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The single point of access team in Preston was not meeting targets for assessing new referrals. Patients frequently experienced cancellations to escorted leave and activities. Staff and managers told us that there were delays receiving information about patients accessing antenatal care from local acute providers and this was recorded on the trust risk register. Information about treatments were available in different languages and formats if patients required them. We provide 24 hour / 7 days access to our service. Clinics were scheduled weekly at set times with some open and some pre-booked slots. The local timezone is named Europe / Berlin with an UTC offset of 2 hours. Staff requested patients consent to care and treatment in line with the Mental Capacity Act. Information was not readily available in different languages, staff stated they could access an interpreter as necessary. We rated safe and effective as requires improvement overall and well-led at trust level as requires improvement. In Ormskirk, there was a hole in the ceiling in the waiting area. 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. There were safe working practices; staff worked to keep themselves and patients safe. A review of patient notes also showed that advanced decisions were recorded for some patients. During the inspection we received feedback from 35 patients. the trust had a dedicated team to investigate serious incidents, all of whom had additional qualifications in root cause analysis. The hope is we can also support other local charities or foodbanks with any excess. This meant that meeting people's diverse needs was embedded in practice. This demonstrated a lack of connection between service delivery and the board. The service was working in partnership with UCLAN (The University of Central Lancashire) on research into the involvement of patients and families in violence prevention and management. Patients felt that there were not enough staff on the wards and that staff did not always have time to speak to them. Staff had manageable caseloads. Patients with minor injuries were triaged by staff who were not clinically trained. Young people were supported by a range of skilled professionals and had access to good information to make decisions about their care; they described a participative service where they felt staff treated them with dignity and respect. 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. Staffing levels were adjusted to meet the need of each ward. Staff cared for patients with kindness and compassion. Devon Recovery Learning Community courses. Requires improvement Avondale Clinical Decisions Unit provides a period of assessment for people experiencing a mental health crisis. The service used systems and processes to safely prescribe, administer, record and store medicines. Staff were not consistently reporting these breaches. Thomas MACDONAGH, FY1 Doctor of Lancashire Care NHS Foundation Trust, Preston | Contact Thomas MACDONAGH Avondale Unit RPH, North West Posted today Applied Saved. Initially this will consist of a three day assessment to identify your needs and the support / treatment you require. This resulted in patients having to sleep in a reclining chair because the crisis support units did not have beds. At the time of our inspection the antenatal contact was not being delivered consistently to all pregnant women in the trust. We issued the trust with a Section 29A warning notice. Complaints about the service were low and young people and their parents/carers had good information about how to raise a complaint. 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. Our Home Treatment team (Southwark) provides a community based service to support people, aged 18-65, at home, rather than in hospital. We inspected this service at the Harbour because that was the location where concerns were raised. Some patients had been held in the 136 suite for several days. Governance structures were in place to monitor performance targets and risk. There were clear policies and procedures covering all aspects of medicines management. Here in Powys we have two Dementia Home Treatment Teams who provide a rapid response, assessment and intensive support to patients in their own homes, residential and nursing homes and community hospitals. The service did not manage beds well. Implemented best practice guidelines such as routine outcome measures to plot patients progress and experience (and had taken part in Royal College of Psychiatrists' Quality Network for Inpatients (QNIC) reviews). We saw some examples of excellent practice which meant people were able to stay in the community. There were delays in patients accessing a bed in Blackpool and staff had to manage patients risks in the community until a bed became available. The wards they were on sought to create an environment that reduced restrictive practise. An audit of antipsychotic prescribing in people with a learning disability identified that there was action required against standard three of a quality improvement programme-prescribing audit. Staff understood and implemented safeguarding procedures. Debriefs did not always occur following an incident. For information about studying at Avondale or living on campus, contact Student Administration Services study@avondale.edu.au or call +61 2 4980 2377. Specific scenarios were described with action plans for staff to consider. The structure was in its infancy and, as such, was in the process of being embedded in practice. I have been in acute dental pain throughout the weekend - which has caused my mental health to hit rock bottom. Patients needs were assessed and patient centred goals were set. There was a culture of learning from incidents and staff were clear on what constituted an incident and how they would report it. The local system showed that compliance rates for all modules were above the Trusts target of 85% as at end of April 2015. Equipment that was essential to monitor a patients nutritional needs was broken and a replacement had not been ordered. Throughout the trust we saw positive interactions between staff and patients. However, because this was a focused inspection we did not re-rate the individual key questions or the overall service. Patients and carers described staff as caring and supportive, Published This had resulted in significant issues with recruitment and high levels of sickness. The ward used nationally recognised assessment tools when monitoring patients health. The ward was undergoing a deep clean during the inspection. Clinic room temperatures exceeded the maximum of 25 degrees on numerous occasions on four wards. People who used services were enabled to participate in the activities of the local community so that they could exercise their right to be a citizen as independently as they were able to. Staff delivered care in a multidisciplinary manner and in line with national guidance and best practice. 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. However, it was noted that mandatory training figures for the wards did not match the figures provided by the trust and the system of core and effective training was confusing. Staff were motivated and described good teamwork, they talked positively about their roles. NorthWestern Mental Health is a service of The Royal Melbourne Hospital. If you wish to make a complaint, you can reach out to our Complaints Team. A bed was not always available locally to a person who would benefit from admission and there was a very high demand for the beds and an ineffective strategy to manage those demands. However it was not clear that people who use the service were routinely offered a copy of their care plan. However, when the cars were diverted for use elsewhere, such as medical appointments, activities were cancelled. Staff were seen to interact in a professional and caring manner with their patients, with time and attention being given to all. If you have complex needs, we also support you care coordination during your discharge process. Comments were mainly positive, ranging between 96% and 100% at the locations we inspected. Method: Staff delivered care in a responsive, caring manner and strived to ensure patients cultural and diverse needs were met. Overall compliance was 83.9% at January 2015. 