Part I Minutes of the Dorset HealthCare University NHS Foundation ...

Part I Minutes of the Dorset HealthCare University NHS Foundation Trust
Board of Directors Meeting held on Wednesday 28 th September 2011 in the Conference
Room, Trust HQ, 11 Shelley Road, Boscombe, Bournemouth, BH1 4JQ
Present: Mr T Archer Nurse Executive Director/Chief Operating Officer,
Dorset Community Health Services
Mr M Beesley Non-Executive Director
Mr R Browning Chief Executive
Mr N Chapman Non-Executive Director
Ms J Elson Director of Quality
Mr W French Non-Executive Director
Dr B Grant-Braham Non-Executive Director
Mr C Hague Director of Human Resources (CLH)
Mr R Jackson Director of Finance and Performance
Dr L Mynors-Wallis Medical Director
Ms J Owens Non-Executive Director
Ms H Robinson Non-Executive Director
Mr J Walsh Chairman
In
Attendance: Mr J Barton Director of Adult Mental Health Services
Ms L Boland Director of Children’s and Young People’s Services
Ms V Graves Chief Operating Officer, Bournemouth & Poole
Community Health Services
Mr C Harvey General Manager Business Development and
Corporate Assurance/Trust Secretary (CH)
Present for Becky Aldridge General Manager, Dorset Mental Health Forum
Agenda Item Jackie Lawson Recovery Lead, DHUFT
9: Phil Morgan Recovery – CHS
Members of Mr Chris Wakefield LiNKS (Bournemouth)
the Public:
Apologies: Mrs G Fozard Non-Executive Director
Dr D Cope Associate Medical Director (Education)
Pam Donnellan Chief Executive, Bournemouth Borough Council
John McBride Chief Executive, Strategy Directorate Borough of
Poole
109/11 CHAIRMAN’S OPENING REMARKS
Action
Mr Walsh welcomed all to the meeting, especially Mr Chris Wakefield
from Bournemouth LiNKS. He warmly welcomed Mr Browning back to
the Trust and the Board Meeting.
Mr Walsh officially welcomed Ms Elson to the Board as the Executive
Director of Quality.
Mr Walsh reported that the Annual Members Meeting, held on the 8 th
September 2011 at the Carrington House Hotel, was a great success
and was attended by more than 300 people. There was a broad
Page 1 of 10
C:\Documents and Settings\leslford\Local Settings\Temporary Internet Files\OLKED\Part I Board Minutes for 28th September
2011.doc

spread of nominations for the Annual O*S*C*A*R*S Awards from
across the newly enlarged organisation. He hoped that it would be an
even bigger event next year.
Action
Board members had now visited all four prisons where the Trust
provides Prison Health Care Services.
Mr Walsh stated that the “Vision” was being reviewed in partnership
with Bournemouth University. 100 people from across the Trust had
attended a focus event in Blandford and a further event was scheduled
for later today.
CLH
110/11 MINUTES OF PREVIOUS MEETING
• Mr Archer should have been noted as present not “in attendance”.
• It was noted that Mr Wakefield’s name had been incorrectly spelt
in the previous minutes. The Trust Board Secretary apologised
for this and gave assurance that this would be amended in the
Trust minutes and in all future correspondence.
100/11 – Heading should read “Final Compliance Report for Fairmile
House (Flaghead) from CQC from the Director of Quality”. It was also
additionally requested by the Board that Mrs O’Donnell, Director of
Learning Disabilities Services, passes on the Board’s wishes that the
staff involved are to be commended.
SO’D
102/11 – Re Clostridium Difficle Infection - Mr Archer wished to have
an addition made to read, “of those managed there was no cross
infection”.
103/11 – CQC CMHT Survey Results – Mr Barton to action the
comparisons regarding lessons to be learnt.
JB
With the above alterations, the minutes were accepted as a true and
accurate record of the meeting.
111/11 MATTERS ARISING AND ACTION PLAN
87/10 – update on website – Mr Browning advised the Board that Ms
Higdon was leading on the development of a new website for the
Trust. This will be operational by January.
The Service User and Carer Involvement Strategy would be uploaded
onto the Trust’s current website by the end of October.
CH
86/11 – Delayed Transfers (Twynham Ward) – To be discussed with
the Minister of Justice/CEOs/FT Confederation. Mr Browning reported
that he would be meeting with Mental Health Chief Executives within
the South West and raise this topic. He would update the Board
accordingly.
Page 2 of 10
C:\Documents and Settings\leslford\Local Settings\Temporary Internet Files\OLKED\Part I Board Minutes for 28th September
2011.doc

