Since the last inspection the service now had a Section 136 suite that met the standards set out in the Royal College Standards. Managers ensured they used regular bank staff to achieve the required safer staffing levels and to promote continuity of care of patients. We spoke with five informal patients at the Bradgate Mental Health Unit who were unaware of what they could and could not do as an informal patient. Staff received feedback on the outcomes on investigation of complaints via their managers. We inspected all key lines of enquiry in all domains (safe, effective, caring, responsive and well-led) in two services. Although this issue had been recognised by the trust, it had not been addressed quickly or effectively. Patients had the use of their mobile phones on the ward. Some wards and patient areas had blind spots, where staff could not easily observe patients. Beds were not always available for people living in the trusts catchment area. Staff used the mental health clustering tool, which included Health of the Nation Outcome Scales (HoNOS) to assess and record severity and outcomes for all patients. Nursing staff interacted with patients in a caring and respectful manner. As one of the largest registered investment advisors in the U.S., we offer a broad range of services to institutional clients, including corporate and higher-education retirement plans, foundations and endowments, and religious organizations. The trust had significantlyreduced waiting times and the total numbersof children and young people waiting for assessments. We rated Leicestershire Partnership NHS Trust as Requires Improvement overall because: Published There were a high number of patients on the waiting list for treatment in the specialist community mental health services for children and young people. This was because the EDU batch refer sending four or five referrals at a time rather than when they arrive. Staff treated patients with respect and maintained dignity. It has been developed within the context of the area we serve in Leicester, Leicestershire and Rutland and the new Integrated Care Partnership. The trust had robust governance structures and they had assured any potential gaps or overlaps had been considered. The environment in some services was poor, not well maintained and not kept clean. We found a patient being nursed in the low stimulus area and their liberty was restricted. 87 of the total patients had been waiting over a year to begin treatment. Community meetings and patient involvement in the services did not always take place. The Trust had a number of unfilled positions being covered by long-term bank staff. However there were significant problems with key areas of governance in relation to the management of prescriptions. Detention renewal paperwork had been signed by a doctor prior to them seeing the patient. Staff had a good understanding of patients needs. They provided feedback to staff via monthly ward meetings, MDT meetings supervision and handovers. there are some services which we cant rate, while some might be under appeal from the provider. The trust did not ensure that they meet set target times for referral to initial assessment, and assessment to treatment in the majority of teams. We spoke with carers; they all stated that staff responded well when they contacted the service. Where relevant we provide detail of each location or area of service visited. They told us that staff were kind and caring. The rating had improved from the November 2016 inadequate rating. Some care plans had not been updated and physical healthcare checks were not routinely documented in young peoples notes. Staff were not always recording their supervision on the electronic system so we could not be assured they were receiving it regularly. It is generally accepted that when occupancy rates rise above 85%, it can start to affect the quality of care provided to patients and the orderly running of the hospital. The trust had set safe staffing levels and these were followed in practice. Some actions were required to ensure adherence with the Mental Health Act. Leicestershire Partnership NHS Trust | 5,409 followers on LinkedIn. On four wards in acute wards for adults of working age, there were shared sleeping arrangements for patients. We use cookies to improve your experience on our website. There were no vision panels on patient bedrooms. Staff were not meeting the trusts target compliance rate for annual appraisals and mandatory training. Staff morale in some teams was low, with high levels of stress. The summary of this service appears in the overall summary of this report. We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels: Outstanding Staff did not assess and record the risks posed by medicines stored in patents homes. All the team leaders we interviewed said there were internal waiting lists for patients who had been initially assessed to access profession specific treatments. Staff undertook comprehensive assessments and developed high quality care plans. Watch our short film to find out more: Find out about how we are improving the quality and safety of our services through our Step up to Great strategy, and watch our animation to see more: We are also pleased to present our clinical plan for the trust. Patient outcomes were not routinely collected so the quality of the clinical care being delivered could not be measured or benchmarked. Response times to maintenance request were variable. 42% of staff on Phoenix ward and 27% Griffin ward had received clinical supervision. Patients returning from leave from the acute mental health wards were not assured of returning to their original ward. Concerns about high bed occupancy, record keeping and delayed discharges were identified in the March 2015 inspection and had not been sufficiently addressed. Curtains were missing from bed spaces and staff did not wait for an answer from patients before entering rooms on acute wards. We were pleased to hear about the trusts investment in well-being events and initiatives for staff, such as valued star award, choir, yoga and time out days. On Phoenix ward patients were not allowed access to the garden. We carried out this unannounced inspection of Leicestershire Partnership NHS Trust because at our last inspection we rated two mental health services provided by this trust as inadequate, four mental health services and one community health service as requires improvement. