Muckamore Abbey Hospital

1. Muckamore Abbey Hospital A Centre of Excellence in the treatment and care of people with Learning Disabilities since the late 1950’s

2. What Do We Do? • We provide assessment and treatment services for people with learning disabilities who have an additional mental disorder. • Psychiatric Illness • Severe Challenging Behaviour • Co-Existing complex neurological disorder

3. Muckamore Abbey Hospital • Opened in the late 1950s/ early 1960s • Provides a regional specialist assessment and treatment service for people with Learning Disabilities. • Max Patient No.s 1980s - Over 800 • Currently 318 beds, • Staff No’s 620 wte • Strategic Direction • Resettlement of Long Stay Patients to the Community • Reduction of Inpatient Bed Capacity • Assessment and Treatment Services

4. In the midst of change: • Redevelopment of Hospital Services • Resettlement Programme • Reprovision of Children’s Services

5. Resettlement of people who can leave immediately Development of Community Infrastructure Reprovision of Services for Children and Adolescents Reduction of Treatment Beds Key Strands Hospital Service Re-development 115 Beds

6. Future Hospital Service Specialist Hospital Services will be for People with Learning Disabilities who live in the community and: • Who require Assessment and Treatment because of associated Mental Health or Behavioural Difficulties. or • Who require Assessment and Treatment in a semi-secure environment because of their offending behaviour.

7. Quality Agenda • Standard Setting • Awards • Development of a multidisciplinary audit tool • Patient/Carer involvement • Continuous Quality Improvement

8. EQCEvaluating Quality Care Jenni McKay Resource Nurse

9. EQC A multidisciplinary / multidepartmental audit of the quality of care provided to patients within Muckamore Abbey Hospital

10. Audit tools previously used in the Hospital • Hospital Core Standards • Nursing Standards • Day-care Standards • EQUATE  EQC Evaluating Quality Care

11. EQC acts as • a useful step in the process of quality assurance • a tool which raises questions in many specific areas in the quality of care • a provider of a series of pointers to areas which need attention • an agent of change • a facilitator for best practice It encompasses the entire treatment and care provided to the patient

12. Themed Questions Themed questions allow audit tools to be created specifically relating to each department, e.g. • Ward • Physio • Hotel Services • Maintenance • Medical Other themes allow audits to be completed in relation to specific areas , e.g. • Safety • Facility Management • Care plans • Mental Health • Leisure

13. Audit Questions 3 types of questions • General - pertaining to the hospital • Facility specific • Patient related 2 trained auditors present for each audit All questions include auditors advice to assist in gathering the evidence required

14. General Questions • Is the procedure in case of fire/emergency evacuation prominently displayed? Advice to auditor: Look for procedure on walls - must be at all entrance/exit doors to receive a yes • Are all drugs stored according to policy, e.g. controlled drugs? Advice to auditors: Check all drug cupboards are locked and controlled drugs are kept in a locked cupboard within the locked drug cupboard and the person in charge is carrying the key

15. Facility Specific Questions • Are furnishings or fittings in the facility appropriate to the physical needs of the patient? Advice to auditor: Observe while in facility/ask staff • Do hospital drivers who transport patients hold a current PCV (Passenger Carrying Vehicle) Licence? Advice to auditors: Only applicable for drivers who are transporting patients invehicles of more than 16 seats. The paper work is kept in Hotel Services Office

16. Patient Related Questions • If the patient requires special precautions or observations, is there documentation that appropriate actions are being taken? Advice to auditor: Includes patients who may take seizures, abscond, smoke, choke, etc. Ask staff if applicable and if so check care plan under appropriate part of assessment (check up to 5 patient care plans) • Has the patient had a dental review in the past 6 months? Advice to auditor: Randomly select 5 patients, check copy of dental review form

17. EQCprocess 2 trained auditors Quasar2 software analysis of result action plan devised discussed with person in charge change agent nominated audit of action plan on an agreeddate

18. Benefits • One audit tool for the hospital • Individualised action plans for each dept • Direct impact on patient care • Direct impact on the quality of care all services provide • One point of contact for all reports and audits • Up to date audits • Flexibility • Precise and measurable standards • Use of up to date technology e.g. pda’s and Quasar2

19. Conclusion All pilots are completed Areas of improvement already identified and acted upon Staff identified areas of improvement within own practice and acted upon Fully inclusive tool Includes clinical and support service standards A model for other areas interestedin developing such an initiative

20. FOCUS GROUPS Mr B Mills Behavioural, Vocational and Therapeutic Serivces Manager

21. Patient Focus Group • Staff Focus Group • Consultation Sessions with Parents and Friends of the Hospital • M.L.A.’s and Local Councilors

22. Making Decisions

23. Focus Group • Current patients within the hospital • Former patients • Male and female patients • Age range 27 – 45 • Independent Facilitator • Two members of the Project Team

24. Liaising directly with patient • Liaising directly with patient’s consultant • Liaising directly with carers • Liaising directly with relatives

25. One person at a time would speak • When not speaking we would listen to each other • The room would be seen as a safe place to speak and share ideas and opinions • No statement would subsequently be attributed to a specific person without his / her consent.

26. The purpose of the meetings were to: • Share experiences / opinions on Muckamore Abbey Hospital • Give ideas on what would make the hospital better • Feedback to the planners on the new building

27. The general layout of the new buildings • Internal space • Dining arrangements • Food • Management / personnel in the new hospital • Smoking policy and access to personal lighters • Values and attitudes in the new service • Signage on access roads • Unsupervised time within the grounds • Privacy • Education, work and day care service • Good day and bad day experience • Communication within the new units

28. They try and want to do things for you • They try and want to understand you • They care and want to care for you • They use a good tone of voice • They listen to you • Come to you when you feel sad • Give you reasons for the decisions and treatments being offered to you

29. Muckamore Abbey Hospital A Centre of Excellence in the treatment and care of people with Learning Disabilities since the late 1950’s