Background

1. The We Care Culture Change - Engaging Staff to Deliver Person-Centred Care for people with learning Disabilities in East Kent Hospitals Sally SmithDeputy Chief Nurse & Deputy Director of QualityWednesday 18th June 2014

2. Background Inequalities for those with learning disabilities Five times more likely to be admitted from A&E Four times more likely to be readmitted to our Trust The 4C Framework Communication Choice-Making Collaboration Coordination

3. We Care In 2012, East Kent Hospitals launched its We Care programme – aTrust-wide initiativeto develop a culture that: ‘inspires, develops and supports our teams, so that we consistently deliver the best experience that we can, to ensure we care for every patient and every colleague every day.’ Culture affects the way staff feel about work and how staff then behave. This in turn this affects patientexperience and impactspatient outcomes. So we want experiences for our staff and patients to be excellent. • In 2012, many hundreds of staff and patients co-created our We Care values and behaviours – so these standards are based upon what matters most to people who work in and use our services.

4. Reminder of who we listened to 110 patients and 125 staff attended “In Your Shoes” sessions. We also reviewed a year of patient feedback. 700 staff wrote Graffiti Boards and 100 attended “In Our Shoes” sessions Over 1000 staff took part in Values into Action sessions to set out out ‘we care’ behaviour standards What makes a GOOD DAY for staff What makes a BAD DAY for staff Staff likelihood to recommend as a place to work Not valued 30 Need more staff 28 Low morale 17 Poor care 12 Management 10 Job insecurity 10 Nice people 24 Enjoy my job 13 Good care 10 Innovative 6 Good pay 6 Good training 6

5. EKHUFT Shared Purpose Framework Shared Purpose framework - developed at EKHUFT as a tool to enable staff to connect their work to a shared vision. Value: SAFE People feel safe, reassured and involved A shared vision for patient and staff experience We care – how we deliver a great staff and patient experience: commitments, values and behaviours Value: MAKING A DIFFERENCE • Nursing 6 Cs • Communication • Competency People feel confidentwe are making a difference People feel cared for as individuals Value: CARING • Nursing 6 Cs • Commitment • Courage • Nursing 6 Cs • Care • Compassion Shared Purpose Framework

6. The need for We Care

7. The National NHS Staff Survey found East Kent Hospitals to be: • In the worst 20% of Trusts for: • Staff Engagement • Staff Satisfaction • Bullying and Harassment Our NHS Staff Survey Results Below average in staff reporting near misses and incidents Deteriorating in scores on work-related stress and how empowered staff feel to manage their work-related stress

8. Staff Engagement • High staff engagement correlates with: lower mortality rates; improved financial performance; higher quality of care; higher patient satisfaction; lower staff absenteeism; and higher health and well-being of staff. See Department of Health figure below. • West and Dawson (2012) found that engaged Trust’s also report: • Significantly less mistakes • Better patient experience on national surveys • Lower infection rates • Shorter lengths of hospital stays Source: Department of Heath Engaging Your Staff: The NHS Staff Engagement Resource

9. Patient Experience Improvements • Care and compassion can: improve treatment compliance; help an accurate diagnosis as patients open up about symptoms; speed up healing and recovery times – which has been found to decrease when patients are less stressed about their care. • Good communication can: enhance patient well-being and emotional health; hasten recovery and/or symptom resolution; influence functional and physiological measures; decreases reported pain and drug usage;enable independance. • Treating patients with dignity and respect means they are less likely to be rude and abusive to other members of staff and/or other patients and their families. Compassion matters – quote written by a Doctor with cancer “If you’d asked me what was the most important quality in a doctor before I was unwell, I would have said competence. The last three years have taught me how much I now value ‘softer’ aspects of care; by that I mean values that mainly revolve around the patient such as “no decision about me without me” and “see me not just my disease”. I have yet to meet a doctor on this journey who displays these compassionate attributes who wasn’t also competent.”

