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Staff were not receiving the correct amount of supervision as defined by the trust supervision policy. The health-based places of safety provided a safe environment for the risks of people in a crisis to be managed. The trust was transparent and open in its approach to safeguarding and reporting incidents. In Lancaster and Leyland there were patients waiting for up to 12 months for transfer to community mental health teams. Buildings were clean and well maintained. All four courses fell below 75%. 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. We observed people who use the service being treated in a respectful manner and with a caring and empathetic approach. This included patients who were held there after the section 136 had expired. Patients had an assessment of their needs, and a plan of care was developed in response to this. The purpose of the crisis support units was to provide short term support for patients for up to 23 hours as an alternative to hospital admission, or whilst awaiting a hospital bed. Medicines management, infection control management and monitoring of the Mental Health Act was good across the trust. It became routine in September 2014, again with the expectation that the number contacted would increase each quarter. Compliance with clinical supervision and yearly appraisals for nursing staff was poor. Any other browser may experience partial or no support. The trust had a clear vision and a strategy for achieving this vision, clear management structures were in place in the service. 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. In 2000, home treatment became a major plank in Britain's new mental health policy (where services are referred to as crisis resolution and home treatment teams or CRHT). Aims: Due to the variable nature of the patients on the ward, patient outcomes were not routinely collected. We observed positive interactions between staff, patients and their relatives when seeking verbal consent. We may also be able to accommodate some over 16s, where appropriate. Patients told us they were involved in decisions about their care and were encouraged to participate in meetings to develop and manage their care and discharge. Two patients said they found it difficult to access religious services. 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. During the inspection there were two patients with these sub-acute conditions. This had resulted in a disconnect between the four clinical networks which limited opportunities for shared learning across the networks. Staff had access to training and had a good understanding of the Mental Health Act the Mental Capacity Act, and associated code of practice. Wards were clean and well furnished. Implementing the National Service Framework for Long-Term (Neurological) Conditions: service user and service provider experiences. These upgrade works will ensure that additional water can be transferred between Silvan and Greenvale reservoirs to accommodate for the area's future growth and ensure the community continues to be provided with a reliable and secure water supply. Patients complained about the blanket restrictions in place on access to mobile devices, social media and communication technology (IPADs, computers, mobile phones). Patients had access to advocacy services and were aware of their rights under mental health legislation. The service is usually . These were being advertised at the time of the inspection. Electronic patient records were not always accessible when connectivity was poor and access to paper based records was variable throughout all areas. Staff were supported by a central trust team and by Mental Health Act administrators who inputted into each ward. Staff felt involved in the process. The service did not always have enough nursing staff to meet patients needs. We operate 24 hours a day, 7 days a week. There were initiatives in place that supported staff morale and wellbeing. Although staff assessed risk well, the resulting risk management plans did not address all risk identified and were vague and not personalised. An example was given of a service user receiving the same halal microwave meal every day. Motivated and supported patients with care, dignity and respect, so patients felt supported and described positive relationships. 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. The service was not well led, and the governance processes did not ensure that ward procedures ran smoothly. We found that there were variations in the multi-disciplinary make up of teams in different teams; some teams did not have good access to psychiatrists, occupational therapists, or speech and language therapists. Home Treatment Team We provide home treatment services to adults living in the community who require intensive, daily support and who are at risk of being admitted to an inpatient unit (for example, a ward). Overall, we have rated community health services for adults as Requires Improvement. On Fellside, Elmridge and Mallowdale wards, activities and leave were frequently cancelled because staff were diverted to other wards in response to incidents or understaffing. Our observations of staff interacting with patients were positive. 11 January 2017. Community Eating Disorders Intensive Home Treatment Nurse. We observed that staff took time to communicate with patients in a respectful and compassionate manner and patients were empowered to become active participants in their care. Services were being delivered in line with adherence to the Mental Health Act 1983, the Code of Practice and the Mental Capacity Act 2005. 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. Staff involved patients and their relatives in their care where possible and treated them with kindness, respect, compassion and dignity. 