MINUTES OF THE TRUST BOARD MEETING (PART 1)
Held on Wednesday 31st July 2013
In Room 1, Lampton Park Conference Centre
Civic Centre, Lampton Road, Hounslow TW3 4DN
Present: Mr Nigel McCorkell Chairman
Mr Steve Shrubb Chief Executive
Dr Anne Aiyegbusi Interim Director of Nursing & Patient Experience
Mrs Barbara Byrne Director of Finance / Deputy Chief Executive
Ms Jean George Director of Local Services CSU
Ms Carolyn Gray Non Executive Director
Ms Christine Higgins Non Executive Director
Miss Leeanne McGee Director of High Secure Services
Mrs Rachael Moench Director of Organisation Development & Workforce
Ms Elizabeth Rantzen Non Executive Director
In Ms Sarah Rushton Acting Director of Specialist & Forensic Services
attendance Dr Kevin Murray Clinical Director, High Secure Services
Mr Mike Gill (observer)
Ms Ann Utley (observer)
Mr Bryan Joseph Head of Risk, Health & Safety (item 14)
Mrs Barbara Wörts Board Secretary (minutes)
& 1 member of the public
Items were discussed in the sequence they are recorded in the minutes
290/13Item 1 / OPENING & WELCOME
The Chairman welcomed all those present at the meeting, including Dr Kevin Murray who was representing Dr Broughton.
291/13
Item 2 / APOLOGIES FOR ABSENCE
Apologies for absence were received from
Mrs Barbara Kerin Non Executive Director
Mr Neville Manuel Deputy Chair / Non Executive Director
Mr Geoff Rose Non Executive Director
Prof Lefkos Middleton Non Executive Director
Dr Nick Broughton Medical Director
Mr Andy Weir Director of Specialist & Forensic Services
292/13
Item 3 / DECLARATIONS OF INTEREST
No Board member had interests to declare in any of the agenda items.
293/13
Item 4 / MINUTES OF THE LAST MEETING
The minutes of the Board meeting held on Wednesday 26th June 2013 were agreed to be a correct record.
294/13
Item 5 / a)
b)
c)
d)
e)
f)
g) / BOARD ACTION SCHEDULE & MATTERS ARISING
Action Schedule
The Board reviewed the action schedule, noting the completed actions and receiving the following update:
26/06/13 – 250/13(a) – Cassel protocol for patients being escorted to hospital by other patients: Ms Rushton provided the Board with an outline of the protocol followed, saying this process was based on a clear clinical rationale, care planned and carefully risk assessed on the day. The care team were very clear that the patient could decline to act as escort and Ms Rushton said she had been reassured with the approach taken. Mr Shrubb said that he was assured by the information provided and Board members agreed.
26/06/13 – 250/13(a) – Tony Hillis Wing grille: Ms Rushton advised the Board that a grille had been made and tested by the security department and clinical teams. It was found to meet service requirements. Planning permission to install it is being sought. The Board agreed that this item no longer required their oversight and Ms Rushton would only bring an update in the event of unexpected difficulties.
26/06/13 – 250/13(b) – review of smoking policy: Progress is being made with setting up the policy review group, which will be chaired by Mr Jimmy Noak.
26/06/2013 - 259/13(c) - TDA assurance framework: Mr Stacey has circulated the summary as requested.
29/05/13 – 195/13(g) – Review of service user & carer involvement in Local Services: Dr Aiyegbusi reported that planning meetings were scheduled for August and, therefore, the draft action plan would not be completed until September.
Matters Arising
266/13(c) - procurement of a new patient information system: The Chairman confirmed that he had been provided with the financial information requested.
