Quality Questionnaire key findings 2018-19
Andrew Cannon Chief Executive
Jayne Davey Chief Operating Officer
Shaun Parker Chief Financial Officer
Amanda Griffiths Director of Quality
Matthew Flinton Commercial Director
Introduction We are pleased to share the key findings of our second annual Quality Questionnaire for the year 2018-19. Our innovative questionnaire measures the quality of experience of the people we support, recognising that conventional quality metrics in the health and social care sector often fall short of measuring the outcomes that really matter to individuals; their quality of life and wellbeing.
Why do we undertake the Quality Questionnaire? Voyage Care is committed to continuous improvement and we regularly seek out the insights of our regulators, commissioners and fellow health and care professionals. Most crucially though, we understand true quality of care should be measured through the individual experiences of each person being supported; for example their health, participation in daily life and choice making, involvement in their community and their quality of life. There are multiple benefits gained from undertaking the Quality Questionnaire. For individuals, we can evidence their progress over time and how support is enabling them to achieve their goals. For the organisation it highlights the impact we have by identifying positive trends and areas where we have the opportunity to make further improvements. Establishing and completing this unique survey isn’t easy. It takes time and the issues are hard to measure, which is why a similar survey hasn’t been undertaken by other providers but the value is enormous.
People were enabled to be valued members of their local community. There was a genuine emphasis on supporting people to pursue their interests and hobbies. Without the dedicated and focused support from staff, people would not have been able to partake in these activities and to experience new activities for the first time. CQC report, Marlborough House, May 2019
What do the findings tell us? The dedication of our staff teams to enhancing the lives of everyone we support is clear in the findings. We continue to have more services rated Good and Outstanding by the Care Quality Commission than any other provider; and our Welsh and Scottish services are 100% compliant. But more significantly the Quality Questionnaire shows that, over time, we are supporting people to make meaningful improvements in the quality of their life. We are pleased the data shows positive progression in the vast majority of measures across all areas of the questionnaire. Whilst we have made huge strides forward overall, several of the areas where we have seen less positive trends are those for which there is joint or external responsibility. We will be investigating these possible areas of concern with partners to determine what, if any, further action is required. The Quality Questionnaire was completed by/for 2,488 people in receipt of 24-hour support in 2018-19. When it was issued for the first time in 2017-18 it was completed by/for 2,297 people. 1,438 people completed the Quality Questionnaire in both years and the reporting which follows is a summary of the key findings and emerging trends for this consistent cohort over the two years.
Quality of life
96%
97%
+1%
Feel satisfied with how things are going all/ sometimes
99.7%
+0.1%
Feel safe & secure all/sometimes
99.6%
95%
90%
+6%
Choice and control Given choices and people’s general all/sometimes satisfaction with their day to day lives are high level indicators that the care and support we deliver is helping people to live happy and fulfilled lives – our ultimate goal. The questionnaire captures how people feel about their care and support and gives us a clearer picture of our successes and areas for improvement. 17-18 18-19
17-18
18-19
17-18
18-19
Goals The number of people who had their goals revised within the last year increased significantly, which is a powerful indication of the focus placed on supporting people to achieve the outcomes that matter to them.
991 17-18
1,358 18-19
37%
increase
Participation in daily life and choice making As an organisation we firmly believe people should be supported to live life as they choose; the measures around everyday life give a picture of participation levels in the activities that enable people to live fulfilling lives. People who have been on holiday
69%
77%
52%
46%
-13%
The people we support benefit hugely from taking a holiday.
65%
+12%
Participation in shopping
56%
+15%
Participation in meal prep
17-18
18-19
17-18
18-19
17-18
18-19
Is the reduction this year a result of funding constraints or other reasons?
Care management Goals not revised for more than 12 months
930
9
17-18
18-19
17-18
18-19
17-18 18-19
75
1,175
-21%
No A&E admissions
46%
-8%
Named social worker/ care manager from Local Authority
50%
Consistent care planning is integral to the delivery of great care and support. The questionnaire includes a number of measures that combine to give a solid assessment of the structure in place and the resulting benefits of robust care plans on health and care outcomes.
For goal setting to be effective, regular reviews are required!
Community involvement Access to their local community is an important part of supporting people to live active and enriched lives. We measure community interactions to determine whether people are accessing community assets around them on a regular basis, in line with their individual goals and aspirations. This includes measuring their participation in leisure activities, engagement with family and friends as well as whether people are being enabled to make the most of education and employment opportunities. Accessing work experience or employment
91%
56%
62%
9
80
18-19
17-18
18-19
17-18
18-19
34%
33%
36%
37%
-3%
Has a formal advocate
86%
-2%
What more could we do to support and sustain people to have meaningful contact with those who are important to them?
Had contact with friends
88%
Contact with friends and family is an important part of wellbeing.
Had contact with family
+3%
89% 17-18
Health
This year on year increase is a fantastic achievement but 80 people represents 6% of the population surveyed which is no better than the national average. We have to do more to further increase people’s progression opportunities.
+12%
Taken part in daily activities 3+ times in the last 2 months
+2%
Taken part in daily activities 1+ times in the last 2 months
17-18
18-19
17-18
18-19
17-18
18-19
Health inequality is a significant factor in regard to the health outcomes of people with learning disabilities. The questionnaire includes a range of measures to evidence the steps we take to support people to live healthy lives and access health services.
98% of people have had a Health Check in the last two years
Behaviours that challenge Following the introduction of active support and positive behavioural support (PBS) and our continued commitment to STOMP we are delighted with the overwhelmingly positive trends for the measures relating to those we support.
657
-29% 926
18-19
882
768
541
473
-13%
493
-13%
Medication used to reduce behaviours which challenge
17-18
18-19
17-18
18-19
17-18
18-19
Take psychotropic medication
17-18
Any type of behaviours which challenge
529
However, this field wasn’t completed for 45% of people indicating a need for greater understanding and implementation of PBS guidelines.
-7%
PBS guideline in place
29%
decrease
As well as positive progress on overall reductions in the instances of behaviours which challenge, this significant reduction is a key representation of our continued commitment to minimising the use of psychotropic drugs.
Next steps We will continue to undertake the Quality Questionnaire each year, refining the process and interrogating the findings to ensure we are doing all we can to enable the people we support to live life as they choose. There have been some improvements in our processes this year and we are committed to making the questionnaire even easier to complete in future. We are also introducing a portal to enable our managers to understand underlying trends for each individual they support and how local trends compare to the wider organisation. The insight we gain from undertaking the questionnaire leads directly into practice development; what do we need to do more of, what we should improve and what we should stop doing. As we move towards release of the third questionnaire we are asking our teams to review the observations and emerging trends in this report. As an organisation we continue to seek out opportunities to make even more of a difference to the lives of the people we support, as well as reflecting on the many areas of success.