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). Managers had a system in place for tracking and learning from safeguarding incidents and other reportable events. Staff told us their managers were supportive and senior managers were visible within the service. Staff described managers as supportive and approachable. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 22 Jan 2023. To address this deficit the trust moved patients that required an acute bed to a rehabilitation bed which was not clinically justified or met the needs of the patients. There was effective communication between the service and other healthcare professionals. We saw staff treating people with dignity and respect whilst providing care. Leicestershire Partnership NHS Trust Location Leicester Salary 27,055 to 32,934 a year Closing date 2 Feb 2023. The Trust is proposing to close Ashby and District Community Hospital, a proposal which is opposed by Ashby Civic Society who do not accept that 'virtual wards' and 'intensive community support' can fully deliver the reductions on hospital . However, managers had identified funding for two agency nurses to start work the week following the inspection. We saw an example of an SI investigation and also action taken from lessons learnt. The trust had maintained patients privacy and dignity at Short Breaks Services. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. That's what building health equity means to us. The principles will normally apply but will be balanced by inspection teams using their discretion and professional judgement in the light of all of the available evidence. We saw evidence of multidisciplinary working, with staff, teams and services at this trust and external organisations working in partnership to deliver effective care and treatment. Care plans and risk assessments did not show staff how to support patients. -Supporting a variety of Wards such as Cardiology, Respiratory, Urology, Stroke, Renal, Maternity and Vascular.Obtaining physical measurements such as blood pressure, heart rate, SPO2, Temperature,respiratory rates, blood sugars, pain . One patient on Heather ward claimed that they had previously watched a staff member walking past a distressed patient and did not seek to reassure them or ask what was wrong. We did not identify any significant community wide areas for improvement but did find many exemplary services provided by the trust. Bed occupancy for the last two quarters of 2013/14 was around 89%. The trust had begun the process of replacing some beds with more suitable options for the patient group. The community nursing service could not measure its performance in relation to response times for unplanned care. A report on the inspection was . 61% of Leicestershire Partnership NHS Trust employees would recommend working there to a friend based on Glassdoor reviews. The community adult team caseloads varied. Some families carers said that the meals were unhealthy. Staff showed us that they wanted to provide high quality care, despite the challenges of staffing levels and some poor ward environments. There had been several serious incidents (SI) within this service in the last year. Comprehensive relocation action plans were available. We observed positive interactions between patients and staff. At the time of inspection, there were a total of 647 children and young people currently waiting to be seen in specialised treatment pathways. The trust had systems for staff to raise any concerns confidentially. Staff showed caring attitudes towards their patients. Staff were aligned to services to manage data and we have seen improvements in recording and monitoring of supervision and appraisal, improvement in managing risks of those on waiting lists in specialist community mental health services for children and young people and in training data. Patients reported they were treated with dignity and respect. Staff followed infection and prevention control practices and the community inpatient wards were visibly clean. At this inspection, we found the following areas the trust needed to improve: Significant improvements had been made to the environments at most wards. the service isn't performing as well as it should and we have told the service how it must improve. Staff were kind, caring and respectful towards patients. In 3Rubicon Close, it was not clear that information about providing physiotherapy to a patient had been communicated to all staff. Demand for neurodevelopment assessments remained high. We carried out this unannounced focused inspection of adult liaison psychiatry services as part of a system wide inspection of Urgent and Emergency Care provision in the Leicester, Leicestershire and Rutland Integrated Care System. Patients own controlled drugs were not always managed and destroyed appropriately. Mandatory training provided to Advanced Nurse Practitioners did not cover end of life care, and these professionals received little support from trust doctors with a specialism in palliative care. In the dormitories, observation mirrors were situated so that staff could observe patients without having to disturb them. This could have resulted in an increased risk of incorrect safe and secure handling of medicines and unsafe practice in relation to the administration and prescribing of medicines. Care plans were generalised, not person centred or recovery focused. Find out more. Staffing levels were adequate at the time of our inspection but staff told us that they had been short staffed for some time and that there were a number of vacancies. For over 20 years we've ensured that health related grants, policies, and services exist to help give everyone the opportunity to be healthy - especially the most vulnerable. In most services, we were concerned with the lack of evidence in care plans which showed patients and carers had been consulted and involved in their care. Therefore, if a female needed a psychiatric intensive care unit they were sent out of area. The trust was not commissioned to provide a female PICU and have identified the need with their commissioners. The summary for this service appears in the overall summary of this report. The trust was not fully compliant with same sex accommodation guidance in two acute wards, the short stay learning disability service and rehabilitation services. In response, the Care Quality Commission undertook a series of coordinated inspections, monitoring calls and analysis of data to identify how services in a local area work together to ensure patients receive safe, effective and timely care. Staff consistently demonstrated good morale. