Open and H
Honest Care in yourr Local NHS Trust
No
orfolk C
Commu
unity He
ealth &
Ca
are NHS
S Trust
Report for: Septe
ember 2015
The Open and Honest
H
Care: Driving Imprrovement
gramme aims
s to support organisations
o
s to become
Prog
more
e transparent and consisttent in publis
shing safety,
expe
erience and improvement
i
t data; with th
he overall
aim of improving care, practic
ce and culturre.
Norfolk Community Health and Care NHS Trust (NCH&C) provides care to patients and their families within their own home, clinic environments
and community hospitals. This report is based on information received during the month of August 2015. The information is presented in three
key categories: safety, experience and improvement. This report will also signpost you towards additional information about Norfolk Community
Health and Care NHS Trust (NCH&C) performance.
1. SAFETY
Safety Thermometer
On one day each month we check to see how many of our patients suffered certain types of harm whilst in our care. We call this the NHS Safety
Thermometer. The safety thermometer looks at four harms: pressure ulcers, falls, blood clots and urine infections for those patients who
have a urinary catheter in place. This helps us to understand where we need to make improvements. The score below shows the percentage
of patients who did not experience any harm within our care. 93.6%
of patients did not experience any of the four harms in this community trust
Health care associated infections (HCAIs)
HCAIs are infections acquired as a result of healthcare interventions. Clostridium difficile (C.difficile) and methicillin-resistant staphylococcus
aureus (MRSA) bacteraemia are nationally monitored and our staff work hard to try and reduce the incidence of these infections.
Clostridium difficile is a type of bacterial infection that can affect the digestive system, causing diarrhoea, fever and painful abdominal cramps and sometimes more serious complications. The bacterium does not normally affect healthy people, but because some antibiotics remove the
'good bacteria' in the gut that protect against Clostridium difficile , people on these antibiotics are at greater risk.
The MRSA bacteria are often carried on the skin and inside the nose and throat. It is a particular problem in hospitals because if it gets into a
break in the skin it can cause serious infections and blood poisoning. It is also more difficult to treat than other bacterial infections as it is
resistant to a number of widely-used antibiotics.
We have a zero tolerance policy to infections and are working towards eradicating them. Although community providers do not have targets for
reduction in numbers of infections, planned programmes for infection prevention and control are in place.
NCH&C have reported no MRSA bacteraemia for 2015, and no cases of Norovirus in August.
Three cases of Clostridium difficile have been identified, but not confirmed. We are reviewing these cases to determine if they were due to our staffs practice.
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Norfolk Community Health and Care - Open and Honest Report September 2015.
Pressure ulcers
Pressure ulcers are localised injuries to the skin and/or underlying tissue as a result of pressure. They are sometimes known as bedsores. They can be
classified into four categories, with one being the least severe and four being the most severe.
NCH&C investigate all of the pressure ulcers patients acquire in our care and assess if they are:
1. Avoidable - having reviewed our patients care we identified we could have undertaken further assessment or provided equipment more
quickly, which may or may not have prevented the pressure ulcer occurring. We apologise to our patients informing them this has
occurred.
2. Unavoidable – having reviewed the care provided to our patients we conclude nothing more could have been done to prevent the
pressure ulcer occurring.
2015 08 2015 07 2015 06 2015 05 2015 04
The following tables shows the total number of avoidable ulcers, Grade 2, 3 & 4 acquired within the care of NCH&C
Grade 2
17
17
15
13 4 Grade 3
15
10 18 10 5 Grade 4
1
2
1
2
2
Totals:
33
29
34
25
11
Figures validated Some figures not yet validated All Figures not validated Page 3 of 8
Norfolk Community Health and Care - Open and Honest Report September 2015.
Gra
ade Two
Gra
ade Three
Gra
ade Four
Tottals:
81
20
1
102
98
15
3
116
2015 08
2015 07
2015 06
2015 05
2015 04
owing table shows the total number
n
of unav
voidable presssure ulcers, Gra
ade 2, 3 & 4 ac
cquired within the
t care of NCH&C
The follo
80
18
3
101
101
24
4
129
77
31
4
112
Figures validated Some figures not yet validated
d All Figures not validated 2. EX
XPERIENC
CE
asure patient an
nd staff experie
ence we ask a number of que
estions. The ide
ea is simple: if you like using certain
To mea
product or doing busin
ness with a parrticular compan
ny you like to share this experrience with others.
The ansswers given are
e used to give a score which is the percenta
age of patients who responde
ed that they wo
ould
recomm
mend our servicce to their friends and family.
Patien
nt experience
The Frriends and F
Family Test
ends and Famiily Test (FFT) requires
r
all patients to be askked;
The Frie
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Norfolk Community He
ealth and Care
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September 2015.
