Quality Accounts 2021-22

Our priority is to ensure that our services are safe, effective, responsive, caring and well-led...

this is our

Quality Account 2021-2022

provide.org.uk

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Contents PART ONE: Introduction

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What is a Quality Account?

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How to give your feedback on this Quality Account

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Statement from our Group Chief Executive

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About Provide Community Interest Company

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Our Vision, Mission and Values

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What We Do

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Our Services 2021

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Our Quality Assurance Process

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Statement from our Board

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PART TWO: Our Priorities

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Our Care Quality Commission (CQC) Ratings

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Reporting Against Quality Account Mandatory Core Indicators

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Participation in National Clinical Audits

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Taking Part in Clinical Research and Evaluations

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Looking Back: Our Priorities for 2021 - What We Achieved

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Looking Forward: Our Priorities for 2022

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PART THREE: Review of Quality Performance

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Statement from Provide Group Chief Nurse and Chief Operating Officer

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Safe

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Effective

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Caring and Responsive

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Well-Led

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PART FOUR: Statements

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ONE

introduction...

PART

What is a Quality Account?

Each year all providers of NHS services are required to publish a report on the quality of the services they deliver. This is called the Quality Account. Our Quality Account aims to provide you with information about the quality of the services we deliver and our plans to improve further with the needs of service users and their families at the centre of all we do.

Our priority is to ensure that our services are safe, effective, responsive, caring and well-led. To measure our progress against this priority, we collect and review a range of information about our services throughout the year, which we report to our Board and our commissioners. We use this information to identify areas of good practice and to find areas for improvement, so that we can maintain and improve the quality of the services we deliver.

We hope you enjoy reading this Quality Account. If you would like to give us your view of our Quality Account, please contact us by post or email.

we are keen to hear from you...

How to give your feedback on this Quality Account

We are keen to hear from you if you have any views and suggestions on our Quality Priorities for the year ahead or any feedback on any other aspect of the Quality Account presented here. You can contact us by email or by post using the contact details below:

BY EMAIL:

provide.safetyandquality@nhs.net

BY POST:

Quality and Safety Team Provide, 900 The Crescent, Colchester Business Park, Colchester, Essex CO4 9YQ

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Statement from our Chief Executive Following on from the difficult year the nation and our organisation faced in 2020 with the impact of the COVID-19 pandemic being felt at all levels of society, it was heartening that 2021 was a better year.

One of the key successes of the year was the national COVID-19 vaccination programme which Provide colleagues stepped up to support by both delivering vaccinations to people and receiving the vaccine themselves. By doing this they helped to protect the communities where we live and work.

Our services are delivered in the heart of our communities, and I am very proud of how our colleagues in Provide contribute daily to the wellbeing of our communities.

In 2021, Provide colleagues went the extra mile for their communities by helping us once more to respond to the pandemic in so many ways, including supporting more people to continue their treatment at home after hospital discharge and bringing care and treatment to people at home to prevent them having to go into hospital. The range of skills that our colleagues have and can offer to people in our communities is extremely good and the feedback we receive about the care they deliver is very positive as this report demonstrates.

Despite the repeated waves of the pandemic disrupting our daily lives and the delivery of some of our services, we were able to achieve all our quality priorities in 2021. Alongside this, we were able to ensure the services we delivered were safe, caring, responsive, effective and well-led as demonstrated by the data we have shared in this Quality Account. This is a testament to the hard work and dedication of our colleagues, and I would like to take this opportunity to give them recognition and thanks from the Executive Team.

I hope you enjoy reading this Quality Account and, if you have any feedback to give us, we would be pleased to hear from you.

D Mark Heasman Group Chief Executive

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About Provide Community Interest Company

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Provide is a Community Interest Company (Social Enterprise).

A social enterprise is a business with primarily social objectives whose profits are principally reinvested in the business or community rather than being driven by the need to maximise profit.

Social enterprises operate in almost every industry in the UK, from health and education to retail and recycling.

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Transforming OUR VISION

lives

Our Vision, Mission and Values Our customers are central to everything we do. Transforming lives through care, innovation and compassion is at the heart of our culture and is why our colleagues go the extra mile for the people we serve.

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An ambitious, employee-owned OUR MISSION

social enterprise, growing in size and influence.

We

transform lives by treating,

caring and

educating people.

Care , innovation and

compassion.

O U R VA L U E S

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What We Do We deliver a broad range of health and social care services in the community. We do this via our main company Provide CIC Ltd. We also deliver some NHS services through our subsidiary companies and specialist subcontractors. This report takes account of our NHS contracted services delivered across the Provide Group. Our main NHS commissioner is NHS Mid Essex.

O U R C O M PA N I E S :

Provide CIC Ltd - delivering health and social care services across a wide range of settings in the community Tollgate Clinic Ltd - providing minor surgery Provide Wellbeing Ltd – providing private (self-pay) services Calvern Care Ltd – providing supported domiciliary care services We work from a variety of community settings, such as community hospitals, community clinics, nursing homes, and primary care settings, as well as within people’s homes. We are committed to making sure all our services are high quality, safe, effective, responsive and well-led.

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Provide Support at Home

Our services 2021

Service Portfolio June 2022

Long COVID Service

Provide Digital

(CHIS Dorset), (CHIS Essex CHIS East Anglia)

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Medical Examinations

Carpal Tunnel

North Herts Assistive Technology Service

(Castlepoint & Rochford), (NE Essex), (Southend)

Physiotherapy

Joint Injections Autism Service

Podiatry

Minor Skin Surgery Ear Care

Provide Wellbeing

(Milton Keynes), (HertsValley CCG), (East & North Herts CCG)

Vasectomy

Speech and Language Therapy

Provide Children & Family Services

Stroke - Early Supported Discharge Service

Respiratory Virtual Ward

A C C O U N T

ADHD Service

eC-Card App

Indicates services are part of the Mid and South Essex Community Collaborative

Community Wards (inc Community Stroke Unit)

Frailty Virtual Ward

Out Of Hours Nursing Service

Provide Community Partnerships

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Our Quality Assurance Process

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Our Board works in partnership with colleagues across the organisation to ensure the services we deliver achieve the standards of quality and safety required.

