Staff supervision rates were low. Buildings were clean and well maintained. Managers analysed incidents to identify any trends and took appropriate action in response. We observed people who use the service being treated in a respectful manner and with a caring and empathetic approach. The team usually includes a number of mental health professionals, such as a psychiatrist, mental health nurses, social workers and support workers. Staff had good knowledge of safeguarding procedures and were confident in applying trust policy. 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. The trust did not report on patient feedback from the 136 suites, and was unable to provide us with reports for the friends and family test for all its crisis/home treatment teams. Compliance rates were particularly low on some wards. We had significant concerns about patient safety, privacy and dignity and the functioning of the mental health decision units within the mental health crisis services. This had not improved since our last inspection. This included their mental and physical health, potential risks and social situation. Staff understood their responsibilities in relation to the duty of candour and their role in the process for any future incidents where patients experienced harm. Assessed the number of child and adult beds available in the trust, and responded to this by increasing beds and at times placing patients in adult wards to ensure they received the care and treatment they needed promptly. Staff we spoke with were aware of the findings of our last inspection and the actions the service was taking in response. This had not improved since our last inspection. Systems were in place to support young people transitioning to adult services. Welcome to Avondale, one of the North West leading independent providers of care for adults with a wide range of Mental Health related issues. Interventions are usually made via regular home visits and telephone contact. Specialist community mental health services for children and young people, esb.services_rated.community health (sexual health services), Community health services for children, young people and families. Contacts we observed showed information provided to children and families was clear and tailored to the individual child. Supervision and appraisal figures were low. Although the trust had a training schedule in place, staff had not completed all their mandatory training. Website address not added, Address: Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, Lancashire, PR2 9HT. Although staff assessed risk well, the resulting risk management plans did not address all risk identified and were vague and not personalised. Crisis resolution and home treatment: stakeholders' views on critical ingredients and implementation in England. 12 hour shift + 5. NIHR Lancashire Clinical Research Facility Avondale Unit, Sharoe Green Lane, Fulwood Preston, PR2 9HT . Call us on 0151 431 0330. the service is performing exceptionally well. The team will supplement the existing input from the . This meant that teams were meeting the targets expected of them. Staff did not always consider the consent status and scope of parental responsibility when patients came into the service at the age of 16. Outcomes included written apologies to patients, improving patients understanding of policies and practices, adding issues and outcomes to Guild Lodges share the learning document, improving information, guidance and publicity, and supervision of staff. Overall, we have judged that community health services for children, young people & families is Good. 2023 The trust was committed to reducing restrictive practices including the use of prone restraint, which was demonstrated by their strategy on this. 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. About us Wigan Home Treatment Team Atherleigh Park Atherleigh Way Leigh WN7 1YN Tel: 01942 636 317. They were able to decide who should be involved in their care and to what degree. 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 The existing ratings from our inspection in June 2019 remain in place. Accessibility This was a focused inspection which looked at the trusts response to the warning notice issued following our inspection in June 2019. Parents, young people and staff were aware of the independent advocacy service. For example: Lancashire Care NHS Foundation Trust (February 2016) for - PDF - (opens in new window), Lancashire Care NHS Foundation Trust (June 2015) for - PDF - (opens in new window), Lancashire Care NHS Foundation Trust (November 2014) for - PDF - (opens in new window), Lancashire: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Blackburn with Darwen: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Blackpool: Children's Services Inspections Reports (2009) for - PDF - (opens in new window), Inspection Report published 31 December 2010 for - PDF - (opens in new window). This had not improved since our last inspection. The Royal College of Psychiatrists has recently established the Home Treatment Accreditation Scheme (HTAS) to institute a quality standard for HTTs, though it is unclear whether such accreditation could of itself measure effective care. The wards did not have current and up to date ligature risk assessments and environmental risk assessments had not been completed on ward 22. 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. 