Becton Centre for Children and Young People

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 good. At this assessment the rating has remained good. Staff assessed the physical and mental health of all patients on admission. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for patients based on national guidance and best practice. The ward team included or had access to the full range of specialists required to meet the needs of patients on the lodges. Staff from different disciplines worked together as a team to benefit patients. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 8 care records during the assessment. All records reviewed showed evidence of comprehensive mental health assessments in a timely manner. All newly admitted patients also received a physical health review. Each patient was seen on a regular basis by a paediatrician from the Trust.

Patient’s care plans included their personal preferences and key information on their preferred method of communication. Care plans also identified physical health needs and physical health monitoring such as the use of national early warning score charts, height and weight charts, nutritional needs, restrictive interventions and expected date of discharge.

The service provided a range of therapies for patients including psychological therapy, art therapy, occupational therapy, speech therapy and education. The service also provided family therapy for the patients and their families.

We spoke with 7 carers for this assessment, each carer felt involved in their relatives care and treatment. Carers received daily updates and were invited to meetings about the care and treatment including multidisciplinary meetings. We observed 2 multidisciplinary meetings during the assessment and we saw carers and patients at the centre of the conversation.

Discharge planning was discussed early on in the patient’s journey, there were numerous patients having home leave and getting ready for discharge.

The lodges had schedules of activities and events to engage patients along with access to education.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well

The service provided a range of care and treatment interventions suitable for the patient group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence.

A paediatrician from within the Trust attended the lodges regularly to assess the physical health of patients. The service could access specialist physical healthcare if required.

The service had a schedule of audits that staff participated in, feedback from audits was shared with staff through team meetings, email and supervision.

The service had access to a range of professionals including psychologists, speech and language therapists, art therapists, and occupational therapists. The service worked closely with care co-ordinators and the community child and adolescent mental health team.

Staff were offered a variety of supervision including a yearly appraisal, clinical supervision and management supervision. Compliance with the yearly appraisal was above 90% at the time of our assessment. Clinical supervision was above 60% across all lodges. Management supervision compliance was lower with the highest at 43% for Emerald lodge and the lowest at 25% for the multidisciplinary team. The deputy chief nurse for the service was addressing the shortfalls in supervision with a new supervision policy; this was in draft at the time of our assessment.

Mental Health Act

Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.

Staff had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The service had weekly multidisciplinary meetings, we observed 2 meetings during our assessment. These meetings were effective, holistic and involved the patients and the carers.

The service had handovers at the start of each shift to ensure that information about patients was handed over effectively.

The service worked closely with external organisations such as care-coordinators. Staff advised that any organisation involved in the care and treatment of the patient would be invited to key meetings and included in discharge planning.

Quality Statement Score:

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff at the service supported patients to live healthier lives, staff ensured that healthy living advice was tailored to the individual patient as they had numerous patients with eating disorders.

The patients had access to physical activities at the sports hall on site and leave to attend external venues. Staff advised that patients engaged in football and therapeutic gardening, some activities were organised through the onsite school.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The service used a variety of outcome measures such as health of the nation outcome scales for children and adolescents, the children’s global assessment scale and revised children anxiety and depression scale.

The service utilised technology to support patients effectively, all patient observations were entered directly on to smart devices. Staff could use these devices to access risk assessments and care plans also.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

We reviewed 8 care records during this assessment, all records showed staff assessed and recorded capacity to consent appropriately. Section 132 rights were discussed with patents.

Information about advocacy services was displayed on the lodges for patients. Staff informed us that the advocates visited the lodges on a weekly basis.