Colleagues are supported with safe systems of work, guidance, training, equipment, and leadership to enable them to operate safely and effectively. The Board have set in place clear structures and processes to maintain oversight of quality and safety data and information including information about all serious incidents which occur, as well as information about incident trends and harms, risks, customer feedback, infection prevention and safeguarding so that they can monitor the effectiveness of what we do and, where needed, they take action to address any concerns.

The Board encourages reporting of incidents and has set in place systems to enable colleagues to speak up (whistle-blow) so they can take action to address any safety concerns promptly.

The Board also ensures that we respond to incidents and complaints promptly with openness and honesty so that we can learn from them and ensure the people affected are supported and receive an apology and explanation when things go wrong.

Our Board members are highly engaged, visible and approachable and enjoy meeting both colleagues and service users first hand when they undertake their regular visits to service areas.

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Statement from our Board It has been another exceptional year within the Provide Group with much of our activity focused on supporting the continued national response to the COVID-19 pandemic.

Our attention has been focused, as always, on keeping our colleagues and service users safe and maintaining, as far as possible, business as usual. We, like every other organisation across the country, have been working hard over the last year to bring waiting times down where we can for people who have experienced longer waits due to the pandemic. Recovery of our waiting times remains a key priority for us in the coming year. In the past year we have also implemented new ways of working and new services, using a wide range of innovations and new technology, to make our services more efficient, accessible and responsive. We are proud of our colleagues who have embraced all these changes and have been key to making them happen in a way that maintained safety and enhanced the quality of our service delivery. None of what we have achieved would have been possible without their skill, advice, support and can-do attitude.

As we look back at the last year, we can see that we have achieved a lot to continuously improve and build on quality across every area of our business. We intend to do the same again in the year ahead with more innovation and more engagement with our service users to achieve this. If you use our services and have any feedback to give the Board on what we can do to improve quality we want to hear from you. Please get in touch with us by provide.safetyandquality@nhs.net emailing Under the Health Act 2009 and the National Health Service (Quality Accounts) Regulations 2010 to prepare Quality Accounts for each financial year, our Board is required to ensure that the content of our Quality Account is accurate and presents a balanced picture of the organisation’s performance over the period covered and that the information reported is reliable and accurate and has been prepared in accordance with Department of Health guidance. On behalf of the Board, I can confirm our Quality Account meets the required standards.

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Derrick Louis Chairman

Mark Heasman Group Chief Executive

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TWO

PART

our priorities 12

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H OW T H E C Q C R AT E S U S

Provide CIC

Technikon House Supported Living

Our Care Quality Commission (CQC) Ratings

Fern Lodge Braintree

Calvern Care Ltd

Tollgate Clinic Ltd

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Reporting Against Core Quality Account Indicators

In this section we report on how we have performed against key measures organisations are mandated to report against in their Quality Account. As a community provider most of the mandated indicators are not relevant but where we can report we have.

PROVIDE 2020/21

PROVIDE 2021/22

90%

95%

97.40%

99.25%

Clostridium Difficile rate per 100,000 bed days Reported within Provide community hospital wards

0%

0%

-

Incidents resulting in severe harm

0%

0.06%

0.3%

Incidents resulting in death

0%

0%

0.3%

INDICATOR

Staff Friends & Family Test The percentage of staff employed by, or under contract who recommend Provide as a provider of care to their family or friends VTE Risk Assessment Risk assessment completed for people admitted to hospital who are at risk of venous thromboembolism

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N AT I O N A L BENCHMARK

85% NHS Digital

96%

NHS England and Improvement

NRLS

NRLS

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ACCURACY OF DATA CORE INDICATOR

PURPOSE

Percentage of patient records held which include NHS number and General Medical Practice Code for a patient’s GP practice.

Recording the NHS number and GP details ensures patients can be identified correctly and receive appropriate treatment and information can be provided to their GP to support continuity of care.

Number contacts 40271 Missing GP Code 62 (0.15%) Missing NHS Number 62 (0.15%)

NHS Digital Information Governance Toolkit

Using this toolkit helps providers measure the quality of the IT data systems, standards and processes used to collect data.

Exceed Required Standards

PROVIDE

Participation in National Clinical Audits Participation in national clinical audits and confidential enquiries enables us to measure the quality of the services we provide against other organisations delivering NHS care. In this way we can identify areas where we can improve our services. Due to the COVID-19 pandemic data collection was paused periodically when services were focusing on supporting the national pandemic response.

NATIONAL AUDITS

PROVIDER O R GA N I SAT I O N

SSNAP - Sentinel Stroke National Audit Program

Kings College London

PASCOM Audit for Podiatric surgery

Royal College of Podiatry

National Diabetic Foot Care Audit

NHS Digital

LeDeR - Learning from lives and deaths of people with a learning disability and autistic people

NHS England

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CONTRIBUTED TO IN 2021

TO CONTRIBUTE TO IN 2022

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Taking Part in Clinical Research and Evaluations Clinical research and evaluation of clinical care is a central part of the NHS, as it enables the NHS to identify and offer new treatments that improve people’s health. Provide Group promotes participation in research. In 2021 we supported the following research projects.

