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. Patients frequently experienced cancellations to escorted leave and activities. The development of the HBPoS and joint working arrangements with the police reduced the numbers of people being assessed in police cells. Our DHTTs can make referrals where needed to our mental health inpatient wards for individuals who would benefit from a hospital stay. This was due to long waiting lists and ineffective care pathways. 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. Keywords: Patient records did not always record patients views and it was not clear whether patients received a copy of their care records. On admission to a ward, patients had a comprehensive assessment of their needs, and systems were in place to asses and monitor physical health and nutritional needs. This limited who had access to the sessions. Hurstwood ward was due to close in December 2016 and a new location with more space was planned. We rated them as requires improvement because: During the inspection we visited all six wards and observed how staff were caring for patients. There was improvements to supervision, training and appraisal rates from the last inspection. The OT works with new and existing residents, where appropriate, to devise a structured occupational therapy plan for their stay. 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. Telephone referrals only to the Acute Crisis and Assessment Team (ACAT) are received on ext 67774. Any other browser may experience partial or no support. Evidence based tools were used in the assessment process and staff used recognised rating scales to measure a young persons progress. We spoke with 18 patients and three carers. This meant that some patients were not treated as an adult. To explore opinions of HTT service users on the care they received to guide future research and service provision. within the community health services for adults, staff did not do all that was reasonably practicable to mitigate the risks of patients developing pressure ulcers on their caseload. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding. There was significant damage to Calder and Greenside wards. This meant that staff had a good understanding of patients needs and how to deliver particular care. To find out more, click here, Leaders within the service were aware about the issues the service was facing. Staff could describe incidents that had been reported and identified actions taken in response. We found that a third of care plans we reviewed were not completed collaboratively with patients. The service reviewed staffing levels daily. We strive to empower people to make choices that will promote wellbeing helping them to achieve their individual hopes and aspirations. 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. Maudsley Hospital, 5 Windsor Walk, London, SE5 8BB. There was not an effective, existing governance structure in place across the four clinical networks. You can contact them oncomplaints.penninecare@nhs.netor 0161 716 3083, Opening hours:8am-8pm, seven days a week, Heywood, Middleton and Rochdale early attachment service, Heywood, Middleton and Rochdale young peoples mental health support team, Oldham young peoples mental health support team, Tameside and Glossop early attachment service, Tameside young peoples mental health support team, Full mental state examination and assessment, Medical input on consultations, review, medication prescribing and management, Providing access to other supporting agencies, Brief cognitive behavioural therapy (CBT), Guidance (Young Minds, Papyrus, Pennine Care CAMHS website), Information about our patient, advice and liaison service (PALS). We issued the trust with a Section 29A warning notice. The incident reporting system did not allow for routine analysis of themes and trends in the 136 suites. Staff in all services were generally described as discreet, respectful, and responsive when caring for patients. Where possible, well try and provide treatment in your own home so you can avoid being admitted to hospital. You can view full details of the Home Treatment Team - West service in our services directory. You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection. The care plans were thoughtful and fluid, changing as and when needed. Patients spoke highly about the care they received from the staff within each of the older adult services. Wards used regular bank and agency staff where possible. Some wards were entirely smoke free and some permitted smoking in garden areas. They worked collaboratively with the young person and their family and always sought their agreement. Incidents were investigated and where necessary the patient was fully informed, and an apology given in line with the duty of candour. SY16 2DW Supervision and appraisal figures were low. Actions in relation to complaints were often recorded as an apology being offered or expectations managed, but there was no evidence of investigation of systemic issues and wider changes. We carried out this unannounced focused inspection because we received information giving us concerns about the safety and quality of this service. There was access to translation services and arrangements for patients with sight and hearing loss. 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 had co-located its two locations into one location at The Cove. The services received positive comments about the staff and the care provided and patients were treated with dignity and respect. Staff were supported by a central trust team and by Mental Health Act administrators who inputted into each ward. Staffing had been improved by the use of the safecare system, allowing shortfalls to be identified and covered. People expressed that whilst sometimes they had to wait to be seen in clinic, they felt the standard of care was good and the staff were friendly. Your IP: We found evidence that demonstrated the teams implemented best practice guidance within their clinical practice. Melbourne Water is undertaking water main upgrade works in Melbourne's northern suburbs. Every service will be 'open-access' by 2021, meaning that people and families can self-refer, including those who are not already known to services. Staff working for the home treatment teams provided a range of care and treatment interventions that were informed by best practice guidance and suitable for the patient group. One team held a regular clinic for people to attend. Young people and families knew how to make a complaint or raise a concern about the service and staff had responded to these. Patients and carers we spoke with were generally positive about staff. If you would like this information in large print, audio, Braille, alternative format or a different language, please contact Customer Services and we will do our best to help. However, in some other mental health services, staffing levels were not adequate or staff were not suitably qualified to meet patients needs. Staff felt well supported by the team leaders. The services were not routinely undertaking fire drill testing at each of the team localities. 