St Andrew's Healthcare - Birmingham Also known as 1-121538294

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

People had mixed feedback about being involved in the assessment of their needs. Some people were involved but others said they had limited involvement.

Staff assessed people’s needs, and this included their mental and physical health needs.

Some staff had limited awareness of how they delivered evidence-based practice however there was evidence that Safewards techniques were used on the wards. Safewards is a model used that deals with conflict and containment and how best to minimise their use.

There were processes to share information about people’s needs and risks.

People had access to a GP on site who supported them to meet their physical health needs.

Information was not always shared effectively to nursing staff by the multidisciplinary team about monitoring the outcomes of people’s treatment.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People provided mixed feedback in their involvement in the assessment of their needs. Although people were invited to attend weekly care plan update meetings, some people said they took less involvement as they did not feel listened to. One person told us they had not seen their care plan for months even though they had asked about it, they felt staff made the decisions about their care and treatment.

Although they were invited to care plan update meetings and Care Programme Approach meetings, carers of people we spoke with told us they did not feel involved in their relative’s care plans.

Staff told us they assessed people’s needs through spending time talking with them and in their weekly ward rounds with their multidisciplinary team. They invited people’s carers to these if the person consented to this.

Staff told us they supported people where needed to maximise their involvement in their assessment, engaging them in 1 to 1 conversation, using activities and escorted leave to have these conversations.

Records showed that assessments included people’s physical health as well as their mental health and communication needs.

People’s needs were assessed during periods when they were in seclusion. Seclusion reviews were robust, well recorded and in line with requirements.

People were not aware if their nutritional needs were included in their care planning. Some people told us they were not encouraged to eat a healthy diet and were not made aware of how they could choose healthy options. However, the provider demonstrated they ensure people's physical health is robustly monitored and incorporates people's needs and wishes. They showed us nutritional screening scores were completed for all people at the hospital. These allowed referral to dietitians and dietitian interventions were care planned and monitored. People had access to a dietitian and were offered a choice of healthy food options, and meals, provided by the onsite kitchen. Trays of fruit were delivered to each ward twice daily . There was a 'Food forum' held as part of the October Patient Council Meeting.

Most staff told us they were updated on evidence-based practice and guidance through training. They said the Clinical Director organised training sessions. However, some staff on Lifford and Northfield wards were less able to articulate this.

Psychologists and occupational therapists provided therapy groups on the wards in line with evidence-based practice.

There was evidence that all wards had a Clinical Treatment Model that outlined how they delivered evidence-based care and treatment as well as evidence that the use of ‘Safewards’ was promoted on the wards. There were posters on walls promoting the use of ‘Safewards’ interventions and some staff showed an understanding of how to use interventions to improve the way they delivered care. Records showed that people’s physical health needs were met in line with good practice standards.

Although all staff received a handover at the start of each shift, some people told us they did not think that enough information about their needs and risks was passed to bank and agency staff. They said some bank and agency staff did not know how to support them.

People and their relatives did not always feel involved in the discharge planning process with their community teams.

Staff told us they shared information about people’s needs at handovers at the beginning and end of each shift. They said this was enough information to assess, plan and deliver people’s care, treatment and support. They also used email to share information and where needed the nurses’ passed information on in people’s meetings with their multidisciplinary team.

Staff had access to the information they needed to appropriately assess, plan and deliver people’s care and treatment. However, staff said they did not always have time to read people’s care plans.

We observed the handover between the day and night shift on Speedwell and Edgbaston wards. Staff shared sufficient information at the handover on Speedwell ward about people’s needs and risks.

There was a handover at the beginning of each shift to share information about people’s needs and risks. This included allocation of tasks such as therapeutic observations. There were gaps in people’s therapeutic observation records due to technical delays. This meant that the systems were not effective in ensuring continuity of care.

People gave us mixed feedback about being supported to live healthier lives. Some people told us that staff did not give them second helpings of food at mealtimes because they said they would put on weight. However, this meant that some people chose to buy unhealthy snacks which they felt was worse. They said they felt staff did not encourage them to make healthy food choices. People said they had fruit offered at lunchtimes, but it was not freely available as a snack. Fruit was delivered to the wards twice daily for people to snack on and the provider had healthy eating support systems in place. One person said that staff were trying to help them to reduce their sugar intake.

People told us there was a physio exercise group they could attend if they had a referral from the GP. People had access to GP appointments on site and staff escorted them to these.

People’s records showed they were involved in the physio exercise group to help them to increase their physical exercise. However, there was not always staff available or trained to support people to use the gym onsite. People’s records showed that smoking cessation was offered where appropriate. People’s records showed that their physical health needs were monitored, and appropriate referrals made to the GP or specialists where needed.

The multidisciplinary teams on the wards told us about the outcome measures they used to review people’s progress and outcomes of their care and treatment. However, most nursing staff were unaware of outcomes measures in use. The provider demonstrated that outcome measures are displayed through the ward board which the nursing staff access daily. The provider showed us their governance process, from ward to board that included several outcomes measures generic and specific to the service, that are monitored and used in clinical decision making.

Recognised outcome measures to monitor people’s mental and physical health and their risks were used. These were reviewed and updated in people’s reviews with their multidisciplinary teams. The provider demonstrated that outcome measures are displayed through the ward board which the nursing staff access daily. The provider gave showed us their governance process, from ward to board that included several outcomes measures generic and specific to the service, that are monitored and used in clinical decision making.

People gave mixed feedback about their understanding of their rights around consent to their care and treatment. Some people were not aware of their rights however others told us they were aware, and staff informed them of these in a way they understood.

People’s records clearly evidenced their consent to be included in their care planning, or not if they choose not to. People’s records included an assessment of their capacity to consent to their care and treatment and how they would need to be supported if they did not have the capacity to consent.

Although the care plans we reviewed did not contain information about intervals for informing them of their rights under the Mental Health Act there were clinical records to support each person's rights had been given and the provider had access to dashboards which supported the timely completion of this.