Some senior staff gave examples of learning from incidents for their ward. St. Andrews Hospital had its own physical healthcare team who saw patients on the wards. We were not assured that leaders had taken sufficient action to address concerns raised during the focused inspection of the forensic service in January and February 2020 or addressed concerns of the same themes identified at other service inspections in St Andrews Healthcare. On our second visit we were assured that senior leaders had started to address the concerns and were providing the ward with the support needed. Staff on the forensic, long stay rehabilitation and learning disability and autism wards did not always treat patients with compassion and kindness. However, the service did not always have enough staff which meant that peoples programme of support was not always delivered in time. We saw evidence in progress notes that staff sought support from the providers physical health team when required. We rated it as requires improvement because: In the service isn't performing as well as it should and we have told the service how it must improve. Bayley PICU is a member of NAPICU and adheres to the NAPICU minimum standards and their admission criteria, Admission exclusion Criteria for PICU -Admission should not occur in the following circumstances. Staff completing extended periods of enhanced observations may be less likely to maintain the levels of concentration required to maintain patient safety. The managers told us, and we saw the documents to show, they were offering an Aspire campaign, which supported healthcare support workers to undertake their nurse training. Staff at the forensic service used derogatory and inappropriate language to describe patients. there are some services which we cant rate, while some might be under appeal from the provider. Staff had not ensured the physical security of Willow ward. Patients told us that the CAMHS service were insufficiently staffed which meant that they were not always able to have their granted leave. Staff did not always ensure that the privacy and dignity of all patients was respected and maintained. Patients had access, without supervision, to the main courtyard, however, there was a large opening in the ground of the courtyard that had been there for over 10 months without repair. There were robust systems in place for reporting and investigating incidents and complaints. The provider had strengthened the implementation of positive behaviour support planning since the last inspection in June 2016. the service is performing badly and we've taken enforcement action against the provider of the service. The service had appropriately skilled staff to keep them safe. People had their communication needs met and information was shared in a way that could be understood. Leaders had delivered a project to address poor culture found at the last inspection. Staff supported people to make decisions following best practice in decision-making. The following services and wards were visited on this inspection: Acute wards for adults of working age and psychiatric intensive care units: This service was one of three hospital sites chosen by NHS England to pilot a blended setting of medium and low security levels, to reduce overall length of stay in hospital. Your information helps us decide when, where and what to inspect. Bayley Ward (VIC) Pty Ltd. BayleyWard VIC (Head Office) 21-23 Chessell St Southbank VIC 3006. Staff received training in safeguarding and made appropriate referrals. Staff did not manage patient risks effectively. 113, St Andrews . Managers sought to embed a culture promoting transparency, respect and inclusivity. Wards had seclusion rooms, low stimulus rooms and extra care suites for patient use. We found gaps in hourly observation records on 193 out of a possible 1,008 occasions. Multidisciplinary teams worked effectively across all wards. Blanket restrictions continued to be in place on most wards. At least one standard in this area was not being met when we inspected the service and, Find out more about our inspection reports, Child and Adolescent Mental Health Services (CAMHS). Staff on forensic inpatient or secure wards did not always undertake and record physical health observations following rapid tranquilisation. 5 October 2022. Our team are expert in treating people with acute mental illness and complex needs, offering a range of group and individual therapeutic interventions to meet the patients needs at different stages of their recovery, including: Once risk is reduced and the patients mental state and behaviour has been stabilised, transfer to an appropriate facility will take place we focus on moving individuals on to these services and back in to less secure or community setting as soon as possible. entry of bacteriophages and animal viruses into host cells. This meant staff could not find the most up to date plan of how to care for people using the service. In three services, governance processes in place did not always ensure checks and audits were effective enough to ensure care delivery was improved. Staff did not read patients their rights under section 132 of the Mental Health Act in some wards. Good NN1 5DG. Practice nurses from the GP surgery attended the wards to address patients physical healthcare needs. They were knowledgeable about the principles of PBS and were involved in observing behaviour and reporting to the multidisciplinary team to enable planning. One patient told us that the staff we have are amazing. Two carers told us that the social worker was helpful and another two told us their relative was in the right place for the care and treatment they needed. One seclusion room did not have a shower and whilst the provider had made progress in the processes to plan, fund and source a shower in the seclusion room, it remained without a shower. People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. All patient bedrooms had ensuite facilities. This posed a risk to staff and patients if staff were following two different approaches. Silverstone ward, a longer term high dependency rehabilitation unit for women over 18, with emotionally unstable personality disorder (EUPD) and disordered eating, 12 beds. Psychiatric intensive care unit, we spoke to four patients. We received mixed comments from the patients that we spoke with over our two day visit. Feedback from the outcome of complaints was not shared with the complainant on all occasions. Senior managers of the hospital and senior ward-based staff had taken steps to address a closed culture that was identified at our last inspection. the service is performing well and meeting our expectations. Carers reported issues with communication and gave examples of having to battle to be listened to and be involved. For example, gaps in environmental checks, long term segregation reviews, and medicines management checks were not followed up. Two services did not make timely repairs to the environment when issues were raised. Any other browser may experience partial or no support. Recommendations from external bodies were not always taken on board and these decisions were not always justified. In particular high numbers of