Burton Park

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Improvements had been made to the procedures for gaining lawful consent for care and treatment. Health care, wellbeing and communication needs were assessed and reviewed. Care and treatment was delivered to meet patients individual preferences and in line with legislation and current evidence-based good practice and standards. Staff worked effectively across teams and were motivated to achieve good outcomes which were monitored to ensure they met both clinical expectations and the expectations of patients’ themselves.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients said staff worked together to provide the care they needed, which included input from therapy leads such as the occupational therapist, psychiatrist and psychologist as well as nursing staff. They told us their care and treatment was discussed regularly at the multi-disciplinary meetings held.

Staff described the process of assessment and how each staff team were involved and communicated with each other regarding rehabilitation plans. Risk assessments were developed, and these included physical risks such as personal emergency evacuation plans for staff to follow in the event of an emergency such as a fire. Mobility support needs and use of equipment in a safe way was also recorded. These included promoting the patient’s independence and considering their comfort and preferences.

Staff assessed the physical and mental health of all patients on admission to the hospital. Patients’ had their health, care, wellbeing and communication needs assessed and evaluated. Records were maintained and updated accordingly. Any risks identified were also assessed and risk management plans implemented.

Patients and relatives told us about their goals and aspirations and felt they were being supported to achieve these.

Staff told us they received the training and support required to provide evidence-based care. The multidisciplinary team developed treatment plans for each patient such as positive behaviour support plans to provide long term support. Staff described how weekly interventions based on cognitive behaviour therapy had resulted in significant improvement in the quality of life for a patient who was about to be discharged from the hospital.

Staff had training and professional qualifications relevant to patient’s needs. Regular checks were carried out to ensure they were correctly registered and fit to practice. They were able to describe relevant policies and procedures and evidence-based care and treatment being delivered. The provider had a policy around the management of behaviour displayed when a patient was distressed. This included potential causes of distress; the roles and responsibilities of staff; ongoing risk assessment and documentation requirements. The provider referenced best practice, including Positive and Proactive care: reducing the need for restrictive interventions (DH 2014), and the short-term management of violence and aggression in mental health (NICE 2015). A physical health nurse was employed to lead the relationship with patients GP’s and to coordinate, hospital appointments and treatments.

Patients had positive relationships with staff across the different teams.

Staff were supportive of each other and communication was good. Every team and department was patient focused. A visiting advocate told us staff attitude was positive and communication between teams was good. Catering and housekeeping staff told us communication with hospital staff had improved and was good.

We attended the daily ‘flash team meeting’. Staff from each team attended and communicated any changes risks or planned activities for the day. Communication was positive and effective. Each team were motivated to achieve safety and wellbeing for patients and understood their roles and responsibilities.

All staff attended training about safeguarding and restrictive interventions. A range of daily, weekly and monthly meetings took place to support effective communication between teams.

A relative told us the service took action in regard to physical health issues and promoted a healthy diet. Another relative told us access to healthcare such as doctors was good.

Staff knew and understood patients’ individual needs and health aspirations and described how they supported them to achieve these.

Staff promoted and supported patients with healthy eating, smoking cessation and exercise. Staff encouraged patients to keep hydrated, and patients were also encouraged to go outside for fresh air and / or activities as and when possible. Patients had access to healthcare support and staff contacted emergency services when required to.

Relatives told us they were involved and updated about care plans , changes or interventions.

Staff described how therapy and care planning had improved patients’ outcomes and increased independence and abilities. It was acknowledged that some patients were ready for discharge and had reached their rehabilitation potential but were experiencing delays in securing the next placement or community support.

The psychiatrist, therapy leads, and nurses worked with patients to set goals, and these were monitored and evaluated during multidisciplinary team (MDT) meetings held monthly. Patients’ care and treatment was continuously monitored. Outcomes were positive and consistent and met both clinical expectations and the expectations of patients.

Relatives told us staff used the least restrictive methods when managing risk.

Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.

Staff supported people in the least restrictive way.

Patients were only detained or had their liberty deprived in a lawful way following the application of safe requirements and involvement of appropriate professionals including second opinion doctors. Staff understood the importance of ensuring patients needed to understand what they were consenting too around their care and treatment. Within clinical notes it was evident that staff had taken the patient’s views and wishes into account, where possible, when planning their care. Staff made every effort to relay information to individual patients in a way they would understand. Where required, the staff team had made decisions in line with the requirements of the Mental Capacity Act (2005). This had included recording discussions with family members or carers, where appropriate. Staff used the least restrictions where possible when anticipating, de-escalating and managing distressed behaviour or emotional reaction. They used restraint only after attempts at de-escalation had failed.