Chat with Caroline Archive

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    3 October 2019

    With Caroline this week are Louisa Swift (Head of Operations, South Cumbria) alongside Jo Johnston and Alison Napier. The topic this week is South Cumbria.

    Contents
    This week's update - 00:32

    South Cumbria
    Jo Johnston - 02:35
    Louisa Swift - 03:05
    Alison Napier - 03:25

    Question 1 Southport & Formby - 04:50
    Question 2 Carbon Reduction Plan - 07:20

    South Cumbria
    Jo Johnston - 08:10
    Alison Napier - 11:32
    Louisa Swift - 14:10
    On-boarding Events Feedback - 15:42
    LiA Events - 16:45

    Question 3 South Cumbria Locality Based - 17:20
    Thank you - 20:00

    Your Questions

    Question 1

    Can I ask where Merseyside figures in your organisation as the patients in S & F live in Merseyside and not Lancashire or Cumbria. Once again it feels like we are the forgotten part of the Trust.

    We have changed our name for South Cumbria as the ICS that we are a part of is Lancashire and South Cumbria and also because the Cumbria Partnership Trust no longer exists. These are the reasons that we have changed our name and hadn't previously when we took on services outside of our geography. NTW has taken over services in North Cumbria and have changed their name to reflect this. This does not mean the teams in Southport and Formby are not valued, you are a very part of the services we provide.

    Question 2

    Given the recent focus on climate change and the NHS commitment to the Carbon reduction strategy 2009 do we know how LCFT is helping to cut back on emissions? Is there for example a strategy for achieving goals?

    We do have a carbon reduction strategy and plan. It is going to be more challenging with the addition of Cumbria and the details of this will be on our website once published.

    Question 3

    I think staff are mostly quite enthusiastic about the future organisation, but at the same time concerned about what we might lose in CPFT. We were localities then went to networks with some great improvements, going back to localities has lot of logic and potential but the developments through networks should be held onto if possible.

    We absolutely mustn't lose whats good and moving forward we will be moving into an ICP locality based structure. We need to work in local communities and keep the best of everything that's been done in South Cumbria.

    11 September 2019

    With Caroline this week are Lee Morgan, Staff-side Chair, and Russell Patton, Director of Operations. The topic this week is Locality Working Structure.

    Contents
    CQC - 00:58
    Partnerships - 03:16
    Health & Safety Executive Visit - 05:00
    New Executive Directors - 05:45
    Locality Working Structure - 06:21
    Question 1 - 13:10

    Your Questions

    Question 1

    We have just gone through a lengthy admin review within the Mental Health Network which resulted in the Band 6 and Band 5 leadership staff working across more than one locality.

    Has any consideration been given into how this restructure into locality working will affect the admin managers not only in the Mental Health Network but CYP and C & W?

    Caroline - I would urge you to come to one of the workshops we are holding then we can hear your views fully. I have heard about the review which happened before I started. Admin staff are essential and the work we are doing with NTW could demonstrate that we might need more, we have to get skills in the right place.

    Lee Morgan – Staff side are aware of this review, I am very conscious that there is a trend of never ending change, we need to learn lessons and not restructure for the sake. This goes back to the impact on support service, there is concern about how staff are made to feel, and we need to learn from this. We have a different approach now and are more involved and it is useful to hear about the engagement sessions.

    Russell - There will be many ways that we will be seeking feedback from staff, online Q&As will be put in place and a you said we did approach.

    This is more than a structural change, it affects work life balance, people’s happiness at work so we need to do this in the right way so that people feel listened to. I’ve never worked in an organisation that doesn’t have a never ending review of admin. We are doing this review following a number of consultations. Admins have a real role to play in success of the organisation, opportunly we were talking about the value of admin and clerical at Execs yesterday, they can bring a lot to the party.

    Lee – last time was more about CIP-ing and saving money, this time it is more about improving the way we are working and more staff might be needed.

    Caroline - Significant change, this is about us working in a locality model, big change programme which is about us looking at pathways and how they are responding to service users and carers, in partnership with NTW, this will start with what skills do we need to deliver the services across a pathway.

    Russell - Strategic alliance with NTW, well respected provider of MH LD neuro, CQC outstanding, Russell is on secondment from there, need to rec that they cannot instruct how things need to be here. But they can work with transformation teams to look at what can change, the concepts and make things better for people we serve, two particular areas we are looking at.

    Firstly, How we can strengthen bed management services. Secondly, large scale change work in Pennine Lancashire.

    Large scale change PL, agreed with ICS colleagues that we focus attention in this area first, run through patient journey from 1st contact, treatment and discharge. This will be co-produced work with SU and large range of partners. 12-18mth programme which we can then pick up and drop into other ICPs.

