St Andrew's Healthcare. And are detained under the Mental Health Act 1983. In two services, care plans did not always reflect how to manage patients with physical health issues. Sunley and Bayley ward seclusion rooms had blind spots in the ensuite areas. No rating/under appeal/rating suspended 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. The provider reported that 12% of shifts were unfilled between 01 February 2019 and 31 January 2020. Staff did not always ensure patients physical healthcare needs were met at the psychiatric intensive care, forensic and long stay rehabilitation wards. We found examples of poor record keeping of handovers. Teams held regular and effective multidisciplinary meetings. Download easy to read version for St Andrew's Healthcare - Womens Service - PDF - (opens in new window), Learning Disabilities Reviews Report published 13 February 2012 for St Andrew's Healthcare - Womens Service - PDF - (opens in new window), Published A patient is assessed as posing a significant risk of harm to others or extreme aggression towards property, Internally directed aggression. This was particularly high for registered nurses. There were robust systems in place for reporting and investigating incidents and complaints. The provider is required to provide CQC with an update relating to these issues on a fortnightly basis. They provided a range of treatments suitable to the needs of the patients cared for in a mental health rehabilitation ward and in line with national guidance about best practice. Patients told us that they felt the wards could be cleaner and the furniture in places was damaged and not replaced. On Hereward Wake, this meant that a patient requiring seclusion was being transported to a different location by secure transport. Staff restricted access to patients wishing to use their bedrooms, and this was not individually risk assessed. A debrief is an opportunity for staff to reflect on the incident, review what action was taken, any immediate lessons learned and to offer support to patients and staff. This meant staff may not be clear what behaviour was expected in certain situation. Two patients described the furniture as uncomfortable. we have taken enforcement action. Staff on long stay or rehabilitation wards staff did not ensure patients had a care plan in place for the use of rapid tranquilisation. We provide high quality, tailored treatment programmes which are developed to recognise each individuals strengths, needs and risks, with specific emphasis on treating mental illness and starting the recovery process. there are some services which we cant rate, while some might be under appeal from the provider. We found that staff were not aware of learning from complaints, incidents and internal and external investigations. This included visits from senior managers, support from the providers trauma manager and free access to a confidential helpline. Six out of nine patients said they had been involved in their care planning. 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. Therefore, we are taking action in linewith our enforcement procedures to begin the process of preventing the provider from operating the service. There had been an incident one weekend where there were no nasogastric trained staff available to administer the nasogastric feeds to a patient requiring this intervention. Managers had not notified CQC about seven out of eight safeguarding incidents and had not referred one to the local authority safeguarding team. Staff had not always followed the providers policy on patient observations in two services. Two patients told us that they felt the service could benefit from more staff as staff tend to focus more on the patients with the highest support needs. The clinic rooms were fully equipped and resuscitation equipment was checked regularly and recorded however not all wards had equipment. New admissions will need to isolate and complete a lateral flow test. Governance processes did not always ensure that ward procedures ran smoothly. The complaints process was not always clearly displayed on the wards in formats people can understand. 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. In adolescent services, one seclusion room had a faulty two-way intercom system. We found issues with inappropriate storage of medicines, staff not labelling opened medications, patient allergy information and a significant medication error. They were respectful in their approach. We rated St Andrews Healthcare Northampton as requires improvement because: Published Patients could also use their own phones to check emails. Our rating of this location improved. 5 October 2022. Forensic inpatient and secure wards: all patients told us that they had received advice regarding their medications. We will publish a report when our review is complete. However, some areas of the hospital, in particular the bathrooms and one seclusion room, required further work to meet these standards. Staff did not always follow the Mental Health Act Code of Practice in relation to seclusion, long term segregation and blanket restrictions. Discharge is considered at admission and our clinical and social work teams work with appropriate case managers to support a transition. Staff Nurse- Deaf ServiceLocation: NorthamptonFull time - 37.5 hoursSalary: 29,062-29,884 depending on experience and preceptorship status + enhancements. We reviewed 26 incidents that occurred between 1 November 2019 and 3 February 2020. In total we spoke with ten patients. Staff provided a range of care and treatment interventions suitable for the patient group. the service is performing exceptionally well. Regulation 17 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good governance. We found ligature risk and environment audits were undertaken every six months We saw that some ligature risks had been identified and there were contingency plans in place to manage these. Managers did not share learning from incidents with their teams in the forensic and learning disabilities services. Location: NorthamptonFull time: 37.5 hoursSalary: Up to 36,877 depending on experience + enhancements. The emphasis is on short-term intensive treatment with regular reviews of progress. Full text of "The Baptist Quarterly 1973-1974: Vol 25 Index" See other formats The Baptist Quarterly incorporating the Transactions of the Baptist Historical Society NEW SERIES VOLUME XXV 1973-1974 Publidied by tbe Baptist Historical Society, 4, Soudamiptoo Row, Loodon, WCIB 4AB. 