Park Lodge

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 were actively involved in their care and treatment plans and staff knew their individual needs well. People’s wishes and preferences were documented within their care plan which was written in a format that was accessible and individual to the patient’s needs. Staff completed comprehensive assessments with input from a range of professionals within the multi-disciplinary team and developed care plans that were evidence based and in line with good practice around eating disorders. Outcomes were monitored and reviewed on a regular basis by relevant members of the team to ensure continuous improvement and development. Staff encouraged and supported people to live healthier lives by assessing, monitoring and reviewing physical health needs and promoting a healthy lifestyle. Staff understood their roles and responsibilities under the Mental Health Act, Mental Health Act Code of Practice and the Mental Capacity Act 2005. Staff assessed and recorded capacity clearly for young people who might have impaired mental capacity.

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.

People said they were involved in their care and treatment plans and staff knew their individual needs well. They said they knew what their goals were and what it meant to achieve them. Families told us that they were involved in the care planning process from the point of admission.

Staff demonstrated a strong understanding of the importance of involving people when assessing their needs. The service screened referrals as part of the multi -disciplinary team to assess needs and identify how the service could offer support. On admission to the service, a care plan was developed, and needs were assessed using a range of tools. Staff said they supported young people to ensure they could communicate their care needs and helped them develop communication passports. Speech and language therapists helped young people whose communication needs required extra attention. Carers, friends and families could attend a carers forum every couple to months to help facilitate informal feedback and help them learn and understand more about the service.

Staff assessed the physical and mental health of all young people on admission. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Care plans reflected young people's assessed needs, and were personalised, holistic and recovery oriented. Staff completed a comprehensive mental health assessment of each patient either on admission or soon after. We reviewed 6 care records. The assessment included all historical and known risk factors and documented the young person’s current presentation and a summary of needs. Assessments and monitoring took place alongside mental health assessments and prior to any care and treatment. Staff completed and recorded all routine physical health monitoring in line with the young person's needs. A range of appropriate assessments were used within each plan, and these were updated frequently to measure outcomes and progress.

Young people said they were involved in their care and treatment plans and staff knew their individual needs well. They said the service was not restrictive and they had freedom.

Staff were well informed about best practice. Staff were knowledgeable about young people's needs and told us they developed this knowledge through regular reflective practice and training development days. Members of the multi-disciplinary team were actively involved in supporting the development of staff and regularly held evidence-based practice sessions to help inform and raise awareness on how to support the needs of young people.

Staff provided a range of treatment and care for young people based on national guidance and best practice. Staff followed National Institute for Health and Care Excellence (NICE) guidance for eating disorders and medical emergencies in eating disorders (MEED) Guidance on recognition and management (Royal College of Psychiatrists). Policies and procedures reflected this guidance. Staff assessed and met young people’s needs for specialist nutrition and hydration. An in-house dietitian assessed young people’s dietary intake and weight restoration and developed nutrition and hydration management plans with young people and the multi-disciplinary team. The service had a clear protocol on how to manage nasogastric feeding and there was evidence of a robust multidisciplinary approach to treatment. Young people had access to regular psychological interventions and occupational therapy sessions and art therapy. Occupational therapy offered a variety of recovery-based activities. Young people were involved in planning activities relevant to their goals. These included activities that focused on daily living skills, healthy lifestyles and social skills. We were told about one young person who attended a local dog grooming parlour to build social skills and gain work experience. The service offered young people evidence-based family interventions including 1-1 support for parents and relatives.

Young people told us they were supported by the staff team and attended meetings with a range of different professionals involved in their care. One parent said all members of the team worked together to support them and engaged positively with their child. They said this support was consistent with all staff members including support workers, doctors and the manager.

Staff from different disciplines worked together as a team to benefit young people. They attended regular multidisciplinary team meetings and daily risk meetings to plan, monitor and make decisions on care and treatment plans. Young people had access to other healthcare specialists such as district nurses, GPs and dental services. Some staff told us that as the service was new and the multi disciplinary team was still being established some staff had been stretched, however leaders were in the process of recruiting key staff to offer additional support such as a psychology assistant and an occupational therapy assistant. Staff told us the provider welcomed feedback and they felt like their opinions were valued.

We observed good quality interactions between staff and young people. Staff were always present and available for young people offering a range of activities on the ward. Managers, members of the multidisciplinary team and administration leads attended a morning risk meeting each day. A standard format reviewed items that could impact on patient safety; for example, staffing, incidents, environmental concerns, safeguarding, specific patient risks including nursing observations and physical health concerns. We observed staff within these meetings effectively communicating with each other and sharing knowledge about current risk, patient care and treatment. During these meetings we observed staff taking the opportunity to discuss and celebrate the progress and achievements of young people.

Staff had access to support and information needed to provide good quality person centred care. Staff worked well with external partners involved with young people. External partners were invited to treatment reviews to enable continuity of care and support for discharge. We reviewed handover meeting notes. Staff effectively communicated young people’s presentation, risk and concerns while identifying and allocating actions to be taken. Staff were supported to speak up through a range of forums including staff meetings, regular surveys and could give instant feedback through the 'how is your day?" QR code.

Young people told us their health needs were met. They were supported appropriately during mealtimes and had access to a range of activities consistent with a healthy lifestyle such as walks and gym access. One parent told us staff within the service provided additional support when needed for their child to access primary care. Adjustments were made to ensure treatment could continue effectively when they returned to the hospital.

Staff understood the importance of ensuring people's physical health needs were met. Staff had appropriate training to ensure that they were able to effectively assess and monitor physical health needs.

People's physical health needs were assessed and documented within care plans. These were routinely monitored and reviewed. Care plans showed that people were encouraged to make healthier choice and promoted a healthier lifestyle. These plans were consistent with eating disorder recovery guidance.

Young people were supported by the staff team, and they attended meetings with a range of different professionals involved in their care to discuss their progress.

Staff and managers used outcome measures and had completed an audit to review success. Managers gave examples of successful patient outcomes which they had presented at governance meetings and at a recent conference.

Care plans had a range of appropriate assessments which were updated frequently to measure outcomes and progress. The provider used the Children's Global Assessment Scale (CGAS) and the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). We reviewed an audit report of outcome measures which showed that the provider was consistently and effectively implementing outcome measure and were reviewing the care and treatment of young people using recommended tools.

Young people told us they knew their rights and how to appeal under the Mental Health Act if they needed to. People were aware of how to access an independent advocate and told us they regularly visited the service.

Staff ensured young people understood their rights under the Mental Health Act and repeated these regularly to them. Staff knew why consent was important and this was recorded in patient care records.

Records showed that staff gave young people all possible support to make specific decisions for themselves before deciding they did not have the capacity to do so. Staff assessed and recorded capacity to consent clearly each time a patient needed to make an important decision. When staff assessed young people as not having capacity, they made decisions in the best interest of young people and considered the patient’s wishes, feelings, culture and history.

Care plans showed detailed, appropriate and relevant capacity assessments and best interests. There was a clear rationale for decisions made and a strong involvement of the young person and family. Staff had a good working knowledge of the Mental Health Act, Mental Capacity Act, Deprivation of Liberty Safeguards and Gillick Competence. At the time of the inspection, 100% of eligible staff had undertaken mandatory training on these legal frameworks.