges, how the barriers and challenges can be overcome and agreeing a vision for future day opportunities.

People with physical disability have now gained Smartpasses and use Translink travel. Users are now

Local action plans for learning disability to be agreed at final workshop event and rolled out.

Local action plans for physical disability to be agreed at final workshop event and rolled out.

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Adult Disability



Smartpasses for local accessible transport. Service users have been introduced to kneeling buses and advised how to arrange same for disability accessible local transport use.

organising and using local kneeling bus services.

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Adult Disability




Individual Have consulted with service users on various matters (outlined above) in written format (letter / questionnaire) and also verbally in established groups. Consultation takes account of communication difficulties of audience eg BSL interpreter, electronic, large print, audio etc.

Provision of accessible information is a central and core responsibility of all staff throughout neurodisability services.

Accessible easy read information is provided within Thompson House and CBIT services.

Accessible noticeboard within THH accessible for patients and carers outlining forthcoming activities, performance targets and other relevant information

Sensory Support will work with other Departments within the Trust to ensure that the information being shared is in accessible formats- eg Complaints / Equality information

Development and circulation of easy read version of “Tell us what you think” leaflet for staff to distribute to service users and carers.

Services have been developed having consulted with those who will be using them to make sure they are accessible, necessary and meeting the needs of those they are aimed at.

To ensure that patients/clients with cognitive and/or neurological conditions feel involved and part of the care delivery process, can understand what is happening and can make appropriate choices

To ensure service users know how they can make comments, complaints and compliments about the service they receive.

Ongoing consultation in the future.


Same as Aim 3 and Aim 1.

All invited to public meetings via letter sent out

Service Managers ensure that relevant information is shared with the group e.g. Consultation process.

Consultation document and process has been shared

Ongoing

Ongoing

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Adult Disability



to carers and easy-read proposals shared with clients within TRC’s

Development of regional information packs via ABI review

PCP Information documentation has been devised in consultation with clients and staff.

with service users and interest groups.

To help patients, clients, families and carers get the best from Brain Injury Services and support in Northern Ireland

These documents will be piloted in Ards TRC duringApril 12.

Community Same as Aim 3 and Aim 1.

Invite to attend public meetings made through local press and public representatives.

Review of information provided to key stakeholders (GP, referrers, relevant professional personal) following assessment/intervention by Thompson House Hospital.

Relevant information is shared by Disability Services at this Forum. Community groups and members are encouraged to share their views. All members of Community of Interest are responsible for sharing information in an appropriate manner.

Will help ensure up to date and accurate information sharing throughout the pathways of care within specialist and generic service provision.

Ongoing

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Adult Disability




Individual Clients are involved in individual assessment and care planning.

Person Centred Reviews are carried out. Questionnaires are being collated in Ards TRC to review client/carer and staff experience of PCP reviews.

Review of outcome measures systems in both Thompson House and Community Brain Injury Services

Clients and carers have opportunity to feedback during assessment and review process. Outcomes are devised following feedback from clients / carers.

Improved information for service and for service users and carers regarding beneficial outcomes and progress or otherwise.

To continue to facilitate Person Centred Reviews for our clients

We are in the process of reviewing and amending our outcome measures within THH and CBIT. This will result in an evidence based and consistent application of outcome measures across the Trust and regionally


TILLI Group has been established in Lisburn and North Down and Ards Sectors.

Monthly Meetings are held with Lisburn Carers Forum.

Three Consultation Meetings held with key stakeholders regarding Reform and Modernisation Projects.

Consultation with voluntary groups who use Trust transport

Resident/Tenant forum meetings within Struell Lodge Residential/Supported Living

Service users and interest groups can feedback through regular meetings with Disability Managers.Key Stakeholders have been invited to offer feedback from community groups which it is hoped will provide crucial feedback for service planning.Regularity of meetings ensures that there is an opportunity to follow up and to provide feedback on issues.

Gave additional opportunity for people to be involved in the Consultation Process.

Feedback from groups resulted in service being extended facilitate a longer consultation process with Transport Dept.Provides opportunity to involve users/tenants in general feedback about services, keeping people informed and decision making processes.

Evaluation of feedback from consultation period.

