Trust Headquarters, Doncaster
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Inspection Report We are the regulator: Our job is to check whether hospitals, care homes and care services are meeting essential standards. Trust Headquarters, Doncaster St Catherine's House, Tickhill Road, Doncaster, Tel: 01302796400 DN4 8QN Date of Inspections: 24 October 2013 Date of Publication: 23 October 2013 December 2013 22 October 2013 21 October 2013 16 October 2013 15 October 2013 14 October 2013 We inspected the following standards as part of a routine inspection. This is what we found: Consent to care and treatment Met this standard Care and welfare of people who use services Met this standard Cooperating with other providers Met this standard Safeguarding people who use services from Met this standard abuse Staffing Met this standard Supporting workers Met this standard Assessing and monitoring the quality of service Met this standard provision | Inspection Report | Trust Headquarters, Doncaster | December 2013 www.cqc.org.uk 1 Details about this location Registered Provider Rotherham Doncaster and South Humber NHS Foundation Trust Registered Manager Mrs. Jacqueline Saczek Overview of the Trust Headquarters, Doncaster is a service provided by service Rotherham Doncaster and South Humber NHS Foundation Trust. It provides inpatient and community mental health and learning disabilities services for the areas of Rotherham, Doncaster and North Lincolnshire. It also provides integrated community healthcare services in Doncaster. Type of services Community healthcare service Domiciliary care service Community based services for people with a learning disability Long term conditions services Community based services for people with mental health needs Hospital services for people with mental health needs, learning disabilities and problems with substance misuse Prison Healthcare Services Rehabilitation services Supported living service Community based services for people who misuse substances Regulated activities Accommodation for persons who require nursing or personal care Assessment or medical treatment for persons detained under the Mental Health Act 1983 Diagnostic and screening procedures Family planning Personal care Transport services, triage and medical advice provided remotely Treatment of disease, disorder or injury | Inspection Report | Trust Headquarters, Doncaster | December 2013 www.cqc.org.uk 2 Contents When you read this report, you may find it useful to read the sections towards the back called 'About CQC inspections' and 'How we define our judgements'. Page Summary of this inspection: Why we carried out this inspection 4 How we carried out this inspection 4 What people told us and what we found 4 More information about the provider 5 Our judgements for each standard inspected: Consent to care and treatment 6 Care and welfare of people who use services 9 Cooperating with other providers 11 Safeguarding people who use services from abuse 13 Staffing 15 Supporting workers 17 Assessing and monitoring the quality of service provision 19 About CQC Inspections 23 How we define our judgements 24 Glossary of terms we use in this report 26 Contact us 28 | Inspection Report | Trust Headquarters, Doncaster | December 2013 www.cqc.org.uk 3 Summary of this inspection Why we carried out this inspection This was a routine inspection to check that essential standards of quality and safety referred to on the front page were being met. We sometimes describe this as a scheduled inspection. This was an unannounced inspection. How we carried out this inspection We looked at the personal care or treatment records of people who use the service, carried out a visit on 14 October 2013, 15 October 2013, 16 October 2013, 21 October 2013, 22 October 2013, 23 October 2013 and 24 October 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We spoke with one or more advocates for people who use services, talked with people who use the service, talked with carers and / or family members and talked with staff. We reviewed information given to us by the provider, took advice from our specialist advisors and were accompanied by a specialist advisor. We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service. What people told us and what we found The focus of this inspection was the service provided by the Trust Headquarters, Doncaster location. The inspection team of 12 people consisted of inspectors, specialists and experts by experience. We spoke with 52 people who used the service and 13 relatives. We found that before people received any care or treatment they were asked for their consent. If they did not have capacity to consent the provider acted in accordance with the law. People told us they were asked for their consent and their care and treatment was explained to them. We found that care and treatment was planned and delivered in a way that ensured people's safety and welfare. Most people we spoke with told us they were happy with the care provided. We found that the provider worked in co-operation with others. Organisations which co- operated with the trust told us they were satisfied with the way the trust worked with them. We found that people who used the service were protected from the risk of abuse. People told us they felt safe. We found there were enough qualified, skilled and experienced staff to meet people's needs. People told us they felt there were enough staff on duty. | Inspection Report | Trust Headquarters, Doncaster | December 2013 www.cqc.org.uk 4 We found that staff were supported to deliver care and treatment safely. People told us they were satisfied that staff knew what they were doing. We found there were effective systems in place to assess and monitor the quality of service. People told us they were asked for their opinions. You can see our judgements on the front page of this report. More information about the provider Please see our website www.cqc.org.uk for more information, including our most recent judgements against the essential standards. You can contact us using the telephone number on the back of the report if you have additional questions. There is a glossary at the back of this report which has definitions for words and phrases we use in the report. | Inspection Report | Trust Headquarters, Doncaster | December 2013 www.cqc.org.uk 5 Our judgements for each standard inspected Consent to care and treatment Met this standard Before people are given any examination, care, treatment or support, they should be asked if they agree to it Our judgement The provider was meeting this standard. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent, the provider acted in accordance with legal requirements. Reasons for our judgement We found that the provider, Rotherham Doncaster and South Humber NHS Foundation Trust had a policy for consent to examination or treatment. We reviewed this policy and found it covered all relevant areas. We visited the adult mental health inpatient services on Brodsworth and Cusworth Wards, Coral Lodge, and the Psychiatric Intensive Care Unit on Skelbrooke Ward. We spoke with people who used the service and staff, and reviewed people's care records. People who used the service told us that staff always asked for consent. We spoke with four members of staff who told us when and how they obtained consent. They told us that consent was constantly sought due to fluctuations in people's capacity. They explained this was also the case with people who were detained under the Mental Health Act 1983. They also described how people's capacity was assessed on admission and throughout their stay. Our review of people's care records showed evidence of consent being obtained. We also found that the appropriate forms had been completed under the Mental Capacity Act 2005. The Act and the associated Deprivation of Liberty Safeguards are designed to protect people who can't make decisions for themselves. We visited Amber Lodge, a low secure unit which was part of the learning disability forensic service. In this unit people were detained under the Mental Health Act 1983. We reviewed care records and spoke with people who used the service and staff. The staff we spoke with told us that people who used the service were reminded of their rights under the Mental Health Act on a regular basis and this was confirmed in the | Inspection Report | Trust Headquarters, Doncaster | December 2013 www.cqc.org.uk 6 records we reviewed. They were also able to explain to us how consent was obtained in the case of a person who was detained. We saw evidence in care records and through talking with people who used the service that people were involved in developing their care plans. We reviewed three care records, where we found from the notes of meetings that people were involved and consulted about their care plans, risk assessments and treatments. These discussions showed evidence that people agreed to their care and treatment. People we spoke with confirmed they attended their review meetings and that medical and nursing staff talked with them about their progress and treatment. They also told us that they had their rights explained to them on a regular basis. However, we found one care record where a number of care plans and treatments had not been consented to. We brought this to the attention of a senior manager who ensured consent was obtained. We also spoke with two people who told us that although they were aware they had a care plan they didn't know how to access it.