Staff recently recruited had not received all their mandatory training and inductions. Swydd wag: Mental Health Crisis Practitioner, Lancashire & South We issued the trust with a Section 29A warning notice. We have two pathways: supported early discharge and admission avoidance. This meant that patients were receiving holistic treatment within each care pathway. One older peoples ward that breached same sex accommodation guidance. 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. We provide short term supportive care packages to young people and their families/carers being discharged from acute inpatient wards. Staff assessed, managed, and reviewed risks to young people daily but recorded information inconsistently. 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. 33hr contract (36.75 hours paid) 34,398 - 40,131. A new electronic prescribing system was being introduced. We saw a piece of work analysing the main reasons for staff sickness absences and considering how these could be addressed. 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. The HTT does not provide phone support for people not under their current care. There were broken door panels that had been boarded up and were awaiting repair. Welcome to the official Preston Lions FC page on Facebook. Schizophrenia - NCBI Bookshelf 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. 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. Learn more about who makes up your local PPN team. Staff prioritised patient care over completion of supervision, appraisal and team meetings. We are a multi-disciplinary team of healthcare professionals offering a holistic and intensive period of care. Crisis team; HTAS; crisis and home treatment; patient opinion; qualitative. Staff had access to a rolling programme of training in specific models of care relating to the womens service, acquired brain injury, mens service and seclusion. Search for local Hairdressers near you on Yell. The Mental Capacity Act cannot be used to authorise detention in this way. We accompanied staff visiting people who used the service and it was clear that they had a good understanding of peoples needs. It is recognised that people recover more quickly if treated at home in familiar surroundings, with friends and family close by. Understanding of your current mental health issues. 11 September 2019. 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. Clinics were scheduled weekly at set times with some open and some pre-booked slots. Interventions are usually made via regular home visits and telephone contact. About | Intensive Home Treatment Staff were able to submit items to a risk register. In doing so they must be free to occupy a central place in the acute mental healthcare system. Good' overallbecause: We found good processes in place to reduce the risk of abuse and avoidable harm in the service. Ward staff actively tried to ensure discharge to appropriate locations were completed in a timely manner. There are several actions that could trigger this block including submitting a certain word or phrase, a SQL command or malformed data. Track your home now! South London and Maudsley NHS Foundation Trust (SLaM) is the main provider of mental health care in Southwark. Published Some patients had been held in the 136 suite for several days. 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. The service has volunteered to participate with colleagues in Cheshire and Merseyside Workforce Development to improve workforce resilience, by sharing examples of good practice and also looking at alternatives to the current routes to care careers. In order that as a mental healthcare provider, we not only provide care, support and advance wellbeing and independence for individuals who reside at Avondale. Staff involved with the crisis support units and crisis/home treatment teams were impacted to some degree by reorganisation within this core service which led to uncertainty. The content on this page is copied from the Home Treatment Team - West information leaflet. Welcome to the City of Avondale, Arizona! Clipboard, Search History, and several other advanced features are temporarily unavailable. There were initiatives in place that supported staff morale and wellbeing. Staff were not appropriately monitoring patients after the administration of rapid tranquilisation. There were a number of wards and services which had furnishings or fittings that had ligature risks (places to which patients intent on self-harm might tie something to strangle themselves). Due to on going transformation work at the trust, the business case for staffing against activity had been placed on hold. The service could not demonstrate that it managed risks to service users effectively. They had access to wheelchair tippers. Many services were being delivered from less than ideal locations that were not owned by the trust. This helped the service make maximum use of its resources. An audit had been performed to monitor storage of medicines and had reported issues with clinic room temperatures not being monitored which we observed at the time of our inspection and we were not assured that clear actions and improvements had been made. Staff were positive about the new system. Staff did not create specific care plans for patients with epilepsy or moving and handling needs. In some cases staff were still being slotted into positions in the team. We rated acute wards for adults of a working age and psychiatric intensive care units as good because: There was good risk management. Staff completed risk assessments on admission and updated these regularly. Treatment practices were based on nationally recognised guidance. We provide specialist assessment, active therapy, treatment and the opportunity for recovery to older people with a mental health problem. 