Staff supported them to achieve their goals. 5 October 2022. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. there are some services which we cant rate, while some might be under appeal from the provider. In adolescent services, one seclusion room had a faulty two-way intercom system. Staff throughout the organisation were aware of how to report incidents and we saw good examples of staff learning from the investigation of adverse events. Heritage ward is a low secure inpatient ward that can accommodate up to 12 children and adolescent females with complex mental health needs. Bayley Ward is a Psychiatric Intensive Care Unit within the Women's Mental Health Pathway, based in Northampton. Billing Road, Northampton, Northamptonshire, NN1 5DG. Goals for recovery, including an estimated date of discharge from the PICU, will be set as part of the admission process. The service did not have robust governance processes in place to ensure that due consideration was given to recommendations from external reviews and ensure that actions were followed up. 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. Staff had not always followed the providers policies and procedures when they needed to search patients or their bedrooms to keep them safe from harm. Patients regularly had their escorted leave, therapies or activities cancelled because of staff shortages. This meant staff could not find the most up to date plan of how to care for people using the service. Managers did not ensure staff had the right skills, knowledge and experience to meet the needs of patients with a diagnosed eating disorder. One patient was pleased with the physical health doctor visit, however, was told by staff to use mouthwash but their preference was dental floss. Regulation 10 Health and Social care Act 2008 (Regulated Activities) Regulations 2014 Dignity and respect. People and those important to them, including advocates, were actively involved in planning their care. This is an organisation which is involved in promoting and developing work within the PICU settings. Fenwick ward is a low secure inpatient ward that can accommodate up to 10 children and adolescents females with neuro-disability / autistic spectrum disorder. 27 March 2017. Acorn ward (formerly Bayley) is a ten bed medium secure forensic service for boys with autistic spectrum conditions and / or learning disabilities. Staff had completed person centred and holistic care plans for 20 patients reviewed. Across all services, the provider was challenged to ensure staffing numbers met the needs of patients and we found in some cases, patient activities had been cancelled or postponed. The admissions cannot be carried over to following weeks should an admission not occur. This was enhanced with a bleep holder system which reviewed the real time staffing situation in addition to the electronic system. In two services, care plans did not always reflect how to manage patients with physical health issues. The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. The provider reported that 1,698 shifts out of 15,788 were unfilled for the period 1 February 2018 to 30 June 2018. As a result, discharge was rarely delayed for other than a clinical reason. 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). 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. Psychiatric intensive care unit, we spoke to four patients. People and those important to them, including advocates, were actively involved in planning their care. Independent advocacy services were available to all patients. Sycamore ward, a 4-bed medium secure enhanced support service for women with learning disabilities and/or autistic spectrum conditions. We will publish a report when our review is complete. Patients told us that due to high levels of bank and agency staff who did not know them caused them to be cared for and treated differently. Data provided showed a downward trajectory in the use of restraint and in the use of prone restraint. The provider did not have an effective management supervision structure. Leadership development opportunities were available. There was a high use of regular bank staff and agency staff. The remaining staff (2%) were out of date with training. Some senior staff gave examples of learning from incidents for their ward. The provider was required to provide CQC with an update relating to these conditions on a fortnightly basis. The provider would pay these staff a bursary to support their training, following which they would return to work at St Andrews for a minimum of two further years. To find out more about our PICU services and meet the team, watch our videos below, 2023 - All Rights Reserved St Andrew's Healthcare, 2. A new application for a registered manager was in progress at the time of the inspection. Not all seclusion rooms considered the privacy and dignity of patients. There had been an increase in the group of patients with Huntingdons disease on Tallis ward which affected the clinical risks on the ward and this was raised as a concern, this was being addressed by staff receiving extra training in this area. Getting To The Hospital Collapse all By Road View By Bus View By Train View Patients told us there were limited food options, especially if vegetarian. Leaders did not always understand the issues, priorities