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. This monthly award is about recognising members of staff who have gone the extra mile. A positive culture had developed since our last inspection. Adult community health patients did not always have timely access to routine appointments. Staff knew how to report any incidents on the trusts electronic reporting system. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. Managers ensured they monitored the reporting and recording of incidents and complaints. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. Make a difference with a career at LPT. However, 323 were waiting for their first appointment through the access team, to complete a core mental health assessment. There were waiting lists of up to 18 months for psychology and up to 40 weeks for other treatment within the personality disorder service. Staff did not always feel actively engaged or empowered. Staff were consistently caring, respectful and supportive. This left patients without access to treatment when they needed it most. This reduced continuity of care. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service. Staff were passionate about their roles and enjoyed working with the client group. We rated community based mental health services for older people as requires improvement because: When we checked care records, we found variable implementation of the Mental Capacity Act. Staff were aware of the reporting policy and procedure and could give examples of when this was carried out. There was good multi-disciplinary working within the teams. While they made appropriate assessments and were responsive to changing needs, NICE guidelines were not used to ensure best practice and that multi-agency teams worked well together. We rated child and adolescent mental health wards as good because: The ward had clear lines of sight in the main areas of the ward. Each priority within our approach is being led by an executive team member and progress is being monitored through our quality governance framework. Some staff did not receive regular supervision or annual appraisals. Significant vacancy rates and high sickness levels put additional pressure on substantive staff. Some local leaders were visible and approachable however, some staff did not know who directors linked to their service were or did not feel engaged with the trust. The environmental risks in the health based place of safety identified in our previous inspection remained. By: Miraj Vaghadia | Tags: A project to improve patient care by making best use of capacity across Leicestershire Partnership NHS Trust (LPT) District Nursing teams has been shortlisted for the prestigious Nursing Times Awards. It was clear to see the difference the investment and improvements had made since our last visit. The trust had high numbers of vacancies for registered nurses. Patients were involved in the writing of their care plans and their views were reflected in the plans. We will be supporting each other in the delivery of these leadership behaviours so we can all Step up to Great together. Staff received regular supervision and most had received an appraisal in the last 12 months. Mental Health Act documentation was not always up to date on the electronic system. Patients privacy and dignity had been addressed at The Willows, Cedar and Acacia wards with changes made to male and female wards. received 41 comment cards from patients that were available for patients to complete during the time of our inspection. Some wards and community teams had low staffing levels, or an absence of specialist staff, and this had an impact on care.Staffing levels remained low at the Bradgate mental health unit. 30 April 2018. The teams we spoke with, felt the trust board did not set clear timescales or direction on how to move their projects forward. The environment in specialist community mental health services for children and young people, and community based mental health services for adults of working age was not suitable, did not promote safe practice and was not well maintained. Published We observed some very positive examples of staff providing emotional support to people. This had improved since the last inspection in March 2015. In five of the six community nursing teams attendance on some mandatory training courses was below 70%. To ensure that safer staffing levels were met they used regular bank or agency staff to achieve the required amount number of staff for the wards to meet the needs of the patients. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. This had continued during the pandemic. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. Multidisciplinary team work both internal and external to the service was effective and patients were supported to make informed decisions about their care. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. There was good staff morale in services. We're one team with shared values providing the best care possible. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. Staff had set clear guidelines on where and how physical health observationswere completed on wards. The recording of discussions and assessments with people regarding consent to treatment was not always documented. We did not inspect the following areas of this core service: We did not rate this service at this inspection. Mandatory training that fell below 75% included adult immediate life support, adult basic life support, safeguarding children level 3 and fire safety awareness. Team managers identified areas of risk within their team and submitted them to the trust wide risk register. The Step up to Great strategy identified key priority areas of focus which were linked to the trusts vision. The trust had made progress in oversight of data systems and collection. Managers identified the breach in these targets and had plans in place to reduce them and had highlighted this risk on the risk register. We found damaged fixings on one ward; that posed a risk to patients. The HBPoS had no designated resuscitation equipment and emergency medication and shared equipment with acute wards. Some seclusion rooms had