11 Avondale Road, Preston, Vic 3072. In Ormskirk, there was a hole in the ceiling in the waiting area. In addition staff on wards where the ban was being enforced, told us there had been an increase in incidents as a direct result of the ban. Visits tailored to your needs, more than once a day, if required. For Trust values to be evident in all aspects of service delivery and interactions with service users, carers, colleagues and peers. Staff told us that the impact of the trust implementing a smoke-free policy was putting staff and other patients at risk as people were not following the policy. There were some issues that impacted negatively on how responsive some services were. Let's make care better together. The MHCS at Hope House had carried out development work analysing how to optimise home treatment. 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. Assessments were carried out in a timely manner, reviewed and reflected in care plans. We inspected: Shakespeare ward an 18-bed female acute ward, Stevenson ward an 18-bed female acute ward, Churchill ward an 18-bed male acute ward, Byron ward an 8-bed female psychiatric intensive care unit, Keats ward an 8-bed male psychiatric intensive care unit. Staff were not receiving regular supervision of their work. The new appraisal included key objectives and the trusts visions and values. Staff morale was low. Staff delivered care in a multidisciplinary manner and in line with national guidance and best practice. People who used services felt that they had been personally involved in the development of their care plans. Our Home Treatment Team (HTT) is a community-based service set up to support you if you are experiencing severe mental health issues and require 'crisis' support. Issues were raised in relation to Red Books which were not always fully completed with names and address of the children and the Flimsys in the red books were inconsistently completed and we saw evidence of poor quality of scanning of these flimsys making them illegible. We rated Lancashire Care Child and Adolescent Mental Health wards as good because: We rated the trust as good overall because: eleven of the thirteen core services we inspected were rated as good overall, staff treated patients with respect, care and compassion, staff communicated with patients in a way that was appropriate to patients individual needs, patients told us that staff treated them well and were responsive to their needs, patients had been involved in service development, despite the staffing challenges the trust faced, there was evidence to demonstrate that services were committed to minimising the impact this had on patient care, staff completed timely and comprehensive assessments for all patients including risk and physical health needs, the board had strategic oversight of potential risks which could impact on their ability to deliver services and had actions in place to mitigate these. the service isn't performing as well as it should and we have told the service how it must improve. Staff had manageable caseloads. Cloudflare Ray ID: 7a2f0d761874a211 Compliance with clinical supervision and yearly appraisals for nursing staff was poor. We found that the provider was performing at a level that led to a rating of requires improvement overall. We spoke with 18 patients and three carers. 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. Too few staff had completed mandatory training, which had the potential to put young people at risk. Compliance with basic life support and immediate life support training was low. Patients had access to advocacy services. Staff often booked the trusts pool cars to support patients with off-site activities and leave. This limited who had access to the sessions. The Trust introduced a no-smoking policy in January 2015.This had been implemented inconsistently. Feedback from patients was mixed regarding involvement in their care plans. Clinic rooms were approapriatley equipped. Facilities at the Harbour site were excellent, and Wordsworth and Bronte wards used a mock pub and a mock caf in the outdoor area for patients to relax. Patients were regularly held in the 136 suites over the 24-hour time limit set out in the Mental Health Act. Clipboard, Search History, and several other advanced features are temporarily unavailable. Trac proudly powers the recruitment for Somerset NHS Foundation Trust View employer information Open Ref: 184-KP5049692 Vacancy ID: 5049692 Principal Psychologist Inpatient and Urgent Care Accepting applications until: 06-Mar-2023 23:59 View job details Start your application You must sign in to a Trac account before you can apply for this job. This was not being consistently implemented, which had led to increased risks in some areas. All the MHCS carried out home-based clozaril titration. 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. The leaders had plans in place to resolve these issues and were passionate about improving the service. Can you help us improve this information? The service followed British Association for Sexual Health and HIVGuidance on the assessment and treatment of patients. Back to services overview Content Editor [2] C ontact us. (PCMHT), Home Treatment Teams (HTT), Substance Misuse Services and Housing and Emergency Social Services Team in response to client need; Preston & Chorley. OL6 7SR. Activities included woodwork, metalwork, pottery and gardening. Understanding of your current mental health issues. Staff were unsure of the future of the unit and therefore the direction and strategy was also unclear. These were effectively managed and risks mitigated with the use of observation and individual risk management planning. The existing ratings from our inspection in June 2019 remain in place. Children in mental health decision units did not routinely have access to child and adolescent mental health specialists. Mental Health Act administrators provided input into each ward and provided daily updates on the status of each patient. Three wards had dormitory sleeping arrangements. Staff had completed individualised care plans to document the patients wishes. Melbourne Water is undertaking water main upgrade