The wards did not have adequate psychology and occupational therapy provision for people on the wards. Staff did not ensure that patients had a care plan in place for the use of rapid tranquilisation in line with policies and procedures. Not all wards had a seclusion facility available for use. The management team was in the process of reforming the culture on this ward. Patients and carers reported that managers were dismissive of concerns raised. This meant people received compassionate and empowering care that was tailored to their needs. Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. No rating/under appeal/rating suspended This was concerning as staff told us they had been raising concerns since August 2019 and there was still a high occurrence of self harm incidents on our first day of inspection. 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. There was a shower curtain on some, but not all showers. A freedom of information request, revealed, the CQC, apparently, indicating, they were not prepared, to investigate the deaths at St Andrews, "CQC was aware of the service's own reviews . We reviewed minutes from a de brief session, which confirmed this. 5 October 2022. However, we found the following areas of good practice: Published For example, gaps in environmental checks, long term segregation reviews, and medicines management checks were not followed up. One ward lacked appropriate signage and other relevant information for patients with neuro rehabilitation needs. Heritage ward is a low secure inpatient ward that can accommodate up to 12 children and adolescent females with complex mental health needs. 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. Staff had not escalated these issues to estates management, leading to an unpleasant environment for patients. Good At both Thornton Ward and Spring Hill House the patients had expressed concerns about the heating not being suitable, for example bedrooms and communal rooms being either too hot or too cold. 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. Staff had not received the necessary specialist training for their roles on Sunley ward. Northampton, The provider did not have an effective management supervision structure. It has defined its key patient outcomes to be rapid stabilisation, crisis resolution, risk-reduction, prevention of relapse and promotion of recovery. Staff completing extended periods of enhanced observations may be less likely to maintain the levels of concentration required to maintain patient safety. Staff planned and managed discharge well and liaised well with services that would provide aftercare. In addition, at this inspection, we identified breaches in regulation 10, 12, 15, 17 and 18 but are related to different issues from the last inspection in 2021. The provider had not fully responded to the needs of patients on the long stay rehabilitation and learning disability and autism wards. The provider had recently implemented a new system for calculating the right numbers of staff required, based on the acuity of patient need. All other conditions outlined in the section 31 notice of decision from July 2021 remained applicable. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. The provider reported that 1,698 shifts out of 15,788 were unfilled for the period 1 February 2018 to 30 June 2018. Daily checks of the ligature cutters were not always completed. Here are seven reasons why: 1. We found that each patient had a daily schedule of therapeutic activities. (later Organist at the University of St Andrews, Scotland) 2009 Oliver Waterer (later Organist at St. David's . We found that routine restrictive practices were in place to manage risk, behaviours related to daily care and treatments were measured using generic levels. Billing Road, Northampton, Northamptonshire, NN1 5DG (01604) 616000 Provided and run by: St Andrew's Healthcare We are carrying out a review of quality at St Andrew's Healthcare - Womens Service. People and those important to them, including advocates, were actively involved in planning their care. In some wards, Mental Health Act 1983 (MHA) paperwork was in order and stored securely. . Managers had access to dashboards for their teams, which gave details of staff compliance with mandatory training. Click here for our dedicated Neuro Rapid Response service page. Inspection Report published 25 February 2014 for St Andrew's Healthcare - Womens Service - PDF - (opens in new window), Published They minimised the use of restrictive practices and followed good practice with respect to safeguarding. Males aged between 18 and 65 years old mental health issues that may include: These criteria are a guide for assessing suitability. 27 March 2017. Managers did not ensure established staffing levels on all shifts. Bracken ward, a 10-bed medium blended secure service for women. This meant that staff were not working to the most recent guidelines. A mental health hospital in Northampton has been stopped from admitting new patients on some of its wards following a damning CQC report. Some records had part of the paperwork uploaded. Consultants did not always accurately complete medication consent paperwork (T2 and T3 forms). Managers did not ensure all staff had the right skills, qualifications and experience to meet the needs of the patients in their care on the forensic wards and learning disability and autism wards. Managers on the learning disability wards and forensic wards did not make sure staff received specialist training for their role. Staff developed recovery-oriented care plans informed by a comprehensive assessment. Treatment of disease, disorder or injury. More. Staff engaged in clinical audit to evaluate the quality of care they provided. Staff reported incidents accurately and in line with the providers policy. We noted ward teams had made improvements to reducing restrictive practice since our last inspection. Most staff treated patients with dignity and respect and were responsive to patients individual needs. Staff undertook comprehensive assessments and developed care plans that were thorough, holistic and patient centred. Staff received annual appraisals and most staff received regular supervision. The service provided care, support and treatment from trained staff and specialists able to meet peoples needs. People were protected from abuse and poor care. 