To everybody at Calderstones Partnership NHS Foundation Trust...
I have had the privilege of being Chief Executive and your leader for the last three years. There have been high points and lots of low points as well. I have always been able to draw on the strength of my colleagues, staff and service users. I will always be grateful for that. Thank you.
We have all risen to the challenges of improving the quality of our services, buildings and systems, as the Care Quality Commission's "Good in all domains" rating and other bodies have made clear.
We can all join Mersey Care with our heads held high and after 100 years we have left a fitting epitaph to our predecessors.
So, thank you from me. I will never have another job like this. I will always be proud to say I was Chief Executive of Calderstones and I look forward to working with you all to create the best possible future for everybody.
Mark Hindle, 30th June 2016
This is a landmark month for learning disability.
We can be proud of the journey of Calderstones, from what it was asked to do years ago to what it chose to become as a highly rated forensic LD service today. The organisation is in the best place possible to become part of Mersey Care. They have pledged to continue what’s best and shape the future to ensure the most vulnerable get priority…and also that the best staff can be a part of learning disability services going forward.
It’s not easy I know and we’ve worked hard behind the scenes to get the very best we can for service users…and for staff as well. We can rightly reflect on many major achievements and move through this month in a really positive way. There are many opportunities for people in the new organisation, including the Associate Nurse role for support staff. We want you to be a part of it.
As we celebrate the successes of the past and look ahead to the next phase of LD provision, I’ve been looking through the history of our organisation. It’s surprising – although perhaps it shouldn’t be – how often Calderstones has been at the forefront of change. In particular with the closure of Brockhall and the setting up of community services, our predecessors worked hard to get as many service users as possible into the best settings, often pushing hard when community needed an extra nudge or extra funding to enable that care to happen. We saw the need for a forensic service and people with vision made it happen. Something similar is happening now and I have been proud to be a part of it.
After this month I will cease to be your Chief Executive. It’s been an amazing three years and, in every sense of the word, a real journey. Like all staff, I will TUPE into Mersey Care next month, but into a different role. I hope to continue to see you all around and maintain the links we’ve developed over time. It’s been a privilege.
We’ve been talking to the local historians who are documenting stories and photographs from times past. That’s a really important piece of work which preserves the history of Calderstones and recognises the work done and the many achievements and advances in learning disability care seen here.
That heritage and experience also allows us a strong platform to blaze a trail for the future. We are increasingly seen as thought leaders, and alongside our colleagues in Mersey Care, we are actively shaping the future.
This is a future that challenges us – it also challenges the existing system itself – but it is the right one for service users.
We have a real and perhaps unique chance to deliver something better. The right people: nurses, doctors, clinical leaders as well as people in finance, are making it happen. Change Champions and staff at all levels have input into the process. This proves once again that our accrued knowledge and expertise is up to the task of forming the next stage in delivering safe, effective care.
Last year, the Chief Executive of NHS England made it clear what was to happen: the Whalley site will close and a new location in East Lancashire will deliver Low Secure Services. He also said that we would become part of Mersey Care on 1st July 2016. This is what will happen and I want to ensure that all staff will have the opportunity to help develop future services.
As the clinical model and new or alternative services for East Lancashire begin to become clear, we will be focusing on staffing. There is an important reason for this. Most of our staff live in East Lancashire and my concern is to ensure that as many people as possible have opportunities to continue to work in our services in the future.
By now, most of you will have had meetings about TUPE and all of you should have had letters with more details. Everything is in place for that 1st July date and from then, the sign will say Mersey Care NHS Whalley and similar for our other locations. You will work for Mersey Care and be part of their new LD Division.
Crucially – and after complex negotiations and a huge amount of work all round – we have secured the funding to implement the changes we want to see happen. The new clinical model can become a reality. It takes the unique skills we have, the talents that were praised by the Care Quality Commission and by countless peers and colleagues locally, nationally and beyond, and it starts the process of Calderstones expertise, as part of Mersey Care’s centre of excellence, providing the very best care and support.
I’m pleased to have helped lead us there and I am very proud of the team and all the staff who have made it happen. Thank you.
When I am in endless meetings about the future of Calderstones I really envy most of you who are working hard to deliver business as usual. While that is sometimes challenging many of you tell me what a great job you have at Calderstones. The Trust is able to report lower sickness levels and many other positives such as our Governance score and a very high ranking for our openness and transparency in the Department of Health’s ‘honesty league’ – we were less than 10 points from ‘outstanding’.
It is also the start of a new financial year. Bringing the Trust’s 2015/2016 finances to a successful close has been a vital task for our team in finance. I want to thank them for their great work once again. I often thank our clinical staff for the great work they do with service users but I very much appreciate the support that our corporate services give to the organisation. Thank you.
The issue which sits above all of this in the new financial year is the acquisition of Calderstones by Mersey Care. At the heart of that transaction is the need to deliver the national policy in the best, safest way for service users and to make full use of the huge asset of talent, skills and professionalism of our staff. I am really pleased with the number of clinicians and managers who have contributed to and led the development of our model of clinical services for the future. I have spoken with many of you about these plans and received overwhelming support for the direction of travel and the opportunities these services will offer for people.
