There was dissatisfaction with the two day advance ordering process, especially for patients with acquired brain injury. We also smelt smoke and observed two patients smoking inside one ward. Quality reports compiled by the trust showed that the service was actively monitoring physical health, record keeping, mental health and observations, with good results. skip to Main Navigation; skip to Content Menu. Individual pods on the CRU had been mixed gender on occasions. This meant that some patients were not treated as an adult. Gunzenhausen in Regierungsbezirk Mittelfranken (Bavaria) with it's 16,477 habitants is a city located in Germany about 262 mi (or 422 km) south-west of Berlin, the country's capital town. Staff felt supported by their immediate and local senior managers and matrons. Staff described effective communication and referrals between services, such as local schools, social workers, GPs and health visitors. This included patients with a learning disability. There were appropriate health and safety checks. They had access to wheelchair tippers. There was good interagency working including with other teams, crisis teams, primary care and acute mental health hospitals. The trust did not have a robust mechanism in place to capture compliance with supervision. 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. 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. Avondale is a ground floor purpose built centre allowing it to be fully accessible. The trust had introduced a smoke free initiative across all services in January 2015. Annual appraisal rates for non-medical staff in community health services for Children, Young People and Families was 73%. Issues affecting waiting times such as staff performance, sickness and vacancies were monitored and addressed promptly. Staff felt involved in the process. Parents could easily contact staff and found the teams responsive to their needs. The service provided safe care. There were good lone working policies and staff were clear on how this was managed at each team. Our rating of services went down. We offer home visits during the day time and evening. This meant that staffing resources were equally aligned across the service. Staff treated concerns and complaints seriously, investigated them and learned lessons from the results were shared. J Ment Health. Patients needs were assessed and patient centred goals were set. Avondale is a modern city, near the heart of the Phoenix-metropolitan area. Feedback from people who use the service was positive. Staff delivered care in a multidisciplinary manner and in line with national guidance and best practice. 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. Patients individual care and treatment was planned and best practice guidance was implemented, ensuring outcomes were monitored and reviewed. Patients were involved in completing their care plans. Across all the teams, there were issues with staffing, despite staff now being recruited specifically to work in 136 suites. This occurred when patients had been assessed as needing hospital admission, but there were no beds available. It was delivered by passionate staff who gave patients and their families compassionate care were however there were areas for improvement in the effective domain. Specialist community mental health services for children and young people, esb.services_rated.community health (sexual health services), Community health services for children, young people and families. We may also be able to accommodate some over 16s, where appropriate. Staff did not always consider the consent status and scope of parental responsibility when patients came into the service at the age of 16. 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. LD30LU 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 successful . We have our own dynamic resident centred activities programme and activities coordinator for general and therapeutic activities for all. The trust had a robust audit programme in place. We observed some negative interactions between staff and patients, where staff did not engage appropriately with the patient. Complaints processes were clear and staff demonstrated they actively responded to issues raised by patients and their carers. 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. The existing ratings from our inspection in June 2019 remain in place. The service had good systems to ensure the Mental Health Act was followed where patients were on a community treatment order. We gate-keep admissions to the Glenbourne Unit. This meant young people were at risk of receiving care that did not take into account identified risks. Patients were not always given their rights under the Mental Health Act in line with the code of practice guidance. We witnessed several such incidents during our inspection. Review of meeting notes on Marshaw ward confirmed that leave was cancelled owing to staffing issues. However you access the Home Treatment Team, we will work collaboratively with you and the people you identify to understand the current factors that have led to a crisis and to support you to meet the goals you identify. The team can initially visit on a daily basis with visits being reduced according to clinical need. We identified concerns over the transition of young people from CAMHS. Staffing concerns meant people sometimes had to wait to see a doctor. Following that inspection the core service was rated as good in each domain and good overall. At Avondale we have our own Occupational Therapist (OT) who is available on site. The staffing levels had improved since the last inspection to between 90% and 100%. The service had a dedicated participation lead that supported a group of former patients and parents with experience of tier 3 and tier 4 services to develop and improve services across the child and adolescent mental health service for