Emerald Place Clinic

We rated responsive as requires improvement. We assessed six quality statements.



 



Young people were subject to some blanket restrictions which were not inline with their assessed risk and care plans, consequently young people did not have access to fresh air and physical exercise as they should. A series of previous serious incidents and the level of scrutiny led staff to take an approach which did not always put the young person’s needs at the centre of care. Whilst staff were not working more consistently in maintaining boundaries work was still needed to ensure practice was embedded. This was a breach of Regulations 9, Person Centred Care.



 



Young people were restrained in their room, which they didn’t like as this was their safe space. Staff did not always escort them to a quiet room, with equipment that could support safe restraint and was covered by CCTV that could be reviewed to support learning and good practice. This was a breach of Regulation 12, Safe care and Treatment.



 



Young people had limited access to the community. As part of the plan to bring about improvements NHSE and the Provider Collaborative were looking to transfer or discharge young people. Neither young people or staff felt this would be in their best interest. This was a breach of Regulation 9, Person Centred Care



 



Medicines were administered through a hatch in the clinic room door. Young people had to enter an airlock accompanied by staff. Young people queued outside the clinic room to receive their medicines rather than receive them in a more person-centred approach.



 



Each young person had four care plans, alongside positive behaviour support plans, risk assessments and other documentation that needed to be completed. It was difficult to see how staff would keep up with the level of review and recording once the unit was able to admit more young people. Parents and carers told us they would like to be provided with more opportunities to feedback and more information about the care of their child.



 



However,



Young people did not experience discrimination or inequality. Young people with additional needs did not feel they were disadvantaged. This included making reasonable adjustments for people with disabilities, those with communication difficulties or cognitive impairment. Young people were listened to when they wanted to share their experience and were provided with information and support to access information they needed. Young people were supported and encouraged to plan for life outside of hospital, the approach to care was recovery oriented and supported young people to develop skills and coping strategies they could use on discharge. NHSE and the Provider Collaborative told us they no longer had significant concerns about the safety of young people and recognised that the service was working hard to make improvements.