    Different ways you can get involved, feedback system to be set up, working group to be set up.

    28 August 2019

    With Caroline this week are Richard Morgan, Gareth Thomas and Amy Nolan and they are discussing Listening into Action.

    Contents
    Welcome and idea request - 00:00
    Introductions - 01:08
    CQC - 01:48
    Adult Acute Care Pathway - 03:40
    New Locality Working Structure - 05:00
    Listening into Action
    Richard Morgan Introduction - 05:43
    Gareth Thomas Clinical improvements - 11:01
    Amy Nolan Trust wide themes - 13:55
    How do people get involved - 15:00
    Question 1 - Gap in service between IAPT and Secondary Care? - 17:55
    Question 2 - Why are only senior staff invited to Engage? - 21:40
    Quick Wins - 23:14 Sorry for break in recording, this was due to a technical issue
    Question 3 - When will CQC result be announced? - 24:37
    Question 4 - Why are weekly huddles so long? - 25:07
    Simple Things - 25:40
    Question 5 - How will LiA last for, is there a deadline? - 26:27
    Thank you and roundup - 27:26

    Your Questions

    Question 1

    Hi there. I've just recently joined the trust working in the Chorley Minds Matter IAPT Service. I've worked in two other trusts previously and there seems to be a gap in service between IAPT and Secondary Care. There are many clients trying to access services who have long term and enduring mental health issues that do not fit the criteria of either IAPT/Secondary Care teams. Is LSCFT looking at this, and if so, where can staff have input?

    It can be difficult to be able access services, we are just starting a partnership with NTW. Workshops will be starting, led by our transformation team. These will have exec involvement led by Russell Patton and we need to pick this up as part of that to ensure that patients are not falling through gaps.

    Community pathways, adult. Difficult to be able access services, we are just starting a partrnership with NTW. Workshops starting led by transformation team, with exec involve led by Russell Patton and we need to pick this up as part of that to ensure that pts are not falling through gaps.

    Richard Morgan - People are falling into gaps and this is a very difficult issue. We will be looking at pathways, looking at how we structure community services right from beginning.

    Question 2

    Why can only senior staff attend engage as I feel all ranges of staff should be asked the questions about the changes to the trust?

    We have over 6000 staff so this is just one way that we engage. At engage we have approx. 300 leaders that we are connecting with. When Maria starts she will be thinking about engagement with nursing workforce, LiA and 12 big conversations, hundreds of staff will be involved in this. It is unrealitic to invite everyone onto one room all at once, if you have ideas over and above what is in place then please let us know.

    Question 3

    When will the CQC result be announced to all staff?

    The CQC report is in the factual accuracy checking process, and goes back to CQC on Friday. they have 2 weeks to respond and it should be the end Sep when it will go into the public domain.

    Question 4

    Why are weekly huddles taking over an hour feels like a team meeting should they not be focused at main points and lasting half an hour?

    Can we have more info on this?

    Amy – simple things will enable teams to make these simple changes that make a massive difference to you, further information is in the We can, We will newsletter. If you have more ideas about huddles let the LiA team know

    Question 5

    How will LiA last for, is there a deadline?

    This is not a quick initiative it is about the way we improve things, so years not months that we will be using this an approach to truly engage and really improve. We are asking for change champs, info in newsletter and event on 11 Sep so if you want to get involved pls get in touch.

    The following questions arrived too late to be answered in the live stream.

    Question 6

    What about Southport?

    Going forwards we need to think about what our geographic priority is, taking into consideration the national direction of travel, the ICS and it is also important that we work with Mersey Care in the future.

    Question 7

    How many front line staff have time to watch this and ask questions live?

    We appreciate that many staff members will not be able to watch this live broadcast so we make sure a recorded copy is made available, via the LSCFT website, along with a summary of the questions asked and responses given.

    If you have questions that you would like to ask, but are unable to watch live, then please feel free to ask your question via the broadcast page, using the facility provided. These can then be picked up at our next broadcast.