works in Melbourne's northern suburbs. Straight to the point and made welcome in a calm and friendly manner., I was very impressed by the kind, attentive and empathetic approach evidenced upon my arrival to Avondale. We support people who live in the London Borough of Southwark. Prescribing was in line with National Institute for Health and Care Excellence guidance. Welcome to the official Preston Lions FC page on Facebook. A recent audit confirmed these improvements. The wards did not have enough nurses. There was good leadership at ward level and above. On the acute and psychiatric intensive care wards, staff completed the physical observations of patients following the administration of rapid tranquillisation. We believe people experiencing mental health problems are entitled to the highest quality care. Patients needs were assessed and patient centred goals were set. The services had reliable systems, processes and practices in place to keep patients safe and safeguard patients from abuse. The results of all audits were not always fully disseminated to community mental health staff. Is this information correct and up to date? There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. Good' overallbecause: We found good processes in place to reduce the risk of abuse and avoidable harm in the service. Suspended ratings are being reviewed by us and will be published soon. Our rating of this service went down. Some wards turned a blind eye and others enforced the policy to the letter. When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. Our service helps to avoid the stress, anxiety and upheaval that can happen with a hospital admission. The service had a good safety record; Incidents of harm in the service were low. The ward layout was well planned in the Harbour services: the layout used space to good effect. Records showed that planning was in place for regular supervision and appraisals. At Hope House, a dedicated member of staff contacted everyone who had been discharged from the service in the previous two weeks to ask their opinions. Feedback from patients and carers was generally positive. Staff were kind, caring and compassionate and supportive of people using the service. The criteria for referral to the service did not exclude service users who would have benefitted from care. In the Preston 136 suite and the home treatment team offices at Ormskirk, there were issues in relation to maintenance of the buildings. Discover the wide range of events we host for our members in this region. We are a multi-disciplinary team of healthcare professionals offering a holistic and intensive period of care. You can view full details of the Home Treatment Team - West service in our services directory. Of these responses 99% of patients would either highly recommend or recommend the service to friends and family. About us. The recording of patient activity levels was poorly documented. They were kept up to date about their teams performance. The risks associated with prolonged stays in section 136 suites and decision units were not recognised. The trust target to achieve 90% uptake by 31 August 2015 was not yet met as the actual uptake ranged from 59% to 73% at the time of inspection with four months remaining. Managers had oversight on mandatory training levels. The notes of the service user group meetings showed cancelled activities and leave were common complaints. The trust used high numbers of bank and agency staff on their wards. 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. Additionally, we had concerns about the use of mental health decision units for patients under 18 years old. Crisis teams can: visit you in your home or elsewhere in the community, for example at a crisis house or day centre The RITT Team was established in 2014. Regular checks of prescribing, medication and stock levels were undertaken. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. There were ward-based activities and access to outside space for most wards. The Fylde Coast rapid intervention and treatment team had changed their operational hours as a result of vacancies and safe staffing levels. We provide short term supportive care packages to young people and their families/carers being discharged from acute inpatient wards. An audit of antipsychotic prescribing in people with a learning disability identified that there was action required against standard three of a quality improvement programme-prescribing audit. Staff worked with other healthcare professionals in the best interest of patients. Referral on to other agencies and mental health services, as agreed with you. We saw a piece of work analysing the main reasons for staff sickness absences and considering how these could be addressed. The Childrens Integrated Therapy and Nursing Servicestaff arranged joint visits to families to reduce the need for attendance at multiple appointments and health visitors in the West Lancashire area had returned to individual allocation of community clinics to promote continuity for families in response to service user feedback. Adherence to the principles of the Mental Health Act and its associated Code of Practice was good throughout the trust. The trust had recently opened a crisis support unit, which could be used as an alternative to the health-based place of safety for up to 23 hours, to help someone in a crisis that was felt to be short term. Our observations of staff interacting with patients were positive. In rating the trust, we took into account the previous ratings of the core services not inspected this time. 