24 January 2024, 25 January 2024
During a routine inspection
We rated St Andrew’s Healthcare Birmingham as requires improvement because:
- The service did not always have systems and processes to safely administer, record and store medicines.
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Managers did not ensure that sufficient staff received updated training in basic life support.
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The service had enough staff, but they were not always deployed effectively to support patients on each ward and staff reported feeling burnt out.
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Staff did not always discharge their roles and responsibilities under the Mental Capacity Act 2005 as patients' decisions made about resuscitation were not regularly reviewed and updated where needed. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions were not regularly reviewed or updated.
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The service had some blanket restrictions in place on some wards regarding accessing the courtyard and use of vapes. The provider gave an explanation that these restrictions were necessary and proportionate for managing risk. They were frequently under review through governance processes. However, there were not individual patient care plans for these.
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Care plans were generic and did not show the patient was involved. They did not all include discharge plans.
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Patients were not regularly engaged in therapeutic activities.
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The governance processes were not fully embedded to ensure that ward procedures ran smoothly.
However:
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The ward environments were safe, clean and well maintained.
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Staff followed good practice with respect to safeguarding.
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Staff engaged in clinical audit to evaluate the quality of care they provided.
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Managers ensured staff received supervision and appraisal.
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The ward staff worked well together as a multidisciplinary team.
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The ward teams had access to the full range of specialists required to meet the needs of patients.
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Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood their individual needs.
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Staff planned patient discharge and liaised with services that would provide aftercare, however not all patients had a discharge plan in their records.