RESEARCH AND EVALUATIONS UNDERTAKEN IN 2021

RESEARCH /EVALUATION LEAD

BECOME study Behavioural Weight Management: COMponents of Effectiveness

Real World Services

Racism and Discrimination Evaluation Study

University of Essex

Safer Online Lives: use of the internet and social media by people with intellectual disabilities

NIHR/University of Kent

UPLIFT Trial - UpLifting the occupational wellbeing of NHS staff: A Randomised Controlled Trial. An innovative digital approach to combating stress and burnout in the workplace

NIHR/DASH centre

UrgoStart Treatment Range Evaluation Protocol including UrgoStart Plus Pad and Border and UrgoStart Contact in the local management of Diabetic Foot Ulcers (DFUs)

Urgo and Provide

Chronic Leg Ulcer Pilot Study. Identification of ‘subclinical’ infection in the deep tissues in Chronic Leg Ulcers – a prospective study – Provide acts as a Patient Identification Centre to facilitate research with our partner organisations

Mid and South Essex, East Suffolk and North Essex NHS Foundation Trusts

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Looking Back: Our Priorities for 2021 - What We Achieved The quality priorities for 2021 are set out here along with information about what we did to achieve them.

It is pleasing for us to be able to report that once more, despite the on-going pandemic and the requirement to support the national NHS COVID-19 response, we were able to maintain and improve the quality of our services and to meet the priorities we set.

Our priorities aimed to continue our journey towards better use of technology, continuing to forge partnerships and integrated ways of working with colleagues across the health and social care system.

PRIORITY 1:

Undertake quality review audits to assess the level of quality delivered in our services and identify actions for improvement.

WHAT WE ACHIEVED: We undertook quality assurance visits to our community nursing services, supported living services, Domiciliary Care services and Urgent Care Response Service.

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PRIORITY 2:

Develop a customer engagement strategy to enable us to collaborate with our customers on service reviews and development and improve the ways customers can share their feedback with services.

WHAT WE ACHIEVED: We commissioned Healthwatch Essex to develop a customer engagement strategy for the Mid and South Essex Community Collaborative which consists of Provide, EPUT and NELFT working together as the three community health care providers in the Mid and South Essex Integrated Care System.

PRIORITY 3:

Embed and build on the delivery of virtual services and use of technology and innovation to increase access to and versatility of services for the benefit of our customers.

WHAT WE ACHIEVED: We set up a virtual frailty ward to care for people at home, so they did not need to be admitted to hospital, and supported people needing on-going care following discharge from hospital.

We set up a virtual respiratory ward to support COVID-19 patients at home.

We set up a virtual cardiac ward to provide intravenous diuretic therapy to people experiencing an exacerbation of their heart failure.

We use telecare devices from our CareCall service to support people in our virtual clinics where appropriate.

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PRIORITY 4:

Work in collaboration with colleagues across Mid and South Essex Integrated Care System to review the community nursing service structure required for the future so that good quality care and service delivery can be maintained and enhanced.

WHAT WE ACHIEVED: We have worked with EPUT and NELFT colleagues to implement the following projects: Implementation of National Wound Care Strategy - we have commenced work on staff training and competencies and implementing lower leg wound standards.

Review of Catheter Management Pathways.

End of Life Care - we have identified shared competencies for colleagues.

Community Nursing review of capacity and flow.

PRIORITY 5:

Continue to embed good practice in wound care and enhance this through participation in national and local wound strategy groups.

WHAT WE ACHIEVED: We have commenced work on colleague training and competencies and implementing lower leg wound standards as part of being an implementer site for the National Wound Care Strategy.

We have purchased new doppler machines to make assessment of lower limb circulation quicker and more effective so that compression bandaging can be commenced as early as possible if appropriate.

We rolled out leg ulcer clinics for non-housebound patients.

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PRIORITY 6:

Continue to support the national response to the pandemic and support enhanced infection prevention practices in line with the government guidance.

WHAT WE ACHIEVED: We redeployed colleagues to support the national vaccination booster programme.

We redeployed colleagues to support frontline services at the peak of the pandemic in winter 2021 /22 to support more people at home.

We updated IPC guidance as it changed and supported colleagues with advice and training.

We undertook fit test training so colleague FFP3 training was refreshed and training and fit testing was expanded to new colleague groups.

PRIORITY 7:

Create purpose designed and built video conferencing suites.

WHAT WE ACHIEVED: We have created a purpose designed, state of the art, video conferencing suite to provide clinical colleagues with bespoke facilities to undertake clinical consultations with service users. There are 20 individual rooms along with communal meeting areas and rooms.

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PRIORITY 8:

Progress our digitalisation programme and bring about greater access to online health records, online booking, and improved video consultation functionality for the benefit of service users and colleagues.

WHAT WE ACHIEVED: We have rolled out to our community nurses: New mobile phones with better functionality and access to useful Apps Brigid – a new mobile phone app that enables easy access to our electronic patient record system Dragon Medical One – enabling dictation into patient records, emails and more to improve record keeping.

Autoplanner to make planning rotas and staff travel more efficient and to free up clinical staff time for patient care We have also introduced: Digital room booking system for colleagues to book a workspace, virtual clinic room or meeting.

Extended roll out of AirMid App enabling service users to view their own records and book their appointments.

New Communication Annexe enabling choice and self-service for service users to book online appointments and through a patient portal for our Child Health Information Service.

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Looking Forward: Our Priorities for 2022 Our priorities for the year ahead are designed to ensure continued delivery of highquality care across the Provide Group and to contribute to improvement of health and social care services within the health and care systems we work across. We will also prioritise our people to ensure we set in place the systems, culture, training and engagement needed for outstanding service delivery.

Our priorities focus on maintaining and improving:

OUR PRIORITIES FOR 2021/22:

1 Establish new roles within the Quality and Safety team to provide enhanced service functionality across the Provide Group including implementing the NHS Patient Safety Specialist function within the organisation.

