Regular environmental quality checks were conducted and patients were able to discuss and resolve environmental issues in community meetings. 20 February 2018. We found this was not consistently applied across the site. Staff told us they would try to re-arrange leave when activities were cancelled, however, in the womens service, the occupational therapist helped to cover leave and activities when there were staff shortages. Staff had a low morale. The ward used nationally recognised assessment tools when monitoring patients health. Staff had an annual appraisal which included setting objectives for personal development and they received regular clinical and managerial supervision. Our team gives people the choice and ability to live as independently as possible. The team was well-led by experienced and committed managers. Paper and electronic records we reviewed were completed to a good standard and included relevant patient information including name, address, date of birth as well as care plans, referrals and safeguarding information as appropriate. We rated acute wards for adults of a working age and psychiatric intensive care units as good because: There was good risk management. SY16 2DW This led to some patients spending several days in a crisis support unit when there were no admission beds available. Learn about Avondale Rd, Preston and find out what's happening in the local property market. Staff had knowledge and skills to deliver effective care and treatment and staff received support and supervision from their managers and peers. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The trust data was incomplete in relation to patients who remained in section 136 suites and admissions over 23 hours to mental health decision units. Staff supervision rates had been low over the last 12 months. The service used National Institute for Health and Care Excellenceguidelines to determine care and treatment. This included patients with a learning disability. Staff provided a range of care and treatment interventions suitable for the patient group and consistent with national guidance on best practice. The ward did not participate in national audits to monitor outcomes of some of the conditions that were being treated, for example, hip fracture and sentinel stroke national audit programme. The service engaged well with staff, patients, external stakeholders and other healthcare professionals well in order to continually improve the service. There was ongoing monitoring of physical health utilising the early warning scores system. Patients told us that generally, they were happy with the service, and comment cards from carers were mostly positive. Patients physical health needs were routinely monitored and acted upon appropriately. We did not rate this service at this inspection. This was a focused inspection with emphasis on specific key lines of enquiry within the safe domain, the responsive domain and the well-led domain. All patients had care plans and detailed risk assessments. One team held a regular clinic for people to attend. At the last inspection we had significant concerns about patient safety andthe functioning of the mental health decision units within the mental health crisis services. We are a multi-disciplinary team including practitioners who are registered nurses, doctors, a social worker, occupational therapist and psychologist, alongside support workers and peer support workers. Patients did not have privacy for phone calls as public phones were located in communal areas and not all had a hood. Regular reviews were done and treatment was delivered in line with evidence based guidance. Complaints about the service were low and young people and their parents/carers had good information about how to raise a complaint. Families were offered choice regarding their childs care and given the opportunity to ask questions. Psychological Professions Network, North West Psychological Professions Network Expert by Experience Steering Group, Talking Therapies Leadership & Innovation Forum (previously known as IAPT), Psychological Wellbeing Practitioner Professional Network. Staff spoke highly of their line managers and told us they felt listened to. In Chorley and South Ribble INTs and the treatment room service, there were not always care plans in place for problems that had been identified. This was a focused inspection which looked at the trusts response to the warning notice issued following our inspection in June 2019. Formal clinical supervision was not happening in line with the trust policy. Throughout the trust we saw positive interactions between staff and patients. Staff understood the trusts vision and values. The risks associated with prolonged stays in section 136 suites and decision units were not recognised. Psychological therapies were available. Waiting times for patients once they had been accepted in a team were short. About Us. Telephone: 0161 271 0278. Seclusion records did not document when a seclusion room had last been cleaned. Carer involvement and support with care plans and signposting to further community support for carers. CATT teams aim to help people at home so they don't have to go into hospital. This demonstrated a lack of connection between service delivery and the board. We will try to maintain continuity of three to five practitioners for core visits, but this may not always be possible (for example, if you are being supported with your medication at regular points in the day). Ward managers were able to access bank and agency staff and staffing levels were adjusted to meet need. On ward 22, we observed staff placing aprons around most patients without any explanation or asking the question if they wanted an apron around them. Patients were very positive about the care they received and we saw patients were treated in a professional and caring manner. There was a suspended ceiling in place at Stock Beck psychiatric intensive care unit which posed a potential ligature risk to patients. A review of patient notes also showed that advanced decisions were recorded for some patients. Medical staff received regular supervision, ensuring that lines of communication and support were in place. Staff supervision rates were low. The service had a dedicated participation lead that supported a group of former patients and parents with experience of tier 3 and tier 4 services to develop and improve services across the child and adolescent mental health service for Lancashire Care. A number of seclusion rooms, a health-based place of safety, and the use of Extra care Areas in the adult mental health service and that child and adolescent mental health service (CAMHS) that were not compliant with the Royal College of Psychiatrists standards and the Mental Health Act Code of Practice. Staff knew and upheld the values of the trust: there was lots of evidence on each ward