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Archived: Assessment and Treatment Unit

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All reports

Inspection report

Date of Inspection: 22, 23 November 2011
Date of Publication: 24 January 2012
Learning Disabilities Reviews Report published 24 January 2012 PDF

People should be protected from abuse and staff should respect their human rights (outcome 7)

Meeting this standard

We checked that people who use this service

  • Are protected from abuse, or the risk of abuse, and their human rights are respected and upheld.

How this check was done

Our judgement

Systems to prevent and identify abuse were robust. Patients' concerns were listened to and appropriately reported to the local safeguarding team. Incident reports were completed appropriately with detailed evidence of review and learning from the incident. Patients who were subjected to restrictions had been appropriately assessed in line with legislation and good practice guidelines. This meant that patients were protected from abuse, or the risk of abuse and their human rights were respected and upheld.

User experience

We spoke with two patients and asked them who they would go to if they needed help or felt unsafe. The patient gave us the names of several staff. Another patient told us, they would speak to their relatives.

We spoke with four relatives and carers during the inspection. They told us, patients felt safe at the unit. One relative said, "Staff listen to patients" and thought staff would take patients' and relatives' concerns seriously and act upon them. Another relative told us, "I feel staff are supporting (patient) very well" and staff "Treat (patient) with respect". None of the relatives raised any concerns about how staff supported the patients.

From our observations of staff interactions with patients, we found staff were respectful of patients, offered a range of choices to patients and were able to engage with individuals appropriately to meet their specific needs. The relationships between staff and patients were informal and it was clear staff knew patients well.

Other evidence

Preventing abuse

The service manager told us that systems were in place to prevent abuse. They provided a copy of the local South Yorkshire adult safeguarding policy and procedures as well as the trusts own procedures. We were told these were stored in the ward staff office and were available to all staff at all times. We saw evidence in the staff office of a safeguarding flowchart for staff to follow.

We spoke to three members of staff who were all aware of the local area's safeguarding policy and procedures. They were able to tell us the correct procedures to follow if they suspected abuse or if abuse had been disclosed to them. A nurse told us they had used the procedures in practice.

Staff interviewed confirmed they had completed adult safeguarding training. We saw evidence that safeguarding update training had been planned for the new year for a number of staff. The service manager told us that he was the safeguarding lead for the service.

Staff were aware of whistle-blowing procedures. They were able to explain to us what they would do if they needed to use these to raise concerns. The service manager told us the trust had an up to date whistle-blowing policy and system in place. They also told us they have a 'grumble box', for staff, to pass on any issues they are not happy with and we saw this was sited in the unit.

Patients had access to complaints forms and leaflets, which had been devised in pictorial and easy read formats, to enable them to make complaints independently. These were easily accessible to all patients and relatives and were located in communal areas of the unit.

We spoke to the consultant psychiatrist about how they implemented the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) within the service. They showed us evidence of assessments they had carried out with patients, under the MCA. They also confirmed to us they only used DoLS, when it was in the best interests of the patient and in accordance with the MCA.

The staff showed us a training plan they used for patients in order to ensure patients understand what abuse is, how to protect themselves and to speak up if they had any concerns. This was called, 'Protect yourself and others'. We were told how one patient had been involved in delivering this group work to other patients. Staff told us that during the Rainbow Group, they discussed with patients how the staff could best support them when challenging incidents occurred. We saw evidence of this in the minutes of the Rainbow Group's meeting minutes. The minutes were devised using pictures and easy read formats. This was positive and these initiatives demonstrated an inclusive and empowering approach towards protecting patients from abuse or the risk of abuse.

Responding to allegations of abuse

We saw the service was proactive in referring safeguarding concerns. We were shown recorded evidence of the safeguarding referrals made from the service over the last year. They had been referred through the local area safeguarding team, which is independent of the trust. This demonstrated that patients concerns were listened to and staff were robust in their approach to dealing with allegations or incidents, which could constitute abuse. Most of the incidents had not led on to investigations under the safeguarding procedures, as they had not met the threshold and so had been dealt with by the nursing team by means of care plans and risk assessments. This approach demonstrated the staff team were open and transparent in the way they managed concerns and or allegations of abuse.

Using restraint

The staff told us they have access to the, Alternative to restraints team which is a community team of professionals who advise staff how to support patients who may present challenges and other complex needs. They told us the team offers a range of advice and guidance to ensure that restraint was only used as a last resort.

Staff told us restraint was used within the service. T