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. However people using the service and staff spoke of their frustrations when staff were taken off Spring Hill House to work on other wards within the Women's Service. Willow ward, a 10-bed medium blended secure service for women. 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. 2. Managers had recently recruited a new senior nurse and staff were returning from long term sick leave. 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. 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. Staff used clinical and quality audits to evaluate the quality of care. Concerns identified at previous inspections had not always been addressed. MHA administrators had a thorough scrutiny process. Discharge is considered at admission and our clinical and social work teams work with appropriate case managers to support a transition. Managers ensured that these staff received training, supervision and appraisal. Two patients told us that their escorted leave had been cancelled. Staff supported people to make decisions following best practice in decision-making. Staff developed a comprehensive care and personal behavioural plan for each patient that met their mental and physical health needs. Company Information; FAQ; Stone Materials. 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. St. Andrews Hospital had its own physical healthcare team who saw patients on the wards. Patients told us that they felt the wards could be cleaner and the furniture in places was damaged and not replaced. 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. 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. Prior to Strat City's founding and the expansion of FAS, Stadium-of-Northampton was the largest venue in the country, seating 25,000. . Insufficient improvements have been made such that there remains a rating of inadequate for any core service, key question or overall. There were weekly bed management meetings to review bed numbers. please let us know your views, opinions, thoughts or ideas to help us continuously improve. Regulation 18 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Staffing. . Staff engaged in clinical audit to evaluate the quality of care they provided. Northampton, Inspection Report published 20 September 2013 for St Andrew's Healthcare - Womens Service - PDF - (opens in new window), Published Getting To The Hospital Collapse all By Road View By Bus View By Train View Male or Female Northampton (Out of office hours) -Please contact the relevant ward directly: There is now updated Covid-19 guidance for healthcare settings, which means there are some changes to the admissions and isolation processes affecting our patients: 1. 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. There were regularly high numbers of bank and agency staff used across these wards. Staff discussed current concerns and risk issues for all patients and agreed on actions required. We also looked at seclusion facilities and seclusion records, as concerns had been identified at a Care Quality Commission Mental Health Act seclusion monitoring visit on 22 November 2013. 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 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. Staff provided a range of activities for patients and activities were available seven days a week. There were appropriate systems for managing and recording complaints. Any other browser may experience partial or no support. One patient said,' 'yes the staff are good here they are always ready to have a chat with you'. Silverstone ward, a longer term high dependency rehabilitation unit for women over 18, with emotionally unstable personality disorder (EUPD) and disordered eating, 12 beds. Staff used closed circuit television (CCTV) to monitor patients. Staff on long stay rehabilitation wards did not always know what incidents to report and how to report them, however staff in the other services we inspected did know what to report and how. Bayley Ward, St Andrews Hospital, Northampton, NN51 5DG NHS Gloucestershire CCG 1 Brunel Ward, Priory Hospital, Heath House Lane, Bristol, BS16 1 EQ NHS Herefordshire CCG 1 Cygnet Coventry CV2 4FN NHS Gloucestershire CCG 1 ELGAR UNIT, HOLT WARD, NEWTOWN HOSPITAL WR5 1JG NHS Gloucestershire CCG 1 Frinton Ward, St Andrews Hospital, Essex SS12 9JP . Staff had not always recorded in the patients clinical records, the rationale for seclusion, or the time that a period of seclusion had ended. There remain issues around mixed gender accommodation on some older adults wards. However, monitors were visible to staff from the office and to patients on entering or leaving the adjacent low stimulus room. Staff did not always treat patients with kindness, dignity and respect. the service is performing exceptionally well. We reviewed 21 care and treatment records for patients. 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. 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. Learning disability wards were part of the overall deregation project and were not suitable to meet patients needs, for example they were not accessible for patients with significant physical disabilities or requiring wheelchair access. About Us. Six out of nine patients said they had been involved in their care planning. Staff made prompt referrals for any further specialist physical healthcare input. 