Last year I told staff that we were discussing the ‘outline business case’ - the document which set out why we need to be part of a bigger organisation. This week, the board of Mersey Care NHS Trust saw the full business case. They decided that it is right that we come together and they have approved the plan. Calderstones board saw it as well and agreed. This means that, subject to transitional funding, we are set to come together as planned. We are on track – this is positive news and again, it is thanks to a lot of very hard work.
As we go forward, we will start to refer to the site not as Calderstones but as Whalley, and similarly by name for our other locations. We won’t forget our heritage and we have another event planned to celebrate it, but as part of Mersey Care, we will be a new division with a new identity.
My thanks to staff and best wishes for the next period as we move forward with our plans to be part of Mersey Care and deliver the changes we all need for the benefit of service users.
This has been a massively busy time for everyone involved in the transaction between the two Trusts.
We are really pushing hard with the model of care you have seen as the very best way to deliver quality care. The process is rightly being led by clinicians as well as by finance people. Transforming Care must be about doing things better and we are absolutely making the case for a better, safer, more service user focussed model of care. I spoke to clinicians from both Trusts last week and they are equally passionate about how we deliver the great services in the future.
A great example of this is something that I’m working on with our nurses. We have the 6Cs of Nursing. These are excellent and inform how we work every day. But is there anything else? Is there a seventh principle that would lead us to be outstanding in our care? As we talk about funding, buildings, discharges and all the issues of acquisition, we must keep focussed on care, compassion, courage, communication, commitment and competence. I am going to ask colleagues – commissioners, politicians, stakeholders – to think up their own seventh C. For me, it’s “Collaboration.” What’s yours?
Thank you to the staff Change Champions for another valuable session. Some told me they want to take advantage of CPD opportunities and so should contact Learning and Organisational Development. There are other development opportunities for staff, such as our CQC ‘must do’ resuscitation training. The sorts of things that can be offered also include change management, building resilience, communication skills and a new training plan for support workers.
We met the historians recently. As I said in Core Brief, a local group are looking at ensuring memories and experiences of Calderstones and Brockhall are respected and recorded. This is an important way to commemorate our journey as an organisation and it would be great to see people becoming involved in that project.
Letters about the TUPE are going out to staff. In them we say that staff will transfer to Mersey Care as part of their acquisition of our services. As the future employer, Mersey Care will be liaising with us regarding these transfers. Together, we will keep you informed of any developments as they arise. Staff have been encouraged to be part of these sessions – it’s your opportunity to meet senior leaders and HR staff from both organisations and discuss the process and opportunities in more detail.
Calderstones has been rated as 'Good' in all domains by the Care Quality Commission following a rigorous week long assessment last October.
Our close working with the CQC has benefited service users, staff and all stakeholders as we have seen massive development and a real focus on quality, safety and compassionate care.
The ‘Good’ score, in every category, is a powerful demonstration that we are ready for the next stage in delivering care for some of the most vulnerable people in society.
Staff have worked very hard to achieve this rating and credit must go to their dedication and professionalism in achieving this improvement. I want to thank all service users and partners and also the diligence of the CQC in supporting us to achieve such a positive assessment. We’ve more to do but this is a huge progression.
Our colleagues at Mersey Care received a ‘Good’ CQC score late last year. Now that Calderstones has reached this level, we’re both ready to progress the business case to bring our two providers together. Mersey Care will deliver high quality forensic learning disability services to the high standards noted by the CQC.
Thank you to great staff, excellent service users and our partnership with carers.
We have received the draft report from the Care Quality Commission inspectors. We now completing the formal process of factual accuracy checks. Then we will be able to share the findings with you, as well as with service users and other partners.
Designing the clinical model for future delivery of services is well under way. There is a lot of activity going on with our regulators Monitor, who need to approve the transaction with Mersey Care: quite rightly they are challenging us about the details so that we get it absolutely right.
We are operating closely with Mersey Care now and you will have seen new faces around as some of their finance officers and other senior staff are on site. I am spending quite a bit of time with them alongside Calderstones staff to ensure they understand the needs of our service users and get feedback from staff.
I took on board the request from many of you at the Mega Conversations to have a chance to visit Mersey Care. We are well on with organising site visits for staff and joining up colleagues across both organisations so they can understand each other's roles. I am anticipating that the key themes you raise in the conversations will be ready to share soon as we have nearly completed all the meetings.
Many of you have come forward as Change Champions. I see champions as a real dynamic, acting as a reference and a focus group for the changes. They will be a significant feature as we move ahead, shadowing senior staff and playing a really valuable role.
As Mersey Care’s Chief Executive Joe Rafferty said, we need everyone to work together on this. We have the skills and expertise in learning disability to make the changes we have to make, in a way that delivers better services in the future.
This is a very big year for us all and I want to start with a thank you and to set out why and how you can be a part of the future for our LD services.
I have been thinking about what we are really great at doing and how we will make sure that we maintain that as we become part of Mersey Care. Never has it been more important that staff at Calderstones feel they have a future in the services that will be needed.
I hope to be able to share with you this month the service models that our commissioners want and need to deliver the “transforming care” strategy. There is an emerging vision of secure services supported by crisis services and forensic enhanced community provision. This talks about new and existing jobs being needed in a new organisation that focuses on developing people to be the best they possibly can.
