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We found staff did not always safely manage medicines and act on audit results on three services we inspected. Staff did not always follow the Mental Health Act Code of Practice in relation to seclusion, long term segregation and blanket restrictions. St. Andrew's Hospital, Northampton: The First 150 Years (1838-1988) Staff made every attempt to avoid using restraint by using de-escalation techniques and restrained patients only when these failed and when necessary to keep the patient or others safe. Wards had adequate space for delivering care and treatment of patients, with appropriate seclusion rooms, low stimulus rooms, and extra care suites for patient use. They understood and responded to their individual needs. We found that the risk based safety system is being used to manage non risk behaviours such as non-engagement. Staff were passionate about their job and knew patients well. No rating/under appeal/rating suspended There was no recorded evidence of staff and patients having an immediate debrief following an incident. We reviewed 26 incidents that occurred between 1 November 2019 and 3 February 2020. This was because of the air exchange system sending columns of cold air directly downwards when the ward gets above 28 degrees. For services we haven't rated we use ticks and crosses to show whether we've asked them to take further action or taken enforcement action against them. However, staff told us that they would hear of incidents on other wards by word of mouth rather than through any formal means. This meant that staff did not always evaluate the quality of support provided to people and embed learning into practice. Contact Research Funding Support Walter Bower House Guardbridge St Andrews Fife KY16 0US Scotland, United Kingdom Tel: Contacting the team Documents RBDC Team Structure (PowerPoint, 45 KB) People told us that staff tried their best to accommodate leave and took them out on group outings, but they did not always have sufficient staff to carry out some activities. One patient told us that the staff we have are amazing. Fenwick ward is a low secure inpatient ward that can accommodate up to 10 children and adolescents females with neuro-disability / autistic spectrum disorder. We found issues with inappropriate storage of medicines, staff not labelling opened medications, patient allergy information and a significant medication error. BayleyWard holds the following certifications: ISO 9001:2015 / ISO 45001:2018 / ISO 14001:2015. . However, six patients told us that there were often not enough staff on the ward, another patient said the number of staff on duty on the day of inspection was fake adding that half the staff dont work on this ward. Occupational health services and a trauma nurse supported staff physical and emotional health needs. 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. You'll be coming to a world-class facility with its own teaching hospital and academic centre. 10 February 2015. Staff did not always keep patients safe from avoidable harm whilst on enhanced observations on the forensic wards and on the psychiatric intensive care unit. 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. We found that each patient had a daily schedule of therapeutic activities. Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. Any other browser may experience partial or no support. Two carers told us there were not enough staff on the ward and one carer raised concerns regarding the number of male agency staff on duty at night. 2022 lacrossemits; is randy owens mother still alive cz scorpion evo folding stock fde; cranberry juice for hangoverscant colloid thyroid nodule; 2006 playcraft powertoon; apartments near rivermark plaza; bayley ward st andrews northampton gotrax scooter not accelerating. St Andrew's Healthcare. Staff developed a comprehensive care and personal behavioural plan for each patient that met their mental and physical health needs. The provider had not ensured that ward areas were always well maintained. There were times when patients were not well supported and cared for. We found some expired medicines in the clinic rooms on the wards, and that staff did not act on previous audits where this was found. Cranford is a medium secure ward for male older adult patients. Last year it said improvements . This posed a risk to staff and patients if staff were following two different approaches. Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005. The shower areas upstairs did not provide comfort or promote dignity and privacy. Staff completed patients risk assessments in a timely manner and updated these after incidents. We found staff did not always safely manage medicines and act on audit results on three services we inspected. Bayley Ward is a Psychiatric Intensive Care Unit within the Men's Mental Health Pathway, based in Northampton. Billing Road, Northampton, Northamptonshire, NN1 5DG Managers had implemented additional safety measures following serious incidents, these included updating the ligature audit and assessment following a ligature incident, ensuring staff with specific training were available to provide specialist support to patients and a review of patients access to contraband items. The electronic system was difficult to navigate to find key documents such as PBS reports and some plans. 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. There was a range of psychological interventions available for patients which patients were encouraged to attend. Not all staff in wards for people with a learning disability or autism knew how to find patient information on the electronic record. Doctors and nurses did not complete records for all of the reviews as required by the Mental Health Act code of practice. Staff trained in British sign language (BSL) were available to patients on Fairbairn ward. Any other browser may experience partial or no support. Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. 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. 93%OFF 10OFF BOV2203AP ZETT cannabistrax.com Staff received mandatory and specialist training and most were up to date. Staff used outcome measures such as health of the nation outcome scale and specific tools for acquired brain injury patients. Seacole ward had outstanding maintenance issues. Practice nurses from the GP surgery attended the wards to address patients physical healthcare needs. Managers had not effectively managed the change to the ward profile. Six out of nine patients said they had been involved in their care planning. There were appropriate systems for managing and recording complaints. We observed a senior member of staff dismiss a patient who asked to speak with them about safeguarding concerns. The service provided safe care. Two patients told us that their families did not live locally and they were not happy because their families were unable to visit on a regular basis. 7 August 2017, Published Acorn ward (formerly Bayley) is a ten bed medium secure forensic service for boys with autistic spectrum conditions and / or learning disabilities. 1998-2011 Richard Tanner (from All Saints' Church, Northampton) 2011-2019 Samuel Hudson; 2019- John Robinson; Organist in . Staff on forensic inpatient or secure wards reported a high number of incidents that required restraint and staff did not undertake searches in line with the providers policy. Psychiatric intensive care unit, we spoke to four patients. On Church ward, staff behaviour did not always display the values of the organisation and people told us that attitudes of staff at night were not always kind and respectful. 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. ACUTE-There are currently no Acute Male beds available. Family and friends telephone line: 01604 614570. Staff had not completed the Elgar ward ligature risk assessment. Long stay / rehabilitation wards for working age adults: Wards for people with learning disabilities or autism: Wards for people with a learning disability or autism: people said that they felt well supported by kind, caring and engaged staff who were interested in their well-being and did their best to provide them with the support they needed. . Referrals accepted direct from Clinical Commissioning Groups and Foundation Trusts. It is envisaged that all PICU patients would be detained under the Mental Health Act (MHA) 1983, as admission and detention in a locked PICU environment constitutes a fundamental loss of freedom for an individual. Staff on the forensic wards did not always follow infection control procedures. Supervision was highlighted as an issue in learning disabilities, older adults and rehabilitation services. The provider had recently changed the local leadership of the ward. Not every ward had a dedicated sensory room, but access to one in the same building. Managers had not ensured established optimum staffing levels on all shifts. Staff did not always follow National Institute for Health and Care Excellence guidance for the use of rapid tranquillisation on Sunley ward. This service was placed in special measures on 10 June 2020. Requires improvement The provider as part of a national pilot, had developed a new clinical model (co-produced with staff and patients), which was a blended approach including low and medium security. Leadership had been strengthened and new ways of working implemented to improve the patient experience. Staff did not always ensure patients physical healthcare needs were met at the psychiatric intensive care, forensic and long stay rehabilitation wards. Seclusion rooms are available across our Neuro services where required. 25 February 2014. There was a monthly lessons learnt bulletin for staff. Staff did not always ensure that the privacy and dignity of all patients was respected and maintained. We accept NHS or privately funded referrals across our assessment and therapy services. A range of psychological therapies recommended by the national institute for health and care excellence was available for patients. If you have used our PICU services,please let us know your views, opinions, thoughts or ideas to help us continuously improve. A patient is assessed as posing a significant risk of suicide and the patient is unresponsive to preventative measures available, Absconding patients who are detained under the MHA 1983, for whom the consequences of persistent absconding are serious enough to warrant treatment in the PICU, Unpredictably patients, potentially posinga significant risk to self or others and requiring further assessment. We rated St Andrews Healthcare Northampton as requires improvement because: Published She was a member of the former St. Andrews Episcopal Church where she was very active, including being a member of the choir and the Altar Guild. Child and Adolescent Mental Health Services (CAMHS) in Northampton is a Hospitals - Mental health/capacity specialising in the provision of services relating to assessment or medical treatment for persons detained under the 1983 act, caring for children (0 - 18yrs), caring for people whose rights are restricted under the mental health act, eating Bayley Ward provides short periods of rapid assessment, intensive treatment and stabilisation for patients, before or during, a longer period of inpatient care. Boardman ward is a low secure inpatient ward that can accommodate up to 11 children and adolescent females with complex mental health needs. This is not in line with the providers policy and does not adhere to guidelines by the National Institute for Health and Care Excellence (NG10). Feedback from the outcome of complaints was not shared with the complainant on all occasions. At the time of the inspection, the provider had applied to change its registration with the Care Quality Commission to one location instead of multiple registrations across one site. 