Merry Christmas! Best wishes to everyone in Adult Learning Disabilities.
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LD Staff Briefing – December 2012
Merry Christmas!
Best wishes to everyone
in Adult Learning
Disabilities.
Thank you for all your hard work
this year. Paul Miller,
Dr Satheesh Kumar and Michelle
Churchard-Smith.’
Norovirus affecting hundreds of thousands of people –
take responsibility!
About 880,000 people have been affected by outbreaks of
norovirus across the UK this winter, the Health Protection
Agency (HPA) has said. There have been just over 3,000
confirmed reports of norovirus so far this season, but for
every reported case there are likely to be a further 288
unreported sufferers. It means 880,000 people could be
affected by the stomach bug – an 83% increase on 2011 so
far this season. Norovirus is highly contagious and can be transmitted by contact
with an infected person; by contact with contaminated surfaces or objects or by
consuming contaminated food or water. The virus spreads rapidly in closed
environments such as hospitals, schools and care homes.
Symptoms of norovirus include a sudden onset of vomiting
and/or diarrhoea. Some people may have a temperature,
headache and stomach cramps. The illness usually resolves
in one or two days and there are no long-term effects. Having
norovirus infection is very unpleasant but it is short-lived and
most people will fully recover in a couple of days.
Please remember you must not return to work for 48hrs after your last episode
of diarrhoea or vomiting, to ensure you are fully recovered.
Make sure that you or anyone you are caring for takes plenty of fluids to avoid
dehydration. Over-the-counter medicines can also be useful in reducing headaches
and other aches and pains.
Christmas and New Year arrangements
Please click here
http://www.leicspart.nhs.uk/Library/LDWin
terServiceDirectory20122013.pdf for
everything you’ll need to know about
Christmas and New Year arrangements,
including:
Bed Based Services – Short Break
Homes
Agnes Unit
Community Learning Disabilities
Teams
Clinical Psychology
Speech and Language Therapy Team
Autism, Outreach and Hastings Road Day Centre services
Medical arrangements
Medical on Call arrangements
Managers on Call arrangements and availability
Update on our Performance
The Executive Team congratulated us in November for having no open contacts and
we are successfully bringing our agency expenditure down despite high sickness in
the Division. We are also showing a ‘break-even’ position on the overall Division
budget.
There are still some areas where we need to improve:
To ensure patients/clients have a lead if they are not on CPA we would like
staff to discuss this in their team allocation meeting and then ensure this is
entered onto Maracis as soon as possible.
Personal Development Plans (PDPs). For the first time in months the Division
PDP completion rates have fallen, and we are now red for compliance with
these, please remind your Manager if your PDP is due.
We are still not entering data in a timely manner and this must be improved.
All relevant staff will have a PDP objective related to this but in the meantime
please input your date promptly.
Quality Standards
This is just a reminder that we will be re-auditing compliance with the agreed local
quality standards for working with people in learning disabilities. These are reflected
in the core care pathway document and checklist. Please make sure the checklist is
completed for all referrals to the team from November and evidence of the
discussion or actions are captured in the patient/client notes.
Personal security – please be careful in the car parks
Please remember to take extra care when going to and from car parks, especially in
the darker evenings and around Farm Drive and Mansion House areas.
Report car parking security concerns.
Park in well-lit areas close to your destination.
After dark return to car with colleague if possible.
Have car park access card and car keys handy so you can get into your
car and park/exit quickly.
Close windows, remove ignition keys and remember where your car is
parked.
Do not leave valuables or other attractive items in view in the car. Lock
them in the boot.
Reverse into spaces so you can drive away easily.
Consider protecting your car using window etching and alarms.
Click here to read the Trust’s security guidance, which includes information about car
parking: http://www.leicspart.nhs.uk/Library/PocketSummarySecurity.pdf
Clinical Care Pathways – latest update
From the recent Team Seniors Day there are three messages from each of the
clinical pathways:
1. Epilepsy
a. Please see the assessment guidance (it includes all the NICE
guidelines).
b. Make sure every patient with epilepsy has an annual epilepsy review
using the template given in the pathway.
c. Be aware of risk of SUDEP in people with epilepsy and make carers
aware of this as well.
2. Dementia
a. Make sure that patients suspected to have dementia have a physical
health examination (where this is not possible use OK health check at
the minimum) as well as the dementia screening blood tests.
b. Make sure psychiatrists, community nurses and OTs undertake their
identified roles in the assessment and management.
c. Be aware of the end of life care guidance and implement this in
practice.
3. Mental Health pathway
a. Familiarise with the trigger lists from HoNOS but use clinical judgement
and discussion with psychiatrists before triggering the pathway.
b. Awareness of the treatment protocols for specific mental health
conditions
c. Use of the accessible information to educate users and carers on
mental health conditions as well as medications.
4. Challenging behaviour pathway
a. Use the framework of functional analysis in CB assessments
b. Be aware of your role in the management of challenging behaviour (as
outlined in the Care Pathway)
c. Use pro-active behavioural, communication and environmental
approaches before proceeding to the use of interventions or other
restrictive interventions. All challenging behaviour care plans should
have evidence of proactive, active and reactive strategies in place.
