HMP Swaleside (Healthcare)

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

We found the Trust had implemented effective measures to address the issues we had identified during our previous inspection. There were clear processes in place for staff to assess and monitor patient risk to falls when appropriate. All patients being admitted into the inpatient unit had clear explanations for their referral and management plans while they were in the unit. Staff recorded all decisions when there were changes to patient medication.

Find out what we look at when we assess this area in our information about our new Single assessment framework.

At our previous inspection we found that there were no systems and processes around assessing, monitoring, and improving the quality and safety of services, where patients were a known risk of falls. During this assessment we found the following improvements: The Trust had ensured all staff were trained to carry out patient falls risk assessments (FRA). Staff we spoke with were clear about the FRA policy and had good understanding of when they needed to update information of risk. Managers carried out audits to monitor the effectiveness of these assessments and shared learning with the team. Staff we spoke with were able to explain how they have improved on using the FRA templates and said they found the information helpful to use for developing care plans. At our last inspection we found staff did not always record evidence of the decision-making process when patients were admitted to the inpatient unit. During this assessment we found managers had implemented an inpatient admission template for all patients being admitted to the unit. Staff were recording clear decisions for admission on patient records and staff we spoke with all knew what information was important to highlight, such as sharing risks. Staff were knowledgeable about all of the patients on the unit and knew why they were admitted to the unit, staff attended regular shift handovers, which they said updated them on any new admissions. At our last inspection we found where patient’s medication was stopped, records did not always demonstrate the decision-making process. During this assessment we noted the following improvements: Staff we spoke with explained how they could print a letter to patients and talk to patients when medicines needed to be changed. They knew all the reasons as to why a patients medicine may be changed or safely stopped.

We found that all patients situated in the inpatient unit had a completed Falls Risk Assessment (FRA) when required, the assessments included individual reasons for the risks and a clear plan as how staff can help patients to manage these risks. Staff referred patients to the GP for review where necessary, and incident reported any falls, including where patients had reported they fell. We reviewed six FRA audits that had taken place from December 2023, which showed managers had identified where improvements needed to be made such as, staff developing more effective management plans. Training records we reviewed showed that 100% of staff had received training in the use of FRA. There was a Trust wide Policy for the Prevention and Management of Falls in Adults. Managers ensured all patients over the age of 50, or those at risk of falling, were assessed using the screening and assessment tools. This policy also included essential care for a patient following a fall. We checked patient records and found there were clear explanations for each patient admitted to the inpatient unit. Managers had carried out an audit to check records were clear, up to date and staff had completed the appropriate template. All records we reviewed showed that staff clearly recorded the clinical decisions as to why patient medication, varied or had changed. The reasons included increased or a decreased dose, change of medication named supply and any clinical reasons. We saw staff had recorded where they had discussed medications with patients, or selected a printout to give them, so that they were aware of any amendments. We saw examples where patients medication had been stopped safely, when they were under the influence of illicit substances, staff used a clear compact which explained patient safety and processes. Managers had ensured that staff used a set letter template to send patients who had been observed concealing, diverting medication or medication stopped.

The judgement for Delivering evidence-based care and treatment is based on the latest evidence we assessed for the Effective key question.

The judgement for How staff, teams and services work together is based on the latest evidence we assessed for the Effective key question.

The judgement for Supporting people to live healthier lives is based on the latest evidence we assessed for the Effective key question.

The judgement for Monitoring and improving outcomes is based on the latest evidence we assessed for the Effective key question.

The judgement for Consent to care and treatment is based on the latest evidence we assessed for the Effective key question.