    31 July 2019

    Contents

    Introduction – Welcome and theme suggestions -  00:00
    Mental health and CQC visit, News on MHDUs  - 01:30
    Staffing requirements - 04:16
    New Improvement Director - 05:16
    Speak out, Speak up – LiA results and our culture - 05:48
    Freedom to Speak Up Guardian, Matt Joyes leaving - 07:25

    Questions - 08:12

    1. Peer Support Workers - 08:24
    2. District Nurses Mileage - 10:22
    3. How would you demonstrate improvement against WRES - 12:13
    4. Meeting room closures and effects on meetings etc. - 14:19
    5. Problems with the new Samsung work phones  - 15:51
    6. MHDU closures not communicated fully - 17:19
    7. Plans for C&F and the impact on CAMHS - 19:04
    8. In-house training certificates of attendance - 20:59
    9. Effects of proposed organisational restructure - 21:45

    Your Questions

    Question 1

    Hello Caroline. You are a massive fan of peer support workers and individuals with lived experience working within mental health teams. This my role at the moment and the difference we are making to people's lives, recovery time and throughput is obvious to me in the context of my daily work. Further funding is often dependent on results, but I'm not sure the evaluation of our 12 month pilot is capturing the true impact that we're having. What research design methodology would you use to process and outcome evaluate the success of a peer support pilot?

    Peer support workers are essential and there is plenty of evidence nationally around their impact. My personal view is we don’t need to spend lots of energy evaluating pilots and we should invest in peer support workers.

    Our new DoN, Mariah Nelligan, will be personally championing this when she starts in post early September. It’s also important that people living with experience are encouraged to look at becoming peer support workers.

    Question 2

    District nurses haven't any choice but to drive the miles to their visits. It seems unfair that while endeavouring to meet service needs and cover more areas staff are penalised heavily after a certain amount of mileage has been claimed for. We still have to tax insure and MOT our cars and put fuel in to reach our visits. How is this fair? The question was in relation to mileage expenses being paid at a lower rate after 2500 miles. The lower rate is significantly reduced. All miles are justified for work related home visits to our patients which can be seen on ECR. Why doesn't the mileage expense rate remain the same?

    We have the Agenda for Change national contract that states a point at which the rate reduces. It is felt that the mileage rate is more than the actual cost of the journeys although we understand that there is more to the overall cost than just the fuel used.

    It’s really important to us that our staff don’t feel demotivated by things such as this so I would like to take this away and see if we can be more flexible, step outside agenda for change and see if there is anything we can do.

    I will ask Deborah Cox to take leadership on this.

    Question 3

    How as chief executive of LSCFT you would demonstrate continuous improvement against the 9 indicators of Workforce Race Equality Standards (WRES). Especially the ones about a workforce that represent the community we serve. Very senior leadership of Black, Asian and Minority Ethnic (BAME) background within LCT and reducing the high rate of Disciplinary matters with BAME staff. More Transparency and timely resolution.

    I am very passionate about this and in my previous Trust I personally sponsored equality, diversity and inclusion and set up an inclusion board. It’s something we must take seriously and is one of my priorities.

    I know we have an equality lead and also Julie Seed is meeting with BAME nurses to ask what more can we be doing. Going forward this is something I will be personally sponsoring and seeing how we can increase our diversity.

    We cannot tolerate different experiences for any of our staff.

    We need the enthusiasm, ideas and support from you and this may be something we need a listening into action theme around.

    From experience this really needs to be led by people on the front line who are experiencing diversity and inclusion issues.

    Question 4

    Should it be acceptable to cancel all room bookings from 2 of the 6 meetings rooms at Sceptre Point at 16:10 on a Friday taking effect the following Monday? This is unfair on people who have meetings booked including 1:1s and team meetings that must now be cancelled at such short notice, with only 4 small meetings rooms now available for a building of this size.

    I can only apologise that it happened at such a late time to inform people.

    We received notices from CQC and have had to act quickly to set up a central clinical improvement team. A room had to be found at HQ urgently which is why Communications and PMO had to move at such short notice.

    Again, I can only apologise for any inconvenience and hope you can understand why this happened so quickly.

    Question 5

    Our recent New Samsung SM-G390F Work mobile phones are too slow to respond and are unable to take any further Apps recommended from the trust as the internal memory capacity is unable to cope with any further downloads which is making the mobile slow in response. Also why is the Wi-Fi connection so poor in trust buildings on these mobile phones?

    We have had lots of feedback from Listening into Action with suggestions for improvement from staff. One of our themes is definitely going to be digital, this was a big issue at my previous Trust and we created an improvement programme.

    The most important message is that there are lots of frustrations from people around IT and digital and we need to work collectively to continue to improve this.

    In regards to these phones the advice I am not a technical expert so please see the reply below from our Telecoms team and also an email for any further queries.

    The Samsung Phones are set-up (if configured correctly by end users when setting up their phones) to have connectivity by default to LSCFT Wi-Fi if available. Also the phones have Wi-Fi calling to enable phones to make and receive calls when there is no mobile signal available within LSCFT buildings.