Lancashire Care. Staff reported good working links with other services within the trust and external organisations. The 136 suites were generally in keeping with the standards in the Mental Health Act and its code of practice. Clinical supervision enables the managers to assess the quality of staff's work. Unauthorized use of these marks is strictly prohibited. Patients and carers were involved in decisions about their care. Welcome to Avondale Mental Healthcare Centre We are an independent not for profit charity and have been successfully providing services to individuals with mental health needs since we were established in 1991 as a 50 bedded unit. Most teams met the trusts target of 18 weeks waiting time from referral to assessment. Peoples physical health needs were considered alongside their mental health needs. An example was given of a service user receiving the same halal microwave meal every day. This meant that young people might wait as long as three days to be seen by a specialist at a weekend. The 136 suite at Preston had a shower room which had evidence of mould growing and cracked tiles. Uptake of mandatory trainingwas in line with trust policy. Patients in the 136 suites had their mental capacity assessed regularly. The home treatment team service for older adults functioned from April 6 to August 31 2020. This meant that the use of blanket restrictions was low and patients freedoms were proportionate to the level of risk. The trust was part of a multiagency group that had developed and implemented a policy for the use of section 135 and 136 across the Lancashire area. Throughout the trust we saw positive interactions between staff and patients. 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. Person-centred therapeutic interventions were being delivered to patients to support them to achieve improved independence and wellbeing. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Staff were seen to interact in a professional and caring manner with their patients, with time and attention being given to all. Staff generally assessed and managed risk well. Our Home Treatment team (Southwark) provides a community-based service to support people, aged 18-65, at home, rather than in hospital. There was a gap in service provision for young people aged 16-18 years old. It is situated close to all the necessary local amenities, such as shops, public transport links, hospital, GPs, dentist, leisure centres etc. Staffing levels were adjusted to meet the need of each ward. Most non-refrigerated medicines must be stored at less than 25C to ensure they remain effective. We rated Community sexual health services as ' While staff were completing comprehensive risk assessments in most cases, there was a small number of patient risk records, which had not been reviewed recently. East London NHS Foundation Trust 3.7. 2023 9.3 Community mental health teams; 9.4 Assertive outreach (assertive community treatment) 9.5 Acute day hospital care; 9.6 Vocational rehabilitation; 9.7 Non-acute day hospital care; 9.8 Crisis resolution and home treatment teams; 9.9 Intensive case management; 10. Complaints about the service were low and young people and their parents/carers had good information about how to raise a complaint. This meant that staff had a good understanding of patients needs and how to deliver particular care. 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. The trusts visons and values were embedded across the trust. 2022 Jun;21(2):166-167. doi: 10.1002/wps.20958. Three records did not have 15-minute recordings of the patients progress. Staff morale was low. They ensured that people did not stay in hospital longer than necessary and promoted early discharge. For people in the health-based places of safety, risk assessments were completed jointly with the police. Gimnez-Dez D, Maldonado Ala R, Rodrguez Jimnez S, Granel N, Torrent Sol L, Bernabeu-Tamayo MD. The service had not addressed two regulatory breaches from the inspection in 2018 and had a further regulatory breach that was also a breach in 2016. The site is secure. Home Improving care College Centre for Quality Improvement (CCQI) Quality Networks and Accreditation Electroconvulsive Therapy Accreditation Service - ECTAS List of ECTAS Member Clinics ECTAS Member Clinics Below is a list of ECTAS Member Clinics, sorted by region and detailing their ECTAS membership status. Staff assessed and managed risks to patients and themselves well and followed best practice in anticipating, de-escalating and managing challenging behaviour. Our observations of staff interacting with patients were positive. The existing ratings from our inspection in June 2019 remain in place. https://avondale.org.uk/. This involves intensive home treatment, with visits arranged depending on your needs. People had access to information in different accessible formats. 12 hour shift + 5. Staff spoke positively about the support they were given by seniors and management within end of life care although staff were not aware of who the trust lead for end of life was. Staff supported patients to manage their own crisis through using methods that had worked in the past and creating new ways to manage their symptoms or emotions. As part of each inspection, we look at the way health services provide care and treatment to people. We are an independent not for profit charity and have been successfully providing services to individuals with mental health needs since we were established in 1991 as a 50 bedded unit. Staff were not receiving regular supervision of their work. Thomas MACDONAGH, FY1 Doctor of Lancashire Care NHS Foundation Trust, Preston | Contact Thomas MACDONAGH Avondale Unit RPH, North West Posted today Applied Saved. Our rating of services improved. Staff were knowledgeable and committed to providing high quality and responsive care. Some of these ligature risks had not been identified through local audits. We strive to empower people to make choices that will promote wellbeing helping them to achieve their individual hopes and aspirations. Any other browser may experience partial or no support. This indicated it was not the patients voice. There were clearly defined roles and responsibilities within the service supported by an effective management structure. The recording of patient information did not optimise the sharing of patient data between staff of differing services and teams. L34 1PJ, In It was not clear that lessons learned from adverse incidents were effectively shared across locations and services within the trust. 