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. Staff on the forensic, long stay rehabilitation and learning disability and autism wards did not always treat patients with compassion and kindness. Chief Inspector of Hospitals. The multi-disciplinary team had not conducted reviews as required. People received kind and compassionate care from staff who protected and respected their privacy and dignity and understood each persons individual needs. Wards had seclusion rooms, low stimulus rooms and extra care suites for patient use. Published Let's make care better together. Find out more about our inspection reports. 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. 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. We found that the provider had taken account of our previous inspection findings and had introduced additional quality monitoring measures. Staff completing extended periods of enhanced observations may be less likely to maintain the levels of concentration required to maintain patient safety. Police were called to St Andrew's Hospital's Marsh ward at just before 6pm . 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. Patients could personalise their bedrooms and had lockable spaces to secure possessions. Telephone: 01604 614584. Staff had reported a high number of drug errors in Willow ward. The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. 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. They told us that staff only used restraint when it was needed, and patients were given a debrief afterwards. Staff could access emergency physical health care from the providers emergency response teams and the local general hospital to cover out of hours emergencies. 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. Since its establishment in 2012, we have grown to a team of more than 20 architects, interior designers and urban designers working collaboratively with stakeholders to deliver excellence at every level. The management team was in the process of reforming the culture on this ward. 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. St. Andrew's Hospital, Northampton: The First 150 Years (1838-1988) Inadequate Two patients told us that they often had to wait a while for repairs to be carried out, we saw that patients frequently raised repair issues during community meetings. Managers had not ensured a safe environment at the learning disabilities service. Prior to Strat City's founding and the expansion of FAS, Stadium-of-Northampton was the largest venue in the country, seating 25,000. . We found that routine restrictive practices were in place to manage risk, behaviours related to daily care and treatments were measured using generic levels. Bayley ward is a medium secure inpatient ward that can accommodate up to 10 children and adolescent males with learning+ disabilities / autistic spectrum disorder. The service does not have a registered manager in post but does have a nominated individual as required, and a controlled drugs accountable officer. People were supported by staff to pursue their interests. Staff did not always provide patients with information about their rights under the Mental Health Act. On Seacole ward, the furniture in the night lounge was torn and dirty. Staff had quick access to ligature cutters and pocket masks (for use in mouth to mouth resuscitation) in different areas of the wards. We spoke with staff and people using the service and the ward managers for the three wards visited. Staff cared for patients who presented with behaviour that challenged. We reviewed incidents where staff had not provided physical health interventions as required and staff did not always record patients physical health or nutritional needs. Referrals accepted direct from Clinical Commissioning Groups and Foundation Trusts. 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. Staff did not follow the providers policy and record all the medicines they had disposed of. There was a high use of regular bank staff and agency staff. Staff did not always follow National Institute for Health and Care Excellence guidance for the use of rapid tranquillisation on Sunley ward. The provider recently introduced daily safety huddles involving the whole staff team. Staff did not always follow the Mental Health Act code of practice in relation to seclusion, long term segregation, blanket restrictions and section 17 leave on the long stay rehabilitation and learning disability and autism wards. 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. Menu. People and those important to them, including advocates, were actively involved in planning their care. the service is performing well and meeting our expectations. Also, staff were not always able to take their breaks and support the activities provision. 