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). Thomas MACDONAGH, FY1 Doctor of Lancashire Care NHS Foundation Trust, Preston | Contact Thomas MACDONAGH Avondale Unit RPH, North West Posted today Applied Saved. The recording of patient information did not optimise the sharing of patient data between staff of differing services and teams. Service and service type . Despite this, we found a committed competent staff group who were patient focussed. Staff were open and transparent in reporting safeguarding issues and incidents. However there were shifts that operated below the expected establishment. home treatment team avondale preston. Staff felt valued and supported by their colleagues and were aware of the senior management team within the trust. Psychological therapy was provided to a good standard. The criteria for referral to the service did not exclude service users who would have benefitted from care. This had a direct impact on patient care. Mental Health Act administrators provided input into each ward and provided daily updates on the status of each patient. Staff spent the majority of their time on observations for certain patients. The applications were not completed as there had not been a bed identified in a specific hospital. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. Avondale is a care home. The Mental Capacity Act cannot be used to authorise detention in this way. All the MHCS carried out home-based clozaril titration. Reported, investigated, and responded to ward incidents, using clear processes to safeguard young people. Gimnez-Dez D, Maldonado Ala R, Rodrguez Jimnez S, Granel N, Torrent Sol L, Bernabeu-Tamayo MD. Staff spoke highly of their line managers and told us they felt listened to. The OT works with new and existing residents, where appropriate, to devise a structured occupational therapy plan for their stay. Staff had a good understanding of issues of consent and Gillick competence in their work with young people. The teams included or had access to the full range of specialists required to meet the needs of the service users. Parents, young people and staff were aware of the independent advocacy service. Staff employed by the service had good compliance with mandatory training, supervision and appraisals and had opportunities for specialist staff training and development. Staff were not receiving regular supervision of their work. Staff developed good care plans and reviewed and updated these when patients needs changed. There was outstanding commitment to quality improvement, innovation and development. These units were intended for short stay, under 23 hours, but were now routinely being used as additional wards. To service A&E department and Medical Assessment Wards. They assess adults who're having a mental health crisis or need intensive home-based support and treatment. They were able to decide who should be involved in their care and to what degree. This had not improved since our last inspection. This page is monitored daily. There was no current protocol for staff to follow and inconsistency in practice. The incident reporting system did not allow for routine analysis of themes and trends in the 136 suites. Some of the people we see may need admission to hospital but we will try to maintain your care at home for as long as possible. Issues were raised in relation to Red Books which were not always fully completed with names and address of the children and the Flimsys in the red books were inconsistently completed and we saw evidence of poor quality of scanning of these flimsys making them illegible. 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. Staff understood their responsibilities in relation to reporting incidents. Monday toSunday between 8:00 and 20:00 on telephone01284 719724 or from 20:00 to 9:00 telephone0300 123 1334. The Trust had strategies in place to mitigate these risks. Although the same member of staff may not attend every visit, all staff will be familiar with your situation. 020 3228 3500. the trusts strategy had been developed with the populations specific health needs in mind, the trust had a dedicated equality and diversity lead to ensure the protected characteristics of the population were considered, the trust had identified that some wards did not meet the needs of the patient groups and had plans in place to move these to more appropriate buildings, arrangements for children and young people transitioning to adult mental health services had improved since our last inspection, the trust had a clear vision, supported by six values. We rated 10 of the trusts 14 core services as good overall. There was an established governance structure with a defined hierarchy of reporting and decision making within the service. Wards were clean, well equipped, well furnished, well maintained and fit for purpose. We rated community based mental health services for older people as good because: There were safe lone working practices which were standardised across each of the localities. 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. Safeguarding systems were in place to support staff in the safeguarding process and monitor safeguarding incidents across the trusts children and families network. Welcome to Avondale, one of the North West leading independent providers of care for adults with a wide range of Mental Health related issues. Formal clinical supervision was not happening in line with the trust policy. We found that the provider was performing at a level that led to a rating of requires improvement overall. Pain, nutrition, hydration and skin condition was regularly assessed and treatment delivered following best practice guidance. Staff had access to training and development and there were nurse links for tissue viability, end of life care, dementia, falls and infection control. Leave a review Report an issue with the information on this page Information supplied by Lancashire & South Cumbria NHS Foundation Trust However it was not clear that people who use the service were routinely offered a copy of their care plan. At this inspection we reviewed the safe, caring and well-led domains in full. 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. Staff were not always following the individual support plans of patients. 