295/13
Item 6.1
Item 6.2
Item 6.3
Item 6.4
Item 6.5 / a)
a)
b)
c)
d)
a)
a)
a) / BOARD MEMBER VISITS
Cherington House – 19th June 2013
Miss McGee reported that as there had been no clinics running at the time of the visit, she and Ms Higgins had been unable to speak with service users, however, the staff they met were organised, motivated and enthusiastic. Ms Higgins drew attention to comments made regarding referral and re referral rates and Ms George outlined how this would be reviewed through contract monitoring meetings. Ms Higgins emphasised the staff’s stated willingness to embrace change but said they felt they had not had the opportunity to be involved in the service redesign. Ms George explained that some change had been mandated through the contracting process. However, Ms Maggie Gairdner was in the process with speaking to staff across all community services regarding the impact and implementation of change.
Wolsey Wing – 19th June 2013
Dr Aiyegbusi fed back on the visit she and Mr Rose had made to Wolsey Wing. She commented positively on the work being undertaken by the pharmacist, meeting with service users regarding medication issues but had noted, with concern, the reported issues with CPA where input from the community based care co-ordinators had been described as insufficient. Mr Shrubb asked Dr Aiyegbusi to meet with Ms Maggie Gairdner and Ms Bernadette Hennigan to find solutions to this issue.
ACTION: Dr Aiyegbusi
Ms George reported that the Local Services CSU team were aware of the issue and had developed a new key performance indicator to measure the scope of the problem and to permit focus on areas of particular concern. Mrs Byrne commented that access to Skype had been raised as a possible solution but Mr Shrubb said this would not be appropriate as staff needed to be physically present to enable effective discussion to take place. Ms Rantzen felt strongly that the suggestion should have received further consideration.
The Board noted staff’s expressed concern regarding the short notice they had been given of the forthcoming closure of Starlight Ward. Ms George outlined the requirement and rationale for choosing this area for closure, in consultation with commissioners and said that lessons had been learned by the CSU management team and, in future, there would be greater involvement of staff below the senior nursing team.
The Board noted the agreed action to address concerns regarding patients’ privacy and dignity and security caused by issues relating to the fencing and gate outside of the building.
Wolsey Wing & Jubilee Ward – 19th June 2013
It was noted that the Estates & Facilities team had been working with Jubilee ward staff to address the areas of concern raised following the ward’s refurbishment. In addition partitioning was being installed in Wolsey Wing, to divide the large room where two home treatment teams were based. Mrs Byrne said she, Mrs Kerin and Professor Middleton who had undertaken the visit felt the key issue was to understand how clinical service input into ward design could be improved and what the process for design change sign-off is for capital projects. Ms George said the CSU was holding a lessons learned session on 2nd September 2013 at which such issues would be considered. The Chairman asked that feedback from this event, a progress report on addressing the Jubilee ward issues and the quality impact assessment of the Starlight Ward closure be brought to the Board in the autumn.
ACTION: Ms George
Tagore Ward – 11th July 2013
The Board noted the report of the visit made by Miss McGee and Mr Rose to Tagore ward. Ms Rushton said Mr Meechan was addressing the apparent damp patches with Estates & Facilities. Miss McGee highlighted the staff’s concern at the length of time patients were waiting to transfer to a rehabilitation ward and also at the impact on staffing of patients leaving the ward to smoke.
Wells Unit – 11th July 2013
Miss McGee fed back on the positive visit she and Mr Rose had made to the Wells Unit. The patients had been very positive about their care and treatment and good access to activities was noted. Miss McGee said there were specific issues some patients presented with, related to their ethnic background but said the ward manager had an excellent command of these matters.
296/13
Item 7 / a)
b)
c) / ANNUAL PLAN – QUARTER 1 UPDATE
Mrs Byrne presented this report, advising Board members that the milestones had been updated, following discussion in May 2013 and were now measurable. The summary of progress contained both qualitative and quantitative assessment and the exception report highlighted areas requiring particular focus.
Board members agreed that this revised version represented a significant improvement on previous formats, however, it was noted that some milestones, where there were still some qualitative issues to be addressed (e.g. developing strategic partnerships and outsourcing HR services) were rated as ‘green’ but, intuitively, this did not feel right as there were still issues to be addressed. Mr Shrubb thought it would be difficult to find a better way of reporting progress but said he would ask Mr Stacey to develop a way of reflecting outstanding issues in the report’s narrative.