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. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff documented patients did not have capacity but did not give a rationale as to why they had made this decision nor document any discussion. Staff did not always follow the Mental Health Act Code of Practice in relation to seclusion, long term segregation and blanket restrictions. John Clare ward is a low secure inpatient ward that can accommodate up to nine children and adolescent females with complex mental health needs. the service is performing well and meeting our expectations. 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. We spoke with staff and people using the service and the ward managers for the three wards visited. 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 . Patients told us staff worked hard and were kind to them. In adolescent services, one seclusion room had a faulty two-way intercom system. Patients alleged that staff on Sunley ward used inappropriate restraint techniques. Care plans were comprehensive and holistic, and contained a full range of patients needs. This meant staff may not be clear what behaviour was expected in certain situation. Staff worked well with services and external organisations that provided aftercare to ensure people received the right care and support when they went home. There's no need for the service to take further action. Staff told us when shifts were not filled, staff moved between wards to meet patient need or wards worked short of staff. 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 due to high levels of bank and agency staff who did not know them caused them to be cared for and treated differently. 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. Staffing levels at the time of the incidents were recorded in each report. 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. 1 April 2020. Staff had completed person centred and holistic care plans for 20 patients reviewed. The PICU ward was affiliated to the National Association of Psychiatric Intensive Care and Low Secure Units (NAPICU). The emphasis is on short-term intensive treatment with regular reviews of progress. Staff had not completed care plans that met all the needs of patients with a diagnosed eating disorder. The overall rating for this service has improved to requires improvement. 5 October 2022. Since 1 February 2019, the Bayley PICU have been trialling body ward cameras on nurses. The last comprehensive inspection of this location was in July and August 2021. 24 September 2020. Staff did not always complete physical healthcare monitoring for patients prescribed specific medications and staff did not complete the relevant chart regularly or appropriately. Patients could personalise their bedrooms and had lockable spaces to secure possessions. the service isn't performing as well as it should and we have told the service how it must improve. Managers sought to embed a culture promoting transparency, respect and inclusivity. the service is performing well and meeting our expectations. Not all staff in wards for people with a learning disability or autism knew how to find patient information on the electronic record. We also issued requirement notices for breaches of the following regulations: At this inspection, we found that the provider addressed most of the issues from the last inspection of 2021. News you can trust since 1931. . We found staff did not always safely manage medicines and act on audit results on three services we inspected. Staff received and kept up to date with training on the Mental Health Act and the Mental Health Capacity Act. Maple ward, a 10-bed medium blended secure service for women. We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels: Outstanding Staff did not provide a range of care and treatment options suitable for this patient group. People received good quality care, support and treatment because staff were trained to support their needs. Watkins House a longer term high dependency rehabilitation unit for women over 18, six beds. St Andrew's Healthcare - Womens Service 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 people whose rights are restricted under the mental health act, learning disabilities, mental health conditions and We rated it as requires improvement because: In Managers did not provide a safe environment for patients. 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. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare. Sunley ward was not clean, bed linen was stained and smelly, and dirty linen was stored with clean linen. Staff told us that they received de briefs and support after serious incidents. Staff did not always treat patients with kindness, dignity and respect. Patients had good access to physical healthcare when needed. It offers short periods of rapid assessment, intensive treatment and stabilisation for 10 males within a locked setting. The service did not meet the model of care set out in Right Support, Right Care, Right Culture. This posed a risk to staff and patients if staff were following two different approaches. Risk items were only removed if the patient had informed a staff member and were kept in locked lockers. All our PICU wards are members of NAPICU, and adhere to the NAPICU minimum standards and their admissions criteria. For example, gaps in environmental checks, long term segregation reviews, and medicines management checks were not followed up. Provided and run by: St Andrew's Healthcare. The origins of the General Lunatic Asylum later St Andrews Hospital Northampton . We heard on rare occasions the transport was unavailable leaving both the staff and patient at risk. Fairbairn is a 15 bed ward in purpose-built medium secure service which manages deaf or hearing . Arthur; Trick, Kerith Lloyd Kinsey (1989), St. Andrew's Hospital Northampton: the first 150 years, 1838-1988, . [1] After the election, the composition of the council was: Liberal Democrat 34. Multidisciplinary teams worked well together to provide the planned care. Staff had not maintained patients dignity. 