However, a push button (anti-ligature) staff alert system was installed in all unobservable areas (toilets and bathrooms). Staff had access to performance dashboards to monitor progress and improve service provision. Regular environmental quality checks were conducted and patients were able to discuss and resolve environmental issues in community meetings. Bedford MK40. Any ligature points were assessed and mitigated for, and reflected in the trust risk register. Feedback from patients who used the services was positive, regarding how staff treated patients and their families. Clinical premises where service users were seen were safe and clean. Patients were not always given their rights under the Mental Health Act in line with the code of practice guidance. Wards received monthly performance reports. Patients were generally positive in the feedback they provided. Community-based mental health services for adults of working age. 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. It was at this time a full capacity assessment was carried out. They took into account the opinions and considerations of people who used the service and where possible other staff. An Archiblox modular design melding sustainability with contemporary living delivers this unique four bedroom two bathroom residence. 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. Good Safeguarding systems were in place to support staff in the safeguarding process and monitor safeguarding incidents across the trusts children and families network. The service did not meet the Department of Health guidance on same sex accommodation. The trust used high numbers of bank and agency staff on their wards. Estimate repayments Loading. We rated the trust as requires improvement overall in safe, effective, responsive and well led. Staff morale was low. The Central Home treatment team also provide intervention to Willow House the Crisis support house based in Chorley, The Haven service based in Preston and the136 Rigby suite based at the Avondale Unit at times there may be a need for the successful candidate to undertake these roles. We have issued a section 29A warning notice to the trust with improvements that need to be made by 20 December 2019. The team usually includes a number of mental health professionals, such as a psychiatrist, mental health nurses, social workers and support workers. Staff requested patients consent to care and treatment in line with the Mental Capacity Act. Admissions of children to these units was not incident reported. Public and staff engagement was embedded and included initiatives such as a partnership with Hyndburn Council and Public Health Lancashire in the launch of a voluntary ban to encourage people not to smoke in Council Play Areas and working with people from the community to conduct research studies about how cultural beliefs had prevented access to healthcare. Some wards were entirely smoke free and some permitted smoking in garden areas. Staff were now receiving appraisals and conducting observations post rapid tranquillisation of patients, these were regulatory breaches at the inspection in 2018. The quality of care plans throughout the trust was inconsistent. 23 May 2018. There was inconsistent application of the trusts no smoking policy. There are new and exciting developments happening with a new Intensive Home Treatment programme across Milton Keynes, Bedfordshire. This is in breach of same sex accommodation guidance where service users in mixed sex accommodation are expected to have individual bedrooms or bed areas which are solely for one gender. Since our previous inspection the trust had been reviewing potential tools and had analysed activity data to inform a new model of care. This allowed treatment to be provided in an effective and timely manner. To provide mental health assessments and advice for clients who are in-patients on medical wards within the Acute Trusts, Conduct comprehensive risk and mental health assessments to a standardised level of best practice, To offer advice and support to colleagues within the Acute Trusts, Ensure appropriate signposting/referral onto relevant statutory and non-statutory agencies as identified, including Single Point of Access (SPOA), Perinatal Community Mental Health Teams (PCMHT), Home Treatment Teams (HTT), Substance Misuse Services and Housing and Emergency Social Services Team in response to client need. the trust had a dedicated team to investigate serious incidents, all of whom had additional qualifications in root cause analysis. No rating/under appeal/rating suspended Incorrect entries made on the ECR system could not be amended by the author and had to be amended by the information technology staff which complicated the process and could explain why trust figures for reporting documentation issues was high. and acting on these as appropriate on a multi-disciplinary basis.. To allocate and utilise resources to provide an effective and responsive service countywide, being There was significant damage to Calder and Greenside wards. the service isn't performing as well as it should and we have told the service how it must improve. Track your home now! We found evidence that demonstrated the teams implemented best practice guidance within their clinical practice. We found examples ofexcellent practice in disseminating information. Systems in place to ensure staff were safe at the end of an evening shift were not always followed. Staff were detaining patients in the health-based places of safety past the expiry time of the section 136. Contact Details: Stroke rehabilitation Team: 01257 245118. This occurred when patients had been assessed as needing inpatient admission, but there were no beds available. Staff were not always following the seclusion policy, infection control practices and best practice in relation to medicines management. Celebrate with us on Wednesday 24th May in Manchester City Centre to find out more, click here -, AHP and Psychological Professions Collaboration to Support Art, Drama and Music Therapists! Gimnez-Dez