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Archived: York & Selby Early Intervention Service Good

Reports


Inspection carried out on 10 February 2017

During an inspection to make sure that the improvements required had been made

We rated the York and Selby Early Intervention Service as good overall because:

Following our inspection in June 2016, we rated the services as good for responsive and caring. Since that inspection, we have received no information that would cause us to re-inspect these key questions or change the ratings. During this inspection, we found that the service had addressed the issues that had caused us to rate safe, effective and well led as requires improvement following the June 2016 inspection. However, the service had outstanding issues in the effective domain regarding training in the Mental Health Act.

The service was now meeting Regulations 12, 15, 17 and 18 of the Health and Social Care Act (Regulated Activities) Regulations 2014.

  • We felt that the service was safe because medicines management practice had improved. The provider had also made changes to the building to make it safer for service users and staff. Staff had received training in resuscitation and in the prevention and management of violence and aggression. The learning of lessons from incidents had improved.
  • We felt that the service was effective because the provider had made clear policies and guidance available to staff regarding the Mental Health Act and Mental Capacity Act. The provider had made training in both Acts mandatory for staff. The involvement of advocacy services had increased.
  • We felt that the service was well led because the service manager had taken action to rectify the concerns raised from the last inspection and made improvements. The service had a robust governance system in place relating to policies and procedures which had been updated since our last visit. The service had formed a clearer governance and reporting structure with the NHS trust it contracted with.

Inspection carried out on 29 and 30 June 2016

During a routine inspection

We rated this service as requires improvement because:

  • Staff training did not include basic life support, breakaway techniques to avoid conflict, the Mental Capacity Act (2005) and the Mental Health Act (1983). This meant that staff could not provide effective care if, for example, patients needed emergency first aid.
  • Staff did not always record that they had assessed patients’ capacity, when there was an indication (such as a learning disability) that they lacked capacity to make specific decisions, for example, agreeing to their care and treatment.
  • People with mobility difficulties could not access all parts of the building, the service was provided in a building over three floors with no lift.
  • Patients’ safety, dignity and comfort was compromised because the waiting area was also used as the staff kitchen. Also, the building had only one toilet that was used by staff, patients and other visitors. There were some areas of the building, such as the kitchen and toilet, that put patients at risk because they contained dangerous items such as sharps (knives and forks) and boiling water. The service had not included these in the risk register to highlight the need for action.
  • Arrangements for managing the service were complex between Community Links and the NHS trust, which contracted it. Senior managers across both providers did not communicate with each other effectively.

  • The service had no arrangements for checking and auditing medication kept on site, and keeping it at the right temperature. This increases the risk that staff might administer medication incorrectly.
  • The service was not investigating serious incidents so enable staff to learn lessons and improve practice.

However:

  • The service was managed well on a local level, despite issues at provider level. Staff saw patients within two weeks of referral and there was no waiting list.
  • The service was focused on development, and making use of innovative practice and new models of working.
  • We saw excellent examples of compassionate and responsive care. Patients and carers that we spoke with made positive comments about their experience of the service.

Inspection carried out on 28 November 2013

During a routine inspection

People told us they were able to consent to their care and treatment. They told us the service was able to provide support to them and/or their relatives. They said they were fully involved in decisions about their care. Relatives told us that the support offered to families was good.

People had access to a range of professionals and their views and opinions were documented within their care records. Care records were detailed and based on National Institute for Clinical Excellence (NICE) guidance. People told us they had access to emergency support. They were positive about the service they received.

The service had systems in place which helped to safeguard people. They followed child and adult safeguarding procedures to protect people.

We were told the premises were not always suitable. There were no staff recreation facilities for staff to take a break and this had to be done in the waiting area where people were sat. There were limited meeting facilities and only one shared WC in the building.

We were told that there were sufficient staff to meet people's needs. The staff we spoke with confirmed they had good training opportunities.

The service had procedures in place to manage complaints. They held regular meetings with people so that their views and opinions could be shared and acted upon.

Inspection carried out on 11 December 2012

During a routine inspection

People told us that they were able to consent to their care and treatment. The service provides support to people and to their relatives. All of the people we spoke with said that they were fully involved in decisions about their care. Relatives told us that the support offered to families was good.

People had access to a range of professionals and their views and opinions were documented within their care records. Care records were detailed and based on National Institute for Clinical Excellence (NICE) guidance. People told us that they had access to emergency support. They were positive about the service they received.

The service had systems in place which helped to safeguard people. They followed child and adult safeguarding procedures to protect people.

We were told that the premises were not always suitable. There were no staff recreation facilities for staff to take a break or to make lunch or a drink this had to be done in the waiting area where people were sat. There were limited meeting facilities and only one shared WC in the building. We were told that meetings could take place away from the premises which meant that people could have support in a venue of their choice.

Staff received good training opportunities. They received regular supervision and support to help them in their roles.

The service had procedures in place to manage complaints. They held regular meetings with people so that their views and opinions could be shared and acted upon.