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. Avondale is a ground floor purpose built centre allowing it to be fully accessible. Whilst the treatment of people who used services was seen as holistic, it was also person-centred. To inform, in writing, GPs and other relevant agencies with the outcomes of assessments within 24 hours. Due to the relocation of acute and psychiatric intensive care units to the Harbour, the trust lost a significant number of experienced and qualified staff. The Home Treatment Team approach commenced on 20th January, 2014 as a pilot project under the guidance of Dr. Navroop Johnson's Community Mental Health Team in South Kerry. The service had good multi-agency relationships which matched the holistic needs of patients. This meant that managers did not have an accurate picture of safeguarding activity across the trust. Seclusion records did not document when a seclusion room had last been cleaned. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Ambient room temperatures in two clinic rooms regularly exceeded this temperature. The trust had co-located its two locations into one location at The Cove. This meant that staffing resources were equally aligned across the service. Team leaders had no consistent system to monitor the uptake of clinical and management supervision of staff. The teams included or had access to the full range of specialists required to meet the needs of the service users. 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. Morale was high in the teams we visited. Avondale Clinical Decisions Unit provides a period of assessment for people experiencing a mental health crisis. Clinical supervision enables the managers to assess the quality of staff's work. Regular patient surveys and community meetings informed improvements in patient care across the hospital. Staff and managers told us that there were delays receiving information about patients accessing antenatal care from local acute providers and this was recorded on the trust risk register. We had significant concerns about patients detained without lawful authority once the detention period under section 136 had ended. Patients had not exercised their rights to appeal and we could not be assured that this was an informed choice. This resulted in a reliance on the use of agency and bank staff to ensure patients were kept safe. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the service user. During the inspection we found: Patients admitted to health-based places of safety (136 suites) were unlawfully detained beyond the legal timeframe for their detention. This included the police, other NHS trusts, and the local authority. Staffing levels were reviewed daily and in twice weekly meetings. The ward staff knew how to report incidents and as a result improvements were made to ensure patients were safe. Staff knew how to report incidents and these were discussed at monthly team meetings. They worked collaboratively with the young person and their family and always sought their agreement. This meant that the use of blanket restrictions was low and patients freedoms were proportionate to the level of risk. 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. We'll work with you to minimise risks you are facing and support . 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. Access to crisis care was not delayed by having to access it through the accident and emergency department, for example. Staff spoke highly of their line managers and told us they felt listened to. Staff received training in the MCA and there was an on-going training schedule to ensure they remained skilled. CATT teams aim to help people at home so they don't have to go into hospital. 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). At Hope House in particular, the MHCS was proactive in their approach to gaining feedback from people who used the service. There were medical reviews in some records but it was unclear when the medical review took place. We found evidence of the trusts commitment to improve how it responded to complaints. reason for each breach was nowdocumented, along with, Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983, and the Mental Health Act Code of Practice. Staff cared for patients in a respectful and dignified way. All Avondale staff and Trustees are DBS checked and updates sought on a regular basis. Norfolk and Suffolk NHS Foundation Trust values and celebrates the diversity of all the communities we serve. the trusts strategy had been developed with the populations specific health needs in mind, the trust had a dedicated equality and diversity lead to ensure the protected characteristics of the population were considered, the trust had identified that some wards did not meet the needs of the patient groups and had plans in place to move these to more appropriate buildings, arrangements for children and young people transitioning to adult mental health services had improved since our last inspection, the trust had a clear vision, supported by six values. Patients were very positive about the care they received and we saw patients were treated in a professional and caring manner. Some patients had been held in the 136 suite for several days. It had brought innew staff to introduce systems to monitor compliance and improve services; and employed four new staff to reduce waiting lists. Keywords: We issued the trust with a Section 29A warning notice for this core service. Patients were well cared for on Longridge ward. Review of meeting notes on Marshaw ward confirmed that leave was cancelled owing to staffing issues. There was effective teamwork and visible leadership across the teams. 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. Llanfair Road The teams were compliant with the requirements of the Mental Capacity Act 2005 (MCA). In most places CRHT teams are an innovation and wider changes are needed in service organisation and patterns of clinical responsibility and decision . titanic museum los angeles,