To update you on the process of bringing the acquisition together: The main focus at the moment is talking to staff to understand concerns and opportunities. Additionally, senior managers from both organisations are leading workstreams that will inform the Business Case for both Boards and for approval by Monitor.
Last from me is a massive thanks to the people at Calderstones who give their all to support service users and their families. I am frequently in awe of what you do. A special thank you to everyone who worked over the holiday period: there were a number of challenges on the wards and our particular thoughts go to those affected by the flooding in the village and many other places: you can read in this Brief what we are doing to help.
The word “change” is rarely off our lips or off our agendas. In fact, many of you will remember when “Agenda for Change” was brand new and we were full of uncertainties about what that meant. Over a decade has since passed and the only constant has been that word “change”!
Next year sees the biggest change of all for us. NHS England have been very clear that LD services must change to deliver and they have stated the timetable for that transformation and what it means for us. Much of what they said chimed with the plans to be acquired by Mersey Care that I have been talking to staff and stakeholders about for a couple of years.
The media reported much of what I wanted to say. I was very clear that staff are proud to work here and that likening us to some other organisations is not accurate and not helpful.
What happens now is that we develop the workstreams with Mersey Care to ensure a smooth transition of services. Senior staff here will be working with their opposite numbers from Mersey Care and ensuring a clear process of transformation. That’s in the best interest of all service users and staff.
Communication will, as ever, be essential. We scored very highly in the last NHS Staff Survey for the quality of comms as a Trust and I know that my briefings to staff are appreciated (if not always welcome in terms of some of the news I have to share!). I have pledged to continue to keep staff informed as things develop.
The headlines are about new models and new provision. I recognise that it is very unsettling to be again on the wider stage as learning disability policy is discussed but the truth is, we have already chosen the right path for the services we provide and the individuals we provide them for.
We are forging our future with Mersey Care and we have a timetable for change. They are the right organisation to deliver the centre of excellence model being discussed. Their senior staff are on record saying they have seen great things here and they want to include the very best in the new organisation.
I have discussed the current issues with staff at all levels and I have thanked everyone for their resilience and their professionalism.
I also want to reflect on our CQC Inspection at the beginning of October. About 60 inspectors came to the organisation and did a full CQC compliance visit against the Fundamental Standards of Safe, Effective, Responsive, Caring and Well Led. The initial feedback was positive and there was a consistent theme of improvement.
It’s important that, as we look to our future and the policy direction, we take a moment to reflect on this positive change and the good work which has taken us there. Thank you all.
I want to share some of the really big things that are going on and to thank people at Calderstones for the hard work and compassionate care that I see every day.
We do get some negative reports but we also get a lot of positive attention as well: a ‘rising star’ nurse, top hygiene ratings for our food, nominations for service users at national awards, those great PLACE assessment ratings, the high scores in the NHS staff survey, great Royal College of Psychiatry peer review scores, the success of Our Shared College, our top rated library, research and development and lots more.
There are two really big issues approaching us: the CQC inspection and the Transforming Care policy and how we have been talking to our commissioners about how it is implemented.
We have been talking about these topics in The Big Conversation and if you haven’t been able to go to a session, I have also written to staff about these issues.
Keep the great work coming please and be proud of what you do for Calderstones and for everyone we support here. If anyone wants to discuss any issues about Calderstones and the things raised in this letter I will be holding a series of Big Conversations around the organisation in the next few weeks. Also all the Directors will be about in the organisation every Tuesday and Thursday mornings to talk with staff about any issues.
Thank you to all our hardworking, compassionate staff.
We have all made huge strides forward.
This month the positive headlines we had in the press for our PLACE assessment scores for hygiene, food and cleanliness were great to read. They were of course a massive contrast to where we were at the start of the year. I want to repeat the thank you that I gave to individuals and team leaders and which I also said to the papers. Staff have delivered and that is brilliant.
Across the organisation, everyone is striving to keep on improving care for our service users and senior leaders are working hard to secure financial stability to ensure services continue next year. As we make our own future, this is our opportunity to demonstrate Calderstones at its best so that as change comes, everyone can look back and know that once again, we all pulled together and delivered.
At a time when there are massive issues affecting us – and all providers of LD services – it is more important than ever that we communicate and keep people informed. It was great to receive praise from the top of the NHS Confederation leadership for having staff who are engaged. I do know that being engaged doesn’t always mean that what you hear is welcome. There are challenges for us all but it’s essential staff know that our top priority remains safe and effective care and ensuring we deliver the best for those we are asked to support – and I know that we all are committed to that.
I have been attending some of the clinical leadership sessions. These were well-received and I know that for busy staff it is an investment of time that needed plenty of careful management. My Boardroom colleagues and I have continued to have ward visits, sometimes in the evenings and these give us invaluable feedback. One of the team gives a summary and a thank you in this month’s Brief and there is also a reminder of who everyone is on the Trust Board.
On a less formal note, but of equal value are the Birthday Breakfasts which give a wide-ranging number of staff change to discuss anything and everything with me informally. I’ve also continued my ‘back to the floor’ sessions to give me real insight into behind the scenes around our great organisation and been given the joys of a grilling from the top service user reporters at ‘News and Views’.