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 treated patients courteously and with appropriate dignity and respect. This was due to long waiting lists and ineffective care pathways. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the service user. I was advised to ring in the morning, but when I . Activity plans on Dutton ward showed patients received below 25 hours per week of meaningful activity. Care plans were person centred and tailored to the individual. Leaders had the skills, knowledge and experience to perform their roles. Print this page There were limitations with staffing in some areas which meant that services stopped if staff were on leave. This was not being consistently implemented, which had led to increased risks in some areas. Staff told us that patients admitted to wards on an informal basis could not leave the ward until a doctor had seen them. Our Crisis Resolution Home Treatment Teams have core operating hours of 9am until 9pm, 7 days a week, 365 days a year. We support people who live in the London Borough of Southwark. Contacts we observed showed information provided to children and families was clear and tailored to the individual child. Patients were able to access the 136 suites, crisis/home treatment teams and crisis support units when required. Apply to Home Treatment Team jobs now hiring in Preston on Indeed.co.uk, the world's largest job site. It was from discussions with patients, relatives, staff and observations that highlighted the commitment and passion staff of all grades had to provide good end of life care. Patients told us this meant they could not go out for a cigarette and, at times, had to wait for a number of hours. This meant they focused on helping patients to be in control of their lives and build their resilience so that they could stay in the community and avoid admission to hospital wherever possible. Guild Lodge was utilising recovery-based models of care such as My Shared Pathway and Recovery Star, though implementation was inconsistent across the wards. Telephone referrals only to the Acute Crisis and Assessment Team (ACAT) are received on ext 67774. Staffing concerns meant people sometimes had to wait to see a doctor. Any ligature points were assessed and mitigated for, and reflected in the trust risk register. Referrals for patients with functional and organic disorders could be made to the generic home treatment team service within the trust. the service is performing exceptionally well. There were good lone working policies and staff were clear on how this was managed at each team. 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 value experience and so everyone in out management team has been a support worker. Staff knew and understood the providers vision and values and how they applied in their work. They ensured that people did not stay in hospital longer than necessary and promoted early discharge. there are some services which we cant rate, while some might be under appeal from the provider. East London NHS Foundation Trust 3.7. The service reviewed staffing levels daily. Although there was a gym on site, it meant leaving the ward with the patient and the time commitment to one patient would leave no time for any others. As a service user, relative or carer using our services, sometimes you may need to turn to someone for help, advice, and support. Staff took action to ensure that patients physical health needs were monitored and treated. We spoke with four senior managers at the Harbour and looked at a range of policies, procedures and other documents relating to the running of the service. Comprehensively assessed patients needs, included consideration of clinical needs, mental health, physical health and well-being and involved patients in developing their own care plans. Patients and their carers were positive about the care and treatment they received and staff behaviours were responsive, respectful and caring. Sometimes, individuals will not have had contact with mental health services previously or not for some-time. Complaints were managed appropriately. Complaints about the service were low and young people and their parents/carers had good information about how to raise a complaint. Managers were able to provide information into the governance meetings and staff received regular feedback from these meetings. We also smelt smoke and observed two patients smoking inside one ward. Staff were not engaging with the patients when not on observations. Actions had been agreed and a CQUIN target was associated the delivery of the action plan. The teams were proactive in following up patients who did not attend appointments and were clear about the protocols they followed when this occurred. Staff followed local procedures and support was available from mental health act administrators. Staff understood and addressed the type of problems presented by the young person and their families. Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), In All wards received performance reports showing a range of data including compliance with mandatory training, sickness absence levels, and complaints. We were unable to speak to people using the service at the time we inspected. At the time of our inspection the antenatal contact was not being delivered consistently to all pregnant women in the trust. 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. Staff did not receive training in how to best meet the needs of people with a personality disorder, learning disability or autism. We witnessed positive interactions between staff and patients throughout the inspection. There was an openness and transparency about safety. Careers. GPs were not given regular updates regarding any plans specific to patient care such as treatment interventions or information about patients being discharged from the teams. All the wards we visited had information boards which showed patients and their visitors the staff who worked on the wards and also the different uniforms they might see.