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 requirements of the warning notice had been met because: Our rating of this service improved. Should you wish to comment on the service received, please contact the Trust on telephone: 01603 421421. At this inspection we reviewed the safe, caring and well-led domains in full. The rotas in use did not provide oversight of all shifts at each location so that the provider could understand whether they are meeting the safe staffing establishment. The team usually includes a number of mental health professionals, such as a psychiatrist, mental health nurses, social workers and support workers. document.getElementById("ak_js_1").setAttribute("value",(new Date()).getTime()); Avondale Mental Healthcare Centre, 11 Sandstone Drive, Prescot, Merseyside, L35 7LS, Email: (function(){var ml="idukgefvro4l0n.%a",mi="0=69? We found that a third of care plans we reviewed were not completed collaboratively with patients. Young people and families knew how to make a complaint or raise a concern about the service and staff had responded to these. The service did not always have enough nursing staff to meet patients needs. Staff used the Friends and Family test as a formal tool to obtain feedback from patients or their relatives. These practices were not based on individual patient risk assessments. Avondale, AZ 85323 602-540-1271 99th Ave ACT 824 N. 99th Ave #107 Avondale, AZ 85323 602 . This had not improved since our last inspection. Shifts were filled to the required staffing level by redeploying staff from the CRU to the HDRU and through the regular use of bank staff. Managers showed good leadership and supported staff to deliver high standards of care. Where possible, we'll try and provide treatment in your own home so you can avoid being admitted to hospital. 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. Staff treated patients courteously and with appropriate dignity and respect. Risk assessments were comprehensive and included risk management plans. Buckton Building Tameside General Hospital Foundation Street Ashton-Under_lyne OL6 9RW. We have two pathways: supported early discharge and admission avoidance. At the last inspection management of the risk register was found to be poor. Patients care and treatment needs were assessed using a holistic approach that included a comprehensive physical health needs assessment. Staff were able to access patients electronic records across the trust. Staff followed the trust's values of teamwork, compassion, integrity, respect, and intelligence when carrying out their work. Our rating of the trust stayed the same. The trust was committed to reducing restrictive practices including the use of prone restraint, which was demonstrated by their strategy on this. Norfolk and Suffolk NHS Foundation Trust values and celebrates the diversity of all the communities we serve. the service isn't performing as well as it should and we have told the service how it must improve. At Pendle House, we saw an electronic notice board accessible to all staff that included an SUI action tracker that showed shared learning and good practice. Systems were still not in place to ensure that the corresponding legal authority to administer medication to patients subject to a community treatment order were kept with the medicine chart and reviewed by nurses administering medication. Patients had access to advocacy services and were aware of their rights under mental health legislation. The recording of patient information did not optimise the sharing of patient data between staff of differing services and teams. 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. Staff had knowledge and skills to deliver effective care and treatment and staff received support and supervision from their managers and peers. Service and service type . 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. 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. Patients had an assessment of their needs, and a plan of care was developed in response to this. There was a clear structure of reporting and responsibility for safeguarding adults and children. Despite the challenges staff faced due to the increased acuity of patients, staffing issues and increased demand for beds in some core services, staff remained committed and motivated to providing the best care possible and improving services for patients. 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. This meant that the use of blanket restrictions was low and patients freedoms were proportionate to the level of risk. 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. Across all the teams, there were issues with staffing, despite staff now being recruited specifically to work in 136 suites. 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. Paper and electronic records we reviewed were completed to a good standard and included relevant patient information including name, address, date of birth as well as care plans, referrals and safeguarding information as appropriate. There were no clear dates for the action plan implementation following the audit. Staff were observed being responsive and respectful to patients, and demonstrated that, where possible, patient were participating in the planning of their care. The service continued to have input from pharmacists, a physiotherapist, occupational therapist, integrated therapy technician and speech therapy. Telephone referrals only to the Acute Crisis and Assessment Team (ACAT) are received on ext 67774. Patients therefore remained in the health-based place of safety longer than necessary. Teams were well-led by committed managers and staff felt respected and supported. The majority of staff were up to date with mandatory training. 