and challenges the forensic and long stay rehabilitation services faced. an inspection looking at part of the service. The new ward manager and operational lead had recently started in their posts. Staff worked well with services and external organisations that provided aftercare to ensure people received the right care and support when they went home. People benefitted from the interactive and stimulating environment, and the service endeavoured to make further improvements in providing sensory spaces for people on the wards. Staff did not always follow the providers policy and procedures on the use of enhanced support when observing patients assessed as being at higher risk harm to themselves or others at all core services. The origins of the General Lunatic Asylum later St Andrews Hospital Northampton . During our visit, we witnessed several occasions where staff responded to patients distress and they did so discreetly and appeared to be always mindful of the patients dignity. Two services did not make timely repairs to the environment when issues were raised. The provider had recently implemented a new system for calculating the right numbers of staff required, based on the acuity of patient need. Most staff treated patients with dignity and respect and were responsive to patients individual needs. No rating/under appeal/rating suspended We found gaps in hourly observation records on 193 out of a possible 1,008 occasions. However, the provider does have various avenues through which staff can raise grievances and concerns. We found examples of poor record keeping of handovers. A relative we spoke with told us the team on the ward liaised well with her relatives professional team in their home area to ensure the care was effective and were accurately informed of their progress. On Seacole ward, the furniture in the night lounge was torn and dirty. Discharge is considered at admission and our clinical and social work teams work with appropriate case managers to support a transition. Following our inspection, we served an urgent Notice of Decision because of the immediate concerns we had about the safety of patients. Staff did not always ensure that the privacy and dignity of all patients was respected and maintained. There were regularly high numbers of bank and agency staff used across these wards. This meant that due to staff redeployment to work on other wards the arrangements in place to ensure people were supported by appropriately qualified and skilled staff were not being effectively managed. Who protects the vulnerable voiceless, like Bill, and Kristian, paying 6,000 (4,500 tax free) per week, for their enforced 'treatment'?. Two patients told us that they felt the service had aided their recovery more than any other and that staff that staff were generally kind, caring and took the least restrictive approach. Staff stated that that the training offered by St Andrews was excellent. 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 did not provide a range of care and treatment options suitable for this patient group. Some documents were saved on a shared drive rather than in the electronic system. Staff at these services were not reporting all incidents and not recording all incidents appropriately. Teams held regular and effective multidisciplinary meetings. Compton Ward Northampton General Hospital, Cliftonville, Northampton, Northamptonshire, NN1 5BD 01604 634 700 Send email Visit website View Accessibility Symbols View photos View on a map Access Guide Show Easy Read Easy Read Print/Save as PDF Something changed? In wards for people with a learning disability or autism, seclusion occurred in areas other than a seclusion room and staff did not always record it correctly in line with the MHA Code of practice. Insufficient improvements have been made such that there remains a rating of inadequate for any core service, key question or overall. We found that the space on the older adults wards was a challenge to make feel homely, however we saw they had utilised the ends of corridors to create small areas of interest. Conservative 12. We found that staff were not aware of learning from complaints, incidents and internal and external investigations. Staff received training in de-escalation skills and conflict resolution. Patients could personalise their bedrooms and had lockable spaces to secure possessions. Staff supported patients to engage with the wider community. the service is performing exceptionally well. Facilities and premises used on Elgar and Spring Hill wards were not appropriate for the service being provided. 7: Sir William Wake 9th Bt 17681846 page . Foster is a locked ward for male older adults. Staff did not fully complete seclusion records, including physical healthcare monitoring during an episode of seclusion. Whilst managers booked agency staff to cover vacancies at short notice this resulted in staff who were often unknown and unfamiliar with the wards and the patients. They understood and responded to their individual needs. 