5. Eating and drinking pathway
a. We are doing timely assessments and signposting to right care
(foundation work assessment)
b. Bring back the assessment to the locality team and discuss the findings
to arrive at a care plan.
c. Undertake multi-disciplinary visits where necessary
6. Forensic pathway
a. Be aware of the offending risks in people with LD
b. Thorough risk assessments are the key to a good management
(discuss and consult)
c. Consider multi agency approach (MAPA, CPA framework for multi-
agency liaison, etc.)
7. ASD Pathway
a. Ensure the individual has a clear diagnosis
b. Support carers and users in understanding what Autism means to them
and where to get good help.
c. Be aware of your role in the management of the patient
If you wish to discuss any matters further, please contact the Pathway Leads. Click
here for more information about the Care Pathways:
http://www.leicspart.nhs.uk/_Divisions-LearningDisabilityService-CarePathways.aspx
Short breaks – potential home move
The Trust currently runs a short term break home at Tournament Road in Glenfield,
Leicester. This is available for use by adults with severe learning disabilities, many of
whom have a combination of physical and challenging behaviours. This bungalow
has been adapted many times over the years to improve accessibility, but now
requires extensive structural work if it is to continue to be used. The Trust now needs
to consider whether to invest a large sum of money into carrying out this structural
work or move the facility to another home. The Trust and the West Leicestershire
Clinical Commissioning Group have been working with staff, service commissioners,
Leicestershire LINk (Local Involvement Network) and The Carers’ Centre (previously
CLASP) to look at what the options might be. One of these is to move from
Tournament Road into 2, The Grange on the Glenfield Hospital site. This is next door
to another of the short breaks homes. We’ll keep you updated on progress.
Clinical Photography – guidelines and policy
Clinical photography is used in the Trust to monitor
the progress and deterioration of some wounds and for educational purposes.
This is recorded in the Trust policy for consent available on eSource here:
http://www.leicspart.nhs.uk/Library/ConsentPolicy_Final_October2012.pdf
The following are general guidelines:
• Any wounds where safeguarding is a potential concern must be
photographed on first contact.
• A Trust camera and not a personal mobile phone or any other device
must be used.
• There must be no possibility of recognition from the photo.
• Consent must be recorded in the notes.
• Genitalia must be covered to preserve dignity.
• Where tissue damage has occurred around the genitals and
safeguarding is a concern clinical judgement must be used.
• Clinical judgement is paramount in the decision to utilise photography
at end of life; this must be clearly documented.
Please contact your divisional Tissue Viability or Safeguarding nurse with any
queries.
Therapeutics and Learning Disability symposium success
The Therapeutics and Learning Disability
symposium, held on 9 November at the
Leicester Marriott Hotel, was a huge
success this year with over 130 delegates
from all over the region attending. The
conference is hosted annually by the
Learning Disability Division of LPT in
collaboration with Partnerships In Care
and was inaugurated on this occasion by
Prof Richard Collacott. There were a
variety of topics related to care and
support of people with learning disability. The morning session consisted of lectures
by eminent academics and clinicians on topics ranging from annual health checks,
future direction of inpatient services, and forensic aspects of learning disability. The
afternoon comprised two parallel sessions of four seminars each on topics including
pharmacology, care pathways, guidelines, assistive technology, psychotherapy,
commissioning and innovation. The organisers would like to thank the speakers and
the delegates who attended.
Infection Prevention and Control mandatory training - are you up to date?
As a Division we have very low rates of compliance with Infection Control Training;
only 7% for clinical staff. We have been given a challenge to improve our compliance
rates by the end of March 2013. It is mandatory to undergo update training every
three years. Training is taking place on 11 and 18 January, between 1-4pm and 8
and 15 February between 1-4pm. The training will be held in the Recreational Hall at
Mansion House and can be booked via Debra.Beadman@leicspart.nhs.uk or on
0116 295 7155.
On a related note, Antonia Garfoot, Senior Infection Control Nurse, would
like to say Merry Christmas and a Happy New Year to all her Link Nurses
- thank you for your work carrying out this role.
Training dates
Dates for resuscitation training and Strategies for Crisis Intervention and Prevention
(SCIP) can be found in the Academy Course Directory. Some topics – particularly
resuscitation training – have very limited spaces at present and therefore it is
recommended you call the Academy on 0116 225 3669 to get the latest availability.
More course dates for January to March 2013 are being planned and will be
advertised through the Trust e-Newsletter and cascaded through divisional
management teams.
New resuscitation dates available
In response to demand, extra dates have been scheduled for January to March
2013. If you are out of date with adult basic life support, adult and paediatric basic
life support or adult immediate life support please call The Academy on 0116 225
3669 for the latest availability. If you are unsure which resuscitation you are required
to attend in your role the Academy’s Course Directory gives some basic guidance or
you can contact them to check at academy@leicspart.nhs.uk or 0116 225 3669.
Fire safety training
It is mandatory for every member of staff to complete Fire Safety training every year.
