UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST TRUST BOARD

Transcription

1 UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST TRUST BOARD Date of meeting: 25 July 2012 Title / Subject: Status Internal Purpose: The attached paper provides an update of progess made in UHMB in relation to the actions from the Integrated Inspection of Safeguarding and Looked After Children in Lancashire It summarises the recent Care Quality Commission report of the Integrated Inspection of Safeguarding and Looked After Children in Cumbria. The paper also provides an update of the staffing position in paediatrics. Report of: Prepared by: Contact for queries: Action required / recommendation: Jackie Holt Chief Executive Nurse Lyn Shannon Head of Paediatrics/Assistant Chief Nurse, Women s & Children s Division Lyn Shannon Head of Paediatrics/Assistant Chief Nurse, Women s & Children s Division (lyn.shannon@mbht.nhs.uk) The Committee are asked to: 1. Note the contents of this paper University Hospitals of Morecambe Bay Hospitals NHS Foundation Trust - Page 1 -

2 Supporting Information Background papers/ supporting agenda items (if applicabe): Appendix A Updated UHMB Action Plan Appendix B. Care Quality Commission Report on the Outcome of the Integrated Inspection of Safeguarding and Looked After Children s Services in Cumbria. Previously considered by (if applicable): Link to UHMB s objectives (select those objectives this paper supports): Link to UHMB s business plan: Link to UHMB s Assurance Framework: Link to a Care Quality Commission standard(s): Identification of any statutory / regulatory implications for UHMB: Public and patient engagement: Equality Impact Assessed (if applicable): Safeguarding Report and Action plan presented to May meeting Continuously improve the patient experience - becoming the provider of choice for excellence with safe and effective patient care Support and develop all staff to take responsibility for what they do and help them to do their best - getting staff truly engaged in how the trust works Encourage staff to be innovative when delivering and planning high quality and sustainable services - achieving long term financial sustainability Work with our partners to provide an integrated health service that meets the needs of the local population providing local access, including to specialist services wherever that is feasible Positively contribute to the well-being of the local community Outcome 7,16 NHSLA, Ofsted, Every Child Matters None NA No University Hospitals of Morecambe Bay Hospitals NHS Foundation Trust - Page 2 -

3 UNIVERSITY HOSPITALS OF MORECAMBE BAY NHS FOUNDATION TRUST SAFEGUARDING CHILDREN AND YOUNG PEOPLE SECTION 1- SAFEGUARDING INSPECTIONS BACKGROUND 1. UHMB has participated in two recent inspections of services for safeguarding and looked after children. The inspections, undertaken jointly between Ofsted and the Care Quality Commission, reviewed the provision of services across Local Authority and Health. 2. The Lancashire Inspection undertaken in January 2012 identified some immediate actions for UHMB. The report and Trust action plan have been presented to Executive Team, Clinical Governance and Quality Committee and Board. 3. The key priorities were: To review and strengthen the governance arrangements for the safeguarding of children and young people To improve the capacity for the Named Nurse function To the review the provision of paediatric trained staff in the Emergency Department 4. A detailed action plan was developed following this report. The current version of the action plan is attached as Appendix A. This action plan is being transferred into the Programme Management workbook and cross checked to ensure it maps across to the Cumbria Ofsted and Care Quality Commission reports. 5. The Cumbria Inspection was undertaken in April The Ofsted report was published on 29 May UHMB received the Care Quality Commission Report on 21 June. This report is attached as Appendix B. NHS Cumbria has 21 days to develop an action plan in response to the report. There are no immediate individual actions for UHMB following the report although participation in the NHS Cumbria action Plan will be essential. PROGRESS MADE FOLLOWING LANCASHIRE INSPECTION 6. Although considerable progress has been made following the report, it is acknowledged that the expansion of the safeguarding team will be the major contributory factor to ensuring safeguarding compliance. Progress will be controlled through programme management approach. The Executive Sponsor, Project Lead, Work-stream Lead and Clinical Leads have been agreed. University Hospitals of Morecambe Bay Hospitals NHS Foundation Trust - Page 3 -