The Outline Business Case (OBC) which I have been discussing with staff over the last few months has been approved by the Board of Mersey Care NHS Trust. We’re now working through to a Full Business Case and I will keep you updated as things move forward.
I know that staff want to see how they fit into the new world, and want assurances from us. As the situation becomes clearer – from commissioners as well as from all our stakeholders – we will give you that clarity.
Thank you all for your hard work and compassionate care. This is what we deliver every day for our service users and I want you to know how much it is appreciated by board, managers, carers and by our service users.
National policy for the provision of inpatient services for people with learning disabilities has been consistent for a number of years but the intention to see non-secure service users living in community has now been made very clear to providers with accelerated timescales for implementation. The NHS leadership expect to see change that is significant and soon.
At this time we also want to support, help and advise staff because this affects every one of us. I know that whilst being open and honest is something many of you appreciate, it also means we are dealing with a lot of difficult issues whilst having a continuing duty to some of the most vulnerable people in the system. Thank you to everyone who came to the recent sessions to hear directly from me.
As I discuss the national policy with NHS leaders and politicians and what the changes mean for Calderstones, I will always start by telling them how proud I am of staff and their absolute professionalism working in difficult times caring for vulnerable people.
Last month Joe Rafferty, Chief Executive of Mersey Care, joined us during the board meeting. He said that we are building a great relationship in support of service users. I want to thank staff who came in on Saturday recently for a busy but rewarding carers’ day. Family members wanted to know more about the Green Paper on LD and so I led an awareness session with them: their input and understanding of what we do is very important.
I Tweeted my thanks to staff delivering great quality services on the recent Bank Holidays. It’s a small gesture but a public one and I was really impressed by the dedication of colleagues at the recent birthday breakfast who’d come in on their day off for a brew and a chat with me. Thanking staff is something we need to do more often and although it doesn’t cure all ills, knowing that the work we do for service users is really valued is something that we must never forget.
“Strategy” – that’s a short word that covers a lot of things, a small word for all the things we have to do.
You will also hear managers, not just in the NHS, speak of being on a “journey”. It usually is a metaphor for changes that haven’t yet really happened. We are certainly on a major journey as a Trust and there have already been many things that have had to change. There’s a lot to come of course but I have been very clear to staff now about our long-term strategy.
I am proud we have moved up 23 places in the NHS staff survey in terms of the organisation that people want to work in. We are second nationally in our type of organisation. For those who deliver our services it is essential that we keep that positivity in the months ahead. It’s just one example of how Calderstones is a very different organisation now that we were a year or so back, and certainly we are very different from the one that became an NHS Trust in 1993 and a Foundation Trust in 2009.
We’re increasingly aware of the wider role of secure services and the huge national debate on LD provision. I’ve spoken to many of you in the Big Picture events and there’s a real appreciation now that we have to step up in how we deliver safe and sustainable services. But that is different from delivering a sustainable organisation. Since last Autumn I have been talking to staff, commissioners, service users, carers and local stakeholders about our plans to work with Mersey Care NHS Trust. This partnership will give us a great opportunity to create a more viable service for some of the most vulnerable people in society. We already work together across a number of areas and we share posts. In board meetings in the months ahead, we will setting out a business plan to move things along further.
As ever, I will keep everyone informed as our journey continues.
March sees the financial year end with plenty of activity for our finance colleagues. For most staff, it’s business as usual and once again I want to thank you for the many, many examples of excellence I hear about: the art exhibition, service users sharing their experiences at our Equality and Diversity day, the top rating for our kitchen hygiene standards, presentations to students at the University of Cumbria, the list goes on and the work is really appreciated.
The upcoming financial year will see us continue to assert what we do to our commissioners and other partners. It will also see us make major moves forward with our collaborative working as I have been discussing with staff in the Big Picture engagement events. The new financial year will see much more detail about how secure service provision develops. You can be assured that I will continue to keep you informed of our Trust’s involvement in this.
Thank you to staff who have attended the Big Picture sessions so far and a note of appreciation for the patience of those I’ve yet to speak to directly. Over the last few weeks, I’ve been to locations across the Trust for daytime and evening sessions.
There are a number of serious issues which have been discussed and it’s important that people hear the issues in full and know that we have a clear plan to ensure we deliver for service users.
The CQC reported that service users say they feel safe and are cared for with dignity and compassion in a positive and open culture. You can’t easily fix things like that if they aren’t right, so that is a tribute to high quality staff and the vocation at the heart of our NHS values. The CQC also had a series of concerns. We are working hard to put them right. We’re investing in domestic staff and colleagues have been briefed about the progress made in our Safewards programme. But it is clear that against the national backdrop of calls for people with learning disabilities to be cared for in community settings, the very special nature of our secure services' work has proved very challenging for us to get across.
Our website is very clear on this, our commissioners understand, and the many and often very moving messages from carers about the quality of support we give to their family members, show that what we do is valued.
I said to you last year in the Big Conversation that there were challenges ahead. I said we’d work hard to deliver the best option for our service users. I said we would make sure that we continue to deliver quality and safe services. Those services are needed and we are recruiting. We have a plan and a way to keep delivering for some of the most vulnerable and challenging people in the NHS.
I’m giving staff the “Big Picture” just now. As the smaller details become clear – and what that means in terms of how we operate – I promise that staff will hear about it from me.
