Please ask if you would like this support. Connect with other psychological professionals and stakeholders and grow your professional network. Patients were treated with dignity, respect and compassion whilst receiving care and treatment. Staff understood how to protect patients from abuse and they worked well with other agencies to do so. However, the provider had carried out a safer staffing review that acknowledged the different staffing needs in the new model of mental health urgent assessment centres and were implementing the review recommendations. While safeguarding specialist nurses were available to provide telephone advice and team leaders were available for ad hoc support, this meant that not all safeguarding cases were subject to objective, critical reflection. Care and treatment, policies and procedures and mandatory training was evidence-based and followed recognisable and approved guidelines. Review of meeting notes on Marshaw ward confirmed that leave was cancelled owing to staffing issues. However, this policy would not be appropriate for low secure or step-down services without individual risk assessment. Staff felt involved in the process. However, we requested feedback from patient surveys carried out by the provider. In September 2013, the CQC asked the trust to review the environment of the seclusion room shared by Whinfell and Bleasdale wards. We are looking at different ways to indicate the outcomes of our monitoring in the future. In other community health services waiting times were reasonable except for chronic fatigue service appointments, which were much worse than the expected six weeks, with an average waiting time of 60 weeks. Care plans were of a high standard. Our Home Treatment team (Southwark) provides a community based service to support people, aged 18-65, at home, rather than in hospital. Thomas MACDONAGH, FY1 Doctor of Lancashire Care NHS Foundation Trust, Preston | Contact Thomas MACDONAGH Avondale Unit RPH, North West Posted today Applied Saved. Furniture in the mental health crisis rooms in Blackburn was not set out to reduce the risks to staff. There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. For example. 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. Staff had a good awareness of the need to protect patients from abuse and neglect and there were systems in place to support them. We inspected the four wards for older people with mental health problems based at the Harbour. Should you wish to comment on the service received, please contact the Trust on telephone: 01603 421421. Avondale Clinical Decisions Unit provides a period of assessment for people experiencing a mental health crisis. Staff treated service users with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. Patients using the service were given opportunities to be involved in decisions about their care. Staff supervision rates had been low over the last 12 months. Gimnez-Dez D, Maldonado Ala R, Rodrguez Jimnez S, Granel N, Torrent Sol L, Bernabeu-Tamayo MD. Provide 24 hours nursing care that is person centred and care plan led, with individuals input and objectives key to this process. The service did not always have enough nursing staff to meet patients needs. We did not inspect wards for older people with mental health problems at the Trusts other locations. They found the service helpful and described positive change that had occurred after contact with the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. Is this information correct and up to date? Our observations of staff interacting with patients were positive. Complaints were fully considered. Referrals, admissions, discharges, length of stay and out of area placements were routinely monitored. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. The staff had plenty of time to talk with me and give relevant support., It was my first appointment and I felt very nervous about it but upon meeting staff I instantly felt relaxed calm and at ease., First time receiving proper help and everything I needed to say was said and listened to., A carer commented Patient feels hopeful after speaking to staff and has changed his life., Download full inspection report for - PDF - (opens in new window), Published J Ment Health. Patients spoke highly about the care they received from the staff within each of the older adult services. Patients individual care and treatment was planned and best practice guidance was implemented, ensuring outcomes were monitored and reviewed. Young people were given information and support from independent advocates about their rights under the Mental Health Act. The lack of supervision for band 7 allied health professional (AHP) clinical managers for two years and the lack of visibility of management above service integration managers in the district nursing service further demonstrated a lack of strategic support and control. Staff told us they did not always feel respected, supported or valued. The service had recently come through a period of change, due to sexual health services being tendered across Lancashire. and transmitted securely. To service A&E department and Medical Assessment Wards. People's diverse needs were integrated in policies and proactively taken into account when devising protocols. Our rating of this service went down. Clinical supervision is an important tool for checking that young people have received the appropriate care and treatment. Staff followed the trust's values of teamwork, compassion, integrity, respect, and intelligence when carrying out their work. About us. The Central Home treatment team also provide intervention to Willow House the Crisis support house based in Chorley, The Haven service at times there will be a need for the successful . The purpose of the crisis support units was to provide short term support for patients for up to 23 hours as an alternative to hospital admission, or whilst awaiting a hospital bed. At Pendle House, we saw an electronic notice board accessible to all staff that included an SUI action tracker that showed shared learning and good practice. Clinics were scheduled weekly at set times with some open and some pre-booked slots. They worked with them to plan peoples transition between services in a holistic way. Staff prioritised the safety of people using the service and also the safety of people working for the trust. Patients physical health needs were routinely monitored and acted upon appropriately. Evidence based tools were used in the assessment process and staff used recognised rating scales to measure a young persons progress. 