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. Staff recorded when ligature cutters were used but did not record when they were checked daily in line with their policy. Suspended ratings are being reviewed by us and will be published soon. We found the following areas the provider needs to improve: Published Patients described the new dietician as amazing. Bayley Ward is a Psychiatric Intensive Care Unit within the Men's Mental Health Pathway, based in Northampton. We believe there's nowhere better to start your career than St Andrew's Healthcare. Medical staff told us clinical decisions were made at a senior level without any evidence based rationale or consultation at a clinical level. Patients told us staff worked hard and were kind to them. Staff had not always recorded patients vital signs (in line with the National Institute for Health and Care Excellence (NICE guidance) when using rapid tranquilisation. The shower areas upstairs did not provide comfort or promote dignity and privacy. Bayley Ward uses medication led model and follows the nursing approach of Safewards which incorporates: Depending on their mental state, patients will be engaged on a suitable OT programme to facilitate recovery. Berkeley Close (ground floor) is a female locked ward. This meant that staff did not always evaluate the quality of support provided to people and embed learning into practice. Recommendations from external bodies were not always taken on board and these decisions were not always justified. Managers were visible on the wards and staff felt supported by operational managers and clinical nurse leads. Staff did not always share clear information about patients and any changes in their care. Daily checks of the ligature cutters were not always completed. Our rating of this service stayed the same. Nick oversees all areas of architectural design and delivery for the studio with broad experience in residential, commercial, cultural and leisure sectors. This location consists of four core services: acute wards for adults of working age and psychiatric intensive care units; long stay/rehabilitation mental health wards for working age adults; forensic/inpatient secure wards; wards for people with learning disabilities or autism. We looked at the Mental Health Act paperwork for patients and found it to be accurate and complete in all sections. Click here for our dedicated Neuro Rapid Response service page. Any other browser may experience partial or no support. Bracken ward, a 10-bed medium blended secure service for women. We rated it as requires improvement because: Published Staff did not allow patients to have snacks outside these times. Staff engaged in clinical audit to evaluate the quality of care they provided. People had a choice about their living environment and were able to personalise their rooms. If negative, the patient can end isolation, but if positive the patient will remain in isolation, see below. There were robust systems in place for reporting and investigating incidents and complaints. cio facial expressions test; uk employee working remotely from another country; blue yeti not showing up on blue sherpa; town of enfield ct tax bill search and pay People were protected from abuse and poor care. Managers had not ensured established optimum staffing levels on all shifts. Staff knew and understood people well and were responsive. However, we found the following areas of good practice: Published 25 February 2014. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Suspended ratings are being reviewed by us and will be published soon. Staff had not always followed the providers policy on patient observations in two services. Three patients told us that their planned activities had been cancelled. The ward managers in the older adults service told us they felt supported in their roles and had excellent support from the directors of the service. In rehabilitation services, staff did not always respond appropriately to a decline in a patients physical health and did not use observation tools to review and assess the response needed. Billing Road, Northampton, Northamptonshire, NN1 5DG Bayley, Hugh Beard, Nigel Begg, Miss Anne Beith, Rt Hon A J Bell, Stuart Benn, Hilary Bennett, Andrew Benton, Joe Berry, Roger Best, Harold Betts, Clive Blackman, Liz Blears, Ms Hazel Blizzard, Bob Blunkett, Rt Hon David Boateng, Rt Hon Paul Borrow, David Bradley, Rt Hon Keith (Withington) Bradley, Peter (The Wrekin) Bradshaw, Ben Brake, Tom One patient felt the unit was the safest place ever, and staff were always available when needed but were always busy. Our PICUs offer a short period of rapid assessment, intensive treatment and stabilisation for people with acute phases of mental illness who are in need of emergency psychiatric care. Staff were confused about what constituted long term segregation and the purpose of using long term segregation. there are some services which we cant rate, while some might be under appeal from the provider. 