    The phones have enough capacity and storage for normal day to day use – If users are storing lots of files, photos and videos onto the phone this will impact the phones performance.

    If you have any queries please email mary.dolan@lancashirecare.nhs.uk

    Question 6

    I would like to know why the MHDU staff have not had any written communication about the units closing. So far this has been verbal and I believe that staff should be treated with a little more respect and have the situation and their rights in terms of job security, alternative roles etc., clearly explained to them.

    I can only apologise, this is a difficult time for people and I hope you understand how quickly we have to respond to CQC.

    For us to develop a plan for the MHDUs this couldn’t be done in isolation and we had to have a lot of discussions with CCGs. Regulators and the team. We need to take everyone with us with our plans.

    We then have to write to CQC suggesting our plans for the MHDUs and only when CQC write back to approve that can we start a formal process.

    In terms of formally writing to staff, it’s difficult to do that until we hear back from CQC.

    We need to engage, listen to you and get your thoughts and ideas through discussions.

    Question 7

    What are the plans for the Children and Family Network? Are we moving to a locality based model and if so what will this mean for CAMHS?

    We are planning to move to a locality model for all of our services as a starting point.

    We are open to thoughts and views about what our structures are going to look like.

    I am very aware that the previous restructure was a very negative experience for people, so it’s really important to me that we have the principal of no change about me, without me. We must listen, talk and co-produce.

    In terms of children’s services I am very open minded and open to thoughts and views about how we should be thinking about Children’s services. It could be we decide they need to go into a locality model, be very locally provided and work with partners across social care, education and health. It could also be that we keep them together as a specialty service.

    Russell Paton will be leading this work and very soon we will be starting a process of listening via workshops and real co-prodiction.

    Question 8

    I have recently attended some in-house training & been informed that certificates of attendance are no longer issued. As a qualified nurse having a certificate of attendance is useful for re-validation & to demonstrate you have actually attended participatory training, from speaking to other nursing colleagues they feel the same, please can certificates be issued again.

    We are in the process of upgrading our training systems and the new system we are looking at will allow automated certificates for people.

    We will provide more details on timescales etc. as soon as they are available.

    Question 9

    I do not attend Engage and have heard there will be another organisation restructure “reset 2”. Although I was not adversely affected by the last reset, I am friendly with lots of people who were affected. I heard their stories, saw their tears and distress and was very unhappy. A lot of very good people, people that gave good service, were forced out and many of those that stayed are still scarred. Can you offer any reassurance that the next change will be handled with more care?

    This is something I have heard repeatedly since I joined and it is absolutely essential that way we change services has to be done in partnership and we treat people with care and respect.

    We cannot avoid change, we need to continue to change, improve and transform. The way we manage change is with people in collaboration, it’s fair and there are fair processes.

    We moved to a locality based model at my old Trust, it took time and a few phases to achieve it.  Overall staff were very positive about how it was managed.

    I need to hear if people are experiencing anything but a positive as we go through this change. Not everyone may agree with this change but the processes and collaboration we use is essential.

    Nationally a locality based model is a massive priority. In our system we already have an integrated care system across Lancashire and South Cumbria and we have integrated care partnerships. Moving to an ICP model is something that will really benefit our service users and carers.

    17 July 2019

    Contents

    Welcome - 00:10
    National visit - 01:00
    12 Hour Breaches - 01:26
    CQC Headline Feedback - 01:45
    Strategic direction - 02:55
    Community services - 03:42
    Blackpool Council meeting - 04:37
    Listening into Action - 04:50
    Palliative care - 05:28
    Questions - 05:50
    Q1 Maternity Leave -  06:02
    Q2 Room bookings in Lancaster and Blackpool - 06:22
    Q3 Risk training in clinical settings - 06:50
    Q4 Community Pathways - 07:24
    Q5 Smokefree - 07:44
    Q6 Adult and Older Adult Mental Health - 07:59
    Q7 Admin team contracted hours - 08:35
    Q8 Trustnet - 08:50
    Q9 Governance meetings - 09:32
    Q10 Adult community LD Teams - 09:57

    26 June 2019

    Contents

    Introduction and thank you - 00:42
    Caroline's experience so far - 01:46
    How do we improve? - 03:25
    Clinical Priorities - 04:12
    Working with partners - 05:55
    Future direction for our Trust - 06:18
    CQC - 07:12

    National Strategy - 07:50
    Welcome to staff from Cumbria - 08:47
    Caroline answers your questions
    Q1 Retiring - 10:10
    Q2 NTW Report - 11:27
    Q3 Smokefree - 13:36
    Q4 Recycling - 14:53
    Thank you and submit your questions - 15:45