Epub 2013 Jun 20. Staff completed risk assessments on admission and updated these regularly. Regular checks of prescribing, medication and stock levels were undertaken. Requires improvement Quarterly multi-agency meetings were well attended and staff reported good inter agency working. In a three month period 1 June 2016 to 31 August 2016, 25% of shifts had been short of substantive staff. Staff were passionate about their role and were caring and supportive towards patients. the service is performing badly and we've taken enforcement action against the provider of the service. Electronic templates had not been set up for all the specialities, which meant staff continued to maintain paper records, which could not be accessed across other specialities. Patients using the service were given opportunities to be involved in decisions about their care. Trust leaders had failed to address these concerns following our last inspection. As a result of these concerns, we have issued the trust with a warning notice to make significant improvements. 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. The trust participated in several internal and external audits to drive improvements, including the quality SEEL (a quality initiative focusing on Safety, Effectiveness, Experience and Leadership). Staff did not have access service user information that was held on the local authority electronic records system. This meant they focused on helping patients to be in control of their lives and build their resilience so that they could stay in the community and avoid admission to hospital wherever possible. Equipment and machinery were subject to regular checks and maintenance. Care plans were developed with the person using the service. From January to August 2016 referral to treatment times for speech and language therapyconsistently missed the 92% standard averaging 89% in this time period. Appropriate risk assessments and paperwork was in place for individuals on community treatment orders. We found a good incident reporting culture where staff were clear on what to report and who they should report to. The Integrated Nursing Teams (INTs) were not using a staffing acuity tool and of the seven INTs we visited we found two that mentioned the use of a caseload weighting tool. Infection control and prevention audits were regularly undertaken. The ward teams included or had access to the full range of specialists required to meet the needs of patients on the ward. These units were intended for short stay, under 23 hours, but were now routinely being used as additional wards. Ashton Under Lyne, Inadequate Patients without leave could not attend and patients with leave could only attend if there were enough staff to escort them. We carry out joint inspections with Ofsted. Some patients had been held in the 136 suite for several days. Religious needs were not always met in a timely manner even though there were spiritual care facilities on site. Learn about Avondale Rd, Preston and find out what's happening in the local property market. Information about treatments were available in different languages and formats if patients required them. They ensured that people did not stay in hospital longer than necessary and promoted early discharge. Any concerns relating to adult and child protection were communicated to the relevant protection agencies. In the meantime, risk was mitigated through observation. Staffing pressures meant that supervision and team meetings did not happen as regularly as scheduled. The facilities were generally clean and maintained. Not all young people had an up to date current risk assessment present in their care records. Team management and governance monitored the completion of care plans through routine audits. The service carried out the NHS Friends and Family Test. Incidents and safeguarding issues were recorded appropriately. Risk assessments included relapse triggers, behaviours and patient involvement regarding the management of risk. The managers of the individual services were supported by senior managers in this measured and effective approach. Translation services were available if required. Referral on to other agencies and mental health services, as agreed with you. We were told these were being developed. Patients needs were assessed and patient centred goals were set. Our DHTTs can also refer individuals to other services such as Psychology, Community Mental Health Teams, Local Primary Mental Health Support Service Teams and many more. Staff were supported by means of supervision and appraisal processes, to identify additional training requirements and manage performance. Patients care and treatment needs were assessed using a holistic approach that included a comprehensive physical health needs assessment. 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 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. Staff had been advised to assess capacity and that patients were then detained in their best interests, but this is not a lawful deprivation of liberty. An audit had been performed to monitor storage of medicines and had reported issues with clinic room temperatures not being monitored which we observed at the time of our inspection and we were not assured that clear actions and improvements had been made. Where appropriate, we will also help you to access other services that could be relevant to your care (such as the Community Mental Health Team, Voluntary Sector services), as well as reviewing your current medications and helping with social issues. Sixsmith J, Callender M, Hobbs G, Corr S, Huber JW. However there was insufficient staffing and leadership capacity to ensure that staff supervision, appraisal and team meetings took place regularly. The occupational therapy team said the main reason for activities being cancelled was transport being diverted at the last minute for use at appointments. Staff involved patients and their relatives in their care where possible and treated them with kindness, respect, compassion and dignity. Accessibility 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. We provide residential care, supported accommodation and floating support. Often individuals accessing home treatment do so as a step-up in care from their usual community team or step-down following a period of care in a psychiatric hospital. We can't believe the NWPPN turns 10 this year! The decreased skill mix of staff had been recognised and changes to work patterns were being discussed. This meant that patients were less likely to be harmed by poor infection control practices or self-harm/suicide incidents. Staff sought feedback from patients and carers, and openly shared information on what they had done in response to the feedback. We also had significant concerns that governance systems in place for the oversight of the 136 suites and stays over 23 hours in mental health decision units were not effective. There were no waiting lists for the services provided within this core service. The services received positive comments