Quality improvement award: Using accreditation as a framework to ensure quality improvement at Cuan Mhuire

Cuan Mhuire, winner of the CHKS quality improvement award 2015, is Ireland’s largest voluntary provider of treatment and rehabilitation for people suffering from addiction. It has used the CHKS programme of accreditation successfully to ensure improvements for its residents.
Cuan Mhuire has five treatment centres across Ireland, helping residents who have a dependence on drugs, alcohol or gambling. The residents are supported through a 12/20- week, abstinence-based residential treatment and support programme, which works in partnership with their families.
At Cuan Mhuire, the policies and procedures ensure that the service contributes to residents’ enjoying a good quality of life, experiencing care that is positive, person centred, safe and respectful. Quality of care is regularly monitored and reviewed to ensure continuous development and improvement.
In 2009, it started working towards gaining accreditation. Through accreditation, the process of self-assessment and external peer review set an agenda for service and team development. It has helped the organisation to see where its strengths and weaknesses lie and what needs to be improved in order to achieve the best outcome possible for its residents.
Accreditation helped the organisation on three level – with organisational improvements, staff and also residents. In terms of organisation, the CHKS accreditation programme provided a valuable tool for the organisation, helping to put in place systems for continuous improvement. It set out a framework of policies times and procedures that need to be in place to help provide a consistently high-quality service.
The professional guidance helped Cuan Mhuire operate in line with best practice at all times and also enabled it to examine itself critically against an internationally recognised framework of organisational standards. The most important step for the organisation was to ensure that all policies and procedures were documented. Sister Sheila Cronin is based at the Cuan Mhuire site in Newry, which started the long and significant journey towards accreditation at the beginning of 2013. She says it was a process that brought all the staff together; they worked as a team, taking on board changes and coming up with their own ways to improve. This enables the team to ensure they are working in line with best practice at all times.
To help Cuan Mhuire gain accreditation, the team held local area meetings, looked at what accreditation meant to the staff and ultimately how they could improve outcomes for their residents. Suggestion boxes were put in place and interactive workshops were also held to ensure that everyone knew about what was going on. Induction sessions were introduced and helped staff understand the learning processes and the impact of learning on the outcomes for residents.
For accreditation to be successful, staff had to engage. Sister Sheila says they also wanted to reassure staff that change was happening for a reason and not just for the sake of change. That year, after a lot of hard work, Cuan Mhuire achieved full CHKS accreditation.
Measurement of success was a key factor. Quality improvement audits help to improve support, treatment and outcomes for both residents and their families or carers. Systematic reviews are carried out in selected areas and evaluated against explicit criteria. The centre also worked hard to improve waiting times and 94 per cent of residents are now accommodated within three days of making an initial contact. Risk management has also been improved and staff are now encouraged to report all incidents and near misses so lessons can be learned from them.
A number of quality markers have also been introduced to enhance the experience of residents and of their families or carers. A complaints procedure has been put in place, as have resident and family feedback and support plans. There is also continuous risk assessment in which residents’ safety is a priority.
The audits also highlighted good practice. They revealed that residents were treated with respect and dignity, which is a significant factor. Many people with an addiction feel neglected and suffer with low self-esteem so it is important for them to be treated with respect. Sister Sheila says: “We needed to use the information to make change but also give praise where things were going well. It is important to give praise and keep up staff morale. It all goes to ensure good clinical governance, good management and good residents’ outcomes.
“The accreditation process has helped us to drive quality and safety, and monitor the care provided to residents using our treatment and aftercare facilities.”
Now accreditation has been achieved, the improvements have not stopped and Cuan Mhuire continues to build on the framework to maintain continuous development. It is currently looking at reducing readmission rates for the future by improving follow-up care once a resident has left the centre. As a result of feedback the centre has developed a six-week non-residential relapse programme, which will provide improved follow-up support once a resident has left, andhelp to reduce readmission rates. This support works alongside the two-year aftercare programme for those in recovery and their families.

For advice and further information email info@chks.co.uk.

It was a process that brought all the staff together; they worked as a team, taking on board changes and coming up with their own ways to improve. This enables the team to ensure they are working in line with best practice at all times. Sister Sheila Cronin, Cuan Mhuire