Learn about Avondale Rd, Preston and find out what's happening in the local property market. Keep posted for updates on our trials, fundraising events and achievements. We observed use of the seclusion facilities on the two psychiatric intensive care units Byron and Keats and whilst there were care plans in place and staff observing, we found that 20 episodes of seclusion had not been entered into the log on Byron ward. If we are unable to make contact we may ultimately request assistance from the police, and on occasion (if we are concerned) the police may attempt to access your property. Find Avondale House in Preston, PR2. This meant that nursing staff did not receive the appropriate support and professional development needed to carry out their duties effectively and managers were unable to review their staffs competency or assess the quality of staff performance. Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. For people in the health-based places of safety, risk assessments were completed jointly with the police. Clinics were scheduled weekly at set times with some open and some pre-booked slots. Staff understood and addressed the type of problems presented by the young person and their families. Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005. Staff spoke highly of their line managers and told us they felt listened to. The services had reliable systems, processes and practices in place to keep patients safe and safeguard patients from abuse. Please ask if you would like this support. Our Dementia Home Treatment Teams provide an intensive, safe home treatment service in the least restrictive way. the service is performing badly and we've taken enforcement action against the provider of the service. Motivated and supported patients with care, dignity and respect, so patients felt supported and described positive relationships. However, on other wards patients were offered between 13 and 21 hours of meaningful activity per week. We spoke with 18 patients and three carers. Please enable it to take advantage of the complete set of features! There were a number of wards and services which had furnishings or fittings that had ligature risks (places to which patients intent on self-harm might tie something to strangle themselves). The service proactively monitored and managed staffing levels to ensure patient safety. The quality of risk assessments and care plans was of a good standard overall. Staff were not all trained in basic life support and overall completion of mandatory training was below the trust target. This limited who had access to the sessions. All patients were subjected to searches on return from off-site leave owing to smoking-related risks and a recent serious incident. Email this page Ten ex-HTT patients were interviewed on the care they had received, using thematic analysis of semi-structured interviews. We examined training records of 193 staff employed and we found only 22 (11%) had completed the required training. There was significant damage to Calder and Greenside wards. Patients had access to advocacy services and were aware of their rights under mental health legislation. We found the majority of records reviewed at the Royal Blackburn Hospital did not contain patient views or evidence that patients had been given copies of their care plans. We rated the community health inpatient serviceas 'requiring improvement' overall because: The ward had encountered issues with nurse staffing. staff were knowledgeable about their responsibilities in relation to reporting safeguarding concerns including to external agencies, most care plans were of good quality with evidence of patient involvement, services were being delivered in line with national guidance and best practice, the trust was compliant with the workforce race equality standard and was acting to understand and close the gap between treatment of white staff and those from Black and minority ethnic backgrounds, staff built and maintained good working relationships with agencies and stakeholders external to the trust. This practice was of concern because the trust did not recognise under 18-year olds as children. These were effectively managed and risks mitigated with the use of observation and individual risk management planning. How to access the service. The trust had also not appointed a board member with a specific lead role for end of life care to ensure executive scrutiny. This had a direct impact on patient care. Staff displayed a good knowledge of both the MHA and MCA. Physical restraint was rarely used as staff were confident in the use of de-escalation techniques. Information about how to complain was readily available to young people and their families. Hurstwood ward did not have a designated outdoor space for patients, but they were regularly taken into the hospital grounds to relax and get fresh air. Staff were unsure how long a patient had been in a soiled room. We observed collaboration and communication amongst all members of the multidisciplinary team (MDT) to support the planning and delivery of care. The trust data identified that a total of 575 pressure ulcers had developed whilst patients were on the services caseloads. We did not inspect wards for older people with mental health problems at the Trusts other locations. Patients consented to treatment and were informed about their treatment and were actively involved in decisions about their care, which included choices about date of appointments. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service. PPN NW is a regional membership network for all psychological professionals, experts by experience and stakeholders contributing to NHS commissioned psychological healthcare across the North West of England. Staff involved patients and their carers in the care and treatment they received. The physical space of four of the five health-based places of safety (HBPoS) we visited provided safe, clean environments to assess people. Staff used the Friends and Family test as a formal tool to obtain feedback from patients or their relatives. To service A&E department and Medical Assessment Wards. Although staff assessed risk well, the resulting risk management plans did not address all risk identified and were vague and not personalised. The manager assured us this was due to be corrected. In one case, the lack of response to a patients request led to a serious incident. Most staff understood the trusts visions and values. Back to services overview Content Editor [2] C ontact us. The trust used comprehensive performance monitoring and risk registers, to identify and respond to organisational risks. Risk assessments completed with the police were not present on 40% of the records we looked at. Reported, investigated, and responded to ward incidents, using clear processes to safeguard young people. Staff were positive about the new system. However, because this was a focused inspection we did not re-rate the individual key questions or the overall service. There was a holistic approach to assessing, planning and delivering care and treatment to patients. The trust was unable to provide consistent information relating to this core service. Newtown
