the trust had a dedicated team to investigate serious incidents, all of whom had additional qualifications in root cause analysis. 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. 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. This requires significant improvement as patients were being deprived of their liberty without a legal framework in place for this. Ashton Under Lyne, 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. 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. The ward staff knew how to report incidents and as a result improvements were made to ensure patients were safe. There was a gym and a sports hall for physical activities. Medicines were not always managed safely. The physical space of four of the five health-based places of safety (HBPoS) we visited provided safe, clean environments to assess people. This meant that patients with low risk could engage in activities that would aid their recovery. In the last 12 months, 13 children were admitted to the decision units at Preston and Blackburn, although three are noted as multiple events so the admissions figure is higher. Crisis resolution and home treatment: stakeholders' views on critical ingredients and implementation in England. The NHS Friends and Family Test results showed the majority of patients would recommend the department to their family and friends. Staff understood and discharged their roles and responsibilities under the Mental Capacity Act 2005. 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. 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. The incident reporting system did not allow for routine analysis of themes and trends in the 136 suites. 10.2 Abbreviations; 10.3 Early intervention . The crisis support units were intended to accommodate patients for up to 23 hours. Consent practices and records were monitored and reviewed to improve how patients were involved in making decisions about their care. we have taken enforcement action. Staff supervision rates had been low over the last 12 months. Staff had a good understanding of issues of consent and Gillick competence in their work with young people. Our service can be contacted 24 hours a day seven days a week. Avondale is a ground floor purpose built centre allowing it to be fully accessible. Patients individual care and treatment was planned and best practice guidance was implemented, ensuring outcomes were monitored and reviewed. Risk assessments were comprehensive and included risk management plans. Neither of the CAMHS teams had an up-to-date environmental risk assessment to ensure the environments posed no potential risks to young people or children. You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection. There was a joint agency policy in place for the implementation of section 136 of the Mental Health Act which had been agreed by the local authorities, police forces and ambulance service. Patients were given information and support to ensure appropriate representation and aid understanding of their rights. The existing ratings from our inspection in June 2019 remain in place. The teams' catchment areas were different in size and socioeconomic circumstances. Let's make care better together. A crisis resolution team (CRT) or home treatment team (HTT) is a service that operates around the clock to provide support for people dealing with a mental health crisis, and is made up of psychiatrists, mental health nurses, psychologists, social workers and team assistants (Home Treatment Accredited Scheme, 2019). Crisis teams can: visit you in your home or elsewhere in the community, for example at a crisis house or day centre visit you in hospital if you're going on leave or being discharged The standard operating procedure did not correspond with practice in relation to the clock starting for 12-hour breaches. Parents, young people and staff were aware of the independent advocacy service. Parents, carers and children were positive about the care and treatment provided. Interview rooms and clinic rooms used by the mental health crisis services (MHCS) were clean, well maintained and safe environments. The teams included or had access to the full range of specialists required to meet the needs of the service users. However, we requested feedback from patient surveys carried out by the provider. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding. Initially this will consist of a three day assessment to identify your needs and the support / treatment you require. Patients frequently experienced cancellations to escorted leave and activities. Staff were not always recording whether patients had been given copies of their care plan. We found evidence that demonstrated the teams implemented best practice guidance within their clinical practice. Good' overallbecause: We found good processes in place to reduce the risk of abuse and avoidable harm in the service. Sometimes, individuals will not have had contact with mental health services previously or not for some-time. Staff used computerised tablets enabling them to source or store information when visiting patients which although useful and speeded up processes when connectivity was poor patient visit lists could not always be accessed. Our Dementia Home Treatment Teams provide an intensive, safe home treatment service in the least restrictive way. , Preston, Lancashire, PR2 9HT Avondale within Maricopa County. Published Preston Blaine Arsement (born: May 4, 1994 (1994-05-04) [age 28]), also known as TBNRFrags and PrestonPlayz, is an American YouTuber which he is known for a variety of content including challenge and prank videos, as well as his Minecraft, Fortnite, Roblox and Among Us gaming content. They were kept up to date about their teams performance. Staff compliance with essential training was low. The HTT does not provide phone support for people not under their current care. At this inspection we found that all breaches of s136 had nowbeen reported as incidents. Patients also complained about the no smoking policy, blanket restrictions on mobile technology and disrupted sleep owing to the practice of 15 minute observations at night for all patients in medium secure wards. To begin your own journey at Avondale, let us help you choose a vocational course (VET), undergraduate or postgraduate degree that's right for you! Incorrect entries made on the ECR system could not be amended by the author and had to be amended by the information technology staff which complicated the process and could explain why trust figures for reporting documentation issues was high. Patients in the 136 suites had their mental capacity assessed regularly. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. The team usually includes a number of mental health professionals, such as a psychiatrist, mental health nurses, social workers and support workers. Governance arrangements were well embedded and there were clear lines of accountability. This had the potential to put people who use the service and staff members at risk. We did not inspect acute wards for adults of a working age and psychiatric intensive care units at the trusts other locations. Patients had access to information, which included how to make a complaint. Staff were not receiving regular supervision of their work. This allowed everybody to be involved in care planning and understand what was expected. Staff were not all trained in basic life support and overall completion of mandatory training was below the trust target. 33hr contract (36.75 hours paid) 34,398 - 40,131. At Pendle House, we saw an electronic notice board accessible to all staff that flagged up best practice guidelines. Infection control audits and hand hygiene were regularly undertaken and results gave assurances of good compliance. The HBPoS at Burnley and the Orchard held teleconferences three times a day regarding bed availability. This meant that staff were not aware if patients had consented to their medication. Staff we spoke with were positive about their roles and were positive about service development. 