This meant young people were at risk of receiving care that did not take into account identified risks. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. There was a range of facilities and activities available on and off-site, although access was limited when there were staffing shortages. With a lack of national guidelines for waiting times, the trust had set a preliminary nominal target of 18 weeks. the trust had established systems in place to support the administration and governance of the Mental Health Act and Mental Capacity Act. Published We spoke with 11 patients and nine carers. This involves intensive home treatment, with visits arranged depending on your needs. 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. Carer involvement and support with care plans and signposting to further community support for carers. 144.217.253.110 Podiatry services had implemented a one stop assessment for patients who may require nail surgery which resulted in a reduction of additional appointments for patients and an increase in podiatry staff availability. These were effectively managed and risks mitigated with the use of observation and individual risk management planning. We can also speed up discharge from inpatient care by making sure intensive home support is available for a short period after discharge. Comprehensive assessment processes, holistic care plans and risk assessments were in place and young people felt involved in the care planning process. Staff employed by the service had good compliance with mandatory training, supervision and appraisals and had opportunities for specialist staff training and development. Staff morale was improving and staff were optimistic that improvements would be made under the new leadership team. There were good relationships with other teams and external organisations to ensure needs were met. They reviewed patients risk regularly and they responded appropriately when risk changed. Medicines management, infection control management and monitoring of the Mental Health Act was good across the trust. Access to care and treatment was timely. Stylishly Sustainable in Preston High School Zone. This had resulted in significant issues with recruitment and high levels of sickness. There were good personal safety protocols in place including lone working practices. Ward 22 had identified insufficient levels of nursing staff on duty during the day from January 2015 March 2015. Board members had good oversight and understanding of the key priorities, risks and challenges faced by the trust and actions in place to mitigate these. For example, an Imam often visited a Muslim patient. Staff were not always following the individual support plans of patients. Staff morale was low. Staff were concerned about staffing levels, but were generally positive about the teams they worked in and local managers. Following two patients attempting to harm themselves by hanging using fixed points in the lounge ceiling where they could attach something. Any other browser may experience partial or no support. At the time of our inspection the antenatal contact was not being delivered consistently to all pregnant women in the trust. Systems were in place to monitor and manage risk. The governance structures in place for the older adult wards were in their infancy and had not been fully embedded. However, we found Greenside and Calder wards were not clean and hygienic. However, we did not re-rate the service at that inspection. There were good working relationships with other teams including child and adolescent mental health service community teams, adult services, social services and outreach teams. We inspected this service at the Harbour because that was the location where concerns were raised. When we spoke with people receiving support they were generally positive about the support they had been receiving and the kind and caring attitudes of the staff team. Assertive Community Treatment, or ACT, provides a full range of services to people diagnosed with a serious mental illness (SMI). There were initiatives in place that supported staff morale and wellbeing. Premises and equipment were clean and well maintained. We observed male and female patients freely accessed each others pods, the communal IT equipment was located in one of the female pods and there was no separate female lounge, We found restrictive practices in place. Staff felt well supported by the team leaders. 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. This was a focused inspection with emphasis on specific key lines of enquiry within the safe domain, the responsive domain and the well-led domain. There was effective multi-disciplinary team working. A map could not be loaded Family living with character and charm. Patients had access to specialist healthcare where required. 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. Individual pods on the CRU had been mixed gender on occasions. Search for local Hairdressers near you on Yell. We found the ward action plan resulting from the health, safety and environmental audit at the Platform. Our team gives people the choice and ability to live as independently as possible. Teams were well-led by committed managers and staff felt respected and supported. We also saw that supervision and appraisals were being done for staff but all wards agreed that they needed to improve this aspect. Our North Powys Dementia Home Treatment Team has core operating hours of 8:30am until 7:00pm, 365 days a year. Pain, nutrition, hydration and skin condition was regularly assessed and treatment delivered following best practice guidance. 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. Parents, young people and staff were aware of the independent advocacy service. The trust data identified that a total of 575 pressure ulcers had developed whilst patients were on the services caseloads. Assessments had always been completed well within the 72 hours required by the MHA and Code of Practice but not always within the trusts four hour target. Our newly established South Powys Dementia Home Treatment Team currently has core operating hours of 9am until 5pm, Monday to Friday. We inspected the mental health liaison services in the emergency departments based at the following locations, all part of the Lancashire and South Cumbria NHS Foundation Trust: We looked at the impact of mental health liaison within an urgent emergency care centre, as well as any possible impact on patient safety. Too few staff had completed mandatory training, which had the potential to put young people at risk. Method: The local system showed that compliance rates for all modules were above the Trusts target of 85% as at end of April 2015. We found evidence that demonstrated the teams implemented best practice guidance within their clinical practice. Complaints processes were clear and staff demonstrated they actively responded to issues raised by patients and their carers. There was access to translation services and arrangements for patients with sight and hearing loss. The structure was in its infancy and, as such, was in the process of being embedded in practice. If the person you are referring is an inpatient in Musgrove Park Hospital or Yeovil District Hospital . People's diverse needs were integrated in policies and proactively taken into account when devising protocols. We are keen to include the whole psychological professions workforce in the region. There were still two registered nurse vacancies to be filled. The trust had legitimately implemented a no smoking policy at Guild Lodge in January 2015. There was an electronic prescribing system in place which alerted staff to any prescribing that was above recommended levels or presented contraindications with other medication. 