Delivering High Quality Compassionate Care

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1 Strategy Nursing Delivering High Quality Compassionate Care 1

2 Foreword Lincolnshire Partnership NHS Foundation Trust (LPFT) is the main provider of NHS mental health and wellbeing services in Lincolnshire, as well as providing some services in surrounding areas. In addition to mental health services we also provide specialist services for people with learning disabilities and those with substance misuse problems. We employ approximately 2,100 staff, of which 426 are Health Care Support Workers (HCSWs) and 543 Registered Nurses (RNs), working across 77 sites, including 15 wards and serving a population in Lincolnshire and North East Lincolnshire of approximately 892,000 people. Nurses represent the largest group of professional staff in the Trust, and therefore nursing remains at the heart of our care delivery. By virtue of this, nursing care remains the measure of quality for most patients, their families and carers. To support this important role we are proud to publish our second Nursing Strategy for , developed by members of the Nursing Executive, in partnership with the Trust s Nursing Council. The Nursing Council is a forum of representatives for Registered Nurses (RN) and Health Care Support Workers (HCSW) from across the Trust. It is committed to embedding the Nursing Strategy from ward / team to Board. 2

3 3

4 Development of the revised Nursing Strategy There have been a number of key local and national developments since the launch of our first Nursing Strategy, which now underpin our revised publication. Five Year Forward View (Oct 2014) The Five Year Forward View has a strong focus on co-working and co-leading with patients and communities to make safer and more effective services. It highlights that, whilst the environment of care will change in the coming years, our values will remain the same. By living the values of the 6Cs (Care, Compassion, Courage, Competence, Communication and Commitment), RNs and HCSWs are able to create behavioural and cultural changes that improve the experience and outcomes for patients and their carers. It also emphasises the importance of good staff experience and its direct impact on patient outcomes. The review two years on of the national Nursing Strategy - Compassion in Practice, acknowledges that future nursing practice will be shaped by the Five Year Forward View. NMC Code Professional standards of practice and behaviour for nurses and midwives (Apr 2015) High quality healthcare requires three elements: the right culture, professional commitment and strong leadership. The new NMC Code reinforces these elements through what it refers to as the 4Ps: Prioritise people, Practice effectively, Preserve safety and Promote professionalism and trust. Within this framework all registered nurses are now required to revalidate every three years; something welcomed for strengthening nursing governance. LPFT Professional Conduct Guide (Apr 2014) As a Trust we were proud to publish our first Professional Conduct Guide (for clinical bands 2-4, without a professional registration) and to be an early implementer of the Care Certificate for HCSWs. These specific developments, along with our developments for registered nurses underpin our learning from many sources including Winterbourne View (2012), the Francis Inquiry (2013) and Keogh (2013). Your feedback As well as being aligned to the Trust s strategic and quality priorities and Clinical, Quality and Organisational Development Strategies we have also used feedback from our Nursing Council, RNs and HCSWs across the Trust to influence our revised strategy. Feedback we received was that the initial strategy had been effective in focusing nursing development within the Trust to the right priorities, however that there were too many strategic intentions to champion and successfully embed. For this reason this revised strategy remains aligned to the six Action Areas in Compassion in Practice (2012) but has a reduction in Strategic Intentions from 22 to 6, each aligned to an Action Area. 4

5 How the revised Nursing Strategy works LPFT is committed to ensuring every HCSW and RN is supported to achieve their very best, to feel valued and involved and to be themselves inclusive of the protected characteristics of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sexual orientation and sex (Equality Act 2010). The purpose of the Nursing Strategy is to set out our Strategic Intentions for nursing development within the Trust, mapped against the six Action Areas (Compassion in Practice, 2012) and aligned to key national and local publications, strategies and developments. The revised Nursing Strategy was widely consulted upon across all services in the Trust. The Nursing Strategy is accompanied by an action plan (available on the Trust s website), consisting of priority work aligned to our strategic nursing intentions (six in total). Progress will be monitored through the Nursing Executive and reported on regularly through the Nursing Council and Operational Governance Meetings. The Nursing Strategic Intentions have been developed under the leadership of Executive Nurse Leads with assigned responsibility, utilising the Trust s Nursing Council as the vehicle to confirm, challenge and support embedding at every level from ward / team to Board. The purpose of this model is to ensure that the Nursing Strategy is proudly owned, developed and embedded across the Trust by RNs and HCSWs of all bands, in community, inpatient and corporate services. The Executive Nurse Leads will present their action plans to the Nursing Council for confirmation and challenge and utilise the Council to agree actions and strategies required to ensure achievement of each Strategic Intention. At the end of year one, the Executive Nurses will present to the Nursing Council a critical review of achievement to date and detail their proposed action plans for year two (June 2016 June 2017). The Nursing Strategy s six Strategic Intentions are detailed over the next few pages. The detailed action plan is available on our Trust website 5