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. Search for local Hairdressers near you on Yell. Staff told us how much they enjoyed their job, and caring for people from the local community. There was a clear framework by which the trust was held accountable for its actions, each clinical network had a clear, effective governance structure from board to ward. We are a multi-disciplinary team of healthcare professionals offering a holistic and intensive period of care. Appropriate documentation was complete and in place. The risks described by the staff on ward 22 were not understood by their managers/leaders. We can accept referrals from health professionals for individuals or carers who require a period of respite for a weekend or one or two weeks depending on availability of accommodation. Buildings were clean and well maintained. Patients and staff on most wards raised concerns about the food describing it as poor quality. The Home Treatment Team is likely to meet with you initially, following your contact with one of our triage and assessment teams. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Used a systematic approach to discharge, using routine outcome measures to measure patients progress and time their discharge process. Staff had an annual appraisal where learning needs were identified. At the last inspection some staff were unsure of their future due to a lack of direction and strategy for the service. Ambient room temperatures in two clinic rooms regularly exceeded this temperature. Health visiting and school nursing teams worked to deliver the Healthy Child Programme and two of the five contacts were delivered using the Ages and Stages evidenced based screening tool. https://avondale.org.uk/. Staff often booked the trusts pool cars to support patients with off-site activities and leave. the service isn't performing as well as it should and we have told the service how it must improve. Preston, VIC (13.0km from Avondale Heights) 1 review. Positive aspects of HTT intervention included a rapid, accessible and crisis-focused approach, though changing staff and appointment times were considered unhelpful. The residents and staff are already looking forward to being part of this project and that in turn will help support their general wellbeing too. The arrangements for adhering to the requirements of the Mental Health Act when patients were on a community treatment order needed improvement. Most non-refrigerated medicines must be stored at less than 25C to ensure they remain effective. There are seven NHS regions in England and we have created a Psychological Professions Network in each. The health-based places of safety had 26 incidents in the 12 months leading up to our inspection where people had been deemed as needing admission but a bed was not found within the 72 hour assessment period of section 136. We rated specialist community mental health services for children and young people as requires improvement because: Although we found inconsistences in approaches to service provision, newly appointed managers had made changes to improve services. Outcomes were monitored to ensure changes were identified and reflected to meet patients needs. Referral on to other agencies and mental health services, as agreed with you. Review of meeting notes on Marshaw ward confirmed that leave was cancelled owing to staffing issues. 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. The staff showed knowledge of procedures and requirements that helped maintain their safety. Patients were involved in completing their care plans. sharing sensitive information, make sure youre on a federal We believe people experiencing mental health problems are entitled to the highest quality care. Families engaged with the Childrens Integrated Therapy and Nursing Servicewere involved in writing their childs care plan. 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. In the meantime, risk was mitigated through observation. Crisis Resolution and Home Treatment Team (CRHTT) If youre suffering from an acute mental health problem or crisis, we can provide you with a safe and effective home assessment. There was improvements to supervision, training and appraisal rates from the last inspection. The service had a good safety record; Incidents of harm in the service were low. The objective of the team is to provide an equal alternative to inpatient care, and to facilitate early discharge from hospital when it is safe to do so. Staff were familiar with incident reporting procedures. Medicines were dispensed and stored securely and audits undertaken to ensure safe practice. In the community health services there were challenges including substantive staffing levels not being met in most childrens teams, although adults teams were better staffed. The board was not aware of these issues, which were not in line with best practice guidance and the Mental Health Act (MHA) Code of Practice (CoP). This was a focused inspection which looked at the trusts response to the warning notice issued following our inspection in June 2019. During our inspection we visited the ward over two days as there was only one in patient on our first visit. Bleasdale, Elmridge, Mallowdale, Fellside, Forest Beck, Marshaw, Dutton, Whinfell and Langden wards were in good condition and presented safe, clean and pleasant environments, Fairsnape and Fairoak needed some updating and Calder, Greenside and The Hermitage were in a poor condition. Patient records did not always record patients views and it was not clear whether patients received a copy of their care records. We rated community based services for people with a learning disability or autism as good because: Interactions between staff and patients demonstrated personalised, collaborative, recovery-oriented care planning. High use of out of area beds was another symptom of the problem. There were good multi-disciplinary working practices in place on most wards and medicines management was in line with good practice. This core service was rated as Good at the last inspection in September 2016. 33hr contract (36.75 hours paid) 34,398 - 40,131. We offer home visits during the day time and evening. The MHCS had established positive working relationships with other service providers. Although staff we spoke with told us they had received some supervisions and appraisals these were not carried out in line with the trust policy. The trust was in the process of introducing a new system that constantly monitored room temperatures. The teams were proactive in following up patients who did not attend appointments and were clear about the protocols they followed when this occurred. This integrated service is for people with severe and complex mental and behavioural disorders such as schizophrenia, bipolar affective disorder, and severe depressive disorder. When staff had raised issues with the temperature recordings being high in clinics and treatment rooms, as per the trust policy, no action had been taken. 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. The management and governance arrangements within the directorate were effective and teams were able to feed information about risk into the risk register.The trust had identified 38 items on their risk register in relation to learning disability and autism community services and these were being reviewed and monitored by the trust.