Let’s move on from recent media reports: we have a job to do and we are working with NHS England to inform the debate about the very specific work we are asked to do. Thank you for your support and professionalism.
Last year we had the Big Conversations with over 600 staff. They were really useful for me and the feedback from the CQC Report was that they were important for you. I promised you then that we would do more of them so you are able to speak directly to me and hear what is going on. The latest round starts today – and I want to speak to as many people across the organisation as possible.
I said in last month’s Brief that this year would be a massively significant one for Calderstones.
We are making the major progress required of us by the CQC and I thank everyone who is contributing to that. We are delivering significant positive change in terms of restraint and restrictive practices. he Safewards model is showing excellent results in our pioneer sites at Gisburn and Scott House and the model’s creator has just praised our work so far.
Ensuring service users get the very best quality of care they need and deserve is priority. As many will know, and as I have announced in the Brief over the last few months, we are developing our links with the wider NHS. We already enjoy excellent networking and collaboration with other Trusts, sharing skills and resources, and our academic linkages are hugely significant and productive. This is the way forward and it means the nursing talent and caring skills we have will continue to support service users into the future.
Mark wrote to staff at the start of the year...
Thank you for your professionalism and your resilience over the last few challenging weeks.
I am in no doubt of the challenges we face and the work that we have to do: we take the issues seriously and we have robust plans to address them. It’s gratifying to know that staff are on board and are working hard for our service users.
We enjoyed the very best that both service users and staff had to offer in December with the brilliant carol service and Snow Queen play. Thank you to everyone involved for giving us an early Christmas present that we really enjoyed. I had the pleasure of talking to many service users and their families.
2015 will be a hugely significant year for Calderstones. As some of the buildings themselves reach a century of use, we are looking at how a small Trust like ours can best deliver for our service users in the busy competitive world of the 21st century. You can be assured that the best interests of service users will inform how we look to work with partners and deliver the best results.
Last year I started the Big Conversations with you and spoke to well over 600 staff at all levels and across our locations. I hope you valued the sessions as much as I did. We need to continue that open, honest discussion and there will be new dates circulated this month. Please make time to attend so I can set out our ideas for the coming year and continue to hear from you.
Can I warmly thank you all once again for delivering our very specialist and challenging work at times when I know it’s been especially demanding.
Calderstones Partnership NHS Foundation Trust received a pilot inspection from the Care Quality Commission in early July 2014. Their final report has just been published and the Trust's Chief Executive has made this statement:
Since the visit from the Care Quality Commission in July, we have been working closely with them in order to learn from the visit which was carried out under the pilot scheme for the new-style CQC inspection regime. The inspection was an important snapshot at that time and disappointingly it highlighted a number of unacceptable and inadequate areas of process and service delivery, which we acknowledge and have taken immediate steps to improve.
There are challenges in supporting people with extremes of behaviour, where many have committed crimes that put themselves and other people in danger.
We are pleased that the CQC note that the people we support say they feel safe and are cared for with dignity and compassion, that faith and gender issues are respected and if complaints were made they would be listened to. We are pleased that family members feel involved and can see progress being made and that that the inspectors found staff are engaged and proud to work for us. The inspectors noted our positive and open culture, with above average scores for engagement.
We accept the inspectors’ concerns about cleanliness and other issues. Whilst some parts of the Trust show areas of good practice, there are others where standards fell seriously below expectations. Since July, we’ve ensured resource, time, money and expertise are in place to address these shortcomings and many have already been put right. In some cases, wards which the report referred to are being closed in the next few weeks. We have employed additional staff and plan to take on more over the coming months as we agree funding with commissioners.
Although the CQC specifically recognise that we are unique and consequently it is difficult to compare us to other services, we are committed to improving quality in this organisation for our service users. We have agreed with them that further inspections, focussed on the specific areas that required improvement, will take place.
On 18th December, I wrote to carers and family members of service users at the Trust as follows:
Yesterday we formally received the report from the Care Quality Commission (CQC) about their inspection of Calderstones Partnership NHS Foundation Trust. This inspection was held in July 2014. A number of carers have rightly been concerned by the reporting of Calderstones in the past 24 hours following the publication of the report. As many of you will know from visits and meetings, the Trust was part of piloting this new inspection system for the CQC in July.
The CQC reported back this week and clearly stated that “the great majority of people” at Calderstones are treated “kindly and respectfully” and had good access to advocacy services who support them, people have good access to interpreting services and faith needs.
However, the main headline which the media have given prominence to was about restraint – which is a way of preventing an individual hurting themselves or other people if they reach a high level of agitation. One television report tried to offer a ‘reconstruction’ of prone restraint which our nursing leaders here viewed as ‘dramatic’ and not conducted in a supportive and dignified manner.
Carers need to know that the July inspection came weeks after the Department for Health issued new recommendations which said that service users should not be deliberately restrained “in a way that impacts on their airway, breathing or circulation, such as face down restraint on any surface, not just on the floor."
At Calderstones this type of restraint is used only as a last resort for the shortest time possible. Inevitably, the data seen by the inspectors about the practice in Calderstones dated back to before the new guidance. I assure you that this year the Trust has seen a major investment in seeking appropriate alternatives and there has been a big reduction in the use of prone restraint.