explaining trust values for both staff and patients. Crisis Resolution and Home Treatment Team (CRHTT) If youre suffering from an acute mental health problem or crisis, we can provide you with a safe and effective home assessment. Patients individual care and treatment was planned using best practice guidance. This resulted in patients raising concerns with us during the inspection. We spoke with 18 patients and three carers. National Library of Medicine Morale within the service was good and staff spoke proudly and passionately about the service which they provided. Patients told us that staff were caring and we observed staff treating patients with kindness, dignity, respect and compassion. There was access to translation services and arrangements for patients with sight and hearing loss. Information provided by the trust showed staff had not received the expected supervisions and appraisals. Your information helps us decide when, where and what to inspect. They understood the trust whistleblowing policy and reported they felt able to raise concerns without fear of victimisation. Staff recently recruited had not received all their mandatory training and inductions. We requested documentation audits specifically for the INTs and were informed by the trust that the INTs had not participated in a documentation audit for the 12 months prior to our inspection. Although the same member of staff may not attend every visit, all staff will be familiar with your situation. We are an independent not for profit charity and have been successfully providing services to individuals with mental health needs since we were established in 1991 as a 50 bedded unit. Proposals were made for greater psycho-and occupational-therapeutic inputs to manage long-term care, and for provision of peer-support within HTTs. The trust continued to experience significant challenges recruiting and retaining staff in some core services. The CAMHS Home Treatment Team provide care to young people living in Stockport, Tameside, Oldham, Rochdale and Bury. The service followed best practice guidance on the decontamination and sterilisation of used dental instruments. FOR ALL DONATIONS PLEASE VISIT OUR JUSTGIVING PAGE BY CLICKING HERE. Teams used a Quality SEEL tool to assess performance and generate improvement. Their aim is to cause minimum disruption to a person's life whilst meeting their needs in the early stages of acute psychiatric presentations. There was a gap in service provision for young people aged 16-18 years old. We rated it as requires improvement because: Our decisions on overall ratings take into account factors including the relative size of services and we use our professional judgement to reach a fair and balanced rating. We were told these were being developed. Team leaders had no consistent system to monitor the uptake of clinical and management supervision of staff. Additionally, we had concerns about the use of mental health decision units for patients under 18 years old. Staff had worked with the trusts violence reduction team to lower incidents of violence and aggression on the wards. Norfolk and Suffolk NHS Foundation Trust When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. Despite this, we found a committed competent staff group who were patient focussed. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. Staff had regular supervision and there was a new structured appraisal process which had quarterly review intervals. Patients and carers we spoke with were positive about staff but acknowledged the impact of staffing levels. The NHS Friends and Family Test results showed the majority of patients would recommend the department to their family and friends. Epub 2013 Jun 20. Gimnez-Dez D, Maldonado Ala R, Rodrguez Jimnez S, Granel N, Torrent Sol L, Bernabeu-Tamayo MD. The ward had input from pharmacists, physiotherapists, occupational therapist and an integrated therapy technician, however, the increased number of patients requiring rehabilitation meant the service was under pressure and some patients did not receive timely treatments. Home Treatment Team - Exeter, East and Mid Devon We provide short term supportive care packages to young people and their families/carers being discharged from acute inpatient wards. Ward environments with the exception of seclusion were clean and a full range of anti-ligature work had been completed. Staff could describe incidents that had been reported and identified actions taken in response. Patients and the ones who were close to them were involved in their care decisions. The standard operating procedure did not correspond with practice in relation to the clock starting for 12-hour breaches. Adverse incidents were reported and reviewed. we have taken enforcement action. Ventilation in reception and in the interview rooms was poor. 1 x Band 6 ED Specialists. Team leaders told staff about outcomes and learning from incidents. Due to our concerns, we used our powers to take immediate enforcement action. This meant that people were empowered to access help and support directly when they needed to, 24 hours a day, seven days a week. Clinic rooms were approapriatley equipped. Managers did not ensure staff received training, supervision and appraisal. The services had good structures, processes, and systems in place to manage current and future performance and ensure quality to drive improvements. The information used in reporting, performance management and delivering quality care was timely and relevant. Staff did not create specific care plans for patients with epilepsy or moving and handling needs. This is an organisation that runs the health and social care services we inspect. Wards were clean, well equipped, well furnished, well maintained and fit for purpose. The service had met the requirements of the warning notice because: The service had enough nursing and medical staff, who knew the patients and received basic training to keep patients safe from avoidable harm. This allowed treatment to be provided in an effective and timely manner. Their aim is to cause minimum disruption to a persons life whilst meeting their needs in the early stages of acute psychiatric presentations. Clinic room temperatures exceeded the maximum of 25 degrees on numerous occasions on four wards. Our Home Treatment team (Southwark) provides a community-based service to support people, aged 18-65, at home, rather than in hospital. While catering for special diets was provided, for example, vegetarian, halal, and altered consistency, it was described as hard to get and same. Epub 2019 Nov 18. However there was insufficient staffing and leadership capacity to ensure that staff supervision, appraisal and team meetings took place regularly. The ward staff knew how to report incidents and as a result improvements were made to ensure patients were safe.
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