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 . Tel: 0161 716 3539 Parking Available: Yes The ward layout was well planned in the Harbour services: the layout used space to good effect. At Hope House, documentation relating to medicines was not being completed consistently. Home treatment teams (HTTs) have limited evidence of altering hospital admissions. Medicines were dispensed and stored securely and audits undertaken to ensure safe practice. Patients care and treatment needs were assessed using a holistic approach that included a comprehensive physical health needs assessment. They were kept up to date about their teams performance. The service could not demonstrate that it managed risks to service users effectively. Our Home Treatment Teams(HTT) area community-based service set up to support you if you are experiencing severe mental health issues and require crisis support. Ward managers had access to staffing figures on other wards and if necessary staff could work on different wards. Staff completed risk assessments on admission and updated these regularly. The service did not provide safe care. Staff had a good understanding of the importance of obtaining and documenting consent and were fully aware of their responsibilities under the Mental Capacity Act 2005. During our inspection we found care plans and risk assessments were not always in place or updated and this was also identified as part of a root cause analysis investigation. The HBPoS at the Harbour had clear windows which compromised patients privacy, dignity and confidentiality. Patients were treated with dignity, respect and kindness and staff were dedicated and enthusiastic about involving patients in their care, However we received mixed comments from patients we spoke with and from comment cards we received gave mixed views about patients experience of dignity, respect and support. There was a clear structure of reporting and responsibility for safeguarding adults and children. They had a good understanding of the services they managed. 7-days-a-week input, including access to 24 hour advice (see Contact us). There was some inconsistency in the recording of monitoring of patients following the administration of rapid tranquilisation. They reported this had impacted on their ability to ensure that staff accessed appraisals, supervision and mandatory training in line with trust policy on some wards. 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. Contacts we observed showed information provided to children and families was clear and tailored to the individual child. There was a governance framework to support the delivery of care. The trust had systems in place to monitor the quality of the services and drive improvements. We can also speed up discharge from inpatient care by making sure intensive home support is available for a short period after discharge. 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. There was good multidisciplinary working especially with the police and ambulance service. The risks described by the staff on ward 22 were not understood by their managers/leaders. Information was not readily available in different languages, staff stated they could access an interpreter as necessary. LD30LU 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 identified a number of issues of concern in relation to the child and adolescent mental health services provided by the trust in the community. Mental health practitioner home treatment team jobs in Preston, Lancashire 2,505 vacancies Get new jobs by email REGISTERED MENTAL HEALTH NURSES NEEDED -START NOW!- 27 - 34 per hour The clinical staff had participated in clinical audits, to look at whether the services had met National Institute for Health and Care Excellence (NICE) guidelines in December 2014 for depression and attention deficit hyperactivity disorder. Patients using the service were given opportunities to be involved in decisions about their care. On a follow up visit to Keats ward we found that there had been inaccurate recording of the seclusion start time and when mandatory reviews had been carried out including medical reviews, as per seclusion policy. We will work closely with you, your family and carers, including your social networks to provide intensive support and care, helping you to draw on your own strengths and to help you learn different ways of improving and maintaining your mental wellbeing. Patients and the ones who were close to them were involved in their care decisions. 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. Three wards had dormitory sleeping arrangements. 2010 Feb;19(1):75-87. doi: 10.3109/09638230903469178. During an episode of care you will see varying members of our team. The blog is to stimulate thought about how psychological approaches play a role in health care. Robust systems were not in place to ensure that certain patients were automatically referred to the tribunal or that the corresponding legal authority to administer medication to community treatment order patients were kept with the medicine chart and reviewed by nurses administering medication, leading to incidents of staff giving medication without legal authorisation. Patients and carers were involved in decisions about their care. Staff worked within the trust's lone worker policy. Get contact details, videos, photos, opening times and map directions. 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. There was evidence of delivering services to meet patients needs. We found the risk register was now up to date, reviewed monthly and actions taken where needed. Staff carried out an initial assessment that focused on peoples strengths, self-awareness and support systems, in line with recovery approaches. Staff knew how to make a safeguarding alert and showed good understanding of safeguarding issues. There was an ongoing programme of recruitment to vacancies. Staff appraisals were completed however there were inconsistencies in staff supervision. We also found some gaps in the recording of observations on some wards. 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 Compliance with clinical supervision and yearly appraisals for nursing staff was poor. Staff cared for patients with kindness and compassion. There was improved responsiveness and staff joint working when patients were in transition from children and adolescent mental health services to adult mental health services. 12 hour shift + 5. Healthcare support workers were about to enrol on the associate practitioners course which would enable them to enhance their practical skills. 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.
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