03300 245 321 during normal hours (8am-5pm, Mon to Fri) 0300 555 5000 (Out of hours) Staff followed a formalised flow chart of actions to be taken if there were instances of sickness. 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. The trust had a protocol in place however this was not being followed consistently and was out of date. Our rating for the trust took into account the previous ratings of the core services not inspected this time. We are a multi-disciplinary team of healthcare professionals offering a holistic and intensive period of care. Access to services was coordinated through a single point of entry in each locality. 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. The following is a brief overview to assist in helping make decisions in relation to potential referrals to Avondale MHC and whom can refer to us for assessment for placement. In addition staff on wards where the ban was being enforced, told us there had been an increase in incidents as a direct result of the ban. Please include what you were doing when this page came up and the Cloudflare Ray ID found at the bottom of this page. Patients on Fellside and Forest Beck step-down wards were permitted to have non-SMART mobile phones. This impacted on the teams abilities to work more proactively, for example, in seeing patients on wards to facilitate early discharge or admission avoidance work. These staff were responsible for ensuring ward procedures were up to date and provided advice and support to their colleagues. There was a clear structure of reporting and responsibility for safeguarding adults and children. The education provision was limited but this was beyond the full control of the trust. This allowed treatment to be provided in an effective and timely manner. This also assisted the trust to develop and recruit senior nurses from within their own workforce. The service had flexible opening times including evening and weekends to cater for its population and also good dispersal of satellite services for easy access. Clinical evidence summary tables. Due to the relocation of acute and psychiatric intensive care units to the Harbour, the trust lost a significant number of experienced and qualified staff. Lancashire Care Foundation Trust - Preston, PR2 9HT; 19,737 - 21,142 per annum; We are looking for a Clinical Team Administrators to work for Home Treatment Team to support the work of the Team which is based at Avondale Unit, Mental Health at Royal Preston Hospital. Connectivity for IT in the community was hindering a full move to electronic records and creating additional work for the staff converting paper records into electronic ones. The service reviewed staffing levels daily. We offer people involved in your care the opportunity to discuss their worries in relation to their role supporting you. Avondale Clinical Decisions Unit works in collaboration with the Mental Health Response Service and treatment units across the unplanned care pathway. There was an established governance structure with a defined hierarchy of reporting and decision making within the service. There were a number of wards and services which had furnishings or fittings that had ligature risks (places to which patients intent on self-harm might tie something to strangle themselves). The main aim of our team is to help you manage and resolve your crisis through assessment and treatment in your home environment. 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. The ward was undergoing a deep clean during the inspection. Patients were subject to restrictive interventions without the appropriate legal safeguards in place. 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. Most teams met the trusts target of 18 weeks waiting time from referral to assessment. Patients with minor injuries were triaged by staff who were not clinically trained. There was dissatisfaction with the two day advance ordering process, especially for patients with acquired brain injury. This meant staff that may administer medication not permitted under the MHA. There was evidence of delivering services to meet patients needs. We found concern amongst the staff in the North Lancashire team that management were not as high profile and hands on in their service, when compared to counterparts based in Preston and Blackburn. the service is performing well and meeting our expectations. We support people who live in the London Borough of Southwark. Patients using the service told us that they were treated with dignity and respect and described the staff as caring and helpful. Buildings were clean and well maintained. Method: This meant that at times of increased risk, staff had the appropriate tools available to safely manage each situation. Not all staff were adequately trained to deal with patients in seclusion. We have judged the service as requires improvement because: However, the unit was clean and well maintained. Physical health care issues were clearly documented in care plans and where necessary results and interventions were recorded. Staff were not sufficiently guided to consider risks relating to children and their placement alongside adults. The hope is we can also support other local charities or foodbanks with any excess. There was good adherence to the Mental Health Act and Mental Capacity Act. They followed good practice with respect to young peoples competence and capacity to consent to or refuse treatment. This was escalated to the management team whilst on inspection. 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. Staff understood and implemented safeguarding procedures. the service is performing badly and we've taken enforcement action against the provider of the service. The services managed complaints and concerns effectively; they listened to patients concerns with a view to improve the services being provided. Patients made complaints about a wide range of issues including concerns about safety on wards, availability and quality of food, cancellation of leave, and staff behaviour. The recording of patient activity levels was poorly documented. Staff felt supported and listened to and there was professional forums for nurses and allied health professionals. During the inspection there were two patients with these sub-acute conditions. The lack of supervision for band 7 allied health professional (AHP) clinical managers for two years and the lack of visibility of management above service integration managers in the district nursing service further demonstrated a lack of strategic support and control. This is because: We were not assured that all lessons learnt were being identified in the root cause analysis investigations we reviewed or areas identified for improvement were being monitored. Staff were supported by a central trust team and by Mental Health Act administrators who inputted into each ward. Website address not added, Address: Royal Preston Hospital, Sharoe Green Lane, Fulwood, Preston, Lancashire, PR2 9HT. Avondale is a ground floor purpose built centre allowing it to be fully accessible. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Assessed the number of child and adult beds available in the trust, and responded to this by increasing beds and at times placing patients in adult wards to ensure they received the care and treatment they needed promptly. We are looking at different ways to indicate the outcomes of our monitoring in the future. The wards did not have enough nurses. Staff demonstrated that they knew the organisations visions and values, and were supportive of them. NIHR Lancashire Clinical Research Facility Avondale Unit, Sharoe Green Lane, Fulwood Preston, PR2 9HT . Staff cared for patients with kindness and compassion. 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! The Fylde Coast rapid intervention and treatment team had changed their operational hours as a result of vacancies and safe staffing levels. They told us that staff were friendly, helpful calm, kind and patient. The MHCS had access to a range of mental health disciplines required to care for the people using the service. They had a good understanding of the services they managed.