Action
All other items were either on the agenda or completed.
112/11 TREASURY MANAGEMENT POLICY
Mr Jackson introduced this paper and wanted to draw the Board’s
attention to paragraph 4.1, “to approve any extension to the upper limit
of total deposits of £6 million (subject to provisions detailed in point
6.13) within this policy or commercial banks listed in Appendix 1 and
£20 million within this policy for deposits with HM Treasury.”
RJ
There were no comments or questions and the Board formally
approved this policy.
113/11 QUALITY RISK DASHBOARD AND QUALITY REPORT FOR
SEPTEMBER 2011
Quality and Risk Dashboard
Ms Elson introduced this above report and stated that it had been
developed to report Monitor’s key measures related to Quality and
Risk. It was presented in line with the Trust’s Quality Strategy under
the following headings;
Clinical Effectiveness
Patient Safety
Patient Experience
Human Resources
Corporate Risk
Ms Elson identified the key points for the report;
All measures presented were “green” with the exception of the
following;
• % of patients screened on admission for MRSA in community
Hospitals – Red
• Recording of patient identified goals/recovery star as a % of eligible
patients – Red
• Recording of second patient identified goals/recovery star for
eligible patients – Red
• % complaints acknowledged in 3 days – Red
• % of total number of incidents which are risk graded orange or red
– Amber
• % of medicine errors resulting in harm, including low level of harm
– Amber
• % of patient to staff violent episodes resulting in harm – Amber
• Number of hospital acquired pressure ulcers developing Grade 3 –
Amber
• Number of written complaints – Amber
Page 3 of 10
C:\Documents and Settings\leslford\Local Settings\Temporary Internet Files\OLKED\Part I Board Minutes for 28th September
2011.doc

Mr Walsh suggested that the Dashboard could be improved by giving
clearer section headings around Clinical Effectiveness, Patient Safety
and Patient Experience, and that thresholds within Human Resources
should be set across the total enlarged Trust.
Mr Browning considered that the Dashboard should include finance,
be more succinct and not cover more than 1 to 2 pages. The Quality,
Clinical Governance and Risk Committee should examine the
underlying detail behind the report. He was keen to ensure that
thresholds set were not simple averages of current performance, but
were challenging targets to ensure that we achieve the best possible
results. The Dashboard should link quality, staff and finances
demonstrating how these related to each other.
Action
JE
Mr French felt that it was important to be flexible around setting
thresholds to help drive the organisation especially around Human
Resources.
Dr Mynors-Wallis felt that whilst it was possible to reduce the size of
the report, the question was to what extent the Board wanted to see
the full detail as opposed to delegating this to the NED chaired Quality,
Clinical Governance and Risk Committee. However, as a start, it was
useful to have full data.
Mr Browning felt that it was important to choose which were the key
issues and how to bring those together in terms of the delivery of
services, ie the number of “hand offs”, and how quickly and easy it was
to get diagnosis and treatment.
JE
With reference to Line 8 of the report –the percentage of people
screened on admission for MRSA in Community Hospitals, Dr Mynors-
Wallis felt that it was important to know if the MRSA screen test was
done within the timescales identified and therefore, we should report
compliance regardless of whether the tests were performed in acute or
community hospital. The target should therefore be 100% regardless
of where the test was conducted.
Line 20/21 Patient Reported Goals/Recovery Star – Dr Mynors-Wallis,
Mr Barton and Dr Cope would be visiting clinical teams to encourage
improvement. Specifically with this indicator, it was important to note
trends through a rolling 3 month figure.
Mr Walsh thanked Ms Elson for continuing to develop the Dashboard
and this will be refined in the future.
JE
The Board accepted the Report.
Quality Report
Ms Elson reported that the Quality Report provides an overview and
assurance of the Quality of Trust Services compiled under the
Page 4 of 10
C:\Documents and Settings\leslford\Local Settings\Temporary Internet Files\OLKED\Part I Board Minutes for 28th September
2011.doc