11 January 2017. Despite good practice we found that some teams had been recently reconfigured and there appeared to be limited integration. They made sure that patients had a full physical health assessment and knew about any physical health problems. the service is performing badly and we've taken enforcement action against the provider of the service. Compliance with staff supervision and appraisal was low at the Junction. The trust was unable to provide consistent information relating to this core service. Records and medicines were appropriately audited . Staff were now receiving appraisals and conducting observations post rapid tranquillisation of patients, these were regulatory breaches at the inspection in 2018. Social inclusion teams worked to ensure peoples holistic needs were met and worked with hard to reach groups in innovative ways to promote mental well-being. Health visiting and school nursing teams worked to deliver the Healthy Child Programme and two of the five contacts were delivered using the Ages and Stages evidenced based screening tool. The new countywide Older Adult Home Treatment Team started operating from October 2018. Patients and staff raised concerns about the quality of food and special diets were not easy to access. Staff clearly expressed the trusts vision and values and portrayed positivity and pride in the work they did. The HTT does not provide phone support for people not under their current care. Managers were able to provide information into the governance meetings and staff received regular feedback from these meetings. This included increased staffing for community teams and closer working relationships with partner agencies. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding. 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. Avondale is run by Delphside Ltd a registered charity (No. Equipment and machinery were subject to regular checks and maintenance. There were concerns expressed by staff and reflected in the services risk register over the capacity of teams. Ventilation in reception and in the interview rooms was poor. We spoke with 34 staff, 18 patients and three carers. The MHCS had access to a range of mental health disciplines required to care for the people using the service. There were some issues that impacted negatively on how responsive some services were. In the last 12 months, 13 children were admitted to the decision units at Preston and Blackburn, although three are noted as multiple events so the admissions figure is higher. https://avondale.org.uk/. This is an organisation that runs the health and social care services we inspect. Adverse incidents were reported and reviewed. Full information about our regulatory response to the concerns we have described will be added to a final version of this report, which we will publish in due course. 7-days-a-week input, including access to 24 hour advice (see Contact us). Our aim is to provide 24 hour person centred support, respite and re-ablement for adults with complex mental health needs. Audits were carried out on the use of section 136 and the use of HBPoS. We rated mental health crisis services and health-based places of safety as good because: The service had enough staff so that people who were in a mental health crisis could be safely managed. Nine evidence based care pathways had been developed and were in the process of being introduced across the service. Staff were de-briefed and supported following serious incidents. These were effectively managed and risks mitigated with the use of observation and individual risk management planning. Specialist Occupational Therapist National Health Service. We identified concerns over the ability of services to manage young people when they transfer from CAMHS at the age of 16. Buildings were clean and well maintained. Any referral from Minor Injuries Units or Community Staffing and Hospitals, please ring the above numbers for Home Treatment Teams. Staffing pressures had been exacerbated by the impact of the COVID-19 pandemic. The team operates 7 days per week within our continuous community and inpatient care pathway. Despite this, we found a committed competent staff group who were patient focussed. We provide specialist assessment, active therapy, treatment and the opportunity for recovery to older people with a mental health problem. Buildings were clean and well maintained. Our team includes both health and social [] Waltham Forest Home Treatment Team Tantallon House 157 Barley Lane Goodmayes IG3 8XJ Tel:0300 300 1882, Option 2 Fax:0844 493 0264 Opening times:24 hours Referrals Email - nem-tr.wfhtt@nhs.net. Crisis team; HTAS; crisis and home treatment; patient opinion; qualitative. Staff did not create specific care plans for patients with epilepsy or moving and handling needs. We saw some examples of excellent practice which meant people were able to stay in the community. Four of the five trusts in NI responded, all of . The NHS Friends and Family Test results showed the majority of patients would recommend the department to their family and friends. The problems with the health-based places of safety and mental health decision units were symptomatic of an acute care pathway that did not function effectively. I have been in acute dental pain throughout the weekend - which has caused my mental health to hit rock bottom. There was an openness and transparency about safety. Performance & security by Cloudflare. Regular reviews were done and treatment was delivered in line with evidence based guidance. the service is performing well and meeting our expectations. 8600 Rockville Pike Staff actively involved patients and families and carers in care decisions, where possible, including working together to produce an impressive wall display to remind patients of ten key rights when attending care programme approach meetings. Staff assessed and managed risk well. Staff on Marshaw ward said they did not have time to facilitate activities, and activities were inconsistent and not structured. Home Treatment Team We provide home treatment services to adults living in the community who require intensive, daily support and who are at risk of being admitted to an inpatient unit (for example, a ward). Staff had a good understanding of the importance of obtaining and documenting consent and were fully aware of their responsibilities under the Mental Capacity Act 2005. Hurstwood ward was due to close in December 2016 and a new location with more space was planned. Information was not readily available in different languages, staff stated they could access an interpreter as necessary. Staff often booked the trusts pool cars to support patients with off-site activities and leave. It became routine in September 2014, again with the expectation that the number contacted would increase each quarter. People who used services were enabled to participate in the activities of the local community so that they could exercise their right to be a citizen as independently as they were able to. The quality of risk assessments and care plans was of a good standard overall. In the community health services there were challenges including substantive staffing levels not being met in most childrens teams, although adults teams were