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. There was a high use of regular bank staff and agency staff. There was a chaplaincy service and access to spiritual leaders for other faiths. Getting To The Hospital Collapse all By Road View By Bus View By Train View Staff and patients spoke highly of the new manager and we observed that positive changes had been made on our second visit. The provider had procedures for children visiting. 2023 - All Rights Reserved St Andrew's Healthcare, 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, Significant risk of harming themselves or others. Psychiatric intensive care service has remained the same as requires improvement. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare. During our visit we saw some patients engaged in their daily activities, such as participating in current affairs sessions and playing board games with other patients and staff. We told the provider they must not admit any new patients until further notice; that wards must be staffed with the required numbers of suitably skilled staff to meet patients needs and to undertake patients observations as prescribed; that staff undertaking patient observations must do so in line with the providers engagement and observation policy and protocol and the provider must ensure there is clear documentation to inform staff of the current observation level of all patients. Peoples risks were assessed regularly and managed safely. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.The service will be kept under review and if needed could be escalated to urgent enforcement action. Staff planned and managed discharge well and liaised well with services that would provide aftercare. the service is performing well and meeting our expectations. Staff had not completed care plans that met all the needs of patients with a diagnosed eating disorder. Staff were unclear about the definitions and terminology relating to de-escalation, restraint, seclusion, segregation and extra care. Staff had quick access to ligature cutters and pocket masks (for use in mouth to mouth resuscitation) in different areas of the wards. please let us know your views, opinions, thoughts or ideas to help us continuously improve. Managers ensured that staff had relevant mandatory and specialist training, regular supervision and appraisal. Arthur; Trick, Kerith Lloyd Kinsey (1989), St. Andrew's Hospital Northampton: the first 150 years, 1838-1988, . Forensic inpatient or secure wards have remained as an overall rating of inadequate. We reviewed seven incident reports. Staff on Spencer North did not know where to find the ligature audit. 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. Not all staff had completed training in the Mental Health Act (MHA) or the Mental Capacity Act (MCA). Staff told us and plans showed that restraint was used as a last resort and staff tried to de-escalate and divert patients who were becoming distressed or agitated. People were supported to be independent and their human rights were upheld. Bayley Ward is a Psychiatric Intensive Care Unit within the Women's Mental Health Pathway, based in Northampton. The majority of patients felt they were supported well by the staff team on the ward. Staff had reported a high number of drug errors in Willow ward. 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. We could detect a strong smell of urine in some bedrooms. He founded Wisden Cricket Monthly and edited it from 1979 to 1996. The provider had recently implemented a new system for calculating the right numbers of staff required, based on the acuity of patient need. Staff assessed and managed risk well. Telephone: 01604 614584. Staff did not always treat patients with kindness, dignity and respect. St Andrew's Healthcare - Womens Service Quality Report Billing Road Northampton NN1 5DG Tel: 01604 616000 . The ward was not resourced with equipment required to support patients with an eating disorder. In three services, governance processes in place did not always ensure checks and audits were effective enough to ensure care delivery was improved. However, one patient told us that staff did not always consider the impact on patients who witnessed the use of restraint. St Andrews Healthcare Womens location has been registered with the CQC since 11 April 2011. Staff attended regular team meetings and recorded any actions and outcomes from these. Some people were not happy about being on the ward because they were detained their under the Mental Health Act 1983. There were meeting three times in a 24-hour period to review staffing across all wards. However, we reviewed evidence that staff checked quality and temperature before serving food. There remain issues around mixed gender accommodation on some older adults wards. Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. 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. In the psychiatric intensive care unit (PICU) some bedrooms, bathroom and shower areas were dirty and carpets were not clean. 29 December 2012. We reviewed ten team meeting minutes from January 2018 and weekly memos from 1 June 2018 sent by managers to staff and there was evidence of one incident being discussed in one meeting. Berkeley Lodge, 37 and 38 Berkeley Close and 19 The Avenue are locked units. The remaining staff (2%) were out of date with training. Professor Edward Baker One patient said,' 'yes the staff are good here they are always ready to have a chat with you'. Following our inspection, we issued a letter of intent informing the provider we were considering taking urgent action because of the immediate concerns we had about the safety of patients. Any other browser may experience partial or no support. Wards had a range of rooms for care and treatment and rooms for patients to meet visitors in private. John Reader 09 Jan 1822 Terrington St Clement, Norfolk, England - 08 Feb 1899 managed by James LaLone . Billing Road, Northampton, Northamptonshire, NN1 5DG. Governance processes did not always ensure that ward procedures ran smoothly. We told the provider they must provide immediate assurance in relation to staffing levels, staff completing enhanced observations of patients in line with National Institute of Health and Care Excellence guidance and staff reporting incidents and appropriate action is being taken. Assessment or medical treatment for persons detained under the Mental Health Act 1983. 