At this inspection we found that all breaches of s136 had nowbeen reported as incidents. Psychological therapies were available. The services had good structures, processes, and systems in place to manage current and future performance and ensure quality to drive improvements. The teams has various functions including assessment, gate keeping and a home treatment function as an alternative to admission. Medication management was good, with the exception of one community health services team where we found issues with the storage of vaccines and another team where medication recording issues were identified. We are an Older Adults Crisis team for both organic and functional illnesses. 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. The service was rated inadequate overall and in the safe and well-led domains; it was rated requires improvement in the effective and responsive domains; it was rated good in the caring domain. Our service helps to avoid the stress, anxiety and upheaval that can happen with a hospital admission. We found this was not consistently applied across the site. J Psychiatr Ment Health Nurs. Staff were compassionate, kind and respectful whilst delivering care. 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. We were also able to provide training to other providers and colleagues in health and social care in relation to mental health resilience during the Pandemic, to better support mental health understanding in the community too. We rated the community health inpatient serviceas 'requiring improvement' overall because: The ward had encountered issues with nurse staffing. the service is performing well and meeting our expectations. There was an effective use of skill mix within the service including dental therapists and dental nurses with extended duties. Ward environments with the exception of seclusion were clean and a full range of anti-ligature work had been completed. They were kept up to date about their teams performance. Staff had an annual appraisal where learning needs were identified. Adult crisis and home treatment teams Every area in England will have a 24/7 mental health crisis service by 2021. Staff were observed talking to patients in a kind, sensitive and caring manner. However, because this was a focused inspection we did not re-rate the individual key questions or the overall service. We found that the service had improved and met the requirements of the warning notice. Children and adolescents had to long waits for appointments. The audit was of poor quality as it was not comprehensive, itemised or specific. The MHCS worked well with the adult acute mental health wards to prevent inappropriate admissions to inpatient beds. The Treatment Team's Roles and Impact in The Effectiveness of Addiction Treatment - Next Level Recovery +1 (385) 500-4822 Addiction Treatment, Drug Addiction, Drug Rehab, Group therapy, Programs, Recovery, Therapy, Treatment The Treatment Team's Roles and Impact in The Effectiveness of Addiction Treatment Ligature risk assessments and reviews of the environment had been carried out. Staff were not always recording whether patients had been given copies of their care plan. Rapid tranquilisation and seclusion were used appropriately. Staff understood processes to safeguard young people, reported incidents and investigated them. 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. Clinics were scheduled weekly at set times with some open and some pre-booked slots. Website address not added, Address: Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, Lancashire, PR2 9HT. Bethesda, MD 20894, Web Policies Staff completed care plans to a good standard and patients received regular formal reviews of their care. This meant that the requirements of the warning notice had now been met. We identified concerns over the ability of services to manage young people when they transfer from CAMHS at the age of 16. The service did not meet the Department of Health guidance on same sex accommodation. 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. We will not share your information with any 3rd parties. Staff were working hard to manage the issues in the service and were keen to deliver safe care under challenging circumstances. We strive to empower people to make choices that will promote wellbeing helping them to achieve their individual hopes and aspirations. Not all staff were adequately trained to deal with patients in seclusion. The service engaged well with staff, patients, external stakeholders and other healthcare professionals well in order to continually improve the service. Staff morale was low. However, on other wards patients were offered between 13 and 21 hours of meaningful activity per week. Help us improve by letting us know Suggest an edit Environmental audits did not include all areas of the ward environment which meant that staff were not following trust procedures. The home treatment teams included or had access to the full range of specialists required to meet the needs of patients under their care, including clinical psychologists and occupational therapists. Staff assessed and managed risk well. This meant that the use of blanket restrictions was low and patients freedoms were proportionate to the level of risk. The MHCS at Hope House had carried out development work analysing how to optimise home treatment. Unspeakable vs Preston with Preston MERCH - http://www.firemerch.com FRIENDS! Unspeakable - https://bit.ly/2KG. The HTT does not provide phone support for people not under their current care. We carry out joint inspections with Ofsted. While detention papers had been checked by the receiving nurse and scrutinised by an administrator, on three out of four relevant records, we did not find evidence of medical scrutiny to make sure the clinical grounds for detaining patients were made out. Priory Hospital Preston is a 38-bedded independent mental health hospital, specialising in the management and treatment of acute mental ill health and eating disorders. A new electronic prescribing system was being introduced. This meant staff might have difficulty when reviewing the records, to locate and identify potential risks. Child friendly posters and the trusts website gave comprehensive advice on how to access independent advocacy services. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Treatment practices were based on nationally recognised guidance. Initially this will consist of a three day assessment to identify your needs and the support / treatment you require. This website is using a security service to protect itself from online attacks. 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. They worked with them to plan peoples transition between services in a holistic way. We have two pathways: supported early discharge and admission avoidance. 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. The site is secure. Records showed that planning was in place for regular supervision and appraisals. Patients were involved in completing their care plans. 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. 2014;36(7):563-72. doi: 10.3109/09638288.2013.804594. 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 delivered care in a responsive, caring manner and strived to ensure patients cultural and diverse needs were met. Within the community based mental health services for adults of working age, risk management plans did not contain detailed information about how to manage specific risks and the legal authority to administer medication to patients on a community treatment order were not kept with the medicine charts. Safeguarding processes were clear and complied with local safeguarding childrens board procedures. Staff told us that patients admitted to wards on an informal basis could not leave the ward until a doctor had seen them. This had the potential to put people who use the service and staff members at risk. We rated eleven of the trusts core services as good for caring and the dental services as outstanding for caring. Advocacy Voiceability (ESAN) 01473 329671, Alcohol and Substance Misuse Turning Point 01284 766554 2 Looms Lane, Bury St Edmunds, Alzheimers Society (Helpline) 0300 222 11 22. Processes were in place to monitor performance. We rated specialist community mental health services for children and young people as requires improvement because: Although we found inconsistences in approaches to service provision, newly appointed managers had made changes to improve services. Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), In This reduced their capacity to perform their managerial functions. There were good multi-disciplinary working practices in place on most wards and medicines management was in line with good practice. There was a clear statement of visions and values, staff knew and understood the vision, values and strategic goals of the service. A patient had been detained at the Orchard without the safeguards afforded by the Mental Health Act or Mental Capacity Act; 12 detained patients had been given medication that had not been included on the relevant consent to treatment documentation; the trusts Mental Capacity Act and Deprivation of Liberty Safeguards policy did not give an accurate definition of the meaning of capacity within the Act. Staff worked within the trust's lone worker policy. We rated safe and effective as requires improvement overall and well-led at trust level as requires improvement. Since our previous inspection the trust had been reviewing potential tools and had analysed activity data to inform a new model of care. This advised the trust that our findings indicated a need for significant improvement in the quality of healthcare. Feedback from people who use the service was positive. The MHCS had established positive working relationships with other service providers. People had access to translation services. Due to the concerns we found during our inspection of the trusts acute inpatient mental health wards for adults of working age and psychiatric intensive care units, we used our powers to take immediate enforcement action. I have been in acute dental pain throughout the weekend - which has caused my mental health to hit rock bottom. 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. Our rating of this service went down. One decision unit, at Preston, was a mixed sex facility where men and women were sleeping in the same lounge. Clinic room temperatures exceeded the maximum of 25 degrees on numerous occasions on four wards. Activity plans on Dutton ward showed patients received below 25 hours per week of meaningful activity. The quality of the capacity assessments varied. However, at the Junction staff did not know the agreed and allowed medication under the MHA. However, the layout and location of the HBPoS at the Scarisbrick Centre at Ormskirk General Hospital compromised patient safety and the bathroom door at the Orchard had no observation panel. Implementing the National Service Framework for Long-Term (Neurological) Conditions: service user and service provider experiences. Home Improving care College Centre for Quality Improvement (CCQI) Quality Networks and Accreditation Electroconvulsive Therapy Accreditation Service - ECTAS List of ECTAS Member Clinics ECTAS Member Clinics Below is a list of ECTAS Member Clinics, sorted by region and detailing their ECTAS membership status. Some patients had been held in the 136 suite for several days. Staff had a good understanding of issues of consent and Gillick competence in their work with young people. We rated it as inadequate because: We have taken enforcement action against this service which has limited ratings for some key questions to inadequate. The wards they were on sought to create an environment that reduced restrictive practise. The Home Treatment Team offers an alternative to hospital admission, to keep people who are acutely mentally unwell out of hospital and living in the community. We rated it as requires improvement because: Lancashire Care NHS Foundation Trust: Evidence appendices published 23 May 2018 for - PDF - (opens in new window), Published There were some issues that impacted negatively on how responsive some services were. Staff and patients were not always offered debriefs by ward managers or other members of the senior management team. Your information helps us decide when, where and what to inspect. This helped the service make maximum use of its resources. 