about the staff and the care provided and patients were treated with dignity and respect. Patients told us they were involved in decisions about their care and were encouraged to participate in meetings to develop and manage their care and discharge. Outcomes were monitored to ensure changes were identified and reflected to meet patients needs. Crisis teams can: visit you in your home or elsewhere in the community, for example at a crisis house or day centre visit you in hospital if you're going on leave or being discharged Llanfair Road Care records were holistic, comprehensive and showed evidence of patient and carer involvement. Compliance rates in individual teams ranged from 29% (6 out of 15 staff) in the Blackburn with Darwen CITNS team to 100% in the 0-19 South Ribble East team (19 staff). The design, layout, and furnishings of the ward/service supported patients treatment, privacy and dignity. Records and medicines were appropriately audited . The Mental Health Act code of practice guidance helps protect patients' rights and ensures patients detention is lawful. Regular governance meetings were held and performance data was on display in teams. We found the ward action plan resulting from the health, safety and environmental audit at the Platform. Ligature risk assessments and reviews of the environment had been carried out. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. These were effectively managed and risks mitigated with the use of observation and individual risk management planning. Before Our therapy team is on the ward 8.30am-4.30pm Monday to Friday It is situated close to all the necessary local amenities, such as shops, public transport links, hospital, GPs, dentist, leisure centres etc. We rated it as good because: Download easy to read version for - PDF - (opens in new window), Lancashire Care NHS Trust: Evidence appendix published 11 September 2019 for - PDF - (opens in new window), Published Crisis resolution and home treatment: stakeholders' views on critical ingredients and implementation in England. Theydid not know the trusts risk assessment policy. We observed strong leadership from team leaders and managers and staff spoke positively about the team leaders, describing them as visible, accessible and supportive. Patients had up-to-date risk assessments in place that were regularly reviewed. Some staff used an electronic records system called ECR where as others used a paper based system. We issued the trust with a Section 29A warning notice for this core service. Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), In We did not inspect wards for older people with mental health problems at the Trusts other locations. Patients had comprehensive risk assessments completed. Patients felt they were afforded sufficient privacy and dignity. We witnessed positive interactions between staff and patients throughout the inspection. Staff were familiar with reporting procedures despite few having reported an incident recently. We identified concerns over the transition of young people from CAMHS. 2014;36(7):563-72. doi: 10.3109/09638288.2013.804594. There were systems in place to monitor the service in order to improve performance. Physical health care was given strong consideration, and was monitored on all patients. 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. It became routine in September 2014, again with the expectation that the number contacted would increase each quarter. 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 . Discharge planning was incorporated into thelocalgovernance reviews and was planned for on the young persons admission to the wards. Staff felt valued and supported by their colleagues and were aware of the senior management team within the trust although the planned move of premises had affected staff morale. Published The trust had systems in place to monitor the quality of the services and drive improvements. The number of staff that had not completed mandatory training was below expected levels. Staff were not always following the individual support plans of patients. The home treatment team service for older adults functioned from April 6 to August 31 2020. Staff told us how much they enjoyed their job, and caring for people from the local community. Intensive support in your own home. Advocacy services were accessible and available to support patients. This allowed everybody to be involved in care planning and understand what was expected. The Specialist Triage Assessment Referral and Treatment Team provides timely triage, assessment, onward referral/signposting and treatment for Service Users referred without the need for multiple assessments. The requirements of the warning notice had been met because: Our rating of this service improved. Regular environmental quality checks were conducted and patients were able to discuss and resolve environmental issues in community meetings. Staff were not alert to the ligature risks on the CRU as the ligature points had not been identified and there was no formal management plan in place. Bronte, Wordsworth and Dickens wards also identified this during March 2015. However, there were plans in place to addressall of the issues associated with the physical environment and ligature risks, and a programme of work was underway. Due to on going transformation work at the trust, the business case for staffing against activity had been placed on hold. , Preston, Lancashire, PR2 9HT Avondale within Maricopa County. Three records did not have 15-minute recordings of the patients progress. Staff cared for patients with kindness and compassion. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. The Home Team is presently based in Killorglin at Ard Alainn Day Centre with satellite . Community mental health services with learning disabilities or autism, Community-based mental health services for older people. There was significant damage to Calder and Greenside wards. The staff showed knowledge of procedures and requirements that helped maintain their safety. Address: Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, Lancashire, PR2 9HT PALS (Patient advice and liaison service) You can talk to PALS who provide confidential advice and support to patients, families and their carers, and can provide information on the NHS and health related matters. the trust had a dedicated team to investigate serious incidents, all of whom had additional qualifications in root cause analysis. The ward had dementia, safeguarding, tissue viability, end of life and infection control champions. 41 Avondale Road, Preston VIC 3072 is a House, with 4 bedrooms, 2 bathrooms, and 1 parking space. There was access to translation services and arrangements for patients with sight and hearing loss. Equipment that was essential to monitor a patients nutritional needs was broken and a replacement had not been ordered. 