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. This page is monitored daily. Staff and patients felt this did not contribute to a welcoming environment. Managers were able to provide information into the governance meetings and staff received regular feedback from these meetings. Any incidents on the wards were reported and dealt with effectively. 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. Estimate repayments Loading. The information it provided did not clearly match up with sample of crisis/home treatment teams we visited as part of this inspection. In addition to the blockages at point of admission, the home treatment teams did not have effective gatekeeping arrangements and discharges from the acute wards were delayed for other than clinical reasons. At least one standard in this area was not being met when we inspected the service and Patients told us this meant they could not go out for a cigarette and, at times, had to wait for a number of hours. Pharmacists inputted into wards on a daily basis. This had not improved since our last inspection. Staff had knowledge and skills to deliver effective care and treatment and staff received support and supervision from their managers and peers. The team was well-led by experienced and committed managers. The staff, including managers and clinicians, told us their services were safe and took pride in their own professionalism and ability to make decisions about risk. Tel: 0161 716 3539 Parking Available: Yes Infection control and prevention audits were regularly undertaken. Capacity assessments had been carried out only when staff had identified an issue with the capacity of a person who used the service. Staff managed patient risk. 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. 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. This meant that staff were not aware if patients had consented to their medication. They had a good understanding of the services they managed. Furniture in the mental health crisis rooms in Blackburn was not set out to reduce the risks to staff. We rated it as good because: We have taken enforcement action against this service which has limited ratings for some key questions to inadequate. The governance systems in place for the oversight of the health-based places of safety and mental health decision units was not effective. 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. 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. This meant that infection control measures were not being followed in these areas and patient safety was compromised. PPN NW is a regional membership network for all psychological professionals, experts by experience and stakeholders contributing to NHS commissioned psychological healthcare across the North West of England. Ward managers were able to access bank and agency staff and staffing levels were adjusted to meet need. How to access the service. The trust participated in several internal and external audits to drive improvements, including the quality SEEL (a quality initiative focusing on Safety, Effectiveness, Experience and Leadership). Not all staff had received appropriate specialised training. 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. HHS Vulnerability Disclosure, Help The buildings were well maintained with adequate access and good infection control measures were in place. Developmental roles for band five nurses had been implemented for staff wanting to develop into leadership roles. This was due to the recent change from two wards to one ward and staff were aware and working on these. Our newly established South Powys Dementia Home Treatment Team currently has core operating hours of 9am until 5pm, Monday to Friday. 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. Emergency equipment was accessible to all and was maintained appropriately. At Hope House, documentation relating to medicines was not being completed consistently. The service has adopted a new approach to assessment of new referrals to the team. However, the provider had carried out a safer staffing review that acknowledged the different staffing needs in the new model of mental health urgent assessment centres and were implementing the review recommendations. Access to psychological assessments and ongoing therapy was provided promptly. The local system showed that compliance rates for all modules were above the Trusts target of 85% as at end of April 2015. Staff were supported by a central trust team and by Mental Health Act administrators who inputted into each ward. Ambient room temperatures in two clinic rooms regularly exceeded this temperature. Access to admission to a psychiatric ward where risk and presentation indicate Home Treatment is not appropriate, and support upon discharge if needed. Of these responses 99% of patients would either highly recommend or recommend the service to friends and family. This usually took place within 24 hours. The Mental Health Act code of practice guidance helps protect patients' rights and ensures patients detention is lawful. The trust did not report on patient feedback from the 136 suites, and was unable to provide us with reports for the friends and family test for all its crisis/home treatment teams.