Update on Healthwatch Enter and View Portfolio ECS Board 11 th September 2013

What is ‘Enter and View’? Legislation Health and Social Care Act 2012: Part 5, Public Involvement and Local Government and established through legislation under Part 6, Section 4 of the NHS Bodies and Local Authorities (Partnership Arrangements, Care Trusts, Public Health and Local Healthhwatch) Regulation Enter and View’ is the opportunity for authorised representatives: To go into health and social care premises to hear and see how the consumer experiences the service To collect the views of service users (patients and residents) at the point of service delivery To collect the views of carers and relatives of service users To observe the nature and quality of services – observation involving all the senses To collate evidence-based feedback To report to providers, CQC, Local Authority and NHS commissioners and quality assurers, Healthwatch England and any other relevant partners To develop insights and recommendations across multiple visits to inform strategic decision making at local and national levels.

To encourage, support, recommend and influence service improvement – by: Capturing and reflecting the views of service users who often go unheard, e.g. care home residents Offering service users an independent, trusted party (lay person) with whom they feel comfortable sharing experiences Engaging carers and relatives Identifying and sharing ‘best practice’, e.g. activities that work well Keeping ‘quality of life’ matters firmly on the agenda Encouraging providers to engage with local Healthwatch as a ‘critical friend’, outside of formal inspection Gathering evidence at the point of service delivery, to add to a wider understanding of how services are delivered to local people Supporting the local Healthwatch remit to help ensure that the views and feedback from service users and carers play an integral part in local commissioning Spreading-the-word about local Healthwatch. Key benefits of ‘Enter and View’

Healthwatch England Recommendations Undertaking Enter & View with clear purpose Robust training and authorisation of Authorised Visitors Clear governance process for the authorisation of enter and view visits (see flow chart below) Clearly defined process for planning, scheduling and undertaking enter and view activities Clear methodology for gathering information: e.g. standard questions, surveys, talking to patients, residents, carers, relatives and staff Concise mechanism for recording observations and patient and resident stories Enter &View Drivers for Change

Does this service fall within the remit and Regulations for Local Healthwatch? Does this Enter and View visit have a clear purpose? Does this visit support Healthwatch Priorities or a wider piece of work? Is an Enter and View visit likely to lead to effective outcomes and/or service improvements? Are Regulators, Commissioners, or Quality Monitoring officers already involved? Could this be duplicating some other work? Has the issue been referred from the community, Commissioners, Regulators? Are there adequate resources and volunteer capacity to available to undertake this activity? To the Healthwatch Advisory Group for approval To H.A.G. For consideration Leave out Yes No Yes No Yes No Is this based on feedback and/or evidence of issues? Yes No

Enter and View Drivers for Change Changes to CQC Regulations in respect of Registration and Inspection processes: New operational model Clear standards 1.Fundamentals of Care 2.Expected standards of care 3.High Quality Care Rating judgement More rigorous registration process and criteria Inspection Taking Action - new powers to: Hold individuals accountable for poor care Prosecute before issue of a formal warning first Sharing information and reports Judgement and Publication Outstanding Good Requires Improvement Inadequate

Enter & View Drivers for Change Feedback from Healthwatch volunteers: Would like standard questions Would like to do unannounced visits Would like to have a clear purpose to visits and not just a number of visits per quarter Simpler process Less paperwork to deal with  just need key highlights for purpose of, and background information to, the visit

Simpler report format that takes less time to complete Better communication  Now produce a weekly bulletin to give information and updates which has received positive feedback from volunteers that this has improved communication Skills training  e.g. Dementia awareness, learning difficulties Bring volunteers together as a cohesive team  share best practice – come together as a group – proposal for two events per year Support  dedicated Enter & View lead recruited, dedicated admin support, volunteer co-ordination Skill match Authorised Visitors in interest areas for visit  introduction of skills audit

E&V workshop evaluation Quotes from Healthwatch Champions “Healthwatch staff were as ever very helpful and supportive and ensured participants had opportunity to express their views”. “Informative and very useful.” “A really good day: constructive; informative; good natured.” “Well done, hope we can meet up regularly.” “Very informative, I gain confidence every time.” In response to the question “Do you feel the format of this workshop was well balanced and productive? Would you like us to use a similar format in the future?” Volunteers scored us 4.5 out of 5

Enter and View Process

Enter and View Visits Key to capture patient and service provider experience - the centre of everything we do Proposals to make more robust and more impact - structured questionnaire (yes / no questions, supporting information, stories, recommendations) Expanding portfolio of primary care (pharmacies, GP’s, dentists etc) as well as Healthwatch priorities 27 Volunteers attended the E&V workshop considered different methods to support the Healthwatch priorities and ways to gather evidence from visits using differing formats

Healthwatch Champions Authorised Representatives Derbyshire – 2 Total - 46 Stoke-on-Trent: 2 Those who have expressed an interest in Enter & View or are ARs – 46 Current ARs - 21 Those who have signed up to E&V training - 25

Volunteer Training Core training sessions: Induction Training including Equality and Diversity and Data Protection and confidentiality Enter and View Training and Assessment Enter and View Refresher Training Mental Capacity Act 2005 Protection of Vulnerable Acts (Safeguarding) Deprivation of Liberty (DOLs) Dementia Awareness Learning Disability Awareness Optional skills sessions: Reporting writing Listening and Communication skills Attending meetings

Schedule of Activity Planned visits include from September – October 2013: 6 visits to Care Homes across Lichfield, Tamworth, Cannock, Stafford and Burton upon Trent 1 visit to an acute hospital Visits will be a mix of announced and unannounced Clear purpose for visits defined based on feedback and information received

Strategic partners with whom local Healthwatch should work to achieve service improvements

Next Steps Ongoing recruitment of Healthwatch Champion Authorised Representatives Ongoing schedule of visits in response to feedback received; in support of a Healthwatch priorities and/or a specific project/activity Rolling programme of training Development of enter and view portfolio including primary care services eg. GPs, dentists, pharmacists Development of methodologies to support this eg. mystery shopping, surveys, telephone interviews/questionnaires and face to face interviews.