This involves intensive home treatment, with visits arranged depending on your needs. They found the service helpful and described positive change that had occurred after contact with the service. They followed good practice with respect to young peoples competence and capacity to consent to or refuse treatment. Audits were carried out on the use of section 136 and the use of HBPoS. Seclusion facilities on Calder, Fairsnape, Greenside wards were poorly equipped. Care plans were person centred and tailored to the individual. There were safe working practices; staff worked to keep themselves and patients safe. This meant that meeting people's diverse needs was embedded in practice. Staff were not receiving regular supervision of their work. Staff had a good awareness of the need to protect patients from abuse and neglect and there were systems in place to support them. This resulted in some people with a personality disorder being admitted to an acute ward whose admission might have been avoided. There were concerns expressed by staff and reflected in the services risk register over the capacity of teams. This resulted in a reliance on the use of agency and bank staff to ensure patients were kept safe. All our staff adopt a holistic approach which is underpinned by the principles of the service which are safe, caring, responsive, effective and well led upholds our core values of respect, privacy and dignity. During the inspection we received feedback from 35 patients. People's diverse needs were integrated in policies and proactively taken into account when devising protocols. the service is performing well and meeting our expectations. Staff knew how to make a safeguarding alert and showed good understanding of safeguarding issues. The buildings were well maintained with adequate access and good infection control measures were in place. 9.3 Community mental health teams; 9.4 Assertive outreach (assertive community treatment) 9.5 Acute day hospital care; 9.6 Vocational rehabilitation; 9.7 Non-acute day hospital care; 9.8 Crisis resolution and home treatment teams; 9.9 Intensive case management; 10. In addition staff on wards told us where the ban was being enforced there had been an increase in incidents as a direct result of the ban. Compliance with staff supervision and appraisal was low at the Junction. There was a clear framework by which the trust was held accountable for its actions, each clinical network had a clear, effective governance structure from board to ward. Podiatry services had implemented a one stop assessment for patients who may require nail surgery which resulted in a reduction of additional appointments for patients and an increase in podiatry staff availability. SY16 2DW
The notes of the service user group meetings showed cancelled activities and leave were common complaints. Governance arrangements were well embedded and there were clear lines of accountability. We rated Lancashire Care NHS Foundation Trust specialist community child and adolescent mental health services as good because: All parents and young people said staff were welcoming, caring and respectful and listened to them. Despite this, longer term staffing issues had been identified in some areas and recruitment plans were in place to address future challenges. This issue had been added to the trusts risk register which showed it had been identified as problem. Patients made complaints about a wide range of issues including concerns about safety on wards, availability and quality of food, cancellation of leave, and staff behaviour. Teams with 24/7 coverage have reduced admissions by 23%; but in some areas admissions were reduced 38-50%. The unit designs were not fit for purpose, they were not being used in the way intended and they persistently failed to meet the basic needs of patients. In case of emergency contact your GP. Families were offered choice regarding their childs care and given the opportunity to ask questions. There was access to translation services and arrangements for patients with sight and hearing loss. FOIA Staff assessed and managed risk well. The service carried out the NHS Friends and Family Test. Staff had access to training and development and there were nurse links for tissue viability, end of life care, dementia, falls and infection control. Infection control audits and hand hygiene were regularly undertaken and results gave assurances of good compliance. HTTs were valued but service users' focus was on goals notably different to factors generally assayed by existing research. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding. Where families and / or carers were involved their opinions and views were also reflected. This occurred when patients had been assessed as needing hospital admission, but there were no beds available. We were told these were being developed. Consent to treatment documentation was not always checked prior to administering medication. Staff did not have access to information that was held on the local authority electronic record system. Individual pods on the CRU had been mixed gender on occasions. To find out more, click here, The local timezone is named Europe / Berlin with an UTC offset of 2 hours. Staff had manageable caseloads which helped to promote staff keeping patients safe. During the inspection there were two patients with these sub-acute conditions. Bookshelf We observed staff attending to patients in a kind and caring manner, with dignity and respect and this was confirmed with patient led assessment results being better than the national average in many areas. The ward teams included or had access to the full range of specialists required to meet the needs of patients on the ward. It had brought innew staff to introduce systems to monitor compliance and improve services; and employed four new staff to reduce waiting lists. Analysis of incidents was undertaken and changes were implemented across the team. This meant that the use of blanket restrictions was low and patients freedoms were proportionate to the level of risk. Recently the whole care sector has been subject to staffing crisis and as a service Avondale have been extremely proactive and successfully recruited additional qualified nurses when others have struggled. Pharmacists attended each ward daily to review prescribing and medication management. Formal clinical supervision was not happening in line with the trust policy. A range of activities were provided at resource centres within the hospital grounds. They were kept up to date about their teams performance. M25 3BL, In If you have been referred or are under the care of