headings of Quality of Services, Patient Safety and Patient
Experience.
Action
Ms Elson highlighted the key points from the Quality Report;
• A re-audit of transition (from Child and Adolescent Mental Health
Services to Adult Mental Health) shows a similar position to the
March 2011 audit. Most standards met 100% of the time.
• The Trust is currently participating in the National Audit of
Schizophrenia.
• Following notification from the CQC to all Trusts, an audit of
Radiograph Clinical Evaluation has been added to the Trust’s
Annual Audit Programme. This is underway.
• The results of the national audit on Prescribing of antipsychotics for
people with dementia have been received. The Trust’s results
show compliance with standards was equal to or better than
national average.
• Training and provision of lead staff in Dual Diagnosis (mental
health and drug /alcohol problems) is on target to meet end of year
targets.
• CQC Visit Update
- The Trust has formally written to the CQC to confirm that the
actions resulting from reviews of King’s Park and St Ann’s
Hospitals have been fully implemented.
- One outstanding action following the CQC registration team visit
to Maiden Castle.
- Draft reports on the CQC visits to Forston Clinic and Alderney
Hospital have been received. These are being checked for
factual accuracy.
- Community team sites have been visited in September as part of
the CQC review of services registered to Trust HQ (prior to 1 st
July). A report is awaited.
- CQC and Ofsted are undertaking a joint Safeguarding
Announced Inspection for Dorset during September.
• The total number of incidents for the enlarged organisation in July
was 1149. Risk grades are in line with reporting across the
organisations prior to transfer of community services.
• The membership of the Trust’s falls group and terms of reference
are being reviewed in the light of the enlarged organisation and
data reported on falls report is being reviewed in line with the South
West Patient Safety Programme.
• The Trust received 121 compliments and 20 written complaints
received in July. 23 written complaints were received in August.
• The PEAT results for 2011 have been published. Overall 49 (74%)
scores for Trust sites were ‘Excellent’ in 2011. In comparison to
2010, 2 scores have improved and 6 scores have decreased
• The response rate to a recent Crisis Service (East) discharge
survey was low. All respondents stated that the service met their
needs either completely or to some extent. There was a reduction
in the overall rating of service compared to the previous survey.
Hand held devices are being implemented and focus groups being
TA
TA/JB
Page 5 of 10
C:\Documents and Settings\leslford\Local Settings\Temporary Internet Files\OLKED\Part I Board Minutes for 28th September
2011.doc