2 Implement the new Mid and South Essex

Community Collaborative Engagement Strategy by putting the agreed principles into practice.

3 Implement the Datix Cloud Incident

Patient safety.

Patient experience and customer engagement.

Reporting System. This system will enable incident reporting to be more accessible to colleagues in the Provide Group.

4 Evaluate the governance structure across

the Provide Group to identify opportunities for strengthening what we do.

Clinical effectiveness.

5 Continue to grow and develop community

virtual wards in line with national guidance.

6 Implement and evaluate the impact of new technologies implemented in our service including in our commununity nursing service.

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review of quality performance 23

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This section provides a review of our quality performance in 2020/21 set against the quality standards of being safe, effective, caring, responsive and well-led. The information included demonstrates some of the ways we measure how well we are doing and enables us to explain, where relevant, the action we are taking to improve our performance.

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Statement from Provide Group Chief Nurse and Chief Operating Officer

When you read this Quality Account you will see it has been another enormously busy year and we, once more, had to ask our colleagues to flex and adapt their roles and places of work to help us respond to the ongoing pandemic.

Once more, our colleagues have willingly gone the extra mile to ensure people got the care they needed, and they have worked tirelessly to ensure the services they delivered were of high quality and met the needs of the people using them. I thank them wholeheartedly for their genuine care and their tireless desire to get things right for our service users.

For the year ahead we have set ourselves new priorities for quality improvement in which we aim to strengthen and build on what we have already achieved. This includes continuing to embed the use of new technology to make our services more accessible and efficient and we will continue to forge ever stronger relationships with our health and care sector colleagues to make the transition between services and agencies smoother for the people who use our services.

Our service users are at the heart of everything we do and, although our Quality Account shows once again that we have performed well in maintaining and improving the quality of our services, we are not complacent, and we recognise that for some people their experience of our services will not have been good.

However, their feedback about their experiences through complaints and surveys, or when an incident occurs, does help us to learn and improve so we want to encourage even more feedback and dialogue with our service users in the year ahead through the implementation of our new engagement strategy which has been developed in collaboration with Healthwatch Essex.

There is no doubt that the year ahead will bring new challenges, but I am confident the priorities we have set will enable us to meet these challenges and drive greater improvements in quality.

Stephanie Dawe Group Chief Nurse and Chief Operating Officer

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Safe

Are services safe?

Safe services ensure you are protected from abuse and avoidable harm.

Incident reporting We have an open and transparent reporting culture which encourages colleagues to identify and report incidents or near misses. All reported incidents or near misses are investigated and action is taken where needed to improve safety. During 2021/22 our colleagues continued to demonstrate a good reporting culture with the level of reporting remaining consistent with previous years. Of the incidents reported, 96% resulted in no harm or minor harm.

Number of incidents reported

2019-20

2020/21

2021/22

2,696

2,753

2,597

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2020/21

2021/22

NRLS BENCHMARK

Patient Safety Incidents resulting in Severe Harm

0%

0.06%

0.3%

Patient Safety Incidents resulting in Death

0%

0%

0.3%

H A R M R AT E S

Severe harm

Moderate harm/ damage

No harm/damage

All incidents reported 2021-22 by severity of harm

Minor harm/damage

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Falls In our hospital ward we work to minimise the risk of falls by undertaking falls risk assessments and setting in place care plans to help reduce the risk of falls. People who use our services can be frail and prone to falling, particularly when they are ill or are recovering from illness. In 2021/22 all falls reported resulted in only minor harm.

Falls /1000 bed days

PROVIDE 2021/22

NHS BENCHMARKING OCT 2021

4.2%

5.5%

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Pressure Ulcers We actively encourage our colleagues to report the presence of pressure ulcers discovered on admission to our services or when we carry out care for people in our services.

Pressure ulcers are injuries to the skin and underlying tissue, primarily caused by prolonged pressure on the skin. They usually affect people confined to bed or who sit in a chair for long periods of time. People who are frail, elderly or very ill are more prone to them especially if they have health conditions which affect their circulation, ability to move or ability to eat and drink. We put in place preventative measures to minimise the risk of pressure ulcers developing and to promote healing where they have developed.

Where a pressure ulcer develops while someone is in our care, that results in moderate or severe harm, we review each case at our Harm Free Care Panel, or we may investigate them as serious incidents to identify learning for service improvement. In 2021 we reported 1 category 3 pressure ulcer as a serious incident and reviewed 51 pressure ulcers at our Harm Free Care Panel where we identified improvements in record keeping as points for learning. The majority of pressure ulcers we report result in minor harm.

Pressure Ulcers All Categories Reported 2021/22 160 140 120 100 80 60 40 20 0

Apr

May

All sources

Jun

Jul

Aug

Sep

Provide source

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Nov

Dec

Jan

Feb

Mar

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Medication Safety We report and investigate all medication incidents. The incidents reported may be because of an issue with the supply, timing, administration, prescription or storage of medicines. The number of incidents reported is low and the majority result in either no harm or minor harm only. We have had no incidents which resulted in severe harm or death. We investigated 1 incident as a serious incident in 2021/22. This incident did not result in harm to the person affected.

Medication incidents reported 2021/22 25 20 15 10 5 0

Apr

May

Jun

Jul

Aug

Sep

30

Oct

Nov

Dec

Jan

Feb

Mar

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TECHNOLOGY AND INNOVATION We now provide Tissue Viability Nursing advice and expertise to nurses caring for people in their own homes using video conferencing to do joint patient assessments.

Wound care Delivering safe and effective wound care has remained a top priority for us over the past year and our clinical teams have been very busy reviewing everything we do regarding wound care. One of the key actions we have taken over the past year is to work in collaboration with EPUT and NELFT, our fellow community health care providers in mid Essex.

