Providence House and Moira House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed all the quality statements from this key question. the rating from the last inspection, was good. Our rating for this key question is good. We found there was good therapeutic activities taking place. Care plans were always clear as to how the young people were involved with their care planning and kept informed and up to date. Care plans reflected identified needs for young people and how staff should support them with these.

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 interviewed the young people, all of whom were positive about the politeness and respectfulness of staff. They spoke positively about staff who they worked with. Staff were described as supportive, kind, respectful and caring. Young people told us staff were compassionate and listened to them, and they could receive emotional support and advice. This was reflected in how occupational therapists designed sessions and how young people were actively involved in creating their own care plan.

Staff on observation duty could tell us about the risks and how they would engage with young people if they became agitated. Staff felt there were enough staff and this allowed staff to engage positively with the young people, for example nurses told us they always had enough time to conduct one to one sessions. Managers had responded to the previous inspection report and had made changes to staff teams and changed staff rotas to ensure worked with different staff.

We saw regular communication with care co-ordinators, and they were consulted on changes to care plans. The service had agreed with care co-ordinator’s that the care plans should represent as closely as possible a parental approach to care so initiatives included pocket money.

Staff were always present in communal areas and intervened when young people were acting in ways that caused distress to others. We also observed positive interactions with young people including staff sitting and chatting with the young people and engaging in activities and saw staff who had a good rapport with the young people.

Young people told us they that staff supported and accommodated their individual needs be they diet or sexual orientation and that these were accurately reflected in their care plans. There was also evidence that young people had been able to develop their own identity be that through their personal appearance or social acceptance of their backgrounds. The service could provide support with language issues as well as links to substance misuse or gender services.

Staff told us how they supported young people with protected characteristics. Meals were available to meet dietary and cultural requirements such as vegetarian and halal food. Staff made adjustments for young people who were fasting for Ramadan. Staff gave examples of how they sourced information in the young persons own language when required to do so. Staff told us they had received training on autism and understood how a young person might struggle with bright lights. Staff also gave examples of how they used personalised approaches used to help young people de-escalate. For example, the use of sensory items to help a young person who had become agitated.

We also observed positive interactions. We observed staff intervening when young people were becoming agitated and engaging young people in activities such as preparing food, board games and general conversation about future plans and what the young people wanted to do when they left the wards on leave.

Care records showed that young people were involved in care plans and risk assessments. Staff recognised each young person’s cultural needs in their care plans. There were community meetings on a weekly basis, where staff and the young people discussed issues on each ward. Staff received equality diversity and human rights training. Equality, diversity and human rights was considered within governance meetings and patients had access to advocacy.

Young people told us that parents were able to visit and that care co-ordinators did attend multi-disciplinary team meetings. They told us there were always enough staff to do preferred activities such as going out to the local shops or cooking.

Staff told us they enjoyed doing activities with young people. We saw staff speaking with young people, interacting in a caring, interested manner and young people appreciated this. Staff understood and respected the individual needs of each young person. We saw in handovers that staff knew the young people well. Staff were able to tell us about the young people and their histories, and how they recognised if young people were having a difficult time and how they would interact with those young people to support them. Advocates visited the young people regularly.

We saw staff ask young people if they wanted to engage with an activity, if the young persons declined staff would follow up suggesting other activities that the young person might like. We saw that leave was individualised with people being able to complete outward bounds activities or visit local shops depending on their interests.

Only one young person was detained under the Mental Health Act with others detained under a Deprivation of Liberty Safeguard order (DoLS). We saw that these were all in order and the provider had complied with their responsibilities. There were regular young peoples meeting to discuss what could be improved within the wards and we saw the service had responded to young peoples requests.

Young people told us they felt staff were responsive to their needs and that they were making progress towards their targets. We saw evidence that occupational therapists had spoken to the young people about their needs before designing individualised therapy sessions. Young people confirmed they had constant contact with their named nurse and that they knew how to make official complaints, but felt they had no need to do so. Some had raised minor concerns and were happy that staff had taken them seriously and dealt with the issues raised. Young people told us they had no difficulty getting support both on and off the ward.

Staff gave us examples of how they supported young people including examples of adjustments made to support young people with spiritual needs, dietary requirements and communication needs. For example, young people were often assessed within the community whilst on leave, this allowed therapy staff to see the young people perform in everyday settings such as shops or social visits. Staff felt that they could raise concerns with managers about disrespectful, discriminatory or abusive behaviour or attitudes towards patients and staff.

We saw staff interacting positively with the young people, they both knew each other well. Staff were always present and they were always engaging young people in either activities or discussing previous or future planned visits.

Managers were available both in the day and at night to support staff and there was an on-call system in place. Staff had regular handovers to share patient information. These were thorough and detailed and contained all the relevant information about all the young people and the current risks on the wards. The service did surveys with the young people every 3 months by an external care consultant, we examined these and they were fairly positive with patients identifying the therapies provided as a positive. Negatives included that young people preferred the old vehicle after it had been replaced with a newer model, managers promised to consult before purchasing another vehicle.

Staff told us they were appreciative that managers had provided a large staff wellbeing centre. This was a separate building from the wards which provided staff with a separate place to relax on breaks. This space included comfortable seating, television and a small kitchen. Several staff had also been supported to engage in additional professional development. Staff told us they felt valued and respected.

Managers conducted staff surveys and had also provided an anonymous feedback opportunity with a locked suggestion box. In response to anonymous whistle blowing, they had commissioned an external service who had offered staff an opportunity to express concerns at an alternative venue. Staff were also offered wellbeing and psychosocial support.