carried out to help get a better understanding of people’s
perceptions of the service and how improvements can be made.
Action
Mr Browning indicated that there were issues in the areas where hand
held units are currently used and also some attitude barriers to using
them. Ms Owens felt that it was very useful to capture this information,
but there could be issues around the siting of the devices.
Ms Boland indicated that it was important to reach those people who
didn’t engage with community services potentially using this system.
Mr Barton reported that the Mental Health Forum were triangulating
this information.
Mr Walsh indicated that real time feedback through a website where
individuals could express their thoughts would be useful.
Mr Archer reminded the Board that Mid Staffs had set up their own
website called www.curethenhs
• In a recent survey of the Palliative Care service in Bournemouth
and Poole CHS, 94% of respondents felt that they had access to all
the care they needed; 95% felt that they were provided with good
information from Health Professionals and over 98% felt that they
had been treated with dignity and respect. Areas for action have
been identified and are being taken forward.
114/11 PERFORMANCE REPORT FOR AUGUST 2011
Mr Jackson presented the Performance Report stating that the
financial performance in August was satisfactory to meet the Trust’s
expected financial targets for the year and that the Trust continued to
meet all Monitor’s service compliance measures during August.
In highlighting the contents of the report, Mr Jackson wished to note
that there had been one case of Clostridium Difficle in August within
Community Services in Dorset, resulting in a total of 9 cases since
April. Contractually, the maximum number of cases permitted for the
whole Trust for this year is 25 cases.
Mr Archer commented that whilst the position across Dorset when
compared to other parts of the country was extemporary, the target
was likely to be more challenging next year.
TA
The Board accepted the Report.
115/11 CABINET OFFICE CONSULTATION ON OPEN PUBLIC SERVICE
AND THE FOUNDATION TRUST NETWORK PROPOSED
RESPONSE
Mr Browning introduced this paper, indicating the consultation on the
Page 6 of 10
C:\Documents and Settings\leslford\Local Settings\Temporary Internet Files\OLKED\Part I Board Minutes for 28th September
2011.doc

Open Public Services White Paper which sets out the principles for the
changing the way in which public service are delivered.
The Board noted the paper and supported the Foundation Trust
Network’s proposed response.
Action
RB
116/11 DATES OF THE FORTHCOMING BOARD MEETINGS 2012/13
The Board discussed the arrangements for holding meetings
throughout the County of Dorset utilising wherever possible
Community Hospitals or Local Authority sites. This would provide an
opportunity for staff in the Community Hospitals to meet with Board
members. A range of options were discussed on how this might be
achieved including the possibility of a service based presentation prior
to the Board Meeting as well as a service user perspective.
Mr Archer said that staff throughout Dorset had a real desire to meet
and interact with the Board.
Mr Browning felt that it was important to reduce the number of items
on the Board agenda, so the Board focus is on the big important
issues. Mr Walsh, Mr Browning and Mr Harvey would work on this.
CH
117/11 PRESENTATION FROM DORSET WELLBEING AND RECOVERY
PARTNERSHIP
This was presented by Ms Lawson, Recovery Co-ordinator Lead, Ms
Aldridge, General Manager and Mr Morgan, Recovery Co-ordinator
Lead.
Ms Aldridge thanked the Board for awarding her team the Chairman’s
Award at the recent Annual Members Meeting.
Ms Aldridge said that the Vision was “nothing about us, without us”
and was focused on the lived and transforming experience to unlock
potential. This was based on strong partnerships that underpins
services by putting the expertise of the lived experience in the heart of
the planning, delivery and evaluation. It was important to listen to the
customer to improve efficiency and effectiveness whilst developing the
workforce to deliver excellence. The Annual Report and Strategy was
officially launched today and Ms Aldridge was seeking Board
endorsement of this Strategy.
The attention now was to empower actions to remove obstacles and
change systems or structures that seriously undermined vision. To
encourage risk taking and develop and implement non traditional
ideas, activities and actions.
Ms Aldridge sought support from the Board to help with the future
direction of the initiative around;
• Workforce planning with peer specialists, through the Dorset
Page 7 of 10
C:\Documents and Settings\leslford\Local Settings\Temporary Internet Files\OLKED\Part I Board Minutes for 28th September
2011.doc