D, Maldonado Ala R, Rodrguez Jimnez S, Granel N, Torrent Sol L, Bernabeu-Tamayo MD. The trust acknowledged that there needed to be a common approach across the four networks to effect alignment with the refreshed governance arrangements and the assurance requirements of the corporate level structure needed to be clearly articulated to be embedded appropriately. We issued the trust with a Section 29A warning notice for this core service. We accompanied staff visiting people who used the service and it was clear that they had a good understanding of peoples needs. Environmental audits did not include all areas of the ward environment which meant that staff were not following trust procedures. We found that the service had improved and met the requirements of the warning notice. We have excellent in house catering, laundry and housekeeping services and these support the wider clinical teams in allowing comprehensive service delivery to our residents. The wards were clean and tidy and there was an established cleaning regime. Staff prioritised the safety of people using the service and also the safety of people working for the trust. The services received positive comments about the staff and the care provided and patients were treated with dignity and respect. 22 July 2022. Patients were able to access the 136 suites, crisis/home treatment teams and crisis support units when required. This core service was rated as Good at the last inspection in September 2016. This had a direct impact on patient care. PMC Following two patients attempting to harm themselves by hanging using fixed points in the lounge ceiling where they could attach something. The service had a good safety record; Incidents of harm in the service were low. Information provided by the trust showed staff had not received the expected supervisions and appraisals. Staff demonstrated that they knew the organisations visions and values, and were supportive of them. Mental capacity assessments and best interest decisions were not always formally recorded. Staff managed patient risk. Home Treatment Teams (HTT) Home Treatment Team supports people living in the community, aged 16 years old or above who have moderate to complex or serious mental health problems across Lancashire. We rated The Lancashire Care NHS Foundation Trust as good because: There was an open and transparent approach to the treatment of people who used services that allowed for identification of safeguarding issues or inefficient practice. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Patients and carers were involved in decisions about their care. Staff did not have access to information that was held on the local authority electronic record system. At Hope House, documentation relating to medicines was not being completed consistently. We found examples of wards managed by committed managers with strong visions and values for example, the womens service operated a gender-based model of care, and the mens rehabilitation/step down ward (Fellside) strongly promoted hope and independence to patients. Care records were holistic, comprehensive and showed evidence of patient and carer involvement. Individual and environmental risks were monitored and managed appropriately. This allowed everybody to be involved in care planning and understand what was expected. Managers reviewed individual and team performance. Patients received input from a range of mental health professionals. People did not have to be admitted to hospital when they were prescribed clozaril as staff carried out monitoring in the person's own home. This had not improved since our last inspection. 2023 Stylishly Sustainable in Preston High School Zone. An electronic staffing recording system highlighted gaps in provision and automatically advertised bank shifts to other staff. This is because: We were not assured that all lessons learnt were being identified in the root cause analysis investigations we reviewed or areas identified for improvement were being monitored. They were kept up to date about their teams performance. This limited who had access to the sessions. Governance structures were in place to monitor performance targets and risk. The trust had legitimately implemented a no smoking policy at Guild Lodge in January 2015. Patients individual care and treatment was planned using best practice guidance. Back to Mental Health Liaison Team (MHLT) (PCMHT), Home Treatment Teams (HTT), Substance Misuse Services and Housing and Emergency Social Services Team in response to client need; Preston & Chorley. This usually took place within 24 hours. This included patients who were held there after the section 136 had expired. The service had met the requirements of the warning notice because: The service had enough nursing and medical staff, who knew the patients and received basic training to keep patients safe from avoidable harm. Staff were unsure how long a patient had been in a soiled room. In addition, at the Junction compliance with clinical and management supervision was low. On the child and adolescent ward, staff did not always have time to spend with all patients due to high levels of staff observation required for some patients. These staff were responsible for ensuring ward procedures were up to date and provided advice and support to their colleagues. Comprehensive assessment processes, holistic care plans and risk assessments were in place and young people felt involved in the care planning process. This had resulted in significant issues with recruitment and high levels of sickness. Patients told us that staff were caring and we observed staff treating patients with kindness, dignity, respect and compassion. The hope is we can also support other local charities or foodbanks with any excess. We can support you if you are 16 or under and in full-time education. At the last inspection management of the risk register was found to be poor. Staff in all services were generally described as discreet, respectful, and responsive when caring for patients. Our primary aim is based