Where we do use this technique, there is careful monitoring and support in place by Registered Nurses, and the teams supporting the service users are constantly looking at ways to reduce the need for restraint of any kind.
We have been aware of the results of the inspection for a considerable period of time and you can be reassured that significant improvement has been made since then. Unfortunately, until the CQC published their final report, I could not share the details with you but some of the actions we’ve taken include:
The reality of the report is that whilst there were areas of major concern which we have been and continue to address with the utmost seriousness, the CQC highlighted positive examples. The media were less interested in these, but you need to know that the inspectors said most service users were active participants in their care, that good assessments of people’s physical and mental needs were made and that multi-professional teams meet regularly to review care.
The inspectors found that senior leadership are visible to front line staff. Since taking office, I have undertaken a major programme of ward visits, staff meetings and briefing sessions. I greet new starters on their first day, invite those with birthdays to a monthly breakfast meeting and I have led a drive to instil a strong values set in all staff – this is vital for how they then support your family members. The report draws strong attention to these examples of leadership and engagement. It also notes that staff are engaged with the Trust’s strategies and are caring in their interactions with service users.
Inspectors noted good practice in applying the Mental Capacity Act, with teams “fully involved in discussions”. They also highlighted other examples of the positives and whilst the shortfalls are priority, we want you to be clear on the full picture.
There is a lot of work for us to do, but also much work that has been done since July. Our focus is on delivering safe and secure environments for every service user and getting the basics right.
If you have any questions about the details of care being given to your family member, do please contact the named clinical leads directly, or contact our central line where a member of the Trust Administration Team will put you in contact with a Senior Clinician.
Chief Executive's Blog (December 2014)
A couple of weeks ago, senior staff gathered for a major away day. Ward managers, heads of department and many others invested a fifth of their working week on perhaps the important and serious meeting of our organisation’s leadership ever.
We were looking at outcomes from the CQC report and what we need to do. The day was a really useful and clinically led session. Our Director of Nursing and Quality John Smith took us through the action points. We reminded managers that there wasn’t another team meeting in another conference room looking at how Calderstones needs to change. This applies to all staff at all bands: the changes we must make are ones that will affect and involve all staff.
John Smith told the meeting that we have a fantastic opportunity to reflect and make progress in how we deliver our work for service users.
There are things we can be positive about: staff are strongly aware of safeguarding procedures, we see service users making excellent progress and they say they are treated with dignity and respect. The report we were looking at says they saw good examples of staff learning from problems and incidents. Staff are quoted saying they are proud to work for Calderstones. That’s excellent to hear and means we’ve a lot of really great work which we can keep building on.
As we look ahead, I will be sharing our Trust’s long term strategy and how are looking at plans to work with colleagues and external partners in the future. There will be further Big Conversations sessions – we need staff to be part of the discussions as Calderstones moves forward.
Each month, I have an informal 'birthday breakfast' with those members of staff who've had a recent birthday. I said to colleagues at the most recent session that the last few months have been really busy, even by the current hectic standards. But we talked about a number of real positives – including our recent Research and Development Celebration event which showcased what we at Calderstones do so well.
We’ve received the Care Quality Commission's draft report and I shared the headlines with staff straightaway. We’ve a lot to do and there will be changes but I immediately thanked all staff again for how we came through that challenging week in July. Staff's message to the inspectors – about being proud to work here – was really good to hear. Now, it’s all our jobs to learn from what the CQC have said and keep us moving forward.
Senior staff have attended a number of ‘summit meetings’ recently where we’re subject to external scrutiny, including from the Chief Nurse of NHS England. The themes include safe staffing, culture and values and also safeguarding. All these areas are being managed with an action plan to link with what the CQC tell us. NHS England have also written to us recently to say they are keen to support Calderstones in our transformation process.
There has been much talk about future partnerships and how the Trust will need to evolve to be a part of the wider health economy in the years ahead. I can confirm that senior staff have spent several months scoping how this may be achieved and beginning the work of preparing our Trust to work in collaboration with partners in the wider NHS. At Board, we pledged to remain focussed on service users, on quality and on safety as we move into more uncertain times. But in the political, funding and regulatory environment, we need to work more closely with partners in the future.
Chief Executive's Blog (October 2014)
The Value of Great Staff
At our Annual Members Meeting colleagues tried to thank every person and every team for their work. I am sure we didn’t get to everyone on the day so I am putting on record my personal thanks now. We celebrated a huge number of successes and I recalled just a few of my personal highlights as I complete my first year as CEO.
What really stood out for me was the way Stephen delivered his own presentation on service user involvement at Board meetings. He gave his PowerPoint like a professional, following on from the possibly dull but necessary presentations given by me and others. That positivity and engagement with those we support here is precious and I am proud to see how it is developing.
We are currently dealing with a range of challenging issues and await our CQC results after the recent inspection. Safeguarding and providing safe, effective and well-led services are priority. The safe staffing levels that we publish nationally are a key component of how we get assurance on these issues. I would also like to thank a number of people who have taken the time to share their personal experiences and thoughts with me on this matter.
We are absolutely committed to safe staffing levels and we deliver on them. We are also firm about quality staffing levels. But I know the very particular circumstances our Trust works in does present real challenges. I want to pledge to you that we will support new starters better so they are prepared and we have many ideas about how to do that.