This collaboration has allowed us to share expertise and work together to standardise and improve how we deliver wound care. One of the joint projects we commenced in 2021/22 is the implementation of the National Wound Care Strategy as we were lucky enough to be chosen by the National team as one of the accelerator sites for early adoption and implementation. This has brought incredible benefits with even more training that is building on the capabilities of our colleagues and improving clinical outcomes for people with lower leg wounds.

We have also agreed a joint dressings formulary for use across mid and south Essex to ensure we have the right range of dressings available that we know are effective and cost-effective.

Additionally, we have developed leg ulcer clinics where people who are not housebound can be treated by appropriately skilled colleagues with all the right equipment in place and we have invested in new equipment to enable us to measure the circulation in legs, an important step in the assessment and management of people with leg ulcers. This new equipment provides better outcomes for people as they enable a faster and more in-depth assessment to be undertaken compared to our previous equipment.

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We have continued with the success of weekly Tissue Viability and Community Nursing colleagues MDT meeting to discuss complex cases. In 2021/22 805 cases were discussed at MDT. We are also continuing to rotate community nurses into the Tissue Viability service for six months to enable them to build on their existing expertise and competencies in complex wound management. One nurse said about the programme:

“I was apprehensive at the start but after meeting with the (Tissue Viability Clinical Manager) and the other people on the secondment, it soon passed, and I became excited. I have undertaken training over the past few weeks and have found this very beneficial as it has refreshed my knowledge as well as providing me with new information. I feel lucky to be part of the TV secondment roll-out programme” We have also established a very informative and highly engaging wound care newsletter which brings together information about current practice, developments in practice and feedback from colleagues engaging in wound care training or projects. Contributors include community nurses, Tissue Viability nurses, Lymphoedema nurses and Podiatrists.

TECHNOLOGY AND INNOVATION We have invested in new doppler equipment for our Tissue Viability Team which has enabled us to assess leg circulation in more depth and patients no longer need to rest for 25 minutes before the scan can take place. It has also reduced the number of people having to be referred for further assessment.

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Infection prevention The Infection Prevention and Control (IPC) Team provides specialist advice and support to the organisation and works closely with our Director for Infection Prevention and Control and our Consultant Microbiologist to ensure the right systems and processes are in place to prevent and control infections in line with national standards, guidance and legislation.

During the second year of the COVID-19 pandemic we continued to follow government COVID-19 guidance to keep our colleagues and people who use our services safe. We also continued to be vigilant for cases of COVID-19 in our service users and colleagues and, where these occurred, we worked with health and social care colleagues including the local government Health Protection Teams to take action to minimise and manage the impact of any outbreaks. We have also ensured, throughout the year, that our colleagues have had access to plentiful supplies of personal protection equipment (PPE) and we have carried out training of colleagues to ensure the correct use of the PPE. Our colleagues have also followed Government guidance for vaccinations and for testing themselves for COVID-19 and self-isolating when they were symptomatic or tested positive.

98%

of our staff have had their first COVID-19 vaccination.

March 2021

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Throughout the year, a key role of our IPC team is to undertake surveillance in our community hospital wards to monitor for infections of concern. These are infections that are hard to treat or have a high likelihood of causing severe illness or death.

There were no reported infections of this kind in our community hospital wards.

INFECTION SURVEILLANCE 2021/22 INFECTIVE ORGANISM

NUMBER OF CASES IDENTIFIED I N CO M M U N I T Y H OS P I TA L WA R D SETTING

MRSA BSI Bacteraemia

0

Clostridium difficile new isolates

0

Escherichia coli bacteraemia

0

In 2021/22 our Board invested in our IPC team which has enabled us to recruit more nurses into the team which will enable us to provide more surveillance, training and support across the organisation in the year ahead.

34

Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

Safeguarding Provide fully encourages and endorses that safeguarding is ‘everybody’s business.’ During year two of the COVID-19 pandemic we continued to be visible and accessible via video calls, as well as in person, to keep in touch and to provide expertise and support to frontline clinical teams with advice, guidance, training and supervision. Our training compliance has been maintained at a high level during the year with 97% of colleagues compliant with level 1 training and 93% of colleagues compliant with level 2 and level 3 training.

Safeguarding Training Compliance Adults 2021/22

Safeguarding Training Compliance Child 2021/22

100

100

95

95

90

90

85

85 Q1 % compliant

Q2 % compliant

Q3 % Q4 % data compliant as at Feb ‘22

Q1 % compliant

Level 1 Adult and Child Level 2 Adult

Q2 % compliant

Q3 % Q4 % data compliant as at Feb ‘22

Level 1 Adult and Child Level 3 Adult

Level 2 Child

Level 3 Child

To keep people safe from abuse, if we have any concerns about the safety of a person or about the care they are receiving, our colleagues report their concerns to Social Care, following the local Safeguarding Board procedures and guidelines, so that action can be taken to protect people. Occasionally Social Care may receive an alert about the care we are delivering to people in our services. When this happens, we investigate and, where needed, work to put right any issues with the care we deliver. In this way, we learn from these incidents and care and safety are improved. In 2021, we had 8 safeguarding alerts raised against us which we investigated and no significant harm or gaps in care were identified. We raised 102 alerts to Social Care. This shows we are vigilant and take action where needed to keep people safe.

SAFEGUARDING ALERT FORMS

2020/21

2021/22

Number of safeguarding alerts raised by Provide to help protect someone from harm.

161

102

Number of safeguarding alerts raised by others where Provide has potentially caused harm.

7

8

35

Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

Safe Staffing To ensure we maintained safe staffing levels during the second year of the pandemic, our teams reported daily on colleague absence to the designated on-call Chief Officer in our Incident Room. In line with rising cases of COVID-19 in the community, some of our colleagues also experienced COVID-19 infections and self-isolated as needed to protect others. Where required, we moved colleagues with the appropriate skills between teams to support services to cover absence.