Ongoing

Ongoing

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Adult Disability



Client questionnaires have been introduced into disability facilities to gain feedback in regard to infection prevention control

Satisfaction survey for clients/carers being progressed across CBIT services

Annual service user satisfaction surveys completed within Struell Lodge Residential Home

Information is used to inform on local action to improve IPC and environmental cleanliness.

Information will be used to review service provision and adapt if necessary

Results from surveys link into facility quality improvement plan for the coming year.

Ongoing

Ongoing

Community Disability Services have established a Community of Interest for Lisburn, North Down and Ards and Down Sectors.

A questionnaire has been given to all service users who attend Rowan Centre, to illicit their views regarding service provision at the Centre

The Community of interest facilities feedback from community groups which it is hoped will provide crucial feedback for service planning

Workshop Connect event in Ards locality in Oct 12

Feedback from service users will be used to review current activities.

To continue with consolidation of Community of Interest.

Planning for the development of a Carer’s forum in Down Sector has commenced.

Questionnaires to be issued periodically

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Adult Disability

Aim 4 Make sure our staff and others have the skills and qualities they need to carry out personal and public involvement.



Adult Disability Services are working closely with IT Department to increase the skills base of disability staff with regard to use of Information Technology. A number of training/support sessions have taken place

BSL skills – staff within Sensory Support are working to continually improve their signing skills

Effective use of IT can assist staff to enhance service delivery, and make more effective use of staff time and resource.

All staff are trained to level 1 BSL and those working directly with deaf service users are trained to Level 2BSL Level 3 signer is also available as required.

Further training will be accessed

Continue BSL training

Training completed for some VI staff and equipment purchased to enable PPI information to be accessible in Braille

PPI information can be available in Braille when requested

Ongoing

WebCam / Skype available to staff to facilitate accessible signed communication with deaf people

Accessible communication Ongoing

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Adult Disability




The adult disability community teams Lean Project has considered core business in order to enhance service delivery to clients including how clients are involved in the process.

Review of Information Leaflets for Sensory Support team

An outcome of the Lean Project will be to increase time staff have available for face to face contact with clients

More accessible up to date information

Lean Project is in sustainability phase.

Ongoing

Information Groups :Rehabilitation VITinnitus – Deaf /HOH

Accessible information and groups provided in response to identified need.Evaluation of services received.

Ongoing

Sensory support User groups :DeafVI

Regular and ongoing planning and review of services Continue to hold meetings.

Action on Hearing Loss / South Eastern Trust“ Healthy minds “ Newsletter

Publication of relevant local information for deaf service users

First publication completed and positive feedback received.Second publication underway at present

Deaf children North Down – Quarterly Newsletter

Publication of relevant local information for Deaf Children and their familiesFeedback and evaluation of services

Ongoing publication

RNID/ SET Community Connections Programme

Accessible Information re Sight LossEvaluation of services received

Programme completed Feb – March 12

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Hospital Services




Individual Diabetic service continues to provide a person centred approach to the individuals care involving the patient and their family in the training and needs of the person with diabetes.Helpline /phone in service for out of hours continues to be provided from ward 17

Steering group meetings quarterly with representation from GP’s patients and all other stakeholders to look at ways forward to improve services for patients

Plan to introduce new diabetic service for pregnant diabetic women

CAWT Diabetes Project. Co-operation and Working Together(CAWT) is a cross border health and social care partnership comprising the Health Service Executive(HSE) in the Republic of Ireland and the Southern and Western Health & Social Care Trusts in Northern Ireland. It’s focus is on improving the health and social well-being of the resident population through practical cross-border projects

The service continues to promote patient independence and support to families

Pre-pregnancy Care Clinics for women with Diabetes

Structured Patient Education Programme for Children & Young People

BERTIE Training in the Ulster has commenced and continues to be very successful

Funding approval for 0.34 of a clinical psychologist support for the diabetes service

Recruitment of posts to support the new service

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Hospital Services

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Hospital Services



Department of RadiologyPatient satisfaction surveys have been designed around the Patient and Client Experience Standard (DoH 2009) & issues January /Feb 2011 for the following services:

Outpatient AppointmentsDepartment of Radiology

Ards and Bangor Community Hospitals

Lagan Valley Hospital Downe Hospital

Awaiting results

A User Satisfaction survey was issued in January 2011 to children attending the Department of Radiology on all hospital sites and changes are being implemented.