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. One of the long stay or rehabilitation wards, which supported patients with secondary needs associated with disordered eating, did not have access to a specialist dietician. Independent advocacy services were available to all patients. Staff did not always treat patients with kindness, dignity and respect. The service did not have enough nursing and support staff to keep patients safe at all core services. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. 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. At least one standard in this area was not being met when we inspected the service and 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. NN1 5DG. The wards did not have adequate psychology and occupational therapy provision for people on the wards. Nick oversees all areas of architectural design and delivery for the studio with broad experience in residential, commercial, cultural and leisure sectors. Patients had access to independent advocacy services. We carried out this inspection in response to concerning information received through our monitoring processes. On Althorp ward sweets were not allowed and the times for hot drinks were restricted. They minimised the use of restrictive practices and followed good practice with respect to safeguarding. We also found that risk assessments and Care plans around this restraint were not always in place. Staff managed known risks with nursing observations and individual risk assessments. The unit had a shared electronic device which patients could use to make video calls and a shared phone. With the exception of rehabilitation, adolescent and forensic services, staff monitored the physical health of patients regularly and developed physical health goals and treatment for patients. 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. The ward was not resourced with equipment required to support patients with an eating disorder. There were blanket restrictions on Sunley ward. Staff reported incidents accurately and in line with the providers policy. 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. Staff did not follow correct infection control procedures in relation to coronavirus. One patient was not involved in their care plan. Managers ensured that staff had received training in safeguarding and made appropriate referrals. There were no formally reported cases of bullying or harassment when we visited the service. Assessment or medical treatment for persons detained under the Mental Health Act 1983. PICU- Going into the weekend we have 2 beds available on our Male PICU in Essex, there is currently no access to seclusion on this ward. Family and friends telephone line: 01604 614570. 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. Staff told us that the chief executive officer visited regularly. the service is performing well and meeting our expectations. Staff received mandatory and specialist training and most were up to date. Managers did not ensure staff had the right skills, knowledge and experience to meet the needs of patients with a diagnosed eating disorder. The provider had strengthened the implementation of positive behaviour support planning since the last inspection in June 2016. Community meetings were held weekly services where patients could raise issues related to the ward, minutes were available for us to view. People received good quality care, support and treatment because staff were trained to support their needs. Staff completed patients risk assessments in a timely manner and updated these after incidents. 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. The location was rated as inadequate overall and placed into special measures. Staff worked well with services and external organisations that provided aftercare to ensure people received the right care and support when they went home. Action Plan 2011 for - PDF - (opens in new window), Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), Regulatory Assessment Report 2009 for - PDF - (opens in new window), Regulatory Assessment Report 2010 for - PDF - (opens in new window), In 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. There had been improvements since the last inspection. Managers had not followed recommendations from an internal investigation into concerns raised. On the learning disability ward some staff did not know the safeguarding process or where they could find out about current ward issues. Our four male and female PICU wards are based centrally across Northampton and Essex offering 24/7 rapid assessment, intensive treatment and stabilisation for people with acute phases of mental illness, we aim to give you a decision on your referral within the hour. there are some services which we cant rate, while some might be under appeal from the provider. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. Staff used closed circuit television (CCTV) to monitor patients. Levels of restraint significantly increased since the last comprehensive inspection across the forensic service. Qualified Psychologist - Learning Disability & ASD Staff had not met all patients physical health needs. Where necessary, another inspection will be conducted within six months, and if there is not enough improvement we will move to closethe service by adopting our proposal to vary the providers registration to remove this location or cancel the providers registration. Some patients told us they were concerned that sometimes their planned activities, such as outings in the community had been cancelled due to low staffing levels at Spring Hill House. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced. In two services, care plans did not always reflect how to manage patients with physical health issues. Staff had not always followed the providers policy on patient observations in two services. Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. Patients described the new dietician as amazing. Appraisal of performance was undertaken annually. Some staff did not demonstrate understanding about appropriate use of seclusion facilities in the learning disability services. They understood and responded to their individual needs. Staff supported people through recognised models of care and treatment for people with a learning disability or autistic people. Some rooms had sensory equipment that was available for people to use. 13: . We had identified a similar issue in the June 2016 inspection. 5 October 2022. Whilst managers and the health and safety lead had completed ligature audits for Spencer North and Sitwell wards within the last six months prior to inspection, there was no hard copy of the ligature audit and assessment available. Seclusion facilities were beingused for de-escalation and time out. Leadership development opportunities were available. The ward environments were safe and clean. There was a dashboard for monitoring ward performance, quality and safety against agreed targets. We're a specialist charity that invests in innovative, patient-centric, holistic care. Care records confirmed that the room was used regularly and recently. One patient told us that the staff we have are amazing. Nursing and support staff we spoke with in the CAMHS services did not have any understanding of positive behaviour support. One patient was pleased with the physical health doctor visit, however, was told by staff to use mouthwash but their preference was dental floss. They actively involved patients and families and carers in care decisions. Bracken ward, a 10-bed medium blended secure service for women. 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. Peoples risks were assessed regularly and managed safely. There was a range of psychological interventions available for patients which patients were encouraged to attend. Treatment of disease, disorder or injury. There were meeting three times in a 24-hour period to review staffing across all wards. We rated it as inadequate because: Following our inspection we took urgent action because of immediate concerns we had about the safety of patients on the forensic, long stay rehabilitation and learning disability and autism wards. St Andrews Healthcare Womens location has been registered with the CQC since 11 April 2011. Professor Edward Baker 30 October 2018, Published 16 September 2016. In forensic services, the receptionist controlled access to three buildings from one reception area and used CCTV monitors to control access. Sycamore ward, a 4-bed medium secure enhanced support service for women with learning disabilities and/or autistic spectrum conditions. At Spring Hill House, we saw that refurbishments were taking place to the shower and bathing facilities. Type of organisation Voluntary Sector Service Descripton of organisation In patient Out patient Residential miles (straight line) miles (approximate road distance) Entry last updated Whichhem. The provider had procedures for children visiting. 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. Staff did not always ensure that both paper and electronic medicine records were accurate, up to date and correctly identify how staff should give medicines to patients. Bayley Ward is a Psychiatric Intensive Care Unit within the Women's Mental Health Pathway, based in Northampton. Managers and medical staff told us that in recent months they had felt pressurised into accepting patients, who in their clinical opinion, were not suitable. Four people told us that they liked the food but that the options could be improved. Most staff treated patients with dignity and respect and were responsive to patients individual needs. Managers ensured that staff had relevant training, regular supervision and appraisal. Blanket restrictions continued to be in place on most wards. 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. Wards had family friendly visiting rooms along with policies and procedures for children visiting. Staff told us that they dreaded coming into work and felt professionally vulnerable. Staff had not received the necessary specialist training for their roles on Sunley ward. There was a need toassess and treat patients based on individual risk and identified needs, rather than placing emphasis on generic, restrictive risk management processes. Our PICU patients are supported by high levels of experienced medical and nursing staff, Psychologists, Social Workers and Occupational Therapists. All patients we spoke to stated that they had been involved in the development of both their care and behavioural support plans. Staff did not always demonstrate the values of the organisation when supporting patients. This meant senior staff could move staff to where need indicated it was higher on some wards. 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. Staff in forensic services completed regular ligature risk assessments and wards contained very few ligature risks. 27 March 2017. 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. Naseby ward, a longer term high dependency rehabilitation unit for women over 18, providing comprehensive dialectic behaviour treatment (DBT) with a diagnosis of borderline personality disorder (BPD), 12 beds. Willow ward, a 10-bed medium blended secure service for women. Patients on the PICU did not have access to a lockable space in their bedrooms and they did not always have their room key. However, Naseby in Northampton may be able to admit over the weekend, please contact the ward directly on the number below for an update. Multidisciplinary teams worked well together to provide the planned care.