6 ACTION AREA ONE: Helping people to stay independent, maximising wellbeing and improving health outcomes. How does this Action Area link to the 6Cs? In line with the 6Cs, we are committed to delivering high quality evidence-based care in partnership with those using our services; to support people to stay as healthy as they can possibly be. Example of achievement We have implemented systems to strengthen medicines management, which is key to improving health outcomes. This work has focused on improving related care planning, information provision and issues monitoring. Part of this work was to develop local medicines management groups, to ensure embedding across the Trust. We negotiated a related local CQUIN (2014/15) and have identified medicines management as our locally mandated indicator (2014/15 and 2015/16), to ensure we continue to improve our understanding and learning from medication related issues and incidents. Improve our engagement with patients, their families and carers as equal partners in all aspects of care planning, evaluation and service development. Executive Nurse Leads: Matrons 6

7 ACTION AREA TWO: Working with people to provide a positive experience of care. How does this Action Area link to the 6Cs? We are committed to designing our services, based on the values of the 6Cs, in collaboration with patients and carers, responding proactively to feedback. Example of achievement We have successfully implemented the Friends and Family Test across all our inpatient and community services, enabling feedback to be received and services to promptly evidence responsiveness. We monitor the levels of patient satisfaction and feedback sample sizes, reporting these from ward / team to Board level. This assists us in ensuring we are responsive, able to highlight areas of good practice, and be proactive in addressing areas requiring improvement. Embed a culture of listening and responding to the experience of care, which incorporates being open and acting with integrity. Executive Nurse Lead: Quality and Safety Team Leader 7

8 ACTION AREA THREE: Delivering high quality care and measuring the impact. How does this Action Area link to the 6Cs? We will use the values of the 6Cs to underpin quality metrics and information we gather to inform improvements in service delivery and clinical practice across the organisation. Example of achievement Our organisational Heat Map, early warning system, has been implemented and refined to reflect the Care Quality Commission s (CQC) five keys lines of enquiry (how safe, how caring, how effective, how responsive and how well-led). The Heat Map monitors ward / team performance mapped against self-assessment (Provider Compliance Assessments) and objective measures, including stretch targets. This enables proactive monitoring of quality from team / ward to Board level, supporting early detection and intervention where there are quality failings and identification of high standards of practice. Increase our use of quality measures, benchmarking and outcome measures, using these to improve patient outcomes. Executive Nurse Lead: Head of Quality and Safety 8

9 ACTION AREA FOUR: Building and strengthening leadership. How does this Action Area link to the 6Cs? Creating the right environment for delivering high quality care and ensuring the values of the 6Cs for our patients, relies upon clear and robust leadership at all levels and in all roles. Example of achievement LPFT is proud to have developed a Code of Professional Conduct (2014) for all its Health Care Support Workers and to have been an early implementer of the national Care Certificate for new starter HCSWs (October 2014). Work will continue in 2015/16 to embed the Care Certificate and identify learning requirements for our existing Health Care Support Workers, aligned to the Care Certificate. Raise the profile, status, confidence and competence of all nurses and health care support workers (HCSW) aligned to the NMC Code, Revalidation, the Care Certificate and the HCSW Code of Practice. Executive Nurse Lead: Associate Director of Nursing and Quality 9

10 ACTION AREA FIVE: Ensuring we have the right staff, with the rights skills, in the right place. How does this Action Area link to the 6Cs? The 6Cs are the core values we require of all of our staff to enable the highest quality of care delivery, in safe yet innovative ways of working. Example of achievement To support our benchmarking and monitoring of standards of care the Trust pledged to ensure all inpatient areas achieved the Accreditation for Inpatient Mental Health Services (AIMS) or equivalent. To date, the vast majority of inpatient areas have achieved accreditation, with the remainder working towards this. The Trust is proud that a significant number of inpatient areas that have achieved accreditation received a rating of excellent. Embed values based recruitment, new ways of working, safe staffing levels and strategies that release time to care. Executive Nurse Lead: Head of Workforce and Development 10

11 ACTION AREA SIX: Supporting positive staff experience. How does this Action Area link to the 6Cs? Well-led staff, supported to be the best they can be, will result in improved patient outcomes strengthened by the values of the 6Cs. Example of achievement LPFT is proud to be the most improved Trust in the East Midlands Staff Survey results (2013) and strongly believes this was achieved through listening to staff, maintaining a cultural barometer, providing an excellent staff wellbeing service, seeking to improve communication across the Trust, and further developing its leadership programmes. LPFT achieved a significant rise of 145 places in 2015 in the Stonewall Workplace Equality Index to 123, a positive acknowledgement of the Trust s commitment to equality and diversity in every aspect of practice with patients, staff, carers and partners. To embed a culture of regular clinical supervision, training and development and initiatives that support RNs and HCSWs to maintain high levels of motivation and engagement in all aspects of their practice. Executive Nurse Leads: Nurse Consultants 11

12 The detailed action plan for our Nursing Strategy is available on Lincolnshire Partnership NHS Foundation Trust Trust Headquarters, Unit 9, The Point, Lions Way, Sleaford, NG34 8GG Tel: Facebook: LPFT NHS 12

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