New patient information is developed in keeping with service developments,Eg Interventional Breast procedures CT colongraphy

A broad range of information leaflets are electronically generated with all appointment letters.

Specially designed literature is posted with children’s appointments for ultrasound and fluoroscopy imaging examinations.

The Department of Radiology will be required to consider the results from this survey and agree recommendations and action plans to address areas of non-compliance/partial compliance. A designated person will be responsible for addressing any areas of shortfall and will have a time scale for completion.The report will highlight the positive satisfaction reported by patients using the service. This will be shared with patients and staff and used to promote a sustained high quality service.

The views and ideas listed by children/parents/carers have all been considered to help make our service better for other children and their families, eg Improved range of books, puzzles & colouring in for all age groups in waiting areas

This initiative has improved patients’ understanding of procedures and reduced their anxiety levels before invasive/interventional imaging procedures.

These leaflets are designed in a pictorial story format for parents to share with their children. They follow the examination journey and feature staff and imaging equipment which will be used for the child’s examination. Positive praise regarding the value of the leaflets is regularly received from parents/carers and children.

Respondents expressed satisfaction ratings in excess of 90% in relation to all aspects of the service provided. The results were displayed graphically for both users and staff.

The positive feedback from this specially designed pictorial survey was very positive. It is proposed to repeat on an annual basis in order to capture the thoughts of our youngest users.

Ensure that every patient is issued with the appropriate information leaflet for the examination appointed.Undertake regular document control of patient information.



Staff are trained to access Big Word Group Interpreting Service. The service is regularly used to explain instructions for complex imaging procedures to non-English speaking

This initiative has improved patient co-operation and their understanding of the examination procedure. It also facilitates compliance with radiation protection, e.g. pregnancy checks. 29

Hospital Services



Community Cancer Services

National Cancer Awareness Months have been promoted in the Trust including:Lung Cancer October 12Oral Cancer – November 12Cervical Cancer – December 12

The focus of these campaigns is to educate and inform the public around the importance of early detection and diagnosis.




IndividualCancer Services

Review of patient information leaflets was undertaken in the following services:

Gynaecology – Local Ovarian cyst leaflet Jo’s cervical cancer Trust- for low

grade cervical cancer patients Gynae MDM leaflet

Urology-

Prostate Assessment clinic Prostate Biopsy

Head & Neck Cancer- General Information for patients

undergoing major head and neck

Patients have up to date information in a user friendly format, approved by NICaN readers’ panel and patients.

Continue to ensure that all new leaflets are reviewed via the Cancer Services User Forum and there appropriate the NICaN Readers Panel.

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Hospital Services



surgery.


GroupsThe Cancer Services User Forum have been involved in the development of a number of projects including:

Transforming Cancer Follow Up Programme – specifically the group have provided input into the development of care plans

Macmillan One to One support Project- The forum have contributed to the planning of this project and specifically as to how the new roles could support patients on completion of cancer treatment.

Moving Forward Project- the forum has made suggestions as to the content of these Health and Well Being Events

Care Plans have been developed that include the key information that patients want to have on completion of treatment. This includes how to gain rapid access back to hospital services and key contacts

This input has helped the cancer service team to design the follow up of patients at timeframes considered important by patients.

This input has topics and speakers at these events are relevant to patients and meet their holistic needs.

Continue to have a specific Cancer Services User Forum to ensure that service users are involved from the planning to implementation.

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Hospital Services




Community “Do Not Attend” outpatients project funded by the PHA and is now in development for March/April 2013.

Poster campaign, leaflets and rollout of campaign.