ACTION: Mr Shrubb / Mr Stacey
Non executive directors raised some points of clarification which the executives were able to explain and the Board noted that the next update report was scheduled for October 2013.
297/13
Item 8 / a)
b) / CHAIRMAN’S REPORT
The Chairman presented his report to the Board. He fed back on a recent conference he had attended regarding chairing governors’ meetings, emphasising the effort and challenge setting up a Council of Governors and developing positive working relationships would entail. He advised members that a number of briefing sessions had been planned for the coming months, aimed at people who were interested in becoming governors. Dates will be circulated for members’ information.
ACTION: Mrs Wörts
Mr Shrubb reported that a Company Secretary role was to be created and this role would be key in providing newly appointed governors with a single point of contact for assistance and information. It was noted that both the King’s Fund and FT Network run events on working with governors that it would be helpful to participate in.
298/13
Item 9 / CHIEF EXECUTIVE’S REPORT
The Board received and noted Mr Shrubb’s report. He commented positively on his recent experience of speaking at the Hounslow & Richmond Community Trust’s Annual General Meeting which, he said, had provided a useful platform to discuss future partnership working.
299/13
Item 10.1
Item 10.2
Item 10.3
Item 10.4 / a)
b)
c)
d)
a)
b)
a)
a)
b) / EXECUTIVE DIRECTORS’ REPORTS
Director of Nursing & Patient Experience’s Report
The Board was pleased to note the Trust’s 6th Annual Nursing Conference, held on 3rd July 2013 had been very well attended and resulted in positive feedback. Dr Aiyegbusi said that next year’s event would be held in May, to fall in line with International Nurses’ Week.
Dr Aiyegbusi then provided a verbal report on the legionella that had been found last week in taps in the Tony Hillis Wing. She told the Board there was no evidence of Legionnaires’ Disease. A review of how this could have occurred revealed that the legionella had built up in a number of taps that were not being used regularly. However, these were taps that had previously had high use. When their useage level changed, they were not subject to an updated risk assessment and revised management plan. Dr Aiyegbusi said that as there was the potential for this to be a Trust wide issue, she had requested the flushing of all taps twice a week, issued messages and posters to educate staff and instructed Estates & Facilities to undertake random testing. An appropriate entry will be made on the Trust’s level 1 risk register.
All taps in the currently affected area had been subject to daily flushing since the legionella had been discovered and have now been re-tested. Results were expected within 2 weeks.
Mr Shrubb thanked Dr Aiyegbusi for her decisive action and the good education programme she had swiftly implemented across the organisation. He suggested there would be merit in sharing the learning with other organisations.
ACTION: Dr Aiyegbusi
Medical Director’s Report
Dr Murray drew Board members’ attention to the Medical Director’s report on revalidation, highlighting the requirement for Trust Boards to be aware of the associated handbook and emphasising that the Quality Assurance Committee will be responsible for overseeing the evaluation of the Trust’s governance systems in relation to this process. Ms Higgins asked how the revalidation was progressing and whether any doctors had not been revalidated. Dr Murray said medical managers were going through it first and, to date, there had been no issues of concern.
The Board noted that Ms Higgins had accompanied Dr Broughton to a recent meeting of the Board of Imperial College Health Partners and that Mr Robert Bolas had recently taken up his appointment as the Trust’s Interim Director of Governance.
Director of High Secure Services’ Report
The Board received Miss McGee’s report, noting the positive outcome of the unannounced CQC inspection of Broadmoor Hospital on 25th and 26th June. Recent celebrations connected with the Hospital’s 150th Anniversary had been a success as had the visit of the Danish delegation on 3rd July.
Director of Local Services’ Report
Ms George presented her report to the Board, highlighting the successful bid for CAMHS IAPT funding, the receipt of further funding from Hammersmith & Fulham CCG for perinatal services and the well attended “learning lessons” day held on 25th June 2013.