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. Patients without leave could not attend and patients with leave could only attend if there were enough staff to escort them. Staff were observed talking to patients in a kind, sensitive and caring manner. This was due to long waiting lists and ineffective care pathways. Access to crisis care was not delayed by having to access it through the accident and emergency department, for example. You can talk to PALS who provide confidential advice and support to patients, families and their carers, and can provide information on the NHS and health related matters. For a reported incident we looked at, it was not clear whether a root cause had been established. This meant that patients with low risk could engage in activities that would aid their recovery. Recently the whole care sector has been subject to staffing crisis and as a service Avondale have been extremely proactive and successfully recruited additional qualified nurses when others have struggled. 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. Staff knew how to make a safeguarding alert and showed good understanding of safeguarding issues. 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 The community mental health teams were effective in providing multidisciplinary, evidence based care. 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. Staff morale was low. The trust was unable to provide consistent information relating to this core service. There were delays in repairing broken doors which negatively impacted on the environment. Discharge plans were discussed from admission but were based on individual patient needs and did not follow any benchmarked outcomes. The service received 238 compliments within the last 12 months. Maudsley Hospital, 5 Windsor Walk, London, SE5 8BB. Courses Avondale - Avondale University College 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. We found this was not consistently applied across the site. Staff were up-to-date with mandatory training. Laureate House, Wythenshawe Hospital, Southmoor Road, Manchester, M23 9LT. Patients had access to a range of services to meet their needs. Improved communication between the Accident and Emergency Department, Mental health services and other departments within the Acute Trust Hospital setting in relation to patient care and management. https://avondale.org.uk/. The Unit has 14 beds, providing both male and female accommodation. Patients had their risks assessed on admission and on an ongoing basis. We inspected this service at the Harbour because that was the location where concerns were raised. This means we can offer brief interventions to support your recovery and manage any risks, which reduces your chances of having to be admitted to hospital. 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. Staff were encouraged to discuss issues and ideas for service development within supervision, business meetings and with senior managers. 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. All wards received performance reports showing a range of data including compliance with mandatory training, sickness absence levels, and complaints. However, we found that learning from incidents, complaints and the sharing of learning needed to be embedded and shared consistently across services. 19 May 2020. Most staff were up to date with mandatory training and felt proud to work for the Trust. Prompt treatment and support, focused on recovery. This meant that some patients were not treated as an adult. Staffing levels were reviewed daily and in twice weekly meetings. The service followed best practice guidance on the decontamination and sterilisation of used dental instruments. 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. Find resources for carers and service users Contact the Trust. which is extremely helpful in helping maintain community links and allowing individuals autonomy. Patients could access psychological interventions across the service. Read more about the collaboration here , Don't forget to HOLD THE DATE for our NWPPN 10 Year Celebration Event! Staff understood their responsibilities in relation to reporting incidents. Patients had access to information, which included how to make a complaint. However, the governance structure from senior management level to ward level was in the process of being developed and was still in draft form at the time of our inspection. At this inspection, we noted delays in responding to maintenance and cleanliness on the Calder, Greenside and The Hermitage wards. The management of the risk register was poor and changes had not been recorded, one risk was three years old and no changes to the register had been made. Information about how to complain was readily available to young people and their families. Staff had worked with the trusts violence reduction team to lower incidents of violence and aggression on the wards. This meant that meeting people's diverse needs was embedded in practice. However, the timeline of this improvement was slow as this should have been implemented in July 2014. We offer people involved in your care the opportunity to discuss their worries in relation to their role supporting you. Federal government websites often end in .gov or .mil. We inspected the four wards for older people with mental health problems based at the Harbour. Staff worked with hospices, hospitals, GPs and specialists for advice when needed. Staff had the skills, knowledge and experience to deliver effective care and treatment. Home Treatment Teams (SLaM) - Lambeth and Southwark Mind There was access to translation services and arrangements for patients with sight and hearing loss. Avondale is run by Delphside Ltd a registered charity (No. However, on other wards patients were offered between 13 and 21 hours of meaningful activity per week. 020 3228 3500. Managers analysed incidents to identify any trends and took appropriate action in response. This occurred when patients had been assessed as needing inpatient admission, but there were no beds available. Two patients said they found it difficult to access religious services. 