The achievements of Stephen and others, progressing on their care pathways is proof that you do great work. Not everyone will reach their goal easily but your day-to-day professionalism on the wards – and in other parts of the Trust supporting those who deal directly with service users – is something I am proud of. We are aware of the pressures and we are working to make things easier to do what you are best at.
Chief Executive's Blog (September 2014)
It’s been a month for looking ahead and looking back, which you might expect with our Annual Members Meeting coming up on 25th.
We’re starting the process of ensuring Future Directions moves into operating as an independent social care organisation, and ensuring it continues successfully. It’s important service users, staff and commissioners are comfortable with this evolution. For the Trust, we will see a few changes to ensure that the management team moves forward in the most effective way.
Looking back, we’ve continued our commemoration of the First World War. Finance Director Nik Khashu was with the Mayor and some of our governors at a tree planting ceremony which will help future generations remember Calderstones role as a military hospital. We also received a lovely letter from a couple from the north east who visited our exhibition and were able to learn more about their family’s past involvement in wartime.
There was a very moving comparison made by Bill Wilkinson, who retired last month as Head of Estates. At his retirement presentation, Bill said that it was a conflict which started in the Balkans which first brought Calderstones into use as a military hospital a century ago. In 1999, Bill was able to support families affected by the most recent Balkan war by putting people up in the old ward buildings. They’re now demolished of course to make way for the housing estate where the tree was planted.
Our main current business is to receive the Care Quality Commission report later this month and ensure we deal with any issues they raise. We welcome scrutiny and external inspection and, although I know it was a challenging week for many, it is important that we demonstrate that we are open, approachable and, yes, living our values which include trust, respect and communication.
Chief Executive's Blog (August 2014)
I want to put on record formally to staff my sincere thanks to everyone who has contributed over the last few busy months.
Prior to the planned CQC inspection, we had prepared by asking Deloittes to look across the organisation in massive detail. Their final report says that ‘the Trust has transformed its approach to governance and the importance placed upon it’.
The positive findings reported include that we have a much stronger and cohesive leadership. Deloittes said that the Board’s approach to strategy has transformed and the Trust is beginning to realise its unique potential in future specialist care delivery. Management information systems have enabled senior staff to drill down through our performance indicators right into services. The Trust has demonstrated exceptionally innovative practices in this regard which benchmarks them positively compared with other services.
Deloittes concluded that the Trust have met or exceeded their recommendations in relation to quality. The Trust is filled with great staff and excellent, service-user focused work. I am proud of it and I want staff to be too. That’s why we will have our Celebrating Success evening in December again and I asked all staff to think who they want to nominate from amongst the excellent achievements of colleagues.
Chief Executive's Blog (July 2014)
It was good to welcome Doctors from Bangladesh on site during June, as well as a representative from their government. They came to learn about forensic medicine in a busy programme managed by our medical team. Our guests gave us some gifts to thank the team, but most importantly, they take back positive memories of the Trust. This kind of reputation building is crucial for us as we increasingly look outwards to the wider health economy.
Also in the last month, similar positive messages have gone out to friends in the Ribble Valley following our cricket friendly, to Health Education North West as three of our staff received awards, and at several major events. We recently attended the NHS Confederation Conference in Liverpool, the London Autism Conference and the Foundation Trust Network governance meeting, and at all of these, we were noticed for the right reasons; for being professional, for being involved and for the achievements of staff and service users.
The Birthday Breakfasts have enabled me to hear more from staff directly. I look forward to seeing more staff at these informal and successful sessions. I also thank those who provided us with Big Ideas in the new staff suggestion scheme – some were truly excellent and we’ll be in touch soon.
It is important we continue to ensure we give the very best support for our service users. I really believe that we are making great strides in how we demonstrate through our shared values and vision that we are a compassionate, respectful organisation, delivering excellence.
Chief Executive's Blog (30th June 2014)
The Care Quality Commission will be holding an arranged inspection from 7th-11th July.
This is our opportunity to show them how we deliver patient-centred care, how we are proud of our achievements and the progress that service users make.
This is a really busy and important time for us all, which will affect how we work as a Trust not only during the week of the inspection, but for the future as well. In advance, I have thanked staff and governors for their support and understanding. I genuinely appreciate the work being done and am proud to be the chief executive of this unique and compassionate organisation with excellent staff.
Chief Executive’s Blog (June 2014)
We've been having our Big Conversations. They were a great opportunity to speak and listen to staff and talk about our vision and what's on people's minds. I appreciate the time taken by the more than 600 people who attended. I also recognise the support from managers and the work done to get everyone in. We are collating the themes and issues staff raised and they will be discussed at the highest level, in Board. We're now in the next stage - the Big Idea - and forms are out around the Trust for staff to share positive innovations which will help to drive us forward.
One of our key strategic objectives is “to develop and engage our workforce to design and deliver high quality care”. Underpinning this is something which we discussed at the Big Conversations - the quality and quantity of staff in Calderstones. The 'Hard Truths' commitment takes everyone in the NHS to a different level of specifity and reporting. We're taking it very seriously and we'll keep everyone, from the Board to the Ward, informed about how it's being put in place.