10. TheWe Care values and behaviours became the Trust’s new standards in 2014 and are increasingly demonstrated at EKHUFT. • To embed We Care into our culture, we now need every ward leader and manager, and every staff member, to be aware of and understand the We Care values. A We Care Culture To achieve this, we aim to develop We Care Champions in every department across EKHUFT (our five hospital sites and our community sites). We Care Champions will help staff to recognise and engage with the aims and objectives of We Care, and support staff to use a We Care approach in their daily work. This will develop a culture that delivers an excellent patient experience and the best clinical outcomes.

11. The Summer Campaign – Week 1 CARING. People will feel cared for as individuals. Because we are welcoming and polite; attentive and helpful; we respect people, their dignity and their time, and we have the courage to speak up when others don't. Behaviour We say thank you to each other this week, smile, acknowledge, make eye contact Improvement Activities Mealtime Experience Communication around discharge and preparing patients Daily ward rounds by Matrons

12. The Summer Campaign – Week 2 SAFE. People will feel safe, reassured and involved. Because we are consistently safe and reassuringly professional, we listen and communicate clearly, and we work as an effective team. Behaviour Clean Hands Campaign in including telling patients we have cleaned our hands. Helping patients to clean their hands prior to mealtime. Improvement Activity Pain control. ‘Manage My Pain’ Answering call bells quickly

13. Summer Campaign – Week 3 MAKING A DIFFERENCE. People will feel confident we are making a difference. Because we take responsibility for delivering the best outcomes, act as leaders where we can, and we look to improve and develop ourselves and our services. Behaviour Make time to listen to someone. Take a moment to put ourselves in another person’s shoes. Improvement Activity Evaluate this and make a change based on one piece of feedback. Seek feedback from 1 patient and/or 1 colleague

14. The ‘We Care’ staff experience Through: The way we speak The way we look The way we behave …..and the process we have in place that reinforces messages and drives certain behaviours FOCUS Brand FOCUS change programme

15. Brand book

16. Tone of voice What we say How we say it

17. “xxxx began in 1864 with the opening of the first shop in London's Oxford Street. Our unique promise to our customers that the price of any item we sell will always be as low as the lowest price in the neighbourhood, has been our slogan for over 75 years. Through the efforts of our partners serving customers with our high quality goods, we have succeeded in building the largest department store retailer in the UK, with 39 shops and a growing online business. Our partners will tell you that this is a very special place to work. We believe our distinctive culture – our spirit – lies at the heart of this feeling. After all, as a partnership we are a democracy – open, fair and transparent. Our profits are shared, our partners have a voice and there is a true sense of pride in belonging to something so unique and highly regarded.”

18. The Caring way: “It’s great news that we all reached our targets for the last quarter. Special congratulations and well done to the [name and name] teams, who have raised the performance bar for the third time this year.” The wrong way: “Targets for the last quarter were achieved and some areas performed beyond expectation.”

19. How will we improve?

20. Board sign up to the new values and behaviours • Job descriptions will feature the expectations • Via recruitment processes and appraisals • Expectations made clear to all staff groups • Listening events by Exec Directors • ‘Walk the Floor’ sessions – timetables throughout the year • Ward to Board discussions at Board of Directors meetings • Market Place events • We Care Champions Our Actions

21. Recent Market Stall research (collected by current We Care Champions) captured the experiences of our staff, patients and visitors, highlighting: • Positive comments about our teams and their support. • Negative comments to be improved upon through ongoing support from We Care championsand future engagement of staff. The need for We Care Champions • 95 Patient Responses: • 73 positive comments • 101 Staff Responses: • 62 positive comments • 22 negative comments • 39 negative comments • From now on in, We Care champions will hold monthly market stalls to measure our success in living up to We Care standards across the Trust.

22. ‘make a difference for our patients right now.’ • So, what if everyone thought: • ‘as one person I cannot change the world • but I can change the world of one person....’ • We will make a start and aim to succeed. Our current We Care Champions pledged to:

23. Any Questions Sally.smith2@nhs.net