Individual Complaints department Complaints reporting is used as a way to learn lessons for the future Individual complaints are taken through the complaints process within the Trust. All complaints are monitored and actioned as required within the time frames. Governance issues in relation to complaints are investigated and RCA’s completed

Monthly report from complaints discussed at Directorate and Team meetingsLessons learnt are cascaded down to the departments and discussed at ward managers meetings


Groups

North Down and Ards Diabetes user group

Local diabetes service advisory group

Website www.diabetesulster .com

Meet monthly to discuss current events or changes to the serviceMeet quarterly

Clients can access for advice or comment on the service

Diabetes facilitator liaises with all groups and GP’sClient survey still to be commenced

Promotion of the websiteCommunity CAWT will provide cross border initiative for

diabetic pre pregnancy servicePre pregnancy clinic at the Ulster site monthly Education and support for expectant mothers

with diabetes Nurse led clinic. Frequency still to be agreed

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http://www.diabetesulster/

Hospital Services




Individual Feedback from Diabetes service through their networks ongoingNorth Down and Ards groupLocal diabetes service advisory groupBERTIE Training evaluationDAFNE Training evaluationComplaints Department

Provision of training throughout the Trust including Lagan Valley and Downpatrick

Monthly Report to the directorate.

Provision of BERTIE and DAFNE throughout the Trust

Timely response to clientsLessons learnt shared at different forums, directorate meetings and ward manager meetings


Groups

Patient satisfaction questionnaire completed annually includes feedback

Patient transport services included in the surveyHome therapies nursing service included in survey

Patient satisfaction questionnaires are completed annually. Over this timeframe surveys have included:

Breast Cancer- SeptemberGynae oncology –NovemberEndoscopy patient satisfaction surveys are completed yearly

Patients feel the dialysis coordinator is a very necessary part of the service

The home dialysis service has expanded to meet the needs of patients choice and family

Breast Cancer- To improve information around the role of the multidisciplinary team, a specific leaflet is offered at diagnosis outlining roles and responsibilities (77.4%)

Gynaecology - Staff in inpatient ward did not introduce themselves (87.5%). Highlighted at team meetings the importance of introductions and individualised care

This has led to improvement in appointment timesInformation given to patients and relative and post procedure food

Ongoing service

Good networks withthe Belfast Trust

Continued surveys across all tumour sites

This will continue yearly

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HR & Corporate Affairs

Aim 1 Involve people in the decisions we make This is the main purpose of our personal and public involvement process. We believe involving people in our decisions is a basic requirement in developing, planning and delivering the best services. This aim focuses on the way in which involvement happens and the methods we will use to involve individuals, service users, specific groups and communities in making decisions about their care and delivering services.



Service Users and Carers

As part of the regional Involving People programme Linda Davison OWD Department has been working in partnership with Carers NI on a project to enhance the capabilities of Carers and Staff within South Eastern HSC Trust to engage effectively in PPI activity.Two seminars were held to promote PPI, one primarily focusing at Carers and Service users and the second aimed at staff, although both groups were represented on the day.

The first seminar was based on the SCIE paper “The participation of adult service users, including older people, in developing social care “ was hosted by Carers NI during which Carers and staff were given an opportunity to discuss levels of involvement in PPI activities. In addition a questionnaire was also distributed to gather information on barriers faced by carers in taking part in PPI activities.

The second seminar organised was targeted at staff and was titled” Developing Good Practice in Carer Engagement” This gave staff the opportunity toshare their views and experiences of PPI and highlight areas of good practice – staff and service users from the Addictions Unit in the Downshire Hospital gave their experience of PPI in practice.

Further assistance will be given in the development of awareness of PPI within both carer and staff groups, through training and engagement activities. The outcome being to improve the number of effective PPI opportunities available in addition to increasing the number of carers engaging in PPI activities.This model of engagement will be used within the other Trusts by Carers NI

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Service Users and Carers

We engaged with carers who aren’t currently engaged in PPI activities at an open training session Carers NI in the Trust to scope their understanding of PPI and engagement opportunities available to them, including barriers which may stop them from engaging.

To assist in building the capacity of people to get involved as well as enhancing the capacity of staff to involve individuals including carers.

Activities aimed at the development of awareness of PPI within both carer and staff groups, through training and engagement interventions.

The outcome being to improve the number of effective PPI opportunities available in addition to increasing the number of carers engaging in PPI activities.

The Trust Carer Development Officer will work with Carers NI in providing training for carers namely “Be a Better Communicator” which aims to help develop their confidence when communicating at a personal level or engaging with service providers.

