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We saw guidance and procedures for caring for the dying patient and appropriate use of medicines. Staff were unsure of the future of the unit and therefore the direction and strategy was also unclear. Designed and Developed by: Cube Creative 2021. The information it provided did not clearly match up with sample of crisis/home treatment teams we visited as part of this inspection. Clinic room temperatures exceeded the maximum of 25 degrees on numerous occasions on four wards. Complaints were received and investigated in a timely manner. However, in some other mental health services, staffing levels were not adequate or staff were not suitably qualified to meet patients needs. 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 had been identified at a previous inspection but not addressed. Staff knew how to report incidents and these were discussed at monthly team meetings. Staff developed recovery-oriented care plans informed by a comprehensive assessment. Staff were familiar with reporting procedures despite few having reported an incident recently. All clinic rooms were fully equipped. However, on other wards patients were offered between 13 and 21 hours of meaningful activity per week. This had not improved since our last inspection. Good' overallbecause: We found good processes in place to reduce the risk of abuse and avoidable harm in the service. Clinics were visibly clean, tidy and organised. Avondale is run by Delphside Ltd a registered charity (No. Because these units had not been designed to accommodate patients for long periods, there were issues with food availability, bedding and linen, private space to change clothes and no safe places to store possessions. Children and adolescents had to long waits for appointments. Staff at the Platform described secluding patients in an extra care area, but they had not followed the Mental Health Act code of practice guidance of what actions to take when secluding a patient. 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. This was due to the recent change from two wards to one ward and staff were aware and working on these. The following is a brief overview to assist in helping make decisions in relation to potential referrals to Avondale MHC and whom can refer to us for assessment for placement. 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. Staff were able to manage the development of the service they provided. Thomas MACDONAGH, FY1 Doctor of Lancashire Care NHS Foundation Trust, Preston | Contact Thomas MACDONAGH Avondale Unit RPH, North West Posted today Applied Saved. Home Treatment Team How our service can help you Home Treatment (Lambeth) provides a service for people, aged 18-65, with severe mental illness who would benefit from assessment and treatment at home as an alternative to Hospital. Staff displayed a good understanding of their roles and responsibilities in this regard. Good The HBPoS were staffed by nurses from the adjacent acute wards when people were brought to the suite. 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. We provide care for people who live in the London Borough of Lambeth. Person-centred therapeutic interventions were being delivered to patients to support them to achieve improved independence and wellbeing. Despite this, longer term staffing issues had been identified in some areas and recruitment plans were in place to address future challenges. Staff employed by the service had good compliance with mandatory training, supervision and appraisals and had opportunities for specialist staff training and development. Staff completed comprehensive, holistic assessments of all patients on admission/referral. Our Crisis Resolution Home Treatment Teams have core operating hours of 9am until 9pm, 7 days a week, 365 days a year. 2010 Feb;19(1):75-87. doi: 10.3109/09638230903469178. The trust had systems in place to monitor quality issues and there was a clear commitment for continuous improvement with involvement of young people and their families. Care and treatment, policies and procedures and mandatory training was evidence-based and followed recognisable and approved guidelines. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding. The team was well-led by experienced and committed managers. All our staff adopt a holistic approach which is underpinned by the principles of the service which are safe, caring, responsive, effective and well led upholds our core values of respect, privacy and dignity. sharing sensitive information, make sure youre on a federal 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. Seclusion records did not document when a seclusion room had last been cleaned. Rapid tranquilisation and seclusion were used appropriately. Disclaimer. For people in the health-based places of safety, risk assessments were completed jointly with the police. Staff were not engaging with the patients when not on observations. On the acute and psychiatric intensive care wards, staff completed the physical observations of patients following the administration of rapid tranquillisation. We requested documentation audits specifically for the INTs and were informed by the trust that the INTs had not participated in a documentation audit for the 12 months prior to our inspection. We were told these were being developed. Carer involvement and support with care plans and signposting to further community support for carers. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. Staff had a good understanding of National Institute of Health and Care Excellence guidance and other national guidance. Patients and carers we spoke with were positive about staff but acknowledged the impact of staffing levels. Staff managed patients physical health needs. PPN NW is a regional membership network for all psychological professionals, experts by experience and stakeholders contributing to NHS commissioned psychological healthcare across the North West of England. The staff showed knowledge of procedures and requirements that helped maintain their safety. However, we did not re-rate the service at that inspection. Where possible, well try and provide treatment in your own home so you can avoid being admitted to hospital. There was effective multi-disciplinary team working. The staffing levels had improved since the last inspection to between 90% and 100%. The physical space of four of the five health-based places of safety (HBPoS) we visited provided safe, clean environments to assess people. In most teams comprehensive risk assessments were carried out by staff for patients who used the service; risk management plans were developed in line with national guidance. Assertive Community Treatment, or ACT, provides a full range of services to people diagnosed with a serious mental illness (SMI). Avondale Clinical Decisions Unit works in collaboration with the Mental Health Response Service and treatment units across the unplanned care pathway. Contact information. Patients and carers we spoke with were generally positive about staff. The trust met the fit and proper persons requirements. Home treatment teams did not have sufficient flexibility to offer a full 24-hour service. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. A literature review. The risks described by the staff on ward 22 were not understood by their managers/leaders. We observed male and female patients freely accessed each others pods, the communal IT equipment was located in one of the female pods and there was no separate female lounge, We found restrictive practices in place. A number of maintenance and cleanliness issues in the forensic services and a lack of infection control audits in community CAMHS. At this inspection, we noted delays in responding to maintenance and cleanliness on the Calder, Greenside and The Hermitage wards. Staff assessed and managed risk well. Patients had access to advocacy services and were aware of their rights under mental health legislation. Morant N, Lloyd-Evans B, Lamb D, Fullarton K, Brown E, Paterson B, Istead H, Kelly K, Hindle D, Fahmy S, Henderson C, Mason O, Johnson S; CORE Service User and Carer Working groups. Regular governance meetings were held and performance data was on display in teams. The service did not always have enough nursing staff to meet patients needs. Religious needs were not always met in a timely manner even though there were spiritual care facilities on site. Discharge planning was incorporated into thelocalgovernance reviews and was planned for on the young persons admission to the wards. At the Orchard, the door to the bathroom lacked an observation panel, which meant peoples privacy was compromised. Commissioning arrangements meant that the staffing skill mix and provision of psychiatric cover across the trust was variable. We did find that a ligature point had been identified at the wards in the Harbour when the windows of the quiet room were opened into the internal courtyard. the service is performing well and meeting our expectations. The 136 suite at Preston had a shower room which had evidence of mould growing and cracked tiles. We rated the community-based services for adults of working age as good because: We rated wards for older people with mental health problems as 'good' because: We rated forensic inpatient/secure wards as good because: Patients risk assessments were well detailed and comprehensive containing personalised and relevant information. There were gaps in the required observations and incomplete records. If the person you are referring is an inpatient in Musgrove Park Hospital or Yeovil District Hospital . The services received positive comments about the staff and the care provided and patients were treated with dignity and respect. Request quotes. 29 Occupational Therapy jobs in Preston available on Monster. There is a severe lack of longitudinal clinical and patient-centred outcome data. The trust had a protocol in place however this was not being followed consistently and was out of date. Some patients had been held in the 136 suite for several days. Feedback from people who use the service was positive. Any identified spiritual needs and cultural requirements were supported and families and carers groups were active in the service. This resulted in difficulties for staff because patients witnessed and heard of others smoking. 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. The criteria for referral to the service did not exclude service users who would have benefitted from care. We may also be able to accommodate some over 16s, where appropriate. Managers ensured staff received supervision, appraisal and training. Translation services were available if required. Staff were observed treating people who used the service and their carers with dignity and respect. 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. Staff had a good knowledge of the Mental Capacity and Mental Health Act. Furniture in the mental health crisis rooms in Blackburn was not set out to reduce the risks to staff. However staff demonstrated less knowledge about incidents and learning that had happened on adult wards in other localities or from relevant incidents that had occurred in other services within the trust. Equipment and machinery were subject to regular checks and maintenance. 19 May 2020. official website and that any information you provide is encrypted Records and medicines were stored correctly in most areas and audits were completed at intervals. 22 July 2022. There is a night practitioner available for telephone advice and guidance outside of these hours. There was good management of medication. 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. However notices advising informal patients of their right to leave were not on display on all wards. Comprehensive assessment processes, holistic care plans and risk assessments were in place and young people felt involved in the care planning process. We re-inspected the service in March 2020 and found that the conditions of the warning notice had been met. When we spoke with people receiving support they were generally positive about the support they had been receiving and the kind and caring attitudes of the staff team. However, because this was a focused inspection we did not re-rate the individual key questions or the overall service. 