22 July 2022. In the Preston 136 suite and the home treatment team offices at Ormskirk, there were issues in relation to maintenance of the buildings. Patient care, including managing patients nutritional needs and pain relief, were well managed. The local system showed that compliance rates for all modules were above the Trusts target of 85% as at end of April 2015. Physical health care provision was good. Before We inspected the four acute wards for adults of working age and two psychiatric intensive care units for adults of a working age based at the Harbour. Records and medicines were stored correctly in most areas and audits were completed at intervals. Apply now Online Payments Giving Arts Business Education Nursing Ministry Science Vocational Courses Get the full story Read about how the Avondale experience transforms lives. We examined ten sets of health care records that demonstrated good care plans were in place. At the Orchard, the door to the bathroom lacked an observation panel, which meant peoples privacy was compromised. 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. This led to some patients spending several days in a crisis support unit when there were no admission beds available. An electronic staffing recording system highlighted gaps in provision and automatically advertised bank shifts to other staff. This demonstrated a lack of connection between service delivery and the board. We rated it as good because: We have taken enforcement action against this service which has limited ratings for some key questions to inadequate. Information about treatments were available in different languages and formats if patients required them. 32,306 - 39,027 a year. We inspected the mental health liaison services in the emergency departments based at the following locations, all part of the Lancashire and South Cumbria NHS Foundation Trust: We looked at the impact of mental health liaison within an urgent emergency care centre, as well as any possible impact on patient safety. Avondale is run by Delphside Ltd a registered charity (No. Permanent + 2. Compliance rates were particularly low on some wards. 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. National Library of Medicine There was an ongoing programme of recruitment to vacancies. Staff were not sufficiently guided to consider risks relating to children and their placement alongside adults. 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. Wordsworth and Bronte wards had recently taken part in a human rights project with a university faculty; the results were not known at the time of the inspection. There were not sufficient numbers of suitably trained staff. 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. At Hope House in particular, the MHCS was proactive in their approach to gaining feedback from people who used the service. Staff managed patients physical health needs. 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. However you access the Home Treatment Team, we will work collaboratively with you and the people you identify to understand the current factors that have led to a crisis and to support you to meet the goals you identify. The 136 suite at Preston had a shower room which had evidence of mould growing and cracked tiles. Risk assessments completed with the police were not present on 40% of the records we looked at. Staff used computerised tablets enabling them to source or store information when visiting patients which although useful and speeded up processes when connectivity was poor patient visit lists could not always be accessed. The trust provided opportunities for staff to develop which included placements at education establishments. The HBPoS at Burnley and the Orchard held teleconferences three times a day regarding bed availability. Staff we spoke with were aware of the key performance indicators relevant to their role and individual performance was reviewed in monthly one to one meetings with their line manager. This had resulted in a disconnect between the four clinical networks which limited opportunities for shared learning across the networks. Staff treated service users with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. All kitchen knives on the unit were locked away and patients on the CRU did not have a key to lock their rooms when leaving them. 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. This is an organisation that runs the health and social care services we inspect. 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. We found that Lancashire Care Foundation NHS Trust was providing a high quality service regarding end of life care (EOL). Find resources for carers and service users Contact the Trust. At the time of our inspection the antenatal contact was not being delivered consistently to all pregnant women in the trust. There was good interagency working with voluntary and third sector organisations. Some wards had locked the doors however other wards were not aware of the risk. This meant that some patients were not receiving person centred care. An annual appraisal enables the staff to review staff competency and ensure their development at work. Apply now for the Occupational Therapy job in Preston you deserve. 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. Staff had the skills, knowledge and experience to deliver effective care and treatment. This meant that patient safety was important and communicated to the senior management team. However, it was noted that mandatory training figures for the wards did not match the figures provided by the trust and the system of core and effective training was confusing. Staff morale was improving and staff were optimistic that improvements would be made under the new leadership team. In most places CRHT teams are an innovation and wider changes are needed in service organisation and patterns of clinical responsibility and decision . Information about complaints, concerns and compliments was not adapted to meet the needs of some patients with a learning disability. 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. They had a good understanding of the services they managed. Incidents were reported appropriately and lessons were learnt. We rated community based mental health services for older people as good because: There were safe lone working practices which were standardised across each of the localities. This occurred when patients had been assessed as needing hospital admission, but there were no beds available. Staff had a good knowledge of the Mental Capacity and Mental Health Act. Complaints were managed appropriately. Implemented best practice guidelines such as routine outcome measures to plot patients progress and experience (and had taken part in Royal College of Psychiatrists' Quality Network for Inpatients (QNIC) reviews).
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