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. 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. 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. This was enhanced with a bleep holder system which reviewed the real time staffing situation in addition to the electronic system. Some senior staff gave examples of learning from incidents for their ward. Staff did not always follow the providers policy and procedures on all wards on the use of enhanced support when observing patients assessed as being at higher risk harm to themselves or others. Seclusion facilities were beingused for de-escalation and time out. We believe there's nowhere better to start your career than St Andrew's Healthcare. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. The complaints process was not always clearly displayed on the wards in formats people can understand. However, one patient told us that staff did not always consider the impact on patients who witnessed the use of restraint. Managers continued with the planned change despite training not being available, due to coronavirus restrictions, and the ward not being sufficiently resourced. There was a high use of regular bank staff and agency staff. Managers dealt effectively with poor practice and the provider had made significant improvement in following policy and procedure to deal with outcomes of investigations. Staff on Spencer North did not know where to find the ligature audit. Carers reported issues with communication and gave examples of having to battle to be listened to and be involved. Nick oversees all areas of architectural design and delivery for the studio with broad experience in residential, commercial, cultural and leisure sectors. Neurobehavioural Rapid Response -We have one male bed available today. Compton is a locked ward for male and female older adult patients. 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 in forensic services did not always document fully what patients had been offered or received. 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 had completed physical health assessments for patients on admission accessed specialist healthcare providers when needed. This ensured learning not just from their own ward but from other services. 13 February 2012. The new ward manager and operational lead had recently started in their posts. Regulation 10 Health and Social care Act 2008 (Regulated Activities) Regulations 2014 Dignity and respect. Four people told us that they liked the food but that the options could be improved. We were concerned that staff were not reporting all safeguarding concerns to the local authority safeguarding team at the forensic and psychiatric intensive care services. People received kind and compassionate care. We're a specialist charity that invests in innovative, patient-centric, holistic care. This was raised on numerous occasions in community meetings with no evidence of any action taken. One ward team did not have access to a specialist dietician, which was required to meet the needs of patients. the service isn't performing as well as it should and we have told the service how it must improve. the service isn't performing as well as it should and we have told the service how it must improve. Also, staff were not always able to take their breaks and support the activities provision. Another patient told us 'they try to give you a healthy diet and we do a lot of exercise groups'. Staff had not always followed the providers policy on patient observations in two services. The provider recently introduced daily safety huddles involving the whole staff team. Leaders had delivered a project to address poor culture found at the last inspection. The policy around such practice was ambiguous and this was confirmed by the records we viewed. However, we reviewed evidence that staff checked quality and temperature before serving food. The wards did not always have enough nurses. Staff were trained in the Mental Capacity Act and the Deprivation of Liberties Safeguards (DoLS). Richmond Watson ward is a low secure inpatient ward that can accommodate up to 12 children and adolescent males with complex mental health needs. Staff told us that rapid tranquillisation medication was administered most days. 7: Sir William Wake 9th Bt 17681846 page . The provider had strengthened the implementation of positive behaviour support planning since the last inspection in June 2016. the service is performing exceptionally well. Leadership development opportunities were available. Bayley ward is a medium secure inpatient ward that can accommodate up to 10 children and adolescent males with learning+ disabilities / autistic spectrum disorder. Regulation 9 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Person-centred care. Doctors and nurses did not complete records for all of the reviews as required by the Mental Health Act code of practice. One carer told us at the moment its great, the social worker is fantastic, and that there were regular updates from staff. Patients had access to independent advocacy services. 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. Staff restricted access to patients wishing to use their bedrooms, and this was not individually risk assessed. We rated it as requires improvement because: Download full inspection report for St Andrew's Healthcare - Womens Service - PDF - (opens in new window), Published