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. Visit website. 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. There was good use of de-escalation techniques across the wards. Individual and environmental risks were monitored and managed appropriately. Staff spoke positively about the support they were given by seniors and management within end of life care although staff were not aware of who the trust lead for end of life was. There was good adherence to the Mental Health Act and Mental Capacity Act. Individual wards were able to submit items onto the trust risk register in relation to staffing issues however, on ward 22 the trust had not addressed the deficit of replacing permanent staff. To help with your recovery it is important to work closely with other people who support you. Patients described their need to make contact with family and friends. Managers and clinicians had put good governance systems in place which managed risk effectively. We attended two meetings related to staffing. Patients individual care and treatment was planned and best practice guidance was implemented, ensuring outcomes were monitored and reviewed. The service did not meet the Department of Health guidance on same sex accommodation. Families and carers were involved in this process where appropriate. We observed people who use the service being treated in a respectful manner and with a caring and empathetic approach. Staff knew who their senior managers were, and a non-executive director had recently spent a shift on a ward within the service as a support worker to experience life on a ward. Avondale Unit, Royal Preston Hospital, Sharoe Green Lane North, Fulwood, Preston, PR2 9HT. For services we haven't rated we use ticks and crosses to show whether we've asked them to take further action or taken enforcement action against them. Our Dementia Home Treatment Teams provide an intensive, safe home treatment service in the least restrictive way. Understanding of your current mental health issues. 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. We rated Community sexual health services as ' In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. We inspected the four wards for older people with mental health problems based at the Harbour. Staff felt supported by their immediate and local senior managers and matrons. Patients had access to information, which included how to make a complaint. This had resulted in a disconnect between the four clinical networks which limited opportunities for shared learning across the networks. They had a good understanding of the services they managed. Staff involved patients and their relatives in their care where possible and treated them with kindness, respect, compassion and dignity. Suspended ratings are being reviewed by us and will be published soon. The NHS Friends and Family Test results showed the majority of patients would recommend the department to their family and friends. The ward environments were subject to constraints in observation. Patients frequently experienced cancellations to escorted leave and activities. J Ment Health. The service participated in National Institute for Health and Care Excellence audits such as the use of waterlow scales and end of life care. The service followed best practice guidance on the decontamination and sterilisation of used dental instruments. Records showed that planning was in place for regular supervision and appraisals. It was noted that no staff had advanced paediatric life support despite offering services to children over 1 year however this requirement would be dependent on the number of children seen. Staff took the time to listen to patients and to understand their needs. The trust did not have accurate or complete information in relation to patients who remained in the health-based places of safety or the mental health decision units for prolonged periods of time. Leaders had the skills, knowledge and experience to perform their roles. There was a process in place so that patients on a community treatment order were informed about the availability of the independent mental health advocacy service and had their rights read to them. The design, layout, and furnishings of the ward/service supported patients treatment, privacy and dignity. This was because many patients on a community treatment order were not routinely given information about their rights or informed of their rights to an independent mental health advocate verbally. We saw evidence that staff took the time to familiarise themselves with patients and were welcoming and helpful. Staff clearly expressed the trusts vision and values and portrayed positivity and pride in the work they did. Patients care and treatment needs were assessed using a holistic approach that included a comprehensive physical health needs assessment. The Longridge ward team were positive and proud of the service they provided for the local community. 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 requires significant improvement as patients were being deprived of their liberty without a legal framework in place for this. Staff were motivated and described good teamwork, they talked positively about their roles. There was improvements to supervision, training and appraisal rates from the last inspection. We also saw that supervision and appraisals were being done for staff but all wards agreed that they needed to improve this aspect. The health-based places of safety provided a safe environment for the risks of people in a crisis to be managed. A strong therapeutic relationship between staff and patients was evident. 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. Not all staff were adequately trained to deal with patients in seclusion. There were 13 of these that deteriorated which suggest that once a pressure ulcer developed care and prevention strategies were implemented to prevent any deterioration. Welcome to the official Preston Lions FC page on Facebook. 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.