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Individuals andService Users and Carers

During the seminars feedback from carers was sought in regards to barriers they faced in participating in PPI. These were identified as:

Difficulties for carers/service users in accessing and contributing to the PPI agenda.

Lack of training for carers to prepare them to activity contribute.

Lack of training for staff in relation to their PPI role.

Patient Experience DepartmentRestaurant user satisfaction surveys x2 (includes staff)Community transport survey

Patient Experience Survey

Accommodation surveyHelpdesk survey

Environmental cleanliness steering group includes a service user forum representative

Training for Carers is targeted at these areas to build confidence to enable them to better participate in PPI activities.

Staff are receiving awareness training in PPI so they can encourage service users and carers to become involved in the planning, development and improvement of services etc.

Some areas have shown a marked improvement, but others have shown a decrease in satisfaction. These will be addressed.

Satisfaction has increased in the Lagan Valley site.

High levels of satisfaction – nothing in the poor/very poor categories.

Decisions made are assessed for impact on service users at an early stage.

CarersNI are now offering two training courses for Carers in the Trust area i.e. Being involved - for carers who want to act as representatives and take part in committees or form a group

Handling the Media - for carers who want to engage with the Media through press releases or radio and TV interviews.

Results will be used to develop the services further in the coming year. The surveys will continued to be carried out on an annual basis.

Traffic management/Car parking is under review and will be the subject of consultation.

Participation from service users will continue.

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Corporate Response

Aim 4 Make sure our staff and others have the skills and qualities they need to carry out personal and public involvementAll members of our staff have a role in activities to involve people. As such, they should have the training and support needed to allow them to take part fully and productively. We should also offer others actively involved in our activities appropriate support and training.

PPI Activities to date Impact on service – How has this work improved services for clients?


IndividualService Users and Interest Groups

PPI consultation process to produce Involving You

Service users were able to participate in process, which was positively evaluated. Staff have indicated that interest from service users remains consistent.

Summary cards to be produced in the next quarter.

Community Schools engagement

Stakeholder engagement around population plan

Teachers and pupils have evaluated the talks positively and have indicated they had a better understanding of health and social care structures a better understanding of how the Trust develops its plans. The programme was rolled out to eight schools this year.

Support for carrying out TYC reforms has been garnered; commitment from partners affirmed to work in collaboration with political reps, community groups.

Schools have asked if the Trust will come back next year.

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Good Practice Case Studies

Involving People – Good practice example of Personal and Public Involvement

Please give a specific example where PPI activity changed a decision, policy or plan and was implemented and had an impact on the organisation, staff, patients/clients and/or the public? Good practice examples will provide qualitative information to the Trust Board to show how involving carers, users, patients and the public can make a difference.

Directorate: Adult

Department: Mental Health Services

Examples: service users involved in setting daily activities in a ward or day centre, Training staff in PPI, a particular example of care planning, a contribution to a service change using the public or carers.

Please give a brief outline of the activity and what it aimed to do.

The project was concerned with the resettlement of eighteen people who had been long term residents of Downshire Hospital to a newly commissioned community facility.

Each of the individuals voluntarily agreed to the move from Downshire Hospital to this new facility on the Ardglass Road.

The decision was taken as a result of the regional strategic direction for mental health services and the Bamford review. These policies encouraged the development of suitable and appropriate accommodation enabling the discharge of patients from the long stay continuing care wards within, in this case, the Downshire Hospital

What you did; the nature of the activity (focus group, public meeting)

Alongside the early work on the building, the eighteen individuals and their carers were given regular briefings on the progress and invited to offer suggestions on design features, colour schemes and how the facility should be organised.

Visits were arranged to the building for those earmarked to move into it at various stages of the refurbishment. The opportunity to consider their choice of rooms was offered at an early stage and this allowed for each of them to consider furnishings, bedding and curtains etc.

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How many people participated? Were they staff, users, etc and how did you secure their involvement?

All eighteen people were involved in individual meetings to answer any queries they had and to dispel any apprehensions they had in relation to the move.

Meetings were also arranged with their relatives and carers again to answer any queries they had .On occasions the Advocates assisted in securing involvement.

Staff assigned to work in the facility were provided with the necessary training: preparing them to work with a new model of care and recovery in the new environment. The emphasis in the training was on working in partnership with the service user in the active promotion of their recovery.

