Staff told patients detained under the MHA 1983 their rights and gave access to an advocate. The teams were compliant with the requirements of the Mental Capacity Act 2005 (MCA). Our team includes both health and social [] We rated Lancashire Care NHS Foundation Trust specialist community child and adolescent mental health services as good because: All parents and young people said staff were welcoming, caring and respectful and listened to them. They told us that they felt valued, had input into the service and were consulted and involved in service quality developments. Access to the service is by a referral from a health professional. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the service user. Specific scenarios were described with action plans for staff to consider. However; patients who required admission were sometimes held in the unit for several days and nights because there was no bed available on an admission ward. We rated the community based services for people with learning disability or autism as Good' because: However in the Lancaster team, risk information was not consolidated into a single overarching risk assessment and management plan for individual patients. As a result of these concerns, we have issued the trust with a warning notice to make significant improvements. Staff we spoke with were aware of the findings of our last inspection and the actions the service was taking in response. The staffing establishment in the MHCS had been increased following a scoping exercise that looked at the staffing levels necessary to meet the needs of people who used the service, based on agreed trajectories. Staff did not receive training in how to best meet the needs of people with a personality disorder, learning disability or autism. When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. 4 November 2015. Due to the variable nature of the patients on the ward, patient outcomes were not routinely collected. Physical health care provision was good. 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. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. View Accessibility Symbols. There were initiatives in place that supported staff morale and wellbeing. we have taken enforcement action. 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. Staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA). J Ment Health. There was a range of facilities and activities available on and off-site, although access was limited when there were staffing shortages. Whilst some of our residents require lifelong care, our specialised programmes and care planning allow all our residents the opportunity to maintain existing skills or to develop new ones with the aim of progressing to less supported accommodation. We provide 24 hour / 7 days access to our service. Staff cared for patients with kindness and compassion. Staff were committed to provided care which promoted peoples privacy and dignity andfocused ontheir holistic needs. The team was well-led by experienced and committed managers. The structure was in its infancy and, as such, was in the process of being embedded in practice. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. Consent practices and records were monitored and reviewed to improve how patients were involved in making decisions about their care. Desks were placed in the corner of the room which meant staff were not near the door and could potentially be blocked in if someone became aggressive. Identified liaison health visitors were in post to provide support and advice to families placed in a refuge and safeguarding specialist nurses worked in partnership with other agencies to provide health assessment, advocacy and support for children and young people involved with the youth offending team or identified as being at risk of child sexual exploitation. I was advised to ring in the morning, but when I . The trust continued to experience significant challenges recruiting and retaining staff in some core services. 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. 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! Monthly team meetings took place to ensure staff received information and feedback regarding incidents and complaints and were kept informed of developments within the trust. The clinicians provided care and treatment tin line with current nationally recognised guidance. We can support you if you are 16 or under and in full-time education. We reviewed 19 care records and 22 prescription charts. There were gaps in the mandatory/essential training that staff should have received and not all staff had received an appraisal. Local governance structures to support the delivery of care and to monitor quality assurance were not well established. Patients were supported and encouraged to maintain their independence. Clinical supervision is an important tool for checking that young people have received the appropriate care and treatment. Activities did not always take place. The Early Start Team felt proud and honoured to have their hard work and efforts recognised with a National Nursing Times Award. Waiting times were showing an improving trend in childrens services. This also assisted the trust to develop and recruit senior nurses from within their own workforce. Staff had been advised to assess capacity and that patients were then detained in their best interests, but this is not a lawful deprivation of liberty. The wards did not have enough nurses. Staff told us that the impact of the trust implementing a smoke-free policy was putting staff and other patients at risk as people were not following the policy. Adherence to the principles of the Mental Health Act and its associated Code of Practice was good throughout the trust. 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. This resulted in difficulties for staff because patients witnessed and heard of others smoking. There was strong medication management. The risks associated with prolonged stays in section 136 suites and decision units were not recognised. The services managed complaints and concerns effectively; they listened to patients concerns with a view to improve the services being provided. 