Training can be accessed in one of two ways:
Attending Trust Induction (for new starters) and the three-yearly core
mandatory training workshop. Dates can be found in the Course Directory. By
attending one of those training programmes you will be compliant with fire
safety awareness training for one year.
In the years when you do not attend induction or a core mandatory training
workshop you should complete a Fire Safety Checklist with your manager.
The checklist is designed to refresh your memory of fire safety procedures
specific to your work area. This can be found here:
http://www.leicspart.nhs.uk/Library/FireRefresherChecklistSept12.pdf
For further information please visit: http://www.leicspart.nhs.uk/_SupportServices-
EstatesandFacillities-FireSafety.aspx
New policies
A number of policies have been adopted by relevant Board Committees in November
2012 and are now available on e-Source. These are:
Name of Policy Link
H&S Policies
Respiratory Sensitisers and http://www.leicspart.nhs.uk/Library/RespiratorySens
Health Surveillance Policy itisersandHealthSurveillancePolicy_Final_Novembe
r2012.pdf
HR Policies
Dress Code and Uniform http://www.leicspart.nhs.uk/Library/Uniformandwork
Policy wearpolicy2012Finaldoc.pdf
Voluntary Redundancy http://www.leicspart.nhs.uk/Library/VoluntaryRedun
Scheme dancyScheme.pdf
Patient Safety and Experience Group
Venepuncture Policy http://www.leicspart.nhs.uk/Library/VenepuncturePo
licy_Final_November2012.pdf
Senior Clinical Quality Group
Clinical Supervision Policy http://www.leicspart.nhs.uk/Library/ClinicalSupervisi
onPolicy_Final_November2012.pdf
Searching of Patients http://www.leicspart.nhs.uk/Library/ProcedureforSe
archingPatients_January2011.pdf
Please note that the most up to date Directory of LPT Policies 2012 is now
available on e-Source and staff will be informed accordingly via this week’s e-
Newsletter.
Research grants available – but be quick!
Do you have an idea for patient focused research that, when developed and
undertaken, will translate into direct patient benefit? If so, there are Trust awards of
up to £2,500 available for you to take your project forward. The closing date is 25
January, and you will need to submit a short proposal. Click here to find out more:
http://www.leicspart.nhs.uk/Library/AwardsSchemeRevisedDec2012.pdf
Clinical Audit in Adult Learning Disabilities
The clinical audit team is keen to spread the
word about clinical audit and will be regularly
appearing in this newsletter to promote its
involvement in Adult Learning Disabilities. If you
have participated in an audit and not known the
outcome let the team know and they’ll try and
feedback in future newsletters.
Did you know that Clinical Audit is all about improving the quality of patient care? It
enables us to drive up standards, demonstrate quality improvement and plays a
pivotal role in quality assurance. Did you also know that:
“All clinical staff working in LPT are expected to participate in the clinical audit
programme and to accept responsibility for carrying out and/or acting on individual
clinical audits and their findings, and to make the necessary changes to improve
patient experience and outcomes.” Clinical Audit policy, page 6.
The division has a dedicated clinical audit officer, Elena Wragg (pictured above).
Elena assists staff on all aspects of the audit cycle, which includes advising on and
developing appropriate audit methodology and design, inputting and analysing data
and preparing audit reports and action plans. Elena can be contacted on Tel: 0116
295 7636.
For a clinical audit to take place it needs to be approved and eventually audit results
shared at the divisions Clinical Research & Audit Group (CRAG). The group is
chaired by John Devapriam and includes representatives from all service areas.
Clinical Supervision Audit – for all clinical staff to complete
Clinical Supervision is a formal process of professional support and learning where
staff can talk through any issues about their role, or about the people they provide
care, treatment and support to, with their line manager or supervisor. It includes one-
to-one sessions or peer group meetings, and enables staff to develop knowledge,
competence and take responsibility for their own practice and enhance patient care.
Please complete the audit as it will enable the Trust to identify the number of staff
receiving clinical supervision and gather information to inform future training and
policies. If you are a clinical member of staff and have not yet completed the
audit, please click on the link below. The audit will take less than five minutes to
complete: http://s.zoomerang.com/s/ClinicalSupervision_LD
If you would like further information about the audit, please contact Janie Chan
(Janie.Chan@leicspart.nhs.uk) or Diane Postle (Diane.Postle@leicspart.nhs.uk).
Police reminder – suspects may breach bail
At times Leicestershire Police will come into contact with
families who are clients for social care services. In some
cases suspects will be arrested and given bail, either so
further enquiries can be carried out, or so that they can
attend court. Often bail is granted subject to certain
conditions, which are designed to reduce the risk of further
offences being committed. These may include a ban on
making contact with alleged victims or witnesses, a ban on
visiting certain locations, or a requirement to live at a
particular address. Although the police will monitor and
where necessary take action for any breaches, you should not assume that the
suspects will obey those conditions. You should still consider a full range of
options to safeguard vulnerable families and individuals.
Do you have some news? If you’d like to have your good news included in this Staff Briefing, please contact Paul Widdowfield, Communications Manager, on paul.widdowfield@leicspart.nhs.uk or 0116 295 0924.
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