During the winter of 2021/22, there was a national surge in COVID-19 cases and, in line with NHS guidance, we temporarily paused or reduced some of our services to allow us to redeploy colleagues to help look after more people in our frontline services. This enabled people to leave hospital sooner or even avoid going into hospital because we were able to provide treatment and support to them in their own homes.

We also redeployed clinical colleagues to work in our local vaccination centres, thus contributing to the successful roll-out of the vaccine booster programme.

Business Continuity To ensure continued good co-ordination and management of our response to the impact of the pandemic on our organisation and to contribute effectively to the national, regional and local NHS response, we kept our Incident Room set up throughout 2021 as we had done in 2020. This enabled us to: Maintain oversight of the impact the pandemic was having on our colleagues and our services.

Co-ordinate implementation of Government guidance and requirements.

Keep our colleagues informed of changes.

Co-ordinate service changes and changes to colleagues’ working practices such as working remotely.

Monitor for and manage any outbreaks in our services.

Monitor and manage supplies, equipment and staffing to ensure sufficient resources were available to deliver safe, effective care.

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effective Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

Effective

Are services effective?

Effective services ensure your care, treatment and support achieves good outcomes, helps you to maintain quality of life and is based on the best available evidence.

Competent Colleagues Fit to Practice

All new recruits complete our comprehensive Corporate Induction programme and complete a local induction within their service. We offer colleagues a wide variety of training and development programmes to support their continued development and we keep them upto-date and competent through our mandatory training programme which covers key areas for safety such as: Basic Life Support Moving and Handling Fire Safety Infection Prevention and Control Safeguarding

Overall Mandatory Training Compliance

93%

Information Governance Equality and Diversity Conflict Resolution Dementia Awareness

or above

37

Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

During 2021/22, we ensured mandatory training classes continued to be available to colleagues, both virtually or face-to-face as the pandemic allowed, and we were able to maintain our overall compliance above our target of 90% although individual elements of our mandated training subjects periodically dipped below 90% when we had to focus on supporting the national pandemic response.

Mandatory Training Compliance 2021/22 100 99 98 97 96 95 94 93 92 91 90 89 88 87 86 85

98%

94% 93%

93%

90%

90%

90%

90%

Q1

Q2

Q3

Q4

Compliance KPI

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KPI

Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

In addition to mandatory training for all colleagues, we also supported individual colleagues to undertake specialist training and attend conferences relevant to their specialist areas of practice to enable them to update their knowledge and skills or to develop their leadership skills.

Examples of Training Provided to Individual Staff

Best Manager

Clinical and Professional Leadership Development

Presentation Skills

Long COVID

Health Coaching

Cultural Awareness

Active Bystander

Law at the End of Life

Falls Prevention Management in Older People

Wound Care

Minute Taking Skills

Clinical Supervision

Professional Nurse Advocates

Clinical History Taking and Physical Examination Aspiring Managers Programme

39

Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

Nurse Training and Apprenticeships We supported 37 people on a variety of apprentice programmes during 2021/22, including on the Nurse Degree, Nurse Associate and Social Care programmes.

We strive to give all our apprentices good placements and personal support to maximise their learning and support them to complete their training programmes successfully. We receive a lot of positive feedback from our students such as:

“All staff members were lovely and were very supportive which made the placement much more enjoyable. I was able to learn from them and not be afraid to ask questions to enhance this learning” (Student nurse about Children’s Community Nursing).

40

Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

“Starting in the first week, you were able to integrate me into the team and make me feel welcome straight away. I felt it was easy to approach you and discuss any learning needs or problems I may face during the five weeks of placement or any questions I may have had. The first week was a great introduction to MSK outpatients. Here I was able to watch you and fellow physios in action and see how the process works. Moreover, integrating me into manual handling where appropriate. What was great after this first week of introduction to MSK outpatients was that you were then able to set me up with a caseload and begin practising, with you there if I needed support.

At all times, I felt I was able to maintain safe practice and ensure the patients were getting the best management. Moreover, you were able to give me constructive feedback throughout the five weeks, allowing me to progress areas that need to develop and progress my practice.”

(Physiotherapy Student about Musculoskeletal Physiotherapy Team)

41

Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

Performance Development Reviews (PDRs) It is important for colleagues to have the opportunity to review their performance and discuss their personal contribution to the organisation’s objectives and the quality of care we deliver.

PERFORMANCE DEVELOPMENT REVIEWS (PDRS)

2021/22

% colleagues who had an annual PDR completed

90%

Compliance Audits and Clinical Audit Compliance and clinical audits enable the effectiveness or quality of service delivery to be evaluated and the adherence to standards and procedures to be monitored. Where there are shortfalls in performance actions can be identified to improve the quality of care or patient outcomes; achieve assurance of compliance with clinical standards and identify and minimise risk, waste and inefficiencies.

Examples of Compliance Audits and Clinical Audits Completed in 2021/22

Podiatric Surgery Post Operative Infections

National Early Warning Score (NEWS2)

Impact of COVID-19 on Podiatric Surgery

DNACPR Record Keeping

Physiotherapy Outpatients Service Evaluation

Antimicrobial Prescribing

Minor Operations Test Results

Infection Prevention

Record Keeping

Environmental Cleaning

End of Life Preferred Place of Care Adults and Children

Controlled Drugs

42

Q U A L I T Y

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Information Governance (IG)

Data Protection Toolkit

Standards Exceeded 2021/22 Rating

Information Governance is how we ensure we look after the information people share with us about themselves. We want to maintain the trust people put in us to keep their information safe and we work to continually improve the security of information and records. We recognise the ever-changing threat of potential cyberattacks on our systems, so we regularly update our IT security systems.