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. Ligature risk assessments and reviews of the environment had been carried out. Your IP: Avondale House provides individuals with autism the resources, education, and training to develop to their fullest potential. Across all the teams, there were issues with staffing, despite staff now being recruited specifically to work in 136 suites. During the inspection we received feedback from 35 patients. Compliance with basic life support and immediate life support training was low. 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. Performance issues were escalated to the relevant monitoring committee and the board through clear structures and processes. The .gov means its official. Telephone: 01686 617 242, Adult and Older People's Mental Health Services, Your Local Dementia Home Treatment Team (DHTT), Nosocomial Covid-19 Patient Safety Review Team, Adult and Older People's Community Services, Learning Disabilities & Neurodiversity Services, Current Jobs at Powys Teaching Health Board. Home Treatment Team - Lambeth Overview 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. Provide 24 hours nursing care that is person centred and care plan led, with individuals input and objectives key to this process. Despite this, longer term staffing issues had been identified in some areas and recruitment plans were in place to address future challenges. Staff prioritised the safety of people using the service and also the safety of people working for the trust. We found a good incident reporting culture where staff were clear on what to report and who they should report to. This meant that staff had a good understanding of patients needs and how to deliver particular care. Address: Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, Lancashire, PR2 9HT PALS (Patient advice and liaison service) 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. In Ormskirk, there was a hole in the ceiling in the waiting area. The single point of access team in Preston was not meeting targets for assessing new referrals. Staff were kind, caring and compassionate and supportive of people using the service. The trust had a robust audit programme in place. Interventions are usually made via regular home visits and telephone contact. Published OL6 7SR. 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. Systems were in place to monitor and manage risk. The Home Treatment Team approach commenced on 20th January, 2014 as a pilot project under the guidance of Dr. Navroop Johnson's Community Mental Health Team in South Kerry. Also, some equipment in the clinic room had passed the expiry date for use. Managers ensured that these staff received training, supervision and appraisal. Staff understood how to protect patients from abuse and they worked well with other agencies to do so. The main aim of our team is to help you manage and resolve your crisis through assessment and treatment in your home environment. The quality of the capacity assessments varied. Pharmacists attended each ward daily to review prescribing and medication management. Leaders had the skills, knowledge and experience to perform their roles. Staff were concerned about staffing levels, but were generally positive about the teams they worked in and local managers. Patients had comprehensive risk assessments completed. Most staff understood the trusts visions and values. Staff employed by the service had good compliance with mandatory training, supervision and appraisals and had opportunities for specialist staff training and development. Proposals were made for greater psycho-and occupational-therapeutic inputs to manage long-term care, and for provision of peer-support within HTTs. Staff had completed individualised care plans to document the patients wishes. 020 3228 3500. 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. We issued the trust with a Section 29A warning notice. Welcome to Avondale Mental Healthcare Centre. 11 September 2019. We also smelt smoke and observed two patients smoking inside one ward. 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. Email this page Any ligature points were assessed and mitigated for, and reflected in the trust risk register. Out of area placements and delayed discharges were monitored. However, access to religious facilities was inconsistent. 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 rated them as requires improvement because: During the inspection we visited all six wards and observed how staff were caring for patients. Crisis resolution teams in the UK and elsewhere. The design, layout, and furnishings of the ward/service supported patients treatment, privacy and dignity. Staff were not all trained in basic life support and overall completion of mandatory training was below the trust target. The premises at Hope House were not fit for purpose. Staff had good knowledge of safeguarding procedures and were confident in applying trust policy. There was access to translation services and arrangements for patients with sight and hearing loss. There was a clear statement of visions and values, staff knew and understood the vision, values and strategic goals of the service. There was evidence of delivering services to meet patients needs. Patients had access to a range of information. We observed strong leadership from team leaders and managers and staff spoke positively about the team leaders, describing them as visible, accessible and supportive. The Redbridge home treatment team (HTT) provides acute home treatment for adults aged 18 to 65 whose mental health crisis is so severe that they would otherwise have been admitted to a hospital. 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. Work on enhancing the garden areas is underway and we are looking to become far more self-sufficient over the coming year planting more fruit and veg to help with growing our own, reducing our carbon footprint and getting active.