on the recognition that people recover more quickly if treated at home in familiar surroundings, with friends and family close by. However, we did not re-rate the service at that inspection. Services were being delivered in line with adherence to the Mental Health Act 1983, the Code of Practice and the Mental Capacity Act 2005. There were clear systems of accountability and senior managers were actively involved in the operational delivery of the service. staff were knowledgeable about their responsibilities in relation to reporting safeguarding concerns including to external agencies, most care plans were of good quality with evidence of patient involvement, services were being delivered in line with national guidance and best practice, the trust was compliant with the workforce race equality standard and was acting to understand and close the gap between treatment of white staff and those from Black and minority ethnic backgrounds, staff built and maintained good working relationships with agencies and stakeholders external to the trust. Pharmacists inputted into wards on a daily basis. We inspected: Austen ward an 18-bed female advanced care ward, Bronte ward - a 15-bed female dementia ward, Dickens ward an 18-bed male advanced care ward, Wordsworth ward a 15-bed male dementia ward. Activities were not happening on the ward. A literature review. The service engaged well with staff, patients, external stakeholders and other healthcare professionals well in order to continually improve the service. Most staff were up to date with mandatory training and felt proud to work for the Trust. This meant staff might have difficulty when reviewing the records, to locate and identify potential risks. There were sometimes delays in meeting personal care needs. Avondale Unit, The Royal Preston Hospital Town Preston Salary 33,706 - 40,588 per annum, pro rata Salary period Yearly Closing 14/03/2023 23:59. Manchester, Three records did not have 15-minute recordings of the patients progress. This was shown by the number of environmental issues we found across services that compromised the safety of patients. This resulted in some people with a personality disorder being admitted to an acute ward whose admission might have been avoided. Published Because of the rural location of Guild Lodge local public transport was limited. The service had direct access to a vascular surgeon where they could arrange urgent appointments and the service could order diagnostic tests prior to the patient attending the appointment to enable the consultant to have sight of all information at the time of consultation. Clipboard, Search History, and several other advanced features are temporarily unavailable. Staff could describe incidents that had been reported and identified actions taken in response. Our findings from the other key questions demonstrated that governance processes did not operate effectively at team level and that performance and risk were not managed well. Staff were unsure of the future of the unit and therefore the direction and strategy was also unclear. Patient care, including managing patients nutritional needs and pain relief, were well managed. The crisis support units were intended to accommodate patients for up to 23 hours. The trust had systems in place to monitor the quality of the services and drive improvements. We rated 10 of the trusts 14 core services as good overall. The use of internet software allowed staff from across bases to connect in to daily huddles without the need to travel and Chat Health was being introduced across the school health service which allowed students and parents to contact the school health service by telephone and text in a confidential and accessible manner. There were clearly defined roles and responsibilities within the service supported by an effective management structure. It's the responsibility of a Gunzenhausen home architect to transform human needs and desires into visual concepts and habitable structures. Staff understood their responsibilities under the Mental Health Act and patients were regularly informed of their rights. Care plans were of a high standard. There was a clear structure of reporting and responsibility for safeguarding adults and children. These practices were not based on individual patient risk assessments. Staff showed a clear commitment to providing the quality care which individuals needed. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. In one case, the lack of response to a patients request led to a serious incident. The MHCS worked within the principles of the recovery model. The trust had access to interpreters which they used for patients with communication difficulties or for those for whom English was not their first language. There was some inconsistency in the recording of monitoring of patients following the administration of rapid tranquilisation. The team will supplement the existing input from the . The local timezone is named Europe / Berlin with an UTC offset of 2 hours. The HBPoS at the Harbour had clear windows which compromised patients privacy, dignity and confidentiality. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service. 8600 Rockville Pike This site needs JavaScript to work properly. There were enough skilled and experienced nurses and doctors. The physical space of four of the five health-based places of safety (HBPoS) we visited provided safe, clean environments to assess people. 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. Staff followed a formalised flow chart of actions to be taken if there were instances of sickness. The vaccination and immunisation team were not always following the trusts consent policy in relation to the Gillick competency and Fraser guidelines, which resulted in some children not being vaccinated or the parents being contacted to gain verbal consent. Physical restraint was rarely used as staff were confident in the use of de-escalation techniques. 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.
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