Data Security and Protection Toolkit We undertake an annual self-assessment of our compliance using the Data Security and Protection Toolkit which assessed our performance against the National Data Guardian’s 10 data security standards. The last submission of the information governance toolkit took place in June 2021 and we achieved a scoring of ‘Standards Exceeded’. We are on track to achieve the same standard in our 2022 submission.

Cyber Essentials Plus

Accreditation Maintained 2021/22

Cyber Essentials Plus is the highest level of certification offered under the Cyber Essentials scheme which is a Governmentbacked scheme that has been developed by the National Cyber Security Centre and helps organisations protect against cyber security breaches. Provide has held this certification for several years and has again maintained this certification. In 2021/22 we expanded this accreditation to include Tollgate Clinic Ltd and Calvern Care Ltd.

NHS Monthly Cyber Security ATP Report This is another way we are measured for our technical controls using the Windows Exposure Score as the means of assessment.

Provide is proud to maintain a low Windows Exposure Score and this year enrolled our servers into this scheme thereby increasing our monitoring.

ISO27001 is the internationally recognised specification for

Accreditation Maintained 2021/22

an Information Security Management System and helps to reduce information security and data protection risks through several standards, audit and continual improvement.

Provide has this year expanded the coverage of ISO27001 to include all our Child Health Information Services alongside our Technology Service.

43

Q U A L I T Y

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IG Incidents Any errors or incidents concerning the handling, use and storage of person identifiable information is recorded, and we take action to investigate these and learn from them. All incidents are risk assessed and where a serious data incident occurs this is reported to the Information Commissioners Office and investigated as a serious incident. In 2021/22, we investigated one information governance incident as a serious incident and improvements in how we check addresses before we send letters were made as a result of learning from this incident.

To ensure we minimise the risk of incidents occurring, we ensure our colleagues have annual Information Governance refresher training and we share learning from incidents via colleague communication bulletins. In 2021/22, in partnership with NHS Digital, we carried out two simulated phishing exercises to test the ability of our colleagues to identify and manage phishing messages.

44

Q U A L I T Y

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Technology Innovation We have continued to invest in the technology we offer to our services and have brought forward many of our plans to support the continued efforts in response to the COVID-19 pandemic.

Some of the highlights are: New cloud-based telephony system that brings much improved functionality and scalability. We will be expanding this across the Provide Group in 22/23.

Greater digitalisation of our community nursing services which has included: • New mobile phones.

• Brigid – a mobile phone app that enables access to our electronic patient record system.

• Dragon Medical One – software which enables dictation into patient records, emails and much more.

20 new dedicated virtual consultation rooms that have the latest technology in use and additional virtual consultation rooms in Colchester and Halstead.

Enabling service users to view their own records and book their appointments via the AirMid app on a wider scale than ever before.

New Communication Annexe which enables service users to choose their preferred communication methods and gives them the ability to book their own online appointments.

45

caring & responsive Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

Caring and Responsive

Are services caring?

In caring services colleagues involve and treat you with compassion, kindness, dignity and respect.

Are services responsive?

Responsive services are organised so that they meet your needs.

Customer Engagement and Feedback

Our goal is to involve and treat people with compassion, kindness, dignity and respect. Putting our customers first is a top priority for Provide so we empower our colleagues to make the changes they need to improve service delivery for the benefit of our customers. We do this by listening to our customers and being responsive to their feedback.

46

Q U A L I T Y

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Customer Engagement Strategy In 2021/22 The Mid and South Essex Community Collaborative (MSECC) which consists of the three community health care providers, Provide, NELFT and EPUT, worked with Healthwatch to develop an Engagement Strategy to put forward a shared vision and direction for the three community providers to focus on how we engage with the people who use our services. This gives us a firm foundation to establish a programme of work in the year ahead.

47

Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

frien fam Did the care you received feel personal to you and meet your needs?

600

Friends and Family Test (FFT)

The FFT survey asks patients whether they would recommend the service they have received to friends and family who may need similar treatment or care. People also took time to share their views via letter, email and phone calls. It is good to hear all the positive feedback people have given us but also it is also important for people to let us know when their experience is less positive so we can take action to improve our service for others.

The results of our FFT survey show 97% of people’s experience of our services is either good or very good and 98% of people feel they were treated with dignity and respect. In addition, 98% of people felt the care they received was personal and met their needs and 88% of people said their family or carers were involved as much as they wanted them to be, or it was not applicable to them. This is an area we would like to improve on and will consider how we can address this as part of the work we will do in the year ahead to implement our new Engagement Strategy.

500 400 300 200 100 0

Yes

No

Do you feel you were treated with dignity and respect by the team caring for you?

600 500 400 300 200 100 0

Yes

48

No

Q U A L I T Y

A C C O U N T

2 0 2 1 - 2 0 2 2

nds & mily

Were your family or carers involved in your care as much as you wanted them to be?

350 300 250 200 150 100 50 0

Yes

No

Not Applicable

Experience Rating

1200 1000 800 600 400 200 0

Very good

Good

Neither good nor poor

49

Poor

Very poor

Don’t know

Q U A L I T Y

A C C O U N T

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Complaints In 2021/22 our complaint numbers remained low in line with previous years. 50% of the complaints we received were classed as level 1 (low level concerns) and 50% were classed as level 2 (moderate) complaints.

As in previous years we received no level 3 (severe) complaints.

Number of Complaints

2019/20

2020/21

2021/22

180

133

137

We investigate all the complaints we receive with an attitude of openness and honesty, as we believe every complaint can help shine a light on our services and enable us to evaluate what needs to change so we can find ways to do it. It also provides us with the opportunity to engage with our customers and to say sorry when we get it wrong.

