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Clinical Quality Assessment in Nursing Care homes. Anne Moore Director of Nursing and Clinical Quality, Safeguarding Director of Infection Control. Rationale & Context Serious Case Review findings Increase in number of Adult safeguarding referrals – quality of nursing care

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clinical quality assessment in nursing care homes

Clinical Quality Assessment in Nursing Care homes

Anne Moore

Director of Nursing and Clinical Quality, Safeguarding

Director of Infection Control

slide2
Rationale & Context
  • Serious Case Review findings
  • Increase in number of Adult safeguarding referrals – quality of nursing care
  • Care Quality Commission Essential Standards – opportunity to strengthen
  • Improved patient experience -Quality outcomes
slide3
CQA Programme – Project Brief

The scope and objectives are detailed below:

  • Objective 1
  • This project will report the findings of the baseline audit within the first tranche as prioritised
  • Objective 2
  • This project will report on soft intelligence collated as a result of the audit assessment.
  • Objective 3
  • This project will report on a proposed set of core standards to measure and monitor clinical quality nursing care in care homes to inform and ensure contract compliance
  • Objective 4
  • This project will report on the learning outcomes
  • Objective 5
  • This project will report on prospects for continuous improvement of clinical quality standards in care homes
slide4
The Assessment Framework

Key Standards

  • Nutrition and hydration
  • Falls
  • Pressure Ulcers
  • Infection prevention and control
  • Continence care
  • Diabetes
  • End of life
  • Dementia care
  • Stroke
slide5
Key activity
  • Appointment of 1 x Nurse CQA post
  • Completion of self assessments & agreed Improvement Plan
    • 60 nursing care homes across Tees
    • 2 visits per each home ( 1 base line, 1 validation)
    • Communication strategy – all Stakeholders
    • Reference Group - monthly
    • Interim report – October 2010
    • Final Report – December 2010
slide6
Initial Findings & Feedback
  • 14 base line audits completed across Tees
  • ( Hartlepool 1, Stockton 7, Mbro 3, Redcar & Cleveland 3)
  • 7 ( Southern Cross )
  • 7 ( includes Bupa, Executive Care, no of private owners
  • 14 Improvement Plans agreed
slide7
Initial Findings & Feedback
  • Key areas for improvement ( Policy, procedures, workforce development , leadership & management & retention & recruitment of qualified competent staff, clinical supervision, formal induction, audit & care planning.
  • Evidence of Clinical Standards – variance despite a number of corporate providers with frameworks for supporting improvements in clinical ‘quality’
  • Self assessment – received positively by all of the nursing care homes – opportunity expressed by care home staff to share best practice with colleagues working within the sector although limited mechanisms to do this outside of LA/NHS support.
  • Information within the self assessment enabled signposting to tool kits , guidance and access to a range of resources to drive quality improvements ( including local expertise) – awareness limited with some care homes regarding current & up to date information
slide8
Initial Findings & Feedback
  • CQC expectations /regulations – lack of clarity in relation to clinical requirements e.g reporting of pressure sores
  • Confidence in corporate organisations questioned in relation to implementing improvement plan – ( Resource led/driven – e.g availability of staff to undertake identified training within working hours
  • Lack of consistency in corporate response to drive and deliver improvements in clinical practice & quality outcomes
slide9
Key Challenges
  • Sustaining and embedding improvements

( quality of care)

  • Self Assessments – baseline and validation
  • Joint working between LA and NHS to monitor ‘quality outcomes’ across a spectrum of need
  • Contracts – essential standards must be contained
  • Sharing Intelligence and best practice