Service

Month

Score

Deduction

Assessment (Reason)

Action Taken

Estates

Jan 02

94

None24
(£978)25

Two of the ten standards (key indicators) achieved sub 95 scores: Grounds gardens and indoor planting effectively maintained scored 70; Roads and car parks effectively maintained scored 75. As a result of their relatively low weighting factor [Grounds and gardens 21/504 and Roads and car parks 14/504] the aggregated score for Estates only just fell below 95. The PMS noted that there had been no improvement in the Grounds & gardens despite repeated requests and there were also problems with rubbish, bottles, cigarette ends and chewing gum being left around the main entrance and car parks. Evidence was provided through the complaints procedure and site walk round.

Estates staff agreed to have a cleaning purge over the weekend.

July 03

94

None 
(£1,008)

Five of the ten standards (key indicators) achieved sub 95 scores. Three standards, Effective planned preventative maintenance, Environmental control and Effective maintenance in respect of buildings all scored 94 due to issues such as 'lack of periodic cleaning of fans, fire sensors, vents, kitchens, light diffusers…'. Grounds and gardens and indoor planting effectively maintained scored 80 and Roads and Car Parks effectively maintained scored 87. Problems identified with the Grounds included 'Trees not secured, Kerb Lines unswept and not weed sprayed, weeds not removed'.

Aug 03

94

None 
(£1,008)

Five of the ten standards (key indicators) achieved sub 95 scores.

Effective planned preventive maintenance scored 93 as a result of the contractor failing to provide evidence of PPM being carried out during the month.

Grounds and gardens and indoor planting effectively maintained scored 86 and Roads and Car Parks effectively maintained scored 87. Environmental control and Effective maintenance in respect of buildings scored 93 and 94 respectively with issues identified such as build up of insects in light diffusers and damaged kick plates not repaired or replaced.

The contractor now produces a report which details the PPM program

Since January 2004, more resources (2 extra employees) have been put into grounds and gardens.

Domestics

July 03

94

None 
(£1,153)

Five of the ten standards (key indicators) achieved sub 95 scores. Cleaning Standards was awarded 94 with two areas identified: A&E and OPD. It is not clear from the data provided for the PMS, the extent of these cleaning concerns. Agreed staffing levels, Quick response to ad hoc requests, windows kept clean and cleaning schedules all scored 93 with concerns listed relating to 'insufficient management cover', 'poor standards of cleanliness', 'ingrained stains on stairways and corridors', 'windows not clean' and 'little evidence of reference to work schedules'.

Aug 03

94

£1,153.21

Four of the ten standards (key indicators) achieved sub 95 scores. Agreed staffing levels and Overall management of the service both scored 94. Reasons given in the PMS were 'insufficient management cover' and the 'attitude displayed by the management team'. Cleaning schedules and Windows kept clean both scored 93. Evidence provided included 'internal glass overlooked in all areas visited'.

Sep 03

94

£1,153.21

Five of the ten standards (key indicators) achieved sub 95 scores. Cleaning standards and cleaning schedules both scored 94. The issue identified in the PMS was a lack of attention to detail – hence there was criticism such as 'collection of dust underneath beds', 'soap underneath dispensers' and 'staining on walls'. Windows kept clean scored 93 with observations made of poor standards. Agreed staffing levels also scored 94 with concerns remaining over relief cover/training at ward levels.

Quick response to ad hoc requests also scored 94 evidenced, for example, by the 5 days it took to clean the lifts.

Portering

Oct 00

92

£3,380.20

The only documentation in the PMS archive are the complaints sheets. 8 complaints were received relating to Porters. These included long delays waiting for porters and issues regarding waste collection (such as the inappropriate use of yellow bins). 4 complaints were received relating to internal security – 2 of which referred to the reception desk not being manned.26

In 11 cases these complaints were 'noted'. Further action was instigated in 1 case with a letter from the Trust to Carillion.

Nov 00

93

£2,228.43

The only documentation in the PMS archive are the complaints sheets. 12 complaints were received relating to Porters including responsiveness to requests and poor practices e.g. clinical waste bins used to clear general refuse. 7 complaints were received relating to internal security including problems with key issues and slowness of response.27

In 11 cases these complaints were 'noted'. In the remaining 8 cases action, such as a meeting to discuss, was proposed.