The project was planned and guided via a project steering group which met on a regular basis to determine the next stages to progress the scheme.

What was the impact of the PPI activity; what changed and why?

The impact of early and ongoing involvement of the service users and their carers has meant that there is a very high level of satisfaction with the new environment. Service Users report a real sense of ownership of the new facility knowing that were very involved in commissioning and designing the internal design of the building.

Service users openly display their delight at having their own room, en suite, privacy very much increased degree of independence in their new home

What is the impact of the change on staff, users and members of the public?

The residents are in a brand new facility which they helped to create. They and their carers were involved at each step along the way and have expressed high levels of satisfaction and ownership with their new home.

Relatives have reported a marked improvement, both in the general physical and mental health of their loved ones. This has been reinforced by hospital staff who cared for this client group when they visit the facility.

Staff have responded very well to the new setting and for the opportunities to further promote recovery that the new ethos and environment provides. Staff have commented on the joy that they have had working under a new ethos of care and support than that of the hospital setting. Ongoing training will be provided to staff to aid them fulfil their new role.

How this project was implemented seems a very good example of change management.

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How did you measure the change?

The change is now continuously measured monthly through sample interviews with residents, carers and staff.

What did you learn?

The exercise confirmed that valuing services users and carers enough to involve them at an early stage and throughout the process of any new service development makes for a service that is valued by service Users and Carers.Service Users feel a real sense of ownership because they were involved.It is largely due to the collaborative involvement of relatives and carers, listening to what they had to say and answering their queries that allowed for the great success of this scheme. What, if anything, would you do differently next time?

The outcome was so impressive that when a project like this is undertaken again this collaborative, inclusive approach will be taken.

Any other comments?

A short film is being made which will capture the contrast in the environments of where the people lived to where they live now. The film will give the service users and their carers the opportunity to tell how they shaped the new facility and how it has improved the quality of their lives

The implementation of this project is a good example of change management.

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Directorate: Primary Care and Nursing

Department: Older People’s Services

Please give a brief outline of the activity and what it aimed to do.

The Trust was planning to review the future of Ravara Elderly Persons Home and wanted to involve residents, staff and the local community to ensure that people were informed and involved in the decision-making.

What you did; the nature of the activity (focus group, public meeting)

Trust representatives participated in the Ravara Working Group and discussed setting up a Supported Living Model to replace the residential home (this included staff and relatives’ representatives). Prior to the consultation, the Patient Client Council (PCC) worked with the Trust to carry out pre-engagement work. At the Trust’s requests the PCC advocated for individual service users and visited them following transfer to other facilities to ensure satisfaction and that needs were met.

How many people participated? Were they staff, users, etc and how did you secure their involvement?Pre-consultation meetings were held with all permanent residents, their families and political representatives, and with all staff to outline proposals and options.

Involvement was also secured on the community side through the Community Forum, which helped them assert community leadership and helped us achieve credibility with political representatives, so a win for both.

What was the impact of the PPI activity; what changed and why?

Prior to involvement, we may not have considered a supported living accommodation. The biggest change was that the Trust had buy-in from political representatives, the community and staff and relatives. Unlike a previous consultation, there was no opposition and no negative press. People felt involved and had a say in how the Trust made its decision. This has helped the Trust in working with the local community forum on a number of other initiatives as well.

What is the impact of the change on staff, users and members of the public?

Staff were offered the choice of transferring to a number of areas, EOI were issued for vacancies in a number of areas and staff transferred in accordance with their wishes. A group of staff were offered VER / VR which would be initiated on closure of facility. Residents transferred permanently to other facilities based on assessed need and choice with a number of residents transferring to one facility. One lady was put in a temporary placement whilst awaiting place of choice in line with assessed need.

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How did you measure the change?

We measured the change through the settling in of residents to new accommodation, the positive responses received to the consultation and feedback from the PCC and the Community Forum.

What did you learn?

We learned that giving people information early helps them process the change and understand the rationale.

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Documents

Web viewto carers and easy-read proposals shared with clients within TRC’s. ... for carers who want to engage with the Media through press releases or radio and TV interviews