4 7. In response to the immediate actions required from the report the following positive achievements include: Successful appointment of an additional full time Named Nurse. The post-holder has considerable safeguarding experience in both children and adult safeguarding. Due to commence on 30 July 2012 she will be based in Royal Lancaster Infirmary and will undertake duties relating to North Lancashire. The current Named Nurse will be based at Furness General Hospital and undertake duties relating to South Cumbria. They will work collaboratively for provision of training, policy and guideline development and audit. Appointment of a Safeguarding Midwife Appointment of a Registered Children s Nurse in the Emergency Department as part of a continuing recruitment process. Commissioner agreement to reinstate funding for Liaison Health Visitor role in North Lancashire. Monitoring of training via the central Training Management System Development of a multi-disciplinary paediatric interest group in the Emergency Department SUMMARY OF THE CARE QUALITY COMMISSION REPORT ON THE OUTCOME OF THE CUMBRIA INTEGRATED INSPECTION 8. The Care Quality Commission report provides detailed evidence relating to the Health component of the inspection and links these to the Essential Standards for Quality and Safety. 9. The inspection findings for the overall effectiveness of safeguarding services and the contribution of health agencies to keeping children safe are graded as inadequate. The being healthy outcome for looked after children is also inadequate. 10. The report identifies a number of actions required from Cumbria County Council and NHS Cumbria. These include: Ensure that consistently comprehensive assessments of children at risk from harm are undertaken to ensure outcome focused plans that are effectively progressed and monitored Ensuring health and social care partners work together more effectively to assess the needs of looked after children Ensure that looked after children know how to complain and access advocacy services. Further actions include ensuring lessons learned from Serious Case Reviews are embedded in practice and ensuring that consideration to the child s needs are discussed and recorded. 11. There is a requirement for NHS Cumbria to provide a joint action plan and contact has been made with provider agencies to progress this. Cumbria University Hospitals of Morecambe Bay Hospitals NHS Foundation Trust - Page 4 -

5 County Council has hosted a workshop with partners to develop their action plan. A further session to finalise the plan is to be held in mid-july. 12. The report comments positively with regard to the progress made by UHMB following the Lancashire Inspection report. There is particular reference to the improved governance arrangements, the Emergency Department Paediatric Group and improvements in standards in maternity services. SECTION TWO - PAEDIATRIC STAFFING Nurse Staffing in the Special Care Baby Unit at Furness General Hospital. 13. Reduced staffing levels in the Special Care Baby Unit are identified on the risk register. The reasons for staffing problems have been multifactorial including, unavoidable long term sickness, difficulty in recruitment of a replacement ward manager, and a band 5 nurse vacancy. Many of the gaps related to staff holding the neonatal diploma (qualified in specialty) which is required to take charge of the unit. 14. Staffing levels were sustained by rotating senior neonatal nurses from Lancaster Neonatal Unit and backfilling these nurses with temporary staff. 15. Further sickness in June 2012 escalated the situation and options were proposed for alternative short term service provision should staffing levels not improve. Staffing levels were maintained on this occasion. 16. Staffing levels are now much improved with sickness levels reduced to one part time member of staff. A ward manager has been appointed and will commence duties from 5 August Response to the band 5 nurse vacancy is excellent with more than 40 applicants. 17. Nurse staffing is therefore expected to be fully resolved very shortly. To ensure continuity of staff qualified in specialty all newly appointed staff are expected to complete the neonatal diploma within a defined period of time. 18. To ensure robust plans are in place for service provision should nurse staffing problems occur in the future, staff are currently engaging in a further appraisal of suitable options. This work is being led by the Clinical Director and the Neonatal Matron. Paediatric Medical Staffing in Furness General Hospital 19. The short to medium term provision of paediatric medical staff at Furness General Hospital remains a concern. 20. There are 3 senior members of staff unavailable for work due to unplanned absence. University Hospitals of Morecambe Bay Hospitals NHS Foundation Trust - Page 5 -

6 21. One new consultant has commenced work at Furness General Hospital and one further consultant should be in post by the end of July. 22. Locum staff are being sought, but the quality of available staff requires rigorous assurance. 23. The Medical Director and Chief Operating Officer have been updated on progress in securing short to medium-term provision of care. 24. The first meeting on the Paediatric and Maternity Clinical Strategy Group took place on Wednesday 4 July at Westmorland General Hospital in order to begin the process of developing proposals for future delivery of service. University Hospitals of Morecambe Bay Hospitals NHS Foundation Trust - Page 6 -