Pathfinder Ashness House

On this page

• 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

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this inspection, the rating has now improved and is good.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We looked at 6 care and treatment records at the service.

Patients had several care plans in place around their different identified needs and staff updated these regularly. We saw examples of staff providing individualised care to patients. Most patients told us they met regularly with their named nurses. However, most of the patients we spoke with told us they were not aware of what a care plan was and didn’t receive a copy of their care plan.

There were no delays in patients’ physical health needs being assessed after admission. Staff used the national early warning score (NEWS) system to detect and respond to clinical deterioration of physical health, standard NEWS 2 process is followed. Patients’ records showed evidence of regular physical health reviews. We saw examples of staff creating individual care plans to meet patient’s physical health needs, such as, the management of diabetes.

Care plans did not consistently include patient views in their own words.

Staffing establishment included a range of specialists to meet the needs of patients, to support them, stabilise symptoms and gain skills and confidence to live successfully in the community. This included a consultant psychiatrist, hospital director, consultant psychologists, assistant psychologist, clinical services manager, registered mental health nurses, registered general nurses, support workers, a chef, housekeepers, an occupational therapist (OT), OT assistant, administrators and building maintenance. Staff were experienced, qualified, and had the necessary skills and knowledge to care for the patient group.

We observed a range of care and treatment interventions tailored to the patient group’s needs. Interventions provided were delivered in line with National Institute for Health and Care Excellence (NICE) guidelines.

Although the service assisted patients to gain skills for community living, they could have offered a wider range to support rehabilitation. The activities offered included cooking activities and self-medication programmes. The service had made some links with community resources to support leisure and vocational rehabilitation for patients.

The service offered opportunities for patients to access leisure and social opportunities every day, including the weekend. Some patients and carers we spoke with fed back that more activity choice was requested. At the time of assessment, the planned activities included time for medication & personal care, 1 to 1 session, personal shopping, coffee outing, group cinema trip and a barbeque. Patients shared they had enjoyed a recent trip to Bournemouth and would like the option of more trips like this if possible.

Patients were encouraged to do their own laundry and had the facilities to do this. An OT Kitchen was accessible from the lounge. It was kept unlocked but staff supervise kettle use due to a patient’s risks with boiling water.

Patients had good access to physical healthcare, with staff arranging specialist care when necessary. During the inspection we saw patients being supported to have their annual health review by the GP. However, one carer shared they had raised a complaint, as they didn’t feel their relative’s physical health was looked after appropriately and a hospital stay was required due to this.

Where the service had identified specific areas of learning needed, they had arranged for this training to be delivered to staff.

Staff worked actively towards successful discharge into the community. From admission they worked with people to support and stabilise someone’s symptoms and gain skills and confidence to successfully in the community.

The service did not have a clear model of care, that was available to staff and patients to help them understand how the service rehabilitated people into the community.

Staff ensured patient safety by sharing key information, risks and plans for the next week during handover. Handovers took place at the beginning of nursing shifts, as well as on weekday mornings for the multidisciplinary team. We observed a multidisciplinary handover meeting and saw detailed patient-led discussions of new risks since the previous meeting and sharing of information that attendees should be aware of.

The service had effective working relationships with teams outside the organisation. We observed a Mental Health Act Tribunal and person-centred discussions took place regarding the patient and their section status amongst the multi-disciplinary attendees. Staff invited care coordinators to ward rounds and other meetings regarding the patient, although they did not always attend.

Staff supported patients to live healthier lives. For example, supporting issues relating to substance misuse and providing tips around sleep hygiene. A carer told us their relative had been prescribed weight loss injections.

Patients could access several groups to support living and learning about a healthy lifestyle. There were 3 weekly sessions timetabled with a fitness coach which took place in the ward lounge and Occupational Therapy (OT) led, weekly cooking groups.

Staff used CAMS monitoring tool (Co-operations, Anti-social behaviour, Mood/Anger, sexually inappropriate behaviour). The service demonstrated a decrease in number of incidents following the implementation of this monitoring tool. Staff also use SMART (specific, measurable, achievable, relevant and time based) within the positive behaviour support plan, to try and help understand patient’s triggers and to ask patients for their views.

Staff took all practical steps to enable patients to make their own decisions about care.

For patients who might have impaired mental capacity, staff assessed and recorded capacity appropriately. We observed within the care records we reviewed, capacity assessment for consent to treatment and capacity assessments regarding finances.