Emerald Place Clinic

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

Staff supported the development of care plans that were recovery orientated and individualised. Young people had access to a range of therapeutic activities and interventions to meet their needs. Young people provided feedback to their ward rounds, and this feedback was used as the agenda for their review. Young people were encouraged to share their views

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Young people we spoke to reported that staff were supportive and treated them with dignity and respect on the ward. We observed staff knocking on doors before entering patient bedrooms.

Staff told us that when a young person was on enhanced observations, they tried to ensure that same gender staff conduct the observations when the young person is utilising their shower.

Four of the six care records that we reviewed had care plans for the use of therapeutic restraint techniques.

One young person told us that they could not always access their room when they wanted to as it was difficult to find a member of staff. The young person also reported that staff did not always do things that helped them. Young people were able to access their rooms during the day and were given bands that allow them to access their rooms when they wished to do so unless their access was restricted for clinical reasons.

Feedback from surveys for young people after they arrive on the ward highlighted that staff members always introduced themselves and others and showed young people around the ward.

The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

We found that young people’s needs and preferences were reflected in their care and treatment. We saw evidence of how young people wished for their needs to be met. For example, we found evidence of family members contributing to the care plan with their observations about the young person.

We found evidence of leave being planned for personalised activities. For example, one young person requested to have leave to go plane spotting. The leave was granted after a collaborative discussion with the young person and the MDT.

Young people had copies of their Positive Behaviour Support care plans in their room, printed in colour and in a large format. The ward also had information in easy read format and young people had the option of having their care plan given to them in an easy read format.

Staff reported that young people can have a choice to have curtains in their room or if they wished to have magnetic shower guards for their shower. We observed that some young people had personalised their room with their own bedding and items from home.

We observed that one young person was encouraged to use visual cards to let staff know how they were feeling at that time and staff would also use the visual cards to help plan and structure the say for that young person.

The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Young people had access to a range of activities on the ward. However, some young people reported that the activities were repetitive.

Staff gave examples of activities that were planned for young people in the community, for example, trips to the local town centre to do bowling and adjustments were made to be more inclusive.

A community meeting was held weekly, which was attended by various members of the MDT. The minutes of the meeting were shared with the young people and visible in the communal areas. The ward also had a ‘You said, we did’ display board which was regularly updated.

Family members and carers reported that they were involved in the young person’s care and were invited to join multidisciplinary team meetings where they could receive feedback on care and share their views. Attendance could be virtual if they are unable to attend in person.

Family members reported that they are encouraged to visit the unit and visits take place in the family room at the front of the building.

Young people and their families were encouraged to have choice in their care and treatment. For example, we found that one young person was given a choice regarding which medication they preferred to take.

The Consultant Psychiatrist for the ward was happy to speak with family members outside of ward round times as they recognised that family members and carers may not always be able to attend at ward round times.

We observed information boards on the walls with various posters, including how to access advocacy, therapies that were available, helpline numbers, how to make complaints and ward specific activities.

Young people had access to psychology, occupational therapy and a dietician. The service reported that opticians can visit as required.

Young people had meal choices that they can choose daily. They can also have a choice of snacks on the ward.

The evidence showed a good standard. The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Most young people reported that staff were visible on the ward and were able to meet most of their needs immediately. However, some young people reported that staff could not always meet their needs due to them being busy on the ward.

Staff demonstrated a good understanding of young people’s individual needs and understood restrictive practices. The service had a restrictive practice focus group that met monthly and reviewed restrictive practices on the ward. An area of focus for the group was looking at the use of enhanced observations on the ward and consideration was given to the level of observations that was undertaken when a young person is first admitted.

The evidence showed some shortfalls. The service did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

During the inspection, we spoke with a number of staff from various disciplines, and some staff spoke with inspectors following the site visit.

Overall, staff spoke positively about their experience working at the service and reported feeling valued and respected. Many staff reported feeling proud to work for the service. However, some staff reported that they felt they did not feel valued and did not always feel able to do their job as they would like to. Some staff reported that they did not get the support that they felt that they needed. We did not observe this to have a negative impact on care during the inspection.

Managers ensured that staff had regular supervision and appraisals. Staff had access to support for their own wellbeing, and this was confirmed with staff that we spoke with on site.

Staff have access to a Freedom to Speak Up Guardian which is promoted on the ward and staff were aware of how to access this.

Managers told us that they were visible to the team. Managers would often stay late or come in early so that they were visible to staff working out of hours. Managers shared examples of staff support and engagement activities that have been introduced to improve wellbeing, for example, “Wear it Wednesdays”, (an initiative where staff will wear matching colours) and Star Awards. Staff at the service told us that they have a staff room where they can take breaks and that there are lots of opportunities for training. Staff stated that they had a carpool to support staff to be able to get to work and get home. Staff stated that they have had team building days and the service arranged for staff to have massages.