Dec 00

Jan 01

94

94

£1,101.69

£1,101.69

Five of the ten standards (key indicators) achieved sub 95 scores. For both months a score of 92.5 was awarded to 3 key indicators: Response times, Appropriately skilled and trained staff and Quick and easy access to services. The assessment was on the basis of comparison of SLA standards with Help Desk records, complaints and compliments from wards and departments and an analysis of staff duty rosters and training records. The complaint log identified long delays for porters and issues with dedicated Theatre porters. Another key indicator, Grounds and indoor planting, was awarded a score of 87.5 in both months. There were general staff comments regarding 'grounds not maintained' and 'lots of rubbish laying around'. A further key indicator, Roads and car parks effectively maintained, was awarded 92.5 for both months due to the paths and car parks not being kept ice/snow free. There were also complaints regarding poor security service (i.e. doors propped open, loss of sub master key).

Action taken included letters being written to THC Dartford, an investigation into one particular complaint, emails to staff and discussions with various staff members to rectify problems.

June 01

94

£1,108.78

Two of the ten standards (key indicators), Response Times and Appropriately skilled and trained staff, were awarded a score of 92. There were several Portering failures resulting in one patient cancellation and 1-1.5 hour delays (although no specific data is provided regarding the duration of these delays). There were in total 16 complaints about shortfalls in the service.

Staff stepped in to help e.g. transporting patients from wards.

Ongoing consultation between the Trust and FM managers regarding new rotas.

July 03

94

None 
(£1,162)

Five standards (key indicators) achieved sub 95 scores.

Overall management of the service scored 93. The PMS identified an unresolved security breach in occupational health and 'smoking by staff in uniform and immediately outside entrances' as cause for this score. Four areas, Appropriately skilled and trained staff, Routine services, Compliance with the control of infection manual policies and Appropriate equipment kept clean and in good working order, scored 94. These scores were awarded for failure to resolve a lack of flexibility in the X-Ray service, failure to hold a security meeting along with no notes and no security reports received and repeated failure of the waste collection.

July 04

94

None 
(£1,192)

One of the standards (key indicators), Response Times, was awarded a score of 86. The following issues were identified: 13 Complaints: Renton Clinic (2), MRI (3), CT scanning (2), Linden (2) (3hr delay in transferring deceased patient), Daycare (4). Holly Ward: numerous complaints w/c 26/7/04. Ultrasound list cancelled 26/7/04. Pathology delays with samples 24/7/04. A&E incident (no further information given in PMS record).

During this month, Carillion had temporarily employed agency staff to meet an increased demand for Portering. There is an ongoing review of Portering.

Linen & Laundry

Jan 03

94

None 
(£383)

Two of the ten standards (key indicators) scored 93: Sterile Services Unit (SSU) linen service standards maintained and Minimum stock levels maintained. A third standard (indicator) Quick response to requests scored 91. The quality standards survey had not been completed for the monitoring meeting and neither were the satisfaction surveys available. It was reported at the PMS meeting that numerous complaints about the service had been received. Carillion had appointed a new sub-contractor, Synergy, to take over from East Kent Linen Services and hence there were a number of teething problems. This was reflected in a score of 90 awarded to the standard (key indicator) Overall management of the service.

The PMS identified a number of issues to target.

Feb 03

93

None 
(£774)

None of the 10 standards achieved a satisfactory score. Five were scored 94, Four were scored at 93 and one, Overall management of the service, scored 85. It was noted in the Monthly Summary Sheet that "Numerous and regular complaints of insufficient supplies and deliveries received since November 2002 continued and escalated to levels which caused serious operational difficulties in the first week of February, leading to the hand-over to Synergy". The quality standards survey had not been completed. It is however difficult to assess the seriousness of the complaints from the PMS alone since the PMS lists the discussion topics – such as transition period difficulties, insufficient quantities of blankets – without providing more quantifiable evidence or source of evidence other than 'visible inspection'.

Carillion requested a report from Synergy and undertook to address all service issues.

Mar 03

94

£382.68

None of the ten standards achieved a satisfactory score. Seven were scored at 94, one was scored at 93, one was scored at 91 and one, Overall management of the service, was scored at 90. The quality standards survey was not completed. The discussion at the PMS meeting again revolved around start- up period difficulties. Issues such as infected linen and static shocks were discussed.

