Transcript Presentation

Muckamore Abbey Hospital
A Centre of
Excellence in
the treatment
and care of
people with
Learning
Disabilities
since the late
1950’s
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What Do We Do?
• We provide assessment and treatment services for
people with learning disabilities who have an
additional mental disorder.
• Psychiatric Illness
• Severe Challenging Behaviour
• Co-Existing complex neurological disorder
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Muckamore Abbey Hospital
• Opened in the late 1950s/ early 1960s
• Provides a regional specialist assessment and
treatment service for people with Learning
Disabilities.
• Max Patient No.s 1980s - Over 800
• Currently 318 beds,
• Staff No’s 620 wte
• Strategic Direction
– Resettlement of Long Stay Patients to the
Community
– Reduction of Inpatient Bed Capacity
– Assessment and Treatment Services
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In the midst of change:
• Redevelopment of Hospital Services
• Resettlement Programme
• Reprovision of Children’s Services
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Key Strands
Resettlement
of people who
can leave
immediately
Development of
Community
Infrastructure
Reduction of
Treatment
Beds
Hospital
Service
Re-development
115 Beds
Reprovision
of Services
for Children
and
Adolescents
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Future Hospital Service
Specialist Hospital Services will be for
People with Learning Disabilities who live in
the community and:
•Who require Assessment and Treatment
because of associated Mental Health or
Behavioural Difficulties.
or
•Who require Assessment and Treatment
in a semi-secure environment because of
their offending behaviour.
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Quality Agenda
• Standard Setting
• Awards
• Development of a multidisciplinary audit
tool
• Patient/Carer involvement
• Continuous Quality Improvement
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EQC
Evaluating Quality Care
Jenni McKay
Resource Nurse
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EQC
A multidisciplinary /
multidepartmental audit of
the quality of care
provided to patients within
Muckamore Abbey
Hospital
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Audit tools previously used
in the Hospital
•Hospital Core Standards
•Nursing Standards
•Day-care Standards
•EQUATE

EQC
Evaluating Quality Care
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EQC acts as
 a useful step in the process of quality assurance
 a tool which raises questions in many specific
areas in the quality of care
 a provider of a series of pointers to areas which
need attention
 an agent of change
 a facilitator for best practice
It encompasses the entire treatment and care
provided to the patient
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Themed Questions
Themed questions allow audit tools to be created
specifically relating to each department, e.g.
• Ward
• Physio
• Hotel Services
• Maintenance
• Medical
Other themes allow audits to be completed in
relation to specific areas , e.g.
• Safety
• Facility Management
• Care plans
• Mental Health
• Leisure
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Audit Questions
3 types of questions
•General - pertaining to the hospital
•Facility specific
•Patient related
2 trained auditors present for each audit
All questions include auditors advice to
assist in gathering the evidence required
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General Questions
• Is the procedure in case of
fire/emergency evacuation
prominently displayed?
Advice to auditor: Look for procedure on walls - must be
at all entrance/exit doors to receive a yes
• Are all drugs stored according to
policy, e.g. controlled drugs?
Advice to auditors: Check all drug cupboards are locked
and controlled drugs are kept in a locked cupboard
within the locked drug cupboard and the person in
charge is carrying the key
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Facility Specific
Questions
• Are furnishings or fittings in the
facility appropriate to the physical
needs of the patient?
Advice to auditor: Observe while in facility/ask staff
• Do hospital drivers who transport
patients hold a current PCV
(Passenger Carrying Vehicle)
Licence?
Advice to auditors: Only applicable for drivers who are
transporting patients in vehicles of more than 16
seats. The paper work is kept in Hotel Services Office
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Patient Related
Questions
• If the patient requires special precautions or
observations, is there documentation that
appropriate actions are being taken?
Advice to auditor: Includes patients who may take
seizures, abscond, smoke, choke, etc. Ask staff if
applicable and if so check care plan under
appropriate part of assessment (check up to 5 patient
care plans)
• Has the patient had a dental review in
the past 6 months?
Advice to auditor: Randomly select 5 patients, check
copy of dental review form
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EQC process
•2 trained auditors
•Quasar2 software
•analysis of result
•action plan devised
•discussed with person in charge
•change agent nominated
•audit of action plan on an agreed
date
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Benefits
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One audit tool for the hospital
Individualised action plans for each dept
Direct impact on patient care
Direct impact on the quality of care all
services provide
One point of contact for all reports and
audits
Up to date audits
Flexibility
Precise and measurable standards
Use of up to date technology e.g. pda’s and
Quasar2
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Conclusion
•All pilots are completed
•Areas of improvement already identified
and acted upon
•Staff identified areas of improvement within
own practice and acted upon
•Fully inclusive tool
•Includes clinical and support service
standards
•A model for other areas interested in
developing such an initiative
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FOCUS GROUPS
Mr B Mills
Behavioural, Vocational and Therapeutic
Serivces Manager
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Patient Focus Group
Staff Focus Group
Consultation Sessions with Parents
and Friends of the Hospital
M.L.A.’s and Local Councilors
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Making Decisions
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Focus Group
 Current patients within the hospital
 Former patients
 Male and female patients
 Age range 27 – 45
 Independent Facilitator
 Two members of the Project Team
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 Liaising directly with patient
 Liaising directly with patient’s consultant
 Liaising directly with carers
 Liaising directly with relatives
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 One person at a time would speak
 When not speaking we would listen to each other
 The room would be seen as a safe place to speak and
share ideas and opinions
 No statement would subsequently be attributed to a
specific person without his / her consent.
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The purpose of the meetings were to:
 Share experiences / opinions on Muckamore Abbey
Hospital
 Give ideas on what would make the hospital better
 Feedback to the planners on the new building
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The general layout of the new buildings
Internal space
Dining arrangements
Food
Management / personnel in the new hospital
Smoking policy and access to personal lighters
Values and attitudes in the new service
Signage on access roads
Unsupervised time within the grounds
Privacy
Education, work and day care service
Good day and bad day experience
Communication within the new units
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 They try and want to do things for you
 They try and want to understand you
 They care and want to care for you
 They use a good tone of voice
 They listen to you
 Come to you when you feel sad
 Give you reasons for the decisions and treatments
being offered to you
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Muckamore Abbey Hospital
A Centre of
Excellence in
the treatment
and care of
people with
Learning
Disabilities
since the late
1950’s
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