better staffed. This meant that at times of increased risk, staff had the appropriate tools available to safely manage each situation. Overall compliance with essential training was 46%. Managers reviewed individual and team performance. Staff were familiar with reporting procedures despite few having reported an incident recently. Care plans were developed with the person using the service. We found evidence of the trusts commitment to improve how it responded to complaints. We identified concerns about staff not receiving mandatory training; both of which increased risk to patients and staff. The existing ratings from our inspection in June 2019 remain in place. We will not share your information with any 3rd parties. There were unacceptable waiting times for service users to be assessed, to be allocated to a care coordinator and for appointments to see consultant psychiatrists. This included patients with a learning disability. It became routine in September 2014, again with the expectation that the number contacted would increase each quarter. The trusts strategy was embedded across the four clinical networks, the trusts board and council of governors understood their responsibilities. Unauthorized use of these marks is strictly prohibited. Staff spent the majority of their time on observations for certain patients. We found extended waiting times for the Chronic Fatigue Service and podiatry and there was not always good use of available space or adequate wheelchair access in clinics. The service proactively monitored and managed staffing levels to ensure patient safety. Staff were discussing patients religious needs with them but, in one record, these discussions were not fully reflected in the patients care plans. The teams' catchment areas were different in size and socioeconomic circumstances. One team held a regular clinic for people to attend. Staff clearly expressed the trusts vision and values and portrayed positivity and proudness in the work they did. People who used the service were positive about it, with no adverse comments received during home visits, or in telephone conversations with them or their carers. Interview rooms and clinic rooms used by the mental health crisis services (MHCS) were clean, well maintained and safe environments. The Unit has 14 beds, providing both male and female accommodation. Care plans were person centred and tailored to the individual. We saw that multidisciplinary working was in place, the ward had input from therapists and a dedicated pharmacist. Staff felt supported and listened to and there was professional forums for nurses and allied health professionals. However, when the cars were diverted for use elsewhere, such as medical appointments, activities were cancelled. Seclusion facilities on Calder, Fairsnape, Greenside wards were poorly equipped. This integrated service is for people with severe and complex mental and behavioural disorders such as schizophrenia, bipolar affective disorder, and severe depressive disorder. This impacted upon patients privacy and dignity. Complaints were managed appropriately. Team leaders told staff about outcomes and learning from incidents. Due to the variable nature of the patients on the ward, patient outcomes were not routinely collected. Performance issues were escalated to the relevant monitoring committee and the board through clear structures and processes. There was good evidence of services and disciplines working together to improve services for patients and included: the intensive home support service, the discharge planning team, the Care Home Effective Support Service (CHESS) Team and the diabetes service. Discharge planning was incorporated into thelocalgovernance reviews and was planned for on the young persons admission to the wards. Results: Waiting times, delays and cancellations were minimal and managed appropriately. We are fully committed to ensuring that all people have equality of opportunity to access our service, irrespective of their age, gender, ethnicity, race, disability, religion or belief, sexual orientation, marital or civil partnership or social and economic status. An official website of the United States government. At least one standard in this area was not being met when we inspected the service and The team can initially visit on a daily basis with visits being reduced according to clinical need. Full programme details to follow in the coming weeks. The local timezone is named Europe / Berlin with an UTC offset of 2 hours. 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. A number of maintenance and cleanliness issues in the forensic services and a lack of infection control audits in community CAMHS. They followed good practice with respect to young peoples competence and capacity to consent to or refuse treatment. We'll work with you to minimise risks you are facing and support . There were initiatives in place that supported staff morale and wellbeing. The main aim of our team is to help you manage and resolve your crisis through assessment and treatment in your home environment. Patients requiring long term rehabilitation received appropriate intensive support. Told patients how to raise a complaint or concern, and had investigated and responded to concerns and complaints. Sincerely, The Team of Preston Charles Funeral Home View G'Thomas Murray Dear Family and Friends, An obituary for the beloved, G'Thomas Murray is not currently available, but we will be sure to share this with you upon the family's wishes or as soon as it becomes available to share with the community. The team was well-led by experienced and committed managers. We carried out this unannounced focused inspection because we received information giving us concerns about the safety and quality of this service. We have our own dynamic resident centred activities programme and activities coordinator for general and therapeutic activities for all. On ward 22, Department for Health guidance on same sex accommodation as well as the MHA Code of Practice was not being followed, as access to reach bathroom and toilet areas meant patients had to walk through communal areas occupied by either sex, which opened out onto the main ward communal area. Consequently, the gym was not fully utilised. Our rating of services improved. Due to high bed occupancy, staff could not always admit people detained under section 136 of the Mental Health Act within 24 hours, the time limit set out in the Mental Health Act. Patients in the 136 suites had their mental capacity assessed regularly. The health-based place of safety in Burnley had a window that did not have privacy screening on it, therefore this meant that if members of the public or patients from other wards walked by they could potentially see the patient in the place of safety. This was a focused inspection which looked at the trusts response to the warning notice issued following our inspection in June 2019.