We call our long term quality goals BHAGs (Big Hairy Audacious Goals).
They have to be big enough to make people stop and think; hairy or challenging enough to require sustained effort, teamwork, guidance and research to make it happen; and audacious enough to make us aspirational and creative enough to achieve the goal.
Mersey Care adopted this BHAG in 2020 because as a Trust, we remain true to our values that we respect people for what they do and not what they are. Despite racism being rightly regarded as offensive and an offence in law, this hasn’t made the issue go away.
We know equality is still not in place, so we’re committed to lowering the conversational water line.
We want to recognise and call out inequalities, so they’re seen as clearly unacceptable and we aim to do that by supporting our staff in the following ways:
- 100% of new starters to receive Respect and Civility awareness on induction
- Develop Respect and Civility tools to be used as part of team based working interventions to improve patient and staff safety
- Create psychological safety at team level by embedding evidenced-based team working through Mersey Care team accreditation and culture of care improvement plans.
- Increase the number of our workforce attending Just and Learning training (which includes four step process and Respect and Civility)
- Promote Mersey Care Just and Learning journey, achievements, and developments in relation to our people and clinical practices to share our learning widely in the NHS and beyond.
To achieve this we have set the following objectives:
- Create a workforce that is representative of the communities we serve through positive action in recruitment
- To improve understanding of 'what is racism and allyship'
- Improve BAME colleague experience of working within the Trust in line with Restorative Just and Learning Culture approaches
- Reduce the differential between BAME and white staff in their experience of bullying, harassment and abuse
- Identify protected groups disproportionately affected by restricted practice
- Co-produce a standard operating procedure for patients and colleagues on how to report discrimination
- Improve BAME Patient/Service user advocacy representation.
Mersey Care is committed to reducing the number of falls and has introduced new practices to ensure that, which include:
- 100 percent of inpatients have a falls screening within 24 hours of admission and those at risk of falls have a multi-factorial risk assessment and management plan in place
- 20 percent reduction in harm related to falls in inpatient areas taking account of the previous 24 month rolling baseline
- Standardised falls risk assessment process across community settings to be introduced
- Develop a clear pathway for access to support services for those identified as at risk of falling in the community, supported by our integrated care teams.
Mersey Care believes strongly in setting the highest of healthcare standards across everything we do. This includes zero tolerance of harm from medication, which we aim to achieve through the following steps:
- 100 percent drug error reporting to include classification of harm
- Zero moderate or severe harm from drug errors
- 100 percent of medication doses administered and administered on time in EPMA areas
- Reduce errors relating to medicines given by injections to zero, with a focus on dental services and agency staff in 2020/21
- Develop a plan to rollout refresher training to other Trust staff over the next few years
- Implement safety register for high dose anti-psychotic polypharmacy
- 100 percent antimicrobial prescribing reviewed within 72 hours
- 100 percent of medication administration by restrictive method with the risk of psychological harm will be subject to a multidisciplinary review within 48 hours.
We strive for a Restorative Just Culture. This is an environment where we put an equal emphasis on accountability and learning. It’s a culture that instinctively asks, in the case of an adverse event: “what was responsible, not who is responsible”.
Of course, it’s not the same as an uncritically tolerant culture in which anything goes – that would be as inexcusable as a blame culture.
We’ve learnt from established academic works and studied other industries and systems where there's always an element of risk.
Zero tolerance of disrespectful behaviours and racism are now set out in our Trust’s goals.
We’ve created special tools for staff to support civility and manage inappropriate behaviours. This approach has seen a significant reduction in disciplinary cases.
We were the first NHS mental health trust to commit to achieving zero suicides among our service users in 2015.
Mersey Care is a founder member of the Zero Suicide Alliance (ZSA), a collaboration of organisations committed to preventing suicide, and have developed training to give people the skills and confidence to identify, support and signpost someone presenting with suicidal thoughts or behaviour.
You can access the ZSA training here.