Wellbeing and Recovery partnership.
• Risk and positive risk taking including zero restraint
• Recovery Leadership which has worked well in the West and
now needs to be rolled out into the East.
• Promoting vocation and social inclusion - to ensure consistency
of services across the county.
• Using hidden talents
• Establishing a recovery education centre.
Action
Mr Walsh thanked the team for a very informative, thought provoking,
stimulating presentation.
Mr Browning felt that it was important to adopt a policy of self referral
acknowledging this was occurring in some, but not all areas. He said
that it was important to continue to break down the barriers to
accessing services. This had been achieved within Crisis Resolution,
Early Intervention and IAPT Services. He felt that recovery should be
part of the Line Manager Training that occurs across the whole of the
county.
In terms of the Recovery Education Centre – linking with Bournemouth
University could help facilitate this.
Mr Barton considered that the challenge was to change the mind set of
staff focusing on recovery and whilst this might have had its birthplace
in mental health, it was transferable to services within Community
Health Services and therefore it would become a Trust wide piece of
work.
Ms Boland said that it was important to extend this work to include
young people. She was keen to get this philosophy and approach
embedded in Children and Young People’s Services.
Mr Archer said that the real challenge was to get recovery into
everything that we do and to find champions within Community Health
Services to take this forward.
Mr Browning considered that it was important to ensure a strong focus
on Recovery. The importance of Recovery should be promoted to
Doctors in training. The principles of Recovery should be reflected in
the Trust’s new Vision. He suggested that the Board received training
in the Recovery principles.
Mr Walsh again congratulated the team stating that he would want the
Trust to be known as a Recovery Trust.
118/11 DRAFT CHARITABLE FUNDS COMMITTEE MINUTES
The Board accepted these minutes, although considered that the
names of the donors identified in 8.4 and 8.5 should be redacted.
Page 8 of 10
C:\Documents and Settings\leslford\Local Settings\Temporary Internet Files\OLKED\Part I Board Minutes for 28th September
2011.doc

Action
119/11 NATIONAL PATIENTS SAFETY CLUSTER REPORT
This report compared our reported data with those from the Trust’s
Cluster Group enabling comparison of incident reporting data with
similar organisations. Reports for DHUFT, Dorset Community Health
Services and Bournemouth and Poole Community Health Services
prior to the 1 st July were included.
Mr French commented that these reports did not indicate the Board’s
perception that we were a high reporting Trust. Dr Mynors-Wallis
agreed, stating that it was crucial to get a single data system across
the Trust to enable easier drill down of information and that the Trust
had some ground to recover as we were no longer perceived as a high
reporting organisation.
LMW
120/11 APPOINTMENT OF EXECUTIVE DIRECTOR OF QUALITY
Mr Hague was pleased to report that the interview panel who met on
the 1 st September 2011 comprising of;
Mr Walsh, Chair, DHUFT
Mr Jackson, Acting Chief Executive
Ms Bode, Chair of Southern Health NHS Foundation Trust,
Mrs Fozard, Non Executive
Mr Grant-Braham, Non Executive
Ms Webb, Governor
Ms Graves, Chief Operating Officer
appointed Ms Elson as the Executive Director of Quality.
Mr Walsh formally welcomed Ms Elson to the Board, stating that Ms
Elson impressed the panel through endorsing importance of focusing
on the exceptional patient experience as well as demonstrating clear
commitment to quality and supporting quality improvements.
121/11 SIGNIFICANT ISSUES FROM DIRECTORS
None reported.
122/11 ANY OTHER BUSINESS
None
123/11 DATE OF NEXT MEETING
The next Trust Board meeting will take place at 9.30am on
Wednesday 26 th October 2011, Weymouth Community Fire Station,
Radipole Lane, Weymouth, DT4 0QF
Signed: …………………………………
Mr J Walsh, Chair
Date: …………………
Page 9 of 10
C:\Documents and Settings\leslford\Local Settings\Temporary Internet Files\OLKED\Part I Board Minutes for 28th September
2011.doc

Page 10 of 10
C:\Documents and Settings\leslford\Local Settings\Temporary Internet Files\OLKED\Part I Board Minutes for 28th September
2011.doc