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. Staff morale was low and they did not feel supported by senior managers within the trust. There was a robust and realistic strategy for achieving the priorities and developing good quality, sustainable care which had been developed with external stakeholders. Staff were not all trained in basic life support and overall completion of mandatory training was below the trust target. Established in 1991, we are registered with CQC to provide care, support and rehabilitation at Avondale for adults with mental healthcare needs in a 54 bedded, purpose built home. This resulted in a reliance on the use of agency and bank staff to ensure patients were kept safe. We spoke with 21 staff, 11 patients and nine carers. Staff were able to submit items to a risk register. Crisis resolution teams in the UK and elsewhere. Bleasdale, Elmridge, Mallowdale, Fellside, Forest Beck, Marshaw, Dutton, Whinfell and Langden wards were in good condition and presented safe, clean and pleasant environments, Fairsnape and Fairoak needed some updating and Calder, Greenside and The Hermitage were in a poor condition. The service was well led and the governance processes ensured that ward procedures ran smoothly. Following that inspection we issued the service with a warning notice under regulation 9 (person centred care) and regulation 12 (safe care and treatment). Contact information. Further work was needed to ensure these contracts were made substantive. There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. The quality of risk assessments and care plans was of a good standard overall. Patients dignity was protected wherever possible and we found medications were administered privately, in treatment rooms where possible. At Pendle House, we saw an electronic notice board accessible to all staff that flagged up best practice guidelines. Staff met the needs of all patients including those with a protected characteristic. However, this was not in a uniform format. Staff understood and addressed the type of problems presented by the young person and their families. New scientific research has led our team to the use of reliable, gentle treatment thats effective, consistent and safe for the management of a vast range of health conditions. Nine evidence based care pathways had been developed and were in the process of being introduced across the service. There were good personal safety protocols in place including lone working practices. Staff spoke highly of their line managers and told us they felt listened to. Ten ex-HTT patients were interviewed on the care they had received, using thematic analysis of semi-structured interviews. We operate 24 hours a day, 7 days a week. 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. Patients therefore remained in the health-based place of safety longer than necessary. 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. Staff were detaining patients in the health-based places of safety past the expiry time of the section 136. Patients were very positive about the care they received and we saw patients were treated in a professional and caring manner. Staff compliance with essential training was low. Permanent + 2. We spoke with 14 staff, seven patients, eight relatives and we viewed seven patients medical and nursing records. This was due to long waiting lists and ineffective care pathways. The nature of this support will be discussed with you and the people who support you. 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. Seclusion facilities on Calder, Fairsnape, Greenside wards were poorly equipped. We have judged the service as requires improvement because: However, the unit was clean and well maintained. To inform, in writing, GPs and other relevant agencies with the outcomes of assessments within 24 hours. The team will supplement the existing input from the . There was a clear structure of reporting and responsibility for safeguarding adults and children. The service had a good safety record; Incidents of harm in the service were low. They actively involved patients and families and carers in care decisions. Our Home Treatment team (Southwark) provides a community based service to support people, aged 18-65, at home, rather than in hospital. Suspended ratings are being reviewed by us and will be published soon. CAMHS staff were unavailable outside of normal working hours, to assess young people with mental health problems at Lancaster, Blackpool and West Lancashire A&E departments as this is not currently commissioned to be provided by Lancashire Care. The trust was part of a multiagency group that had developed and implemented a policy for the use of section 135 and 136 across the Lancashire area. Activities included woodwork, metalwork, pottery and gardening. We have our own dynamic resident centred activities programme and activities coordinator for general and therapeutic activities for all. There was a positive attitude and culture within childrens services with an ethos on all the services working together with best practice coming from the whole group rather than any individual. How to access the service. Patients requiring long term rehabilitation received appropriate intensive support. Staff were not managing all risks effectively. Reports were of a good standard and there were systems in place to share learning. Staff spent the majority of their time on observations for certain patients. There was an incident reporting system in place. Motivated and supported patients with care, dignity and respect, so patients felt supported and described positive relationships. The risks described by the staff on ward 22 were not understood by their managers/leaders. 2017 Jul 17;17(1):254. doi: 10.1186/s12888-017-1421-0. The trust did not have a strategy or service model for the care of people with a personality disorder. Patients were supported and encouraged to maintain their independence. in community health services for children and young people, not all safeguarding cases were being supervised and the trust safeguarding team was not routinely copied into referrals made to childrens social care, in the community child and adolescent mental health service, not all patients had an up to date and current risk assessment in their care record, in the acute wards and psychiatric intensive care units, significantly less than 75% of staff were trained in life support, the trust policy did not adequately deal with all the requirements of nursing patients in long term segregation in line with the Code of Practice, staffwere not always providing person centred care to patients on a community treatment order, there were problems with the quality of care plans on Elmridge ward, in child and adolescent community mental health services and in community health services for adults, compliance with supervision and appraisal was below 75% in some services, the trust did not notify CQC of applications for Deprivation of Liberty Safeguards in more than 75% of cases between January 2015 and February 2016, there was a high demand for mental health beds, which meant that some patients were either being placed out of area or requiring intensive support from community teams.