Carillion agreed to meet with the Trust.

Aug 03

94

£394.52

Seven of the ten standards were below 95. Three were scored at 94, two were scored at 93, one was scored at 92, and Linen appropriate for use was scored at 89. In the latter case, visible inspection had identified inappropriate: nightwear, underwear, bedspreads, pillow cases, canvasses and Theatre Gowns.

Catering

Oct 00

92

£2,303.96

16 comments/complaints logged, some written, some verbal.28 6 related to catering at Trust meetings, 7 related to a poor standard of catering on a ward and 3 related to the prices and standard of catering in the staff dining room.

Mar 01

94

None 
(£751)

One of the standards (key indicators), Accepted catering services, was scored at 92. There had been a poor Patient Environment Action Teams (PEAT) score, several formal complaints and bad external publicity. The patient satisfaction survey and restaurant satisfaction survey produced 'unusual scoring' and required 'reviewing'.

A meeting was set up to discuss the PEAT comments. Menus were rearranged. New instruction sheets were sent to wards regarding food preparation.

July 03

94

£801.27

Six of the ten standards (key indicators) achieved sub 95 scores. Hygiene scored 92. This score was awarded as a result of several observed cleaning failures e.g. 'electrical fans… have a film of dirt', 'filthy ceiling tiles', 'the toaster had ingrained carbon…' and 'wheels on beverage trolley were filthy'.

Availability of clean uniform crockery, cutlery etc. scored 93 due to a variety of issues such as 'plastic apron ties not used', 'no trays used' and 'condiments were filthy'.

Temperature, Choice, Timely service and Overall management of the service scored 94 due to a variety of problems such as 'pre-heat of crockery not effective', 'special requirements not getting to the patients' and 'service is taking far too long'.

Sep 03

93

£1620.76

Eight of the ten standards (key indicators) achieved sub 95 scores. Hygiene scored 75. An inspection of the Medirest Food Production area by the CSM identified 'extremely poor levels of: hygiene and cleanliness of premises and personnel'. There were also concerns regarding equipment 'not appropriate/not working properly and ingrained with dirt', and 'poor food management practices'. Overall management of the service scored 80. Temperature, Timely service, Function catering and Services provided courteously all scored 94 for problems such as 'meal service taking too long'. Choice scored 93 for 'insufficient quantities of popular dishes'. Availability of clean uniform crockery, cutlery etc. scored 90 for a range of problems such as 'blast chiller never used' and 'industrial knives with no blade'.

The CSM called for an immediate action plan to recover the situation.

Oct 03

94

£801.27

Eight of the ten standards (key indicators) achieved sub 95 scores. Overall management scored 91 – although there had been improvements on the previous month's performance, there were still concerns e.g. 'No evidence of Feedback Sheets received by Medirest from STA – requested at each monthly review for over 12 months'. Function Catering scored 91. Two formal complaints had been received from users and the CSM considered that 'the management of this area is lacking'.

Hygiene, Choice and Availability of clean uniform crockery, cutlery etc. all scored 92. With regards to Hygiene, there were still some cleaning concerns e.g. 'Maple Ward: seals on fridges dirty, build up of grime on cupboard shelves…'.

Services provided courteously scored 93 with the PMS noting that 'customer care re-training was required' and that 'staff were eating in the wash-up area'.

Temperature and Timely service scored 94 with unchanged practices in use. In the FM services exception report, April- October 2003, it was reported that '… a further appointment of a fourth Catering Services Manager… revealed some serious concerns with food hygiene issues and an obvious deterioration of cleaning standards, work methods and practices over a period of time'.

A Catering Manager was formally appointed.

Nov 03

94

£801.27

Seven of the ten standards (key indicators) achieved sub 95 scores. Hygiene scored 91. A visit by the CSM to Rowan Ward identified 'seals on fridges dirty and damaged, build up of grime on cupboard shelves…'. Function catering and Availability of clean uniform crockery and cutlery both scored 92 for reasons such as 'two formal complaints' and 'cutlery and crockery not thoroughly clean during ward visit'. Choice scored 93 for various problems over menus. Temperature, Overall management of the service and Services provided courteously all scored 94.

Switchboard

Oct 00

92

£358.07

Complaints suggests poorly trained operators and initial teething problems.

Total:

£18,691 
(£8,411)29 
£27,10230