24/7 admissions service with decision within an hour of a referral. People and those important to them, including advocates, were actively involved in planning their care. All patients we spoke to stated that they had been involved in the development of both their care and behavioural support plans. Patient is assessed as presenting too high an internal or perimeter security risk for the PICU, requiring a Medium or High secure PICU, The patient has a primary diagnosis of Substance misuse and the primary purpose of admission is solely to prevent access to substances, The patient has a primary diagnosis of Dementia, Learning Disability and Personality Disorder, Patients physical condition is too frail to allow their safe management on a PICU, Patient has a chronic condition which would not benefit from admission to PICU, The patient is restricted ( subject to MHA 1983 , via the courts ,Ministry of Justice) and has no clear pathway or provision for transfer from the PICU once clinically warranted, Patient must be 18 years and over and not above 65 years, Mental health awareness, including: understanding stress, understanding medication, substance misuse and understanding unusual experiences (psychosis), Therapy areas including crafts, information technology (IT) skills, kitchens and vocational rehabilitation. One ward team did not have access to a specialist dietician, which was required to meet the needs of patients. Published We will publish a report when our review is complete. the service isn't performing as well as it should and we have told the service how it must improve. Staff did not complete peoples enhanced and general observations in accordance with the provider policy and we found numerous gaps in the observations records. The patient was turned onto their side or back as soon as possible and the majority of prone restraints lasted less than three minutes. We're a specialist charity that invests in innovative, patient-centric, holistic care. Staff at the forensic service used derogatory and inappropriate language to describe patients. 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. Some staff in the learning disability services told us that there was little engagement with senior managers or the organisations values and they did not feel able to engage with the wider organisational systems. there are some services which we cant rate, while some might be under appeal from the provider. Our rating of this location stayed the same. Patients were at risk of not receiving effective care and treatment. Leaders did not always understand the issues, priorities and challenges the forensic and long stay rehabilitation services faced. When restrictive practices were used, there was a reporting system in place and there were comprehensive reviews to try and reduce the use of these practices. Nursing and support staff we spoke with in the CAMHS services did not have any understanding of positive behaviour support. Not all wards had a seclusion facility available for use. the service is performing exceptionally well. On Hereward Wake, this meant that a patient requiring seclusion was being transported to a different location by secure transport. Staff on forensic inpatient or secure wards did not always undertake and record physical health observations following rapid tranquilisation. 7: Sir William Wake 9th Bt 17681846 page . The provider had plans to improve this, but these had not yet commenced. Staff undertook comprehensive assessments and developed care plans that were thorough, holistic and patient centred. Staff told us that they dreaded coming into work and felt professionally vulnerable. Browser Support Staff communicated with people in ways that met their needs. 3. 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. Some rooms had sensory equipment that was available for people to use. Staffing numbers did not meet establishment levels. 10 June 2020. there are some services which we cant rate, while some might be under appeal from the provider. Staff supported people through recognised models of care and treatment for people with a learning disability or autistic people. The ward environments were clean. Staff could access emergency physical health care from the providers emergency response teams and the local general hospital to cover out of hours emergencies. Managers ensured that staff had received training in safeguarding and made appropriate referrals. On Seacole ward, the furniture in the night lounge was torn and dirty. Staff were not completing risk assessments on Elgar ward, with information being copied between records for different patients. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Agency staff did not have access to all of the systems, adding additional responsibilities onto the permanent staff. Not all staff in wards for people with a learning disability or autism knew how to find patient information on the electronic record. Staff in the forensic service did not always complete handovers in line with the providers policy and procedures. Sunley and Bayley ward seclusion rooms had blind spots in the ensuite areas. Staff protected and respected peoples privacy and dignity. Peoples quality of life was enhanced by the services culture of improvement and inclusivity. Staff at the learning disability and autism wards were unable to define a closed culture or describe how they ensured patients were protected from the risks associated with a closed culture developing. Some documents were saved on a shared drive rather than in the electronic system.