We will welcome inspectors from the Care Quality Commission on site from 7th July. It's an important stage in our development and I have asked all staff to support our guests as they visit all parts of our organisation.
I have thanked all staff for the great work that's going on. A recent highlight for me was the hugely successful LGBT awareness day held on site in May to mark the International Day Against Homophobia. We started by raising the rainbow flag on site - a first for us - and then we heard inspiring, challenging and sometimes funny stories of how far we've come against prejudice...and how we're still on that journey. It was brilliantly organised by our service user led group. I both enjoyed myself and found it set a useful tone for our continuing work on all aspects of equality.
This first week of June sees us in Liverpool at the NHS Confederation Annual Conference: an important networking and learning event in the health economy. We have a stand with our group colleagues in Future Directions CIC and ELFS Shared Services. Staff representing many parts of our organisation will be there, including our Nursing Times national award winner Lynsey Brown (who I am pictured with above). If you are attending conference, do please call in and say hello or follow our Twitter feed for updates.
Chief Executive's Blog (May 2014)
Over 500 staff have taken part in the Big Conversation with me this month. It’s been a brilliant way to talk about the Trust's strategic direction, thank them for the work being done every day on our wards and in our offices and locations, and also to hear what are their issues of concern. I really appreciate everyone’s input.
Going forward we will have to look different as an organisation. We are having a conversation about what this means in the medium term; we need to be well on with our journey in the next few years. It will be a challenge but I have told colleagues and governors that we will continue to develop together because staff are our biggest and most important asset in supporting our service users on their care pathway.
Chief Executive’s Blog (April 2014)
“Changing lives through excellence”
This month we have welcomed new appointments [there was a hyperlink here to the Board profiles] who will be helping to shape the future for Calderstones. We have a new finance director, Nikhil Khashu, who joins us from St Helens and Knowsley NHS Trust, and as Nurse Director, John Smith, who is familiar to many as a stalwart of the Trust. These developments are part of the way the Board is being reshaped so we can ensure we deliver our plans. We also welcome a new company secretary, Angela Wetton, who strengthens our governance team.
But the most important colleagues are those who deliver great work directly to service users. That’s why this month I’m beginning my Big Conversation with staff. These sessions will be important in making sure our vision, values and strategic aspirations are really clear and put into action. The sessions are a valuable opportunity for staff at all levels to talk to me about our organisational journey and for me to listen to them.
The latest NHS staff survey tells us we’re doing well in some areas – we’re above the NHS average for our training, for communications, and for health and safety. But there’s more to do: I’m working with our head of organisational development Helen Scott to keep on driving up quality and performance and I have set out to staff how we will feed back to them with actions from this year’s survey.
It’s a busy time and asking everyone for more and better is always challenging. I want to see Calderstones fit and thriving for all service users and everything I am doing is designed to make that happen.
Chief Executive’s Blog (March 2014)
We’re formatting our vision statement to say that we are ‘changing lives through excellence’.
The next financial year will probably be the most challenging Calderstones has faced. We need to continue to address the quality and governance issues that were identified last year. Our focus is on seeing a safer and effective service model for the future and determining our strategic direction.
I want to start a big conversation with everyone who works at Calderstones where we can discuss these issues in more detail. We’ll have sessions throughout April where all staff will have the opportunity to hear and comment on the vision and strategic direction of the Trust.
Chief Executive’s Blog (February 2014)
We’re formatting our vision statement to say that we are ‘changing lives through excellence’.
That message must inform everything that we do and I've said to staff that they should feel empowered to tell colleagues, friends and stakeholders that it is what we are all about. Examples might include the day-to-day positive stories as we support service users along their care pathway, the Trust’s successes at recent awards and in print, or even the changes on site as we improve buildings and reveal major changes such as the investment in engagement and wellbeing seen in the kitchens and restaurant.
The important thing for me is that the statement has come about through discussions and consultation – a real dialogue which has gone “from Board to Ward”, a phrase that I want to bring real meaning to. What happens in the boardroom matters because we need to ensure what goes on in the organisation is celebrated if it’s successful, challenged if it’s not working and supported to always do better. I want staff to increasingly know that the Board is setting a clear direction for us all by describing a vision and standards that make sense to people and that staff have an opportunity to influence and be part of.
Our Corporate Governance Review is ensuring we know the way ahead, that our plans are being implemented and ultimately embedded in the Trust. It is the major issue for the Board but what is really important is that people in the organisation understand the improvements that we are making and are part of the implementation of these changes.
We are moving forward with the development of robust systems – and there are many good news stories already. I am really pleased to have started the year with an excellent direction of travel for us all.
Chief Executive’s Blog (Christmas/New Year 2013/4)
I want to thank staff for their work this year. As the new Chief Executive, I have been delighted to meet many colleagues and of course at the recent awards night we celebrated some really outstanding work.
This is always great to hear about and we have to keep raising our game.
I have now been in this role as Chief Executive for three months. I have deliberately taken more time to assess the organisation and our services while dealing with some difficult issues.
I want to acknowledge that the leadership of this organisation has not always been good enough to create the conditions for staff
A message from the Chief Executive
What we do
Find out about our services
What you need to know
Advice and information
Making a referral
Information for health professionals
Volunteer or become a member of the Trust
Find out what's been happening
Access our annual report and other documents