registered agency nurses had been booked for night duty, many of whom were male, and not known to the female patients. Staff received and kept up to date with training on the Mental Health Act and the Mental Health Capacity Act. However, this was not always the case with night staff on Church ward. It often occurred that staff were trained up to a level to work with patients, then moved to work on other wards. Staff cared for patients who presented with behaviour that challenged. People were protected from abuse and poor care. One patient told us that the regular bank staff were caring and understood their needs, but two patients told us that bank staff were not responsive to their needs. However, we found the following areas of good practice: Published Staff did not always complete observations in line with patient care plans and the providers policy and procedures. due to sexual disinhibition or over-activity) in the context of a serious mental illness. Patients admitted to the PICU should exhibit mental state or clinical behaviour which seriously compromises their physical or psychological well-being, or that of others, and which cannot be safely assessed or treated in a general adult ward, Externally directed aggression. Goals for recovery, including an estimated date of discharge from the PICU, will be set as part of the admission process. Senior staff monitored incidents and discussed outcomes and learning from them in team meetings. Staffing numbers did not meet establishment levels. Staff were trained in the Mental Capacity Act and the Deprivation of Liberties Safeguards (DoLS). BayleyWard NSW Unit 10 Level 3 24 Hickson Rd Millers Point NSW 2000. Most staff treated patients with dignity and respect and were responsive to patients individual needs. Staff recorded when ligature cutters were used but did not record when they were checked daily in line with their policy. St Andrew's Healthcare Northampton Northamptonshire NN1 5DG Telephone: 0800 434 6690 Email: admissions@standrew.co.uk http://www.stah.org/services/brain-injury.asp. Staff did not always follow the providers policy and procedures on the use of enhanced observations when supporting patients assessed as being at higher risk of harm to themselves or others. Staff did not always keep patients safe from harm whilst on enhanced observations. Staff failed to maintain reliable systems, processes and practice around medicine management. Patients should be detained under the MHA 1983 (all section papers are checked before accepting admission) and patients are not admitted under section 136. At Spring Hill House, we saw that refurbishments were taking place to the shower and bathing facilities. The complaints process was not always clearly displayed on the wards in formats people can understand. 10 February 2015. We found that the risk based safety system is being used to manage non risk behaviours such as non-engagement. This included visits from senior managers, support from the providers trauma manager and free access to a confidential helpline. The wards had enough nurses and doctors. We saw action plans arising from complaints and the resultant changes on the wards. Managers did not provide a safe environment for patients. We rated it as requires improvement because: Published We also found that risk assessments and Care plans around this restraint were not always in place. Teams held regular and effective multidisciplinary meetings. Staff did not provide a range of care and treatment options suitable for this patient group. Updated 1st Jul 2021, 10:14am A former St Andrew's Healthcare carer who kissed a 'vulnerable' mental health patient five times was spared jail at Northampton Crown Court yesterday (Wednesday,. This ensured learning not just from their own ward but from other services. Staff supported them to achieve their goals. Some staff used the Mental Capacity Act to assess capacity for individual decisions. There were weekly bed management meetings to review bed numbers. Staff told us they knew the whistleblowing policy and felt they could raise concerns without fear of victimisation. Watkins House a longer term high dependency rehabilitation unit for women over 18, six beds. One patient was pleased with the physical health doctor visit, however, was told by staff to use mouthwash but their preference was dental floss. This meant senior staff could move staff to where need indicated it was higher on some wards. Therapy provision on wards for people with a learning disability was below establishment and affected the delivery of therapeutic activity. Not all staff in wards for people with a learning disability or autism knew how to find patient information on the electronic record. Concerns identified at previous inspections had not always been addressed. Care records confirmed that the room was used regularly and recently. This meant staff may not be clear what behaviour was expected in certain situation. W K irVJL^ l^l-V-rK^f-VJL/0 THE HI.STC:..- VITAL RECORDS :;DWiyl513^nOM ^ OF MANCHESTER \ Li::..A MASSACHUSETTS TO THE END OF THE YEAR I 849 PUBLISHED BY THE ESSEX INSTITUTE Staff were not always updating patient risk assessments and care plans at the psychiatric intensive care and long stay rehabilitation wards. Staff received annual appraisals and most staff received regular supervision. (01604) 616000, Provided and run by: Regulation 17 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good governance. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. On Hereward Wake, this meant that a patient requiring seclusion was being transported to a different location by secure transport. However, one patient told us that staff did not always consider the impact on patients who witnessed the use of restraint. The patients' comments were overwhelmingly positive with lots of activities in the unit particularly, pamper sessions where they could get their nails done and access foot spas. We found gaps in observation records. 220: . Agency and bank staff did not have adequate information about individual patient care and any safeguarding protection plans on the wards where they are working. Bayley Ward is a Psychiatric Intensive Care Unit within the Women's Mental Health Pathway, based in Northampton. Northampton, Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. Managers did not ensure safe and clean environments in the longstay rehabilitation service and learning disability service. We visited Spring Hill House, Sitwell and Stowe wards. The provider had ongoing recruitment and retention programmes to attract new staff. New admissions will need to isolate and complete a lateral flow test. On Bracken ward we observed two incidents where staff had kept the door of the toilet ajar when observing a patient in the day area. Suspended ratings are being reviewed by us and will be published soon. Staff engaged in clinical audit to evaluate the quality of care they provided. This was enhanced with a bleep holder system which reviewed the real time staffing situation in addition to the electronic system. Each ward had a book dedicated to learning from incidents and complaints generated across the hospital site.
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