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. A number of maintenance and cleanliness issues in the forensic services and a lack of infection control audits in community CAMHS. There were clear policies and procedures covering all aspects of medicines management. 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. Staff also had a good understanding of issues of consent and Gillick competence in their work with young people. Epub 2013 Jun 20. 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. Patients using the service were given opportunities to be involved in decisions about their care. 2023 Staff could describe incidents that had been reported and identified actions taken in response. It was unclear if patient activities had taken place. The trust was unable to provide a definitive list of teams that fitted within this core service. The MHCS had access to a range of mental health disciplines required to care for the people using the service. Find Avondale House in Preston, PR2. We have a range of accommodation options across the county. There was not an effective, existing governance structure in place across the four clinical networks. 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. Staff were able to manage the development of the service they provided. Gatekeeping arrangements were not always made with a home treatment team assessment and monitoring of these patients was often over the phone rather than face to face. The ward layout was well planned in the Harbour services: the layout used space to good effect. Staff spent the majority of their time on observations for certain patients. The service had good multi-agency relationships which matched the holistic needs of patients. Staff provided a range of care and treatment interventions suitable for the patient group and consistent with national guidance on best practice. 2022 Jun;21(2):166-167. doi: 10.1002/wps.20958. Patients consented to treatment and were informed about their treatment and were actively involved in decisions about their care, which included choices about date of appointments. Careers. We were not assured that prevention strategies were put in place to prevent the development of pressure damage. We believe people experiencing mental health problems are entitled to the highest quality care. Information about treatments were available in different languages and formats if patients required them. The education provision was limited but this was beyond the full control of the trust. J Ment Health. NorthWestern Mental Health acknowledges the custodians of the land on which we work: the Wurundjeri people of the Kulin nation. Caseload numbers had continued to increase but shortages were addressed through additional hours by staff and the use of agency staff when required and patient needs were being met. This allowed everybody to be involved in care planning and understand what was expected. Some new staff were working on wards before receiving uniforms, or even name badges. Patients and staff on most wards raised concerns about the food describing it as poor quality. Activities included woodwork, metalwork, pottery and gardening. There was a variety of therapies available to meet individual needs. 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. Staffing levels were sufficient to ensure the safety of patients. 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. The trust engaged with people including carers in the planning of service development initiatives. Cloudflare Ray ID: 7a2f0d761874a211 You can view full details of the Home Treatment Team - West service in our services directory. Patients felt they were afforded sufficient privacy and dignity. This meant that staff were not being appropriately supervised to ensure ongoing competency to practice. Employer. The ward had input from pharmacists, physiotherapists, occupational therapist and an integrated therapy technician, however, the increased number of patients requiring rehabilitation meant the service was under pressure and some patients did not receive timely treatments. To inform, in writing, GPs and other relevant agencies with the outcomes of assessments within 24 hours. The design, layout, and furnishings of the ward/service supported patients treatment, privacy and dignity. Staff assessed risk in observance of national guidelines, to the benefit of people who used services. Care plans were of a high standard. Staff delivered care and treatment based on young peoples needs. Print this page There were service user development workers within the social inclusion teams to promote self-help groups and user involvement initiatives. We don't rate every type of service. Epub 2012 Jan 17. The trust had systems in place to monitor the quality of the services and drive improvements. We reviewed 19 care records and 22 prescription charts. Contact information. Conclusions: Patient records did not always record patients views and it was not clear whether patients received a copy of their care records. This team has now changed to the Crisis Resolution and Home Treatment team visit the service page on our website to find out more. The teams were proactive in following up patients who did not attend appointments and were clear about the protocols they followed when this occurred.