the HTT it is essential that we have an agreed plan, with up to date phone / carer details should we need to contact you. There was dissatisfaction with the two day advance ordering process, especially for patients with acquired brain injury. Patients without leave could not attend and patients with leave could only attend if there were enough staff to escort them. Security systems and processes for the site were good and staff had a good understanding of safeguarding policies and practice. Care and treatment, policies and procedures and mandatory training was evidence-based and followed recognisable and approved guidelines. One team held a regular clinic for people to attend. Clinical supervision is an important tool for checking that young people have received the appropriate care and treatment. There were broken door panels that had been boarded up and were awaiting repair. The service did not always have enough nursing staff to meet patients needs. There were good personal safety protocols in place including lone working practices. Patients in Guild Lodge made 65 complaints in the twelve months prior to the inspection, which was the highest number of complaints throughout the trust. This page is monitored daily. Patients told us about staff going the extra mile to support patients. However it was not clear that people who use the service were routinely offered a copy of their care plan. We identified concerns over the transition of young people from CAMHS. Carer involvement and support with care plans and signposting to further community support for carers. The lack of a clear structure from senior management level to ward level had also resulted in a disconnect between the board and the four clinical networks. we have taken enforcement action. Staff supervision rates had been low over the last 12 months. A literature review. Mental Health Act administrators provided input into each ward and provided daily updates on the status of each patient. There was good use of de-escalation techniques across the wards. This had been identified at a previous inspection but not addressed. This had not improved since our last inspection. Patients were subject to restrictive interventions without the appropriate legal safeguards in place. Risks identified on the board assurance framework and corporate risk register reflected those we found in core services. We found that this information was discussed and used effectively to improve the service. The HBPoS were staffed by nurses from the adjacent acute wards when people were brought to the suite. However, access to religious facilities was inconsistent. Staffing concerns meant people sometimes had to wait to see a doctor. From January to August 2016 referral to treatment times for speech and language therapyconsistently missed the 92% standard averaging 89% in this time period. Keep up to date on all the latest news, comments and analysis in your region. Being a member of the North West Psychological Professions Network is free and gives you access to a wide variety of resources and opportunities to contribute and inuence NHS commissioned healthcare. 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. The new appraisal included key objectives and the trusts visions and values. They reported this had impacted on their ability to ensure that staff accessed appraisals, supervision and mandatory training in line with trust policy on some wards. The main aim of our team is to help you manage and resolve your crisis through assessment and treatment in your home environment. Child and adolescent mental health services had a range of suitably qualified staff who offered a choice of therapies to young people and their families. World Psychiatry. This meant that patients requiring a psychological approach were able to access this without delay. Ashton Under Lyne, Records and medicines were appropriately audited . In rating the trust, we took into account the previous ratings of the core services not inspected this time. Although staff we spoke with told us they had received some supervisions and appraisals these were not carried out in line with the trust policy. People referred to the MHCS were usually seen within four hours of referral. MeSH We spoke with four senior managers at the Harbour and looked at a range of policies, procedures and other documents relating to the running of the service. Full programme details to follow in the coming weeks. They took into account the opinions and considerations of people who used the service and where possible other staff. Staff were de-briefed and supported following serious incidents. 11 January 2017. 2012 Jun;21(3):285-95. doi: 10.3109/09638237.2011.637999. We observed that staff took time to communicate with patients in a respectful and compassionate manner and patients were empowered to become active participants in their care. The procurement process and mobilisation of new teams created some obstacles and challenges for the staff andalso some changes in the services systems. Home based treatment enables the team to visit for a period of between 6 8 weeks if clinically indicated. Good' overallbecause: We found good processes in place to reduce the risk of abuse and avoidable harm in the service. Staff were not engaging with the patients when not on observations. The service followed best practice guidance on the decontamination and sterilisation of used dental instruments. Community-based mental health services for adults of working age. There was effective teamwork and visible leadership across the teams. However, at the Junction staff did not know the agreed and allowed medication under the MHA. We were not assured that service users on Community Treatment Order were being read their rights at regular intervals in accordance with the Mental Health Act and code of practice. LD30LU
Overall compliance was 83.9% at January 2015. Home Treatment - operates 8am to 8pm 7 days a week Provides intensive support in the community for people with acute mental health difficulties for a period of up to 6-8 weeks. Assessments had always been completed well within the 72 hours required by the MHA and Code of Practice but not always within the trusts four hour target. From January to August 2016 referral to treatment times for occupational therapy consistently missed the 92% standard averaging 73% in this time period. Home Treatment Teams (HTT) Home Treatment Team supports people living in the community, aged 16 years old or above who have moderate to complex or serious mental health problems across Lancashire. There were some waiting lists but these were within the guidelines from the standard operating procedure of the service delivery timescales. Patients and carers we spoke with were generally positive about staff. There were some issues that impacted negatively on how responsive some services were.
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