This week at Hawk we’re proud to announce a new template addition to our checks product – Patient-Led Assessments of Care Environments. If you work in the medical weight loss profession, you’ve probably heard a little about PLACE and it’s role in ensuring high-quality environmental control for surgeries and practices around the country. To go along with our new release, we’ve put together this top-to-bottom guide to the PLACE framework and how you can use it to ensure the highest possible standards for patient care.

Let’s start with a little about the new framework, and how it differs from the previous (PEAT) system.

What is PLACE?

As the name suggests, PLACE is a patient-led system for ensuring the quality of a care environment. The system has been pioneered by NHS trusts in the assessment of hospital ward care/conditions and provides a thorough assessment of environmental concerns from the perspective of real patients. This includes assessments of cleanliness and hygiene, overall facility conditions, well-being and dignity, and social factors. Place aims to ensure:

– Lower infection rates through optimal hygiene standards

– Faster recovery through good food

– Patient privacy

– Safety and comfort

– Pleasant decor and surroundings

– Environments that fulfill patient needs

How does PLACE differ from PEAT?

Up until 2013, the Patient Environment Action Team (PEAT) inspection system was the primary method for hygiene assessment in NHS trusts. Led by a select team of trust staff members, PEAT provided a framework for doctors, matrons, and nurses to assess internal conditions.

One criticism of this staff-led approach was that the concerns of caregivers don’t always correlate directly with those of patients. Perceptions of the care environment can be deeply affected by the assessor’s frame of reference, and patients may have different priorities than staff.

By using a dual patient/staff approach to assessment, PLACE provides management with valuable insight from the perspective of patients. This ensures that patient well-being and safety remain the central concerns of environmental assessment.

How does PLACE work?

PLACE provides a framework through which trusts can recruit patients and service-users, train them in environmental assessment, and enable them to feedback into the management process. Trusts build their own teams of assessors, which consist of both service-users and staff members. Each team must consist of at least 50% patient assessors with a minimum of two.

Patient assessors must fit the following criteria:

– Is a user, rather than a provider, of trust services

– Has not been a member of staff within the last two years

– Must be representative of the trust use-population

When building a new PLACE team, trusts should first contact their local Healthwatch committee, who have a default interest in participating in assessments. If your Healthwatch organisation declines to participate, or cannot provide enough assessors, there are a number of national and local organisations that can help. Take a look at the NHS PLACE Guidance Documentation for detailed information on assessor recruitment.

Inexperienced assessors may require some training in order to carry out their checks correctly. PLACE offers guidance documentation to support the training of new assessors, as well as instructive documentation for assessors themselves.

Whilst the PLACE framework provision covers the bulk of the assessment process, some areas may be left up to the discretion of the trust management (such as assessment team size etc.). Some trusts may find it necessary to be flexible on certain factors, such as team sizes, assessment timings, and provision for patients. Check the PLACE Conduct Guidance documentation to ensure that you’re working within the parameters of a successful assessment. If disputes arise in the fulfilment of PLACE requirements, your local Health and Social Care Information Center can provide support.

Carrying out your assessment

PLACE requires you to carry out assessments at a minimum of 25% of all the wards in your facility, with a lower limit of ten wards. Facilities with fewer than ten must assess all wards. Every year, organisations will be given a six-week window in which to carry out assessments. If you’re unable to fulfil the assessment requirements within this window, you can contact the HSCIC to arrange alternative dates.

Different types of environments will have different requirements for optimal management. The PLACE framework provides for these with individualised checklists for separate wards, facilities, and hospital areas. Checklists include provision for:

– Acute wards

– Communal areas

– Emergency departments

– External areas

– Mental Health wards

– Outpatients

– Food and hydration services

Working with PLACE

We’ve designed our new Hawk template to give trusts an all-in-one solution to PLACE assessment. Using our cloud-based checks system, PLACE managers can assign individual tasks to assessors, watch as they’re ticked off one by one, then aggregate results data for an immediate birds-eye view of the assessment outcome. Our hand-held checking tablets also make life simple for patient assessors, allowing them to work through assigned tasks on a fail-safe and easy-to-use platform.

Hawk offers set-up, training and support services with every platform we implement, so you can be sure you’ll be ready for your next assessment date. We’ve made sure that all assessment forms are available digitally on our platform, meaning that you’re covered no matter your services and facilities.

Quality control during PLACE assessment

The NHS stresses that it is the responsibility of trusts to ensure a high standard of care at all times. This means that no allowances can be made for unusual incidents such as changes in weather, construction work etc. Under some circumstances, such as assessment of mental health wards, assessors should be instructed on special considerations that ensure the highest possible quality of care.

Your PLACE results

Results from PLACE assessments are shared with the Care Quality Commission and published nationally online. The publication of results ensures transparency across all NHS trusts and helps to nurture a culture of ongoing improvement to environmental care across the NHS.

More resources

All the required documentation for a successful PLACE assessment, including assessment forms and guidance notes, can be found at NHS Digital.  

You may also find it useful to look through the 2016 PLACE results publication to see how results are aggregated.