environmental concerns at Belvoir and Griffinunits, and Watermead wards. These included the Older Peoples Unit at Loughborough Hospital, the Hand Injury Service, the splitting of planned and unscheduled community nursing services with a single point of access, podiatry and the specialist management of long term conditions. Wards provided safe environments where patients felt secure. Staff documented seclusion well in most services, compared to our last inspection. Patients said they got bored at the weekends, as there were fewer activities on offer. In all three services, not all staff were up to date with mandatory training. Staff usually met patients in their homes or in the community. The clinic rooms across sites had all the equipment calibrated. We found the average wait times for patients presenting with a mental health crisis or specific mental health needs were between 1.5 hours and 1.9 hours. The trusts Board Assurance Framework (BAF) was lengthy, was combined with a corporate risk register and had overdue actions. Patients could not always access a bed in their locality when needed and the trust moved patients between wards and services during episodes of care and following return from leave. The trust had made significant improvements to develop a strengthened vision and strategy. There were systems for lone-working in place including a red folder process that kept workers safe. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. There was a high staff sickness rate reported and managers did not always follow the managing sickness policy. An announcement has been made on the outcome of this appointment. Beaumont ward did not have a poster displayed around informal patients and rights as a patient had ripped it down. Apply. Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. Across teams risk assessments were not always completed and updated. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. specialist community mental health services for children and young people. Patients said staff who cared for them were knowledgeable, professional and friendly. Leicester; 33,706 to 40,588 a year (pro rata) Leicestershire Partnership NHS Trust; We are looking for a Bank Band 6 Speech and Language Therapist to join our innovative, friendly and well supported team working with children and y. We did not inspect the whole core service. The ward had an up to date ligature risk audit, staff mitigated the risks on the ward by observing patients. Staff could not rely on performance reports being accurate. Derby, There was a blind spot in the seclusion room on Acacia ward at the Willows which meant staff could not easily observe patients. Staff made individualised risk assessments which were regularly updated and followed best clinical practice. Patients were protected from avoidable harm by sufficient staffing and safeguarding processes. Risk assessments were completed during the initial assessment at the CRHT team. One family member told us their relative could be challenging but they felt they were well cared for. . At West Leicestershire there was a lack of psychology input. This impacted on staffs ability to assess and treat young people in a timely manner. We rated Leicestershire Partnership NHS trust as requires improvement because: Environmental risks in the Health Based Place of Safety (HBPoS) identified in our previous inspection remained. Leicestershire Partnership NHS Trust Is this your company? Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. Overall, the trusts compliance rates for mandatory training was 87%. the service isn't performing as well as it should and we have told the service how it must improve. The environment in the crisis service did not ensure confidentiality as rooms were not sound proofed and conversations could be heard outside the room. Staff completed comprehensive assessments which included physical health checks and the majority of patients had completed risk assessments. We found positive multidisciplinary work and observed staff were supporting patients. Patients needs were assessed and monitored individually. Staff were adequately supported and debriefed following incidents and could access further support if required. There was good multi-disciplinary working within the teams and good communication with other organisations. Apply. Staff were unaware of any service specific strategic direction. Advanced Directives had been introduced to enable patients to make decisions now about their long term care. Staff interacted with the patients in a positive way and was respectful to them. Staff received regular managerial and group supervision. Engagement with external stakeholders had significantly improved since our last inspection. We reviewed data and documentation including three patients care records and risk assessments. 89% of staff had attended their mandatory training; 92% of appropriate staff had received training in safeguarding adults and 90% of staff had completed safeguarding children training. On acute wards, not all informal patients knew their rights. Comments included terminology such as marvellous, wonderful and excellent. Two patients told us they had experienced cancelled leave, and numerous staff confirmed that facilitating escorted leave had been difficult at times which had led to either a cancellation, or where possible delayed leave. Some staff used tools and approaches to rate patient severity and monitor their health. There could be risks posed by the use of different recording systems across teams as staff may not all have access to all records. Governance structures were in place and risks registers were reviewed regularly. For example, issues found in risk assessments, care plans and environmental concerns had been addressed in some services, but not all since our last inspection. Capacity assessments were not decision specific. Staff demonstrated poor understanding of some aspects of the Mental Capacity Act. Staff were unable to show us evidence of clinical audits or the basis of evidence based practice in end of life services. The service was meeting its target in this area. We rated all three mental health services inspected as requires improvement overall. There was no evidence of patient involvement recorded in some of the notes. View more Profession Nurse Service Child & Adolescent / CAMHS Grade Band 5 Contract Type Permanent Hours Full Time. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. Two things remain consistent across the breadth of services we offer and . Adult liaison psychiatry is categorised under Mental Health Core service of Mental Health Crisis and Health Based Places of Safety (HBPoS), as it is provided by the mental health trust, Leicestershire Partnership NHS Trust. However at South Leicestershire clinical supervision take-up was low at 73%. The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. We rated it as good because: Leicestershire Partnership NHS Trust: Evidence appendix published 30 April 2018 for - PDF - (opens in new window), Published We could not find records for seclusion or evidence of regular reviews taking place as per trust policy. 9 August 2019, Leicestershire Partnership NHS Trust: Evidence appendix published 27 February 2019 for - PDF - (opens in new window), Published The NHS is founded on principles and values that bind together the diverse communities . Three patients told us of times when staff had been rude, threatening and disrespectful towards them. Reductions in social service provision had led to an increase in referrals to the Community Learning Disability Teams. The process for monitoring patients on the waiting list in specialist community mental health services for children and young people had been strengthened since the last inspection. One patient on Watermead ward told us that a staff member had ignored them when they had asked them for a sandwich. The matron opened some vault windows via a remote. Two external governance reviews had been commissioned and undertaken. Managers had plans in place to address this issue. Staff completed detailed risk assessments for patients on admission and reviewed them regularly after incidents. People felt they had benefited from the service and told us how caring staff were. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. The waiting times in community based mental health services for adults of working age were long and breached targets. Cover arrangements for sickness, leave and vacant posts were in place. Risk management in services required improvement. The majority of repairs and maintenance issues highlighted within the warning notice at the Bradgate Mental Health Unit had been fixed or resolved. The most common reason for delayed discharges was due to family choices which were beyond the control of the trust. On Heather ward patients said that there was not enough ventilation on the wards. Outcomes of care and treatment were not always consistently or robustly monitored. We saw evidence of good team working during our inspection. Care and treatment was mostly planned and delivered in line with current evidence. The trust had recruited two registered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. The integrated therapy and nursing teams and the primary care coordinators in conjunction with the night service had clear focus on keeping patients safe and well in their own homes. The service still had challenges in recruiting sufficient staff which meant that the service, in particular community nursing, was understaffed at times impacting on staff satisfaction and compromising patient care. The lack of psychology was an issue highlighted at our 2018 inspection. The ovens were old and the dials were not visible and cupboards were broken. Meeting these standards and developing the capability to exceed them, will not only ensure that we continue to improve and respond flexibly to changing needs as an organisation, but will also help our staff to fulfil their potential, both in terms of personal achievement and career advancement. The trust board, heads of departments and senior leaders had access to the information they needed to manage risk, issues and performance across the trust. The trust reported a 10% increase in the number of referrals received into the CAMHS service. Whilst there was a plan to eradicate the dormitories across the trust, there were delays to the timetable and patients continued to share sleeping accommodation which compromised their privacy. We heard positive reports of senior staff feeling able to approach the executive team and the board. Patient involvement in planning care was now in place and the voice of the patient in changes to services had been considered. This meant some fundamental standards were not being met. Despite considerable effort with recruiting new members of staff for community inpatient areas, staffing was the top concern for all senior nurses and there was still a significant reliance on agency staff to fill shifts which could not be covered internally. The trust had long term plans to address this. Due to the lack of a trust overarching strategy, the BAF did not provide an effective oversight against strategic objectives, gaps in control and assurance. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. Coventry, The service was not effective. This meant that some staff felt insecure. The trust had a patient involvement centre, which was pleasant, well-equipped and supported involvement from friends and family. This meant the police very often had to care for detained patient for the duration of the assessment. Staff were given feedback after incidents had been reported. The trust confirmed contracts for patient transport and local authority care packages were monitored and work was ongoing with partner organisations to improve services for patients. We found out of date and non-calibrated equipment located within a cupboard in the health-based place of safety. Staff were suitably trained with the relevant knowledge and skills to carry out their work, had regular appraisals and had access to the information they needed to perform their duties. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. Some patients continued to share bedroom spaces in dormitories, and personal belongings were stored on the floor because of limited storage provided by the trust. In rating the trust, we took into account the previous ratings of the core services we did not inspect on this occasion. Staff said morale was good and they felt supported by their managers. A family member spoke about enjoying regular meetings in the service gardens with their relative. We found that there were still errors within the staffs application of the Mental Capacity Act. There's no need for the service to take further action. The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. This meant board members were not able to monitor the trusts assertions that there were strong systems and processes in place for identifying and reporting serious incidents, including deaths, or monitoring whether reviews and investigations were completed fully. Staff followed infection control practices and maintained equipment through regular servicing. 