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. We found gaps in observation records. No rating/under appeal/rating suspended In some wards, Mental Health Act 1983 (MHA) paperwork was in order and stored securely. Governance, CQC ratings and Annual reports, Child and Adolescent Mental Health (CAMHS), Information for family, friends and carers, LightBulb Mental Wellness for Schools Program, Centre for Developmental and Complex Trauma. Bayley Ward provides short periods of rapid assessment, intensive treatment and stabilisation for patients, before or during, a longer period of inpatient care. Regulation 13 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safeguarding service users from abuse and improper treatment. Senior leaders demonstrated learning by acknowledging that a lesson learnt was to ensure new services have the correct capabilities in place prior to opening and reported that they were making changes following concerns being raised. Click hereto share your feedback. We found that the CQC had not been sent notifications relating to incidents affecting the service or the people who use it within the learning disability service. Telephone: 01604 614584 Fax: 01604 614578 Family and friends telephone line: 01604 614570 Staff and patients spoke highly of the new manager and we observed that positive changes had been made on our second visit. The provider used bureau (St Andrews bank staff) and agency staff to fill vacant shifts. Menu. Care plans were comprehensive and holistic, and contained a full range of patients needs. 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. However, a significant number of shifts remained unfilled. stoc 2022 accepted papers; the forum inglewood dress code; to what extent is an individual shaped by society; astragalus and kidney disease; lake wildwood california rules and regulations; bayley ward st andrews northampton. due to sexual disinhibition or over-activity) in the context of a serious mental illness. The provider told us they were going to fit a safe diffuser over all of the ducts to try to diffuse the cool air over a larger area. They minimised the use of restrictive practices and followed good practice with respect to safeguarding. The leadership, governance and culture did not always support the delivery of high quality, person centred-care. Requires improvement At Spring Hill House, we saw that refurbishments were taking place to the shower and bathing facilities. You'll be coming to a world-class facility with its own teaching hospital and academic centre. We imposed conditions on the provider's registration that included the following requirements: Following this inspection, we wrote to the provider on 9 May 2022, to vary one condition to allow, from 10 May 2022, that St Andrews Healthcare Womens service may admit up to a maximum of 1 patient per week to each ward without seeking permission from the Commission. Staff on the forensic, long stay rehabilitation and learning disability and autism wards did not always treat patients with compassion and kindness. Tallis, Tavener, Althorp, Berkeley Close (1st floor) are male locked wards. We reviewed 22 out of 115 seclusion records from 1 April 2018 to 30 June 2018. Qualified Psychologist - Learning Disability & ASD Company Information; FAQ; Stone Materials. St Andrew's Healthcare. One patient said,' 'yes the staff are good here they are always ready to have a chat with you'. One patient told us that the staff we have are amazing. Fairbairn is a 15 bed ward in purpose-built medium secure service which manages deaf or hearing . We observed a senior member of staff dismiss a patient who asked to speak with them about safeguarding concerns. Staff failed to maintain reliable systems, processes and practice around medicine management. Fairbairn is a 15 bed ward in purpose-built medium secure service which manages deaf or hearing impaired (profound, severe, partial or hard of hearing . PBS care plans were available in paper form for staff to have easy access and in easy read for patients when needed, as well as on the electronic system. Staff communicated with people in ways that met their needs. Staff did not follow correct infection control procedures in relation to coronavirus. Policies for seclusion, long term segregation and enhanced support were confusing and the long term segregation policy did not meet the Mental Health Act code of practice in respect of review requirements. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. There were a number of locked doors, stairs and potentially an unpredictable patient group, which may impact how quickly the equipment arrived where it was needed. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. Wards had a range of rooms for care and treatment and rooms for patients to meet visitors in private. Six out of nine patients said they had been involved in their care planning. On Althorp ward sweets were not allowed and the times for hot drinks were restricted. Multidisciplinary teams worked effectively across all wards. Your information helps us decide when, where and what to inspect. We found that the provider had taken account of our previous inspection findings and had introduced additional quality monitoring measures. Two patients described the furniture as uncomfortable. Patients will only be admitted to a PICU if they display a significant risk of aggression, absconding with associated risk, suicide or vulnerability (e.g. Published Billing Road, Northampton, Northamptonshire, NN1 5DG Berkeley Lodge, 37 and 38 Berkeley Close and 19 The Avenue are locked units. Last year it said improvements . Practice nurses from the GP surgery attended the wards to address patients physical healthcare needs. Regulation 17 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good governance. gotrax scooter not accelerating. the service is performing exceptionally well.

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