Mersey Care NHS Trust was established in 2001 following a merger with Ashworth Hospital. It provides specialist mental health and learning disability services for the people of Liverpool, Sefton and Kirkby.

Mersey Care is one of only three Trusts in the country providing the entire range of specialist mental health services. It provides specialist inpatient and community mental health, learning disability and substance misuse services for adults. It also provides medium secure services for Merseyside and Cheshire, and high secure services covering North West England, the West Midlands and Wales.

Training Provided

We have been providing Advanced Investigation Skills (AIS) to Mersey Care Health Trust (previously Ashworth Hospital) for over 20 years. The course was originally developed for the Special Hospital Services Authority, who identified a gap in the provision of investigative training for complaints within the NHS Mental Health Services.

The Challenges

With the introduction of Root Cause Analysis (RCA) techniques by the National Patient Safety Agency, the Trust needed RCA to be integrated into the AIS programme. They understood that staff needed to be aware of and confident in undertaking investigations in order to be able to gain the full benefit of RCA.

The Solution

Our facilitator worked with the Trust to develop our AIS programme to include RCA techniques. Later we were asked to shorten the course because of time constraints. They also wanted a separate one-day RCA programme for staff who had already attended an AIS programme, to ensure they were all fully conversant with RCA.

The Results

This is a very successful project in terms of:

  • Development of a rolling programme to ensure new managers are trained
  • Achieving consistent high quality feedback from the training sessions
  • Excellent project management and administration throughout
  • Being responsive to changing demands and priorities of the client
  • Inclusion of the Trust’s revised policies and procedures

These benefits were measured via:

  • Individual delegate evaluation
  • Regular meetings with the Trust

Cumbria Partnership NHS Foundation Trust (CPFT) strives to improve the health and well-being of people by delivering high quality healthcare services. They employ approximately 4000 staff and serve a population of almost half a million across the six districts in Cumbria by working closely with GPs, to deliver community-based healthcare.

Training Provided

Bray Leino Learning have delivered Advanced Investigation Skills (AIS) programmes to CPFT since 2007.

The Challenge

In April 2011 the NHS Cumbria Primary Care Trust transferred community services to Cumbria Partnership NHS Foundation Trust (CPFT). As part of the integration of these new services CPFT needed to standardise the approach to investigations.

The new organisation placed greater emphasis on one-to-one interviews as part of the investigation process whilst retaining emphasis on identifying root cause of occurrence. The resulting detailed report was then considered by a panel of Trust Directors and approved prior to sharing with the Primary Care Trust.

The training provided by Bray Leino Learning took account of these local changes with increased reference to guidance from the National Patient Safety Agency, highlighting use of Root Cause Analysis in the final report. The Trust’s policy was updated accordingly with all investigators being required to undertake training in Advanced Investigation Skills.

The Solution

AIS courses were commissioned to train investigators who were transferring from NHS Cumbria to the Trust. Specifically, these courses needed to:

  • Enable staff to create high quality reports that contained facts rather than opinions, and evidence of how they reached their conclusions
  • Standardise the investigation process and report content by using a prescribed format and structure of evidence within reports
  • Integrate analysis of root causes and contributory factors to prevent reoccurrence
  • Clarify the new Trust’s policies and procedures

The Manager responsible for the investigation of critical incidents supported the training by attending each day, discussing delegates’ experiences and responding to their questions. He arranged for specialist advice from a Trust lawyer re use of reports at Inquests and a HR representative to explain the use of reports in Grievance and Disciplinary processes.

The Results

Following the courses, senior managers reported:

  • An improved quality of investigation reports
  • Fewer requests for further information from external agencies following their scrutiny of reports by investigators
  • Enhanced confidence of staff when carrying out investigations into serious untoward incidents and complaints

In addition, the Directors' Panel commented that reports were more accurate in their identification of care and service delivery problems, root causes and contributory factors and this helped with the preparation for Inquests and HR processes.

Estuary Housing Association is a not-for-profit organisation, providing affordable housing and services to residents. It currently owns and manages over 3700 properties throughout the South East. Working within every district in Essex, the three outer East London Boroughs and in the Suffolk Coastal District, Estuary is committed to the provision of good quality housing, care and support services to meet local needs and to contribute to the development of sustainable communities.

Estuary has just over 300 employees and two thirds of these provide care and support to people with learning disabilities. Estuary provides a variety of services including rent collection, gardening, estate management and it is also involved in projects to build new houses.

Training Provided

After detailed consultation and needs analysis with the HR Director, Bray Leino Learning provided 2 training programmes - one in Advanced Investigation Skills and the other in Root Cause Analysis.

The Challenges

Estuary wished to update the skills of its staff in carrying out thorough investigations and root cause analysis, which would in turn:

  • Build on its commitment to the provision of good quality housing, care and support services
  • Meet local needs and contribute to the development of sustainable communities
  • Keep its residents at the heart of everything Estuary does

The Solution

Our facilitator worked in consultation with the organisation and developed the courses to ensure relevance. This was done by using realistic case studies during the programme. The facilitator also provided links between the two courses which ensured all aspects of investigation were covered including the application of root cause analysis techniques.

The Results

The benefits were measured via individual event feedback which was unanimously positive. Praise was given for our ability to:

  • Focus on individual needs ensuring the programme is relevant for delegates
  • Maintain excellent project management and administration throughout
  • Respond to changing demands and priorities
  • Include the organisation’s policies and procedures
  • Achieve consistently high quality feedback from the training sessions

The Fremantle Trust is a registered charity and a not-for-profit business that prides itself in providing first class care and support services for older people and adults with learning disabilities.

The Trust exists solely to serve its customers. Its mission is to enhance the quality of life of every single service user by providing innovative, high quality care and support services in quality environments. The Trust also aims to meet people’s needs for independence, personal choice and control, privacy fulfilment, safety, citizenship and social interaction in respectful and dignified ways that enable them to live more fulfilled lives.

Training Provided

So far we have provided the Trust with a Root Cause Analysis followed by an Advanced Investigation Skills programme in April 2013.

The Challenges

The Director of Operations chose our courses for 12 Home Managers who carry out investigations. There were two key aims: equipping managers with skills and supporting the managers in improving the standards of the reports they produce following investigations.

As a further challenge, the courses needed to closely reflect the caring environment within which the managers work.

The Solution

Our facilitators worked closely with the Trust tailoring the programmes to suit the specific needs and challenges of the Home Managers and by referencing the Trust's policies and procedures. The facilitators also ensured that emphasis was placed on key elements that were important to the Trust.

The Results

The benefits were shown clearly on the delegates’ feedback forms which were all extremely positive. Delegates:

  • Liked the root cause analysis tools and the fact that using them will enable them to carry out more structured, professional investigations
  • Approved of the patient, measured style of delivery which was very focused on meeting the needs of the group
  • All said that they would recommend the course to others
  • Commented positively on the "great methods and style of delivery" and the "practical application of the tools using a realistic case study"
  • Described the facilitators as being "role models – engaging and positive"
  • Gave the AIS programme a rating of 137 out of a maximum of 140 (98%)