020 3228 3500. 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. 19 Avondale Road, Preston. 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. Capacity assessments had been carried out only when staff had identified an issue with the capacity of a person who used the service. In Lancaster and Leyland there were patients waiting for up to 12 months for transfer to community mental health teams. Powys 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. The ward used nationally recognised assessment tools when monitoring patients health. Only one home treatment team provided any input into inpatient services in terms of early discharge or diversion. Our input will be short term (an average of 2-3 weeks), intensive (as many as 2-3 visits per day dependent on your needs) and is flexible to meet your current difficulties. Patients in the 136 suites had their mental capacity assessed regularly. Can you help us improve this information? They also knew who their senior managers were and said that that they had a visible presence on the wards. Thomas MACDONAGH, FY1 Doctor of Lancashire Care NHS Foundation Trust, Preston | Contact Thomas MACDONAGH Avondale Unit RPH, North West Posted today Applied Saved. Many services were being delivered from less than ideal locations that were not owned by the trust. Back to Mental Health Liaison Team (MHLT) (PCMHT), Home Treatment Teams (HTT), Substance Misuse Services and Housing and Emergency Social Services Team in response to client need; Preston & Chorley. Following that inspection we issued the service with a warning notice under regulation 9 (person centred care) and regulation 12 (safe care and treatment). Staff managed patients physical health needs. Waiting times were showing an improving trend in childrens services. Managers ensured staff received supervision, appraisal and training. Staff took steps to enable patients to make decisions about their care and treatment wherever possible. We issued the trust with a Section 29A warning notice. Avondale is a ground floor purpose built centre allowing it to be fully accessible. There were no clear dates for the action plan implementation following the audit. Incidents were reported appropriately and lessons were learnt. Ten ex-HTT patients were interviewed on the care they had received, using thematic analysis of semi-structured interviews. Patients had access to a range of services to meet their needs. Governance structures and performance management did not always operate effectively to assure staff had completed their mandatory training. Home Remedies Treatment for a Cough - For a severe cough, mix tulsi juice with garlic juice and honey. Crisis resolution/home treatment teams are intended to provide an important feature of this liaison. However, the timeline of this improvement was slow as this should have been implemented in July 2014. Unspeakable vs Preston with Preston MERCH - http://www.firemerch.com FRIENDS! Unspeakable - https://bit.ly/2KG. On Calder, Fairsnape, Greenside and The Hermitage wards there were ligature risks present. This meant that patient safety was important and communicated to the senior management team. 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). The Royal College of Psychiatrists has recently established the Home Treatment Accreditation Scheme (HTAS) to institute a quality standard for HTTs, though it is unclear whether such accreditation could of itself measure effective care. Clinic room temperatures exceeded the maximum of 25 degrees on numerous occasions on four wards. Patients with minor injuries were triaged by staff who were not clinically trained. Staff told us that patients admitted to wards on an informal basis could not leave the ward until a doctor had seen them. 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). Adherence to the principles of the Mental Health Act and its associated Code of Practice was good throughout the trust. PRINCIPAL DUTIES. Staff ensured patients received physical health checks with easy read physical health monitoring tools. We accompanied staff visiting people who used the service and it was clear that they had a good understanding of peoples needs. Young people were given information and support from independent advocates about their rights under the Mental Health Act. Staff prioritised the safety of people using the service and also the safety of people working for the trust. Patients were supported and encouraged to maintain their independence. Debriefs did not always occur following an incident. the service is performing badly and we've taken enforcement action against the provider of the service. There was evidence of delivering services to meet patients needs. Infection control and prevention audits were regularly undertaken. Initially this will consist of a three day assessment to identify your needs and the support / treatment you require. There was no learning from complaints about the food and cancellation of activities and leave. People who used the services were able to ask questions, discuss care, and were involved with decision making. Avondale is a ground floor purpose built centre allowing it to be fully accessible. Staff were not always following the seclusion policy, infection control practices and best practice in relation to medicines management. This is because: Staff knew how to report incidents and reported receiving feedback in a number of ways. Patients did not always have regular one to one sessions with their named nurse. Ty Cloc ACT teams offer complete, communitybased treatment to people in the most difficult situations. Norfolk and Suffolk NHS Foundation Trust values and celebrates the diversity of all the communities we serve. On ward 22 patients were unable to summon assistance throughout the ward as alarm call bells were not fitted in most of the patient areas. Child and adolescent mental health services had a range of suitably qualified staff who offered a choice of therapies to young people and their families. We rated the trust as requires improvement overall in safe, effective, responsive and well led. Patients with more complex healthcare needs were supported to attend specialist hospital appointments. At this inspection, we noted delays in responding to maintenance and cleanliness on the Calder, Greenside and The Hermitage wards. Compliance with staff supervision and appraisal was low at the Junction. The teams included or had access to the full range of specialists required to meet the needs of the service users. The wards were clean and tidy and there was an established cleaning regime. Access to dieticians and speech and language therapists were available and staff were positive about their working relationships. We are a multi-disciplinary team including practitioners who are registered nurses, doctors, a social worker, occupational therapist and psychologist, alongside support workers and peer support workers. Data from the trusts centralised mandatory training system showedbasic life support training being at 64% at the time of the inspection.