17 January 2024
During an inspection looking at part of the service
Our rating of this service stayed the same. We rated it as good because:
- The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices and followed good practice with respect to safeguarding.
- Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
- The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
- Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
- Staff planned and managed discharge well and liaised well with services that could provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason.
- The service was well led and the governance processes ensured that ward procedures ran smoothly.
However:
- Medicines were not always ordered in a timely way.
- Staff did not fully understand and discharge their roles and responsibilities under the Mental Capacity Act 2005. They were unsure of good practice with respect to young people’s competency and capacity to consent to or refuse treatment.
- Internal meetings did not have set agendas and it was unclear whether previous actions had been completed.
- Children felt that some agency staff and some new staff were not always keen to engage with them and were too hasty to apply restraint before fully utilising de-escalation techniques.
- The service recently discharged a child to a service that was not fully OFSTED registered.
- The service lacked adequate transport so that children could access community activities easily.