83% of staff received mandatory training. Our leadership behaviours framework set the standards of expectation we aspire to in our daily work. Some areas at Bradgate Mental Health Unit required further improvements to the environments. Staff morale was low and they felt disempowered in some areas. HBPoS and crisis resolution and home treatment (CRHT) team toilets were not visibly clean. However, staff told us they had little experience of incident reporting within the community childrens services. This was a breach of the patients privacy and dignity to patients as staff might be required to enter the shower rooms to check patients were safe. The trust had robust systems in place which allowed staff to effectively report incidents. This did not demonstrate a consistent temperature, had been maintained to assure the safety and efficacy of the medicines. A psychologist led weekly reflective practice sessions to help staff think about the best way of helping the patient on the ward. At this inspection the overall ratings for mental health services stayed the same in safe, effective and responsive, which we rated as requires improvement. People knew how to make a complaint as this information was provided in welcome packs. When staff deemed a patient lacked capacity there was no evidence that the best interest decision-making process was applied. Staff monitored those patients on the waiting list regarding risk levels. There was an extensive wellbeing offer available to staff. There were issues within the trust of a bullying culture despite evidence that staff knew the trust values. A lack of availability of beds meant that people did not always receive the right care at the right time and sometimes people were moved, discharged early or managed within an inappropriate service. There was no funding for staff to provide activities so patients had limited access to activities of their choice during their stay. We rated it as requires improvement because: Our rating of the trust stayed the same. At Melton, Rutland and Harborough, City East and City West CMHTs m. At City West in conjunction with the young onset dementia assessment service staff developed a digital app for younger who were developing dementia. We rated it as requires improvement because: When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. We remain concerned that a significant period had passed and the trust had not improved access to psychology for patients and staff. Staff were provided with relevant information to care for patients safely. Risks to people who used the service and staff were assessed and managed. The trust was not meeting its target rate of 85% for clinical supervision. ", Laiqaah Manjra, Corporate Affairs Administrator, "I progressed from being an apprentice to a Corporate Affairs Administrator - the NHS really supports staff development. Staff did not document physical health checks for patients detained under section 136 in the HBPoS. This has been brought. There was limited time available for staff to attend specialist courses to enhance their knowledge. Patients gave positive feedback regarding the care they received. One ward matron told us that a patient had recently alleged that a staff member had assaulted them. Managers had introduced a specialist child and adolescent mental health traffic light system, a red, amber and green rating tool for managing risk. Let's make care better together. 100% of staff were trained in how to safeguard children from harm. The trust had a dedicated family room for patients to have visits with children. There was effective multidisciplinary working. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. There were long waiting times from initial referral to being seen in some clinics and services although these had improved in some areas since the last inspection. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. Staff were quick to sort out requests and problems for patients. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. Patients were full of praise for staff and the care and support they offered. Improvements to the inpatient wards included updating seclusion rooms, removing some ligature anchor points and replacing garden fencing. : Staff completed and regularly reviewed and updated comprehensive risk assessments. Assessments and care planning took place for patients needs. Patients were offered smoking cessation treatments, nicotine replacement therapy (NRT), or free vapes. Leicestershire Partnership NHS Trust This is an organisation that runs the health and social care services we inspect Overall: Requires improvement Services have been transferred to this provider from another provider Services have been transferred to this provider from another provider All Inspections 12 April 2022 Your skills are needed for the NHS Reservist project. Team meetings were not regular, or didn't take place.The sharing of lessons learnt remained inconsistent across some wards. . Patient access to psychology and occupational therapy was less than expected on acute wards and rehabilitation wards due to the number of staff vacancies in therapy positions. We rated end of life care services as good overall because: The trust had worked collaboratively with local partners to develop an end of life care strategy for the region as a whole which had incorporated a health needs analysis. We observed positive interactions between staff and children and the use of age appropriate language. Staff monitored patients physical health regularly from the point of admission. Staff showed a good awareness of patient rights. Any other browser may experience partial or no support. The service did not have a system in place to monitor the number of lighters each ward held. The trust ceased mixed sex breaches by maintaining male and female only weeks. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. Staff supported patients to raise concerns when needed. The majority of care plans were up to date. The trust did not have seclusion rooms on all wards. The HBPoS had poor visibility for observing patients. Staff were given opportunities to expand their knowledge and develop their roles. Patients and carers knew how to complain. Medication management systems were in place and followed to ensure that medicines were stored safely. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. The needs and preferences of patients and their relatives were central to the planning and delivery of care with most people achieving their preferred place of care. There were no records of capacity being assessed for patients consent to treatment, and no clear evidence of best interests decisions being agreed. You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection. Urgent and emergency care services across England have been and continue to be under sustained pressure. Whilst there had been some improvements, the process for reporting repairs and issues varied across the wards and a time lag existed for repairs being completed. We will be working with them to agree an action plan to improve the standards of care and treatment. This meant patients had been placed outside of the trusts area. Often patients were admitted to hospital out of the area especially if they need a more intensive support. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. The trust had reviewed existing systems and processes identified improvements and implemented changes. Some facilities lacked essential emergency equipment. With the exception of the liaison psychiatry service and the mental health triage car, managers were not supervising or appraising staff within the trusts supervision policy. o We are passionate and creative in our work. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. Staff told us that the trust were recruiting for their vacancies and they hoped to have a full complement of staff in the coming months. Patients did not have access to regular community meetings where they would discuss ward issues and concerns. Clinic room temperatures were very hot, although one thermometer was above a radiator so would not give an accurate reading. This was highlighted in the previous inspection. The learning disability community team had not met the six week target for initial assessment on average it was six days over. NHS England / NHS Improvement - for general enquiries contact Helen Barlow on 0300 123 2038 or by emailing [email protected]. Staff were caring, compassionate and kind towards patients. Creating high quality, compassionate care and wellbeing for all. Patients we spoke with knew how to complain. The risks and issues described by staff did not always correspond to those reported to and understood by their leaders. This promotion is being run by Leicestershire Partnership NHS Trust. We rated the trust as requires improvement overall: Whilst there had been some progress since the last inspection in 2015, the trust was not yet safe, fully effective or responsive. Following the national withdrawal of the Liverpool Care Pathway the trust has developed an alternative care plan; however this has not yet been implemented. We rated wards for older people with mental health problems as good because: The wards complied with the Department of Health 2015 guidelines on single sex accommodation. The waiting list had increased for those children and young people waitingfor thestart of treatment, following assessment. The trust could not be sure that all staff. DE22 3LZ. Services have been transferred to this provider from another provider, Mental health crisis services and health-based places of safety, an inspection looking at part of the service. Use our service finder to find the right support for your mental health and physical health. Data could not be relied upon to measure service performance or improvement.Data collection and interpretation did not include key pieces of information for example number of delayed or missed visits. Staff were not in receipt of regular supervision in order to discuss training needs, developmental opportunities or performance issues. The trust had no psychiatric intensive care unit (PICU) for female patients. We inspected adult psychiatric liaison services as part of Mental Health Crisis and Health Based Places of Safety core service. Staffing levels were not consistent across the two sites. Ward matrons told us they shared outcomes from incident investigations in team meetings for shared leaning. We spoke with nine patient families and carers. Staff did not routinely complete detailed, person centred, individualised or holistic care plans about or with patients. Managers used a tool to identify and review staff numbers in accordance with need. Multi-disciplinary teams and inter agency working were effective in supporting patients. There was no fridge to keep medicines cool when required. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. We saw evidence of discharge planning in care plans written by CRHT staff. Caring stayed the same, rated as good. Medication management across four of the five services we inspected was poor, despite reported trust oversight and audit. Staff did not record seclusion well. However, we found: We rated the child and adolescent mental health wards as requires improvement because: We rated community-based mental health services for older people as good because: We rated learning disability and autism community services as good because: We gave an overall rating for forensic/secure wards of requires improvement because: We rated Leicestershire Partnership NHS Trust long stay / rehabilitation mental health wards for working age adults as requires improvement because: Overall rating for this core service Good. Staff completed risk assessments that were thorough and had been reviewed following incidents. There was an on-call rota system for access to a psychiatrist 24 hours a day. Some patients told us that staff were polite and respectful and willing to go the extra mile in supporting them. Patients knew how to make a complaint or raise a concern and complaints were taken seriously. Managers had introduced a duty clinician to manage caseload sizes and reduce patients risks. Some local managers were keeping their own records to ensure performance was monitored. All the people who used services and the carers spoken to were happy with the service they had received and spoke positively about their interactions with staff. The trust delivered programmes for staff to develop into senior roles and had a clear career development programme for nursing staff. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. Team managers could not be assured of local performance around record keeping, care planning and patient involvement. Staff were described as putting people who used services first and being person-centred. Until then there is a danger information is not shared or fully available to all staff seeing a person. The trust had developed checklists to assist staff with the receipt and scrutiny process. There were safe lone working practices embedded in practice. Patients had access to advocacy. Multi-disciplinary team meetings took place on a regular basis. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. . Incidents and near misses were reported and learning from these was shared. In the health based place of safety resuscitation equipment and emergency medication were not available and staff had not calibrated equipment to monitor patients physical health. The trust had improved how staff recorded patients physical healthcare, and monitored patients who had ongoing physical healthcare problems. 27 February 2019. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Staff felt they had good local leadership and felt the governance was better with the introduction of a service line. We did not rate this inspection. Access to treatment for specialist community mental health services for children and young people, Maintaining the privacy and dignity of patients and concordance with mixed sex accommodation, Seclusion environments and seclusion paper work. The nurses we spoke with had specialist interests, including mindfulness and dementia. Staff had not received any specialist training on crisis intervention. Patients and carers confirmed in most services they had not received copies of care plans. Whilst staff monitored patients risk on the waiting lists, the length of time to wait was of concern, in addition to the services lack of oversight and management of this issue. Clinical audit was taking place and learning was shared across the service. We work in partnership with a range of NHS organisations, local government and other bodies and are ultimately accountable to the secretary of state for health. Staff maintained a presence in clinical areas to observe and support patients. Managers did not successfully cascade information down to all ward staff in acute mental health services. The assessment and resulting care plans were personalised, holistic and recovery focussed. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. Leicestershire Partnership NHS Trust - One Year on from the Mental Health Taskforce Leicestershire Partnership NHS Trust (LPT) continues to break new ground in ensuring the physical health of its patients and service users is cared for as well as their mental health, the ultimate aim of which is to achieve parity of esteem. Children and young people felt listened to in a non-judgmental way and told us they felt respected. The trust supported a BAME network (black and minority ethnic) however, given the diversity of the geographical area of the trust, they had not significantly developed its agenda or work streams since our last inspection. This impacted on patients requiring care. Record keeping was poor in some services. Managers changed practice because of this. Staff had the right qualifications, skills, knowledge and experience to do their job. The health-based place of safety did not meet some aspects of the guidance of the Royal College of Psychiatrists. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. They later told us that this had been an ongoing concern for around five years. We saw that patient numbers exceeded the number of beds available on wards. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. We noted a box for discarded needles being left unattended in a communal area. We would expect patient involvement to be embedded at all levels of the trust, across as many departments as possible, in planning, review, evaluation and delivery. long stay or rehabilitation wards for working age adults. Administrative staff had not received specific mental health awareness training to assist them when taking calls for people who were acutely unwell and in crisis. The phones on each ward were in communal areas; the phone on Griffin ward had not been moved since the last inspection, although it had a privacy hood installed. A dashboard of key performance indicators was being developed. Whilst staff were working hard to identify and manage individual risks, some ward environments were unacceptable. Patients families and carers were positive about the care provided. Patients were supported to meet their religious and cultural needs. An escape plan was developed with patients (PEEP)who may not be able to reach an ultimate place of safety unaided, or within a satisfactory period of time in the event of any emergency. o We are one team and we are best when we work together. The trust mostly used surveys to gain feedback and we saw limited evidence of face to face engagement with patients about service delivery and improvement. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. 22 June 2022, Published However there was no evidence of clinical audits or monitoring of the service in order to improve care provided to patients and staff were unable to talk about this to inspectors. For example relating to assessment of ligature points at Westcotes. NHS Improvement is pleased to announce the appointments of Alexander Carpenter and Hetal Parmar as Non-executive Directors of Leicestershire Partnership NHS Trust from 1 June 2022 to 31 May 2025. Staff mostly felt positive about their managers and said that the services provided were well-led. Discharge planning was considered as part of board rounds although discharge planning paperwork was not used consistently. The trust had key roles in the development of health and social care system working, and collaboration with other care providers to improve provision of mental health services. ", Daxa Mangia, Mental Health Nurse, The Willows, "I really enjoy my job, helping people to recover - I cannot imagine doing anything else.". There was evidence of lessons learnt from incidents being shared with the team. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. 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