In this way we continuously strive to improve the services we deliver. All complaints are reported to our Board and themes and trends are identified along with recommendations for learning and change.

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Essex Wellbeing Service During the early part of the COVID-19 pandemic we developed the Essex Welfare Service (EWS) to support the most vulnerable people in our communities who were shielding.

Since then, we have transitioned the service to offer care to the wider community to help people in many ways including providing practical support such as help with essential shopping, collecting medication and befriending people who are lonely. It also connects people to specialist support with: Adult learning

Feedback from the people who used the Essex Wellbeing Service:

Caring responsibilities Dementia care Drugs and alcohol Finances, benefits, and debt Form filling Healthy eating

‘Remember you helped me and many others to come out of lockdown because you cared for us, and you bothered to help...you provided.’

Housing Home adaptations Learning disability and/or autism Loneliness Mental wellbeing Mobility support Parenting and family matters Physical activity Practical living skills Sensory impairment Sleep Social isolation Smoking cessation

‘It was the entire team who works at Provide Essex Wellbeing Service who kept people like me with full bellies of food which kept everyone in need physically and mentally in a good state.’

‘So, on behalf of everyone like me who was in need of help a big, big, big thanks is in order, you not only provided us with food but you and team members were at end of phone or email to offer help and care to which I am sure everyone you helped are most grateful.’

ESSEX WELLBEING SERVICE

NUMBERS

Completed Jobs

14,419

Volunteers involved

2,585

New clients

35,518

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Timely Access to Services In relevant services we deliver assessment and treatment to our customers within the 18-week waiting time standard.

In line with national guidance for community service providers, during the COVID-19 pandemic we had to temporarily pause or significantly reduce the delivery of several of our services in year one of the pandemic, in 2020, but also for a short time in 2021 to enable us to move colleagues to work in critical frontline services. This has inevitably meant that our service waiting times have increased as a result. Provide is now working with our commissioners and colleagues across our health care system to ensure we monitor our waiting lists and work to bring waiting times down as soon as practically possible.

WA I T I N G TO B E S E E N A N D T R E AT E D

APR 2021

MAR 2022

% IMPROVEMENT

% of people seen treated with 18 weeks

79%

85%

6%

Number of people waiting over 6 weeks (for a diagnostic service)

839

383

54%

Number of people waiting longer than 52 weeks

245

36

85%

52

Q U A L I T Y

A C C O U N T

Others Areas Where We Demonstrate We Are Caring and Responsive We ensure we deliver services in clean, well-maintained premises and we ensure our services maintain COVID-19 safety in line with government guidance.

We treat our customers as individuals and collaborate with them to agree care plans and treatment regimes.

We seek consent before undertaking care or sharing information.

Caring is reflected in our organisational values.

We provide chaperones to maintain people’s safety and dignity.

We provide translation services if people do not speak English.

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well-led Q U A L I T Y

A C C O U N T

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Well-Led Well-led Services?

In well-led services the leadership, management and governance of the organisation make sure it’s providing high-quality care that’s based around your individual needs, that it encourages learning and innovation, and that it promotes an open and fair culture.

Timely Access to Services Our Board know that the key to delivering caring and compassionate services consistently is our clinical and non-clinical colleagues that work across the organisation in every department and service.

Therefore, as a well led organisation, the Board puts in place clear structures and systems to support colleague development as demonstrated in the effective section of this report. The Board also invests in our colleagues to promote their well-being.

In 2021/22 we supported the wellbeing of our colleagues in the following ways: Big Team Challenge – getting colleagues involved in a virtual walk to an exciting destination in the world.

Seated massages Mindfulness drop-in sessions Book Club Big Garden Bird Quiz Pumpkin carving competitions

95%

of our colleagues would recommend Provide to friends and family if they personally needed treatment or care.

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96%

Colleague Engagement is also a top priority for our Board and they seek to engage with colleagues in a variety of ways including: Walking round the organisation to speak to colleagues.

Communication bulletins.

Regular Webinars to provide information and hear colleague views and answer questions.

Weekly video updates providing a summary of key information for the week.

Reverse mentoring sessions.

New starters meet Chief Officers within their first six months to share feedback.

Whistle blowing is encouraged.

Annual colleague survey.

Colleagues have the opportunity to nominate charities close to their heart to receive a Provide donation.

Promoting a culture of visibility and accessibility so colleagues can speak to their manager or more senior managers informally.

of our colleagues received a COVID-19 vaccine.

Our annual colleague survey demonstrated we have a culture of care and compassion with our colleagues being proud to work for our organisation and willing to go the extra mile and with our organisation putting our service users at the heart of what we do. Our colleagues would recommend our organisation as a place to work and as a place for their families to receive care if they need it.

COLLEAGUE SURVEY QUESTIONS 2021/22

PROVIDE RESPONSE

ETS BENCHMARK

I am proud to work for my organisation

92%

90%

In my job, I am willing to go the ‘extra mile’

97%

89%

To friends and family, I would recommend my organisation as a great place to work

83%

82%

I would recommend my organisation to friends and family if they personally needed treatment or care

95%

-

I understand the impact that my job has on our patients / service users / customers

99%

88%

The organisation I work for puts patients / service users / customers at the heart of what it does

91%

89%

I have the right tools and technology to undertake my job

88%

79%

For my job, I am aware of the training and development opportunities available to me

88%

77%

My Line Manager / Supervisor trusts me to take appropriate decisions to perform my job effectively

95%

87%

My team works well together

92%

83%

In my organisation, it is safe to speak up and challenge the way things are done

80%

81%

In my organisation colleagues would raise concerns about disrespectful, discriminatory, or abusive behaviours if they witnessed them

96%

-

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FOUR

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provide.org.uk PBR-4722-2226-01