‘How likely are you to recommend our service to friends and family if they needed similar care or treatment?’ NCH&C Community FFT percentage
recommended*
98
% recommended
This is based on
674
responses
A patient's story
The following is a story received by NCH&C in the form of a compliment letter from a father of a young boy who had received Starfish Plus
service.
“As you will know, my son, moved to a school in Lincolnshire. Yesterday he witnessed his first review. He is doing amazingly well, flourishing and
is happy and safe. I am so impressed with their efforts. However, it was a long journey. As a family, we did everything within our capabilities to
keep him at home, but his needs and best interests eventually dictated that this placement was indeed needed and appropriate. It was a long,
emotional and hard 18 month journey to reach this conclusion.
During those 18 months the family was supported by Starfish Plus. I desire the Norfolk NHS Trust to be aware of the exceptional work done by
this Team.. Without their efforts I honestly believe that the patient would have left the family home much sooner, which may have resulted in a
'lesser' final placement and been in more harrowing circumstances (which would have been detrimental for both him, and the on-ward loving
contact which he will always have with his family). Starfish Plus have given person-centred and truly holistic care and support. They have been
professional, caring, practical, pastoral and pivotal in supporting our beloved son to remain at home so long. It is not until one finds oneself in a
specific crisis that one is aware of the specialist services 'out there'. Starfish Plus is one such service that I had never previously heard of, but will
now never forget. They acted and supported within their own amazing specialties, but also acted as a pivotal point of contact/introduction/sharing
with other agencies e.g. they liaised with, communicated for us with, dealt with, advocated for us with consultants, psychiatrists, GPs, other multidisciplinary agencies, Norfolk Steps, Education, Transport ... the list could go on.
As for their contact and support it truly was inspirational and so much appreciated. They offered a great amount of practical advice. They gave
time to join us at home to share and guide safe trips and activities (including evenings, weekends and two Christmas periods). They assessed.
They risk assessed. They taught us ideas. They guided us. They convened meetings. They chaired meetings. They represented the family at
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Norfolk Community Health and Care - Open and Honest Report September 2015.
their meetings. They dealt with reports. They often kept him and the family safe and used appropriate strategies. (They shared happy, lovely
times with him too). They gave pastoral support. They were always available.
The team used invaluable communication strategies, plans and equipment; and she also introduced us to invaluable 'Play Therapy' amongst
other things. The team carried out a lengthy assessment which identified needs, and supported numerous other avenues of support. Again the
list really could go on.
I am aware that this feedback may read as being overly emotional or overly full of superlatives; but it is not overly anything, for it is absolutely
true. In fact parts of it are probably unintentionally understated
Finally, as we all know, any service is more than the sum of work done; it is actually the PEOPLE who do said work. And the people who make
up Starfish Plus are exemplary, caring, dedicated and exceptional. Heartfelt thanks and appreciation to them.
Staff experience - The Friends and Family Test
The Friends and Family Test (FFT) requires staff to be asked, at periodic points;
How likely are you to recommend our organisation to friends and family if they needed care or treatment?’ and ‘How likely are you to
recommend our organisation to friends and family as a place to work?’
Number of Responants
1Extremely
Likely
2Likely
3Neither
likely
nor
unlikely
"How likely are you to
recommend this organisation to
friends and family if they needed
care or treatment"
64
162
80
12
11
6
15
350
65.00%
"How likely are you to
recommend this organisation to
friends and family as a place to
work"
36
101
91
61
44
2
15
350
40%
4Unlikely
5Extremely
unlikely
6Don't
Know
7 - No
Response
Total
Percentage
recommend
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Norfolk Community Health and Care - Open and Honest Report September 2015.
3. IMPROVEMENT
Improvement story: we are listening to our patients and making changes
Norfolk Community Health and Care continually engage with our community to hear our patient, carers, families and partners views and
experiences of our services. Our Annual General Meeting and Healthier Fair was held in the Forum, right in the heart of Norwich. We shared
with the public the how our staff continue to provide an excellent service.
The Executive Team and clinicians were available to meet the public and discuss referral into our services and listen to any concerns and
comments that would improve our care.
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Norfolk Community Health and Care - Open and Honest Report September 2015.
Patient led service improvement example;
Our patients said they wanted Wi-Fi access in our community hospitals.
A rollout programme of access to Wi-Fi commenced in March 2015 and is being rolled out to all our hospitals.
Supporting information – Contact us
Contact Norfolk Community Heath and Care with any comments about this report at;
Head Office: Elliot House, 130 Ber Street. Norwich, NR1 3FR
Online: http://www.norfolkcommunityhealthandcare.nhs.uk
Telephone: 01603 697300
www.facebook.com/nchandc
@NCHC_NHS
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Norfolk Community Health and Care - Open and Honest Report September 2015.