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The Royal College of Psychiatrists Improving the lives of people with mental illness

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The Structure and Process

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Elder-friendly quality mark





Who will data be collected from?

The Quality Mark establishes how 'elder-friendly' a ward is by collecting data from different groups of people:


  • Patients and their carers/family members report their experience of the quality of essential care provided on the ward.


  • Members of the ward team rate their morale, the quality of leadership and teamwork on the ward and whether they have the necessary skills, time and resources to meet the care needs of frail older people. They also participate in structured observations of care interactions.


  • The ward manager evaluates the support available to them in their leadership role and access to specialist clinical services for patients on the ward (continence care, dietary and nutritional advice, physiotherapy etc).


  • A lead clinician evaluates the support provided by the hospital from the point of view of a member of the ward team.


  • Hospital governors provide an external, independent view of the quality of the ward environment and of the food provided for patients.


  • The senior managers of the hospital/trust provide evidence that the board has shown leadership with respect to the care of frail, older people and has reviewed information about the quality of the care provided by the hospital to this group of patients.


The assessment tools


The Quality Mark collects data from multiple sources to create a picture of how ‘elder-friendly’ a hospital ward is. The data is collected in two ways:


  • Questionnaire feedback provides information about how enabled the ward and staff are to provide ‘elder-friendly’ care within the hospital and how the patients find their inpatient experience.
  • Observations of staff and patient interactions using the PIE observation tool.  

This table provides information about the tools the Quality Mark will use and how the information will be collected.


This document details what is measured by the Quality Mark data collection tools.


The Quality Mark structure

The Quality Mark is a two-stage process. Please click on the diagram below to the process model for working towards the award:


Stage I- Assessing Quality

At the point of sign up the ward will submit contextual data and start working towards achievement of the Quality Mark by completing a full set of assessment tools, over a three month period. A minimum number of Patient Questionnaires will be specified.  Feedback in the form of a detailed local report describing and summarising the ward's results will be received by month 5 and will highlight areas for action planning. The ward will then develop and submit an action plan identifying its top priority actions. The ward has 9 months from completing Stage I to begin implementing their action plan and to initiate a second round of assessment. If the report suggests that the ward is not performing at the level required to achieve the Quality Mark, wards will repeat Stage I. If results from Stage I suggest that the ward is already or close to achieving the criteria for being awarded the Quality Mark, the ward will inform the Project Team that they wish to proceed to Stage II.

Stage II - Achieving the Quality Mark

The same assessment tools are used within each stage of the Quality Mark over a three month period. Stage II will require a higher level of patient questionnaire return plus commitment to an external validation process. Within two months of completion, the ward will receive a report detailing their performance and comparing their results with those from the previous round of data collection and additional information obtained from external validation. These results will be forwarded to the Quality Mark's Awards and Advisory Committee (AAC) who will assess whether the results confirm that the ward is meeting the criteria for being awarded the Quality Mark. The decisions from this group will then be ratified by the Royal College of Psychiatrists' Special Committee for Professional Practice and Ethics (SCPPE). If the ward is unsuccessful, they will be able to complete another action plan and continue to make improvements before attempting Stage II again. If successful, the ward will hold the Quality Mark for three years, subject to terms and conditions including  interim review and further patient feedback, before being required to repeat Stage II.


A comprehensive guide to the Quality Mark Assessment and Award process can be found here: Quality Mark Award Process.


How much does it cost?

The Quality Mark aims to be an affordable scheme to encourage the continuous improvement of the care provided to older people.

The cost per ward
for each calendar year of participation to is £1,200 which includes a one day training session for two members of staff in the use of the PIE observation tool.


Where next...


Quality Mark, 2nd Floor, 21 Prescot Street, London, E1 8BB


Tel: 020 3701 2682

Fax: 084 3659 3814


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