The service had seven vacancies for qualified nurses andthree for non-registered nurses. 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. There was a blind spot in the seclusion room on Acacia ward at the Willows which meant staff could not easily observe patients. They were supported to have training to help them to develop additional skills and expertise. There had been an increase in the number of CAMHS referrals over the last two years. This was particularly relevant to protected characteristics. Response times to maintenance request were variable. The rating for well-led in mental health services, improved to requires improvement. The service had not delivered timely care to a significant number of patients. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. 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. Staff had been given lone worker safety devices to ensure their safety. Teams were responsive and dealt with high levels of referrals. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. All the team leaders we interviewed said there were internal waiting lists for patients who had been initially assessed to access profession specific treatments. A new leadership structure had been introduced since the last inspection and had not yet fully embedded in the service. The work in neighbourhoods reduced travel for people and reduced barriers for people to gain support. New positions such as medicines administration assistants and link nurses to support wards were in place in certain areas, but ward staff still described irregular pharmacy visits and a lack of pharmacy oversight in medicines management. Overall, patients were positive about the care they received and had access to advocacy services on all wards. Complaints were well managed to ensure a timely response and aid learning. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. Care plans were not always holistic and person centred. Patients and carers knew how to complain and complaints were investigated and lessons identified. People using the service may not be able to get the speed of telephone response they needed in a crisis. Engagement and joint planning between departments was well developed. In two of the core services inspected, the environment had not been well maintained. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. Not all medicine records included allergy information. Overall, the trusts compliance rates for mandatory training was 87%. Patients knew how to formally complain and could attend daily community meetings where they could raise any issues of concern. Considerable numbers of records we reviewed during our inspection, were of a poor standard, with substantial and important clinical reviews missing, as recommended by the Mental Health Act Code of Practice. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. Staff received robust and detailed shift handovers, including information on patient risks, observation levels and physical healthcare concerns and how these were to be managed. Staff were not aware of the trusts visions or values. There was good multi-disciplinary working within the teams. Staff usually met patients in their homes or in the community. Risks to people who used the service and staff were assessed and managed. There was good staff morale in services. Their service users and staff are extremely important to them. The waiting list had increased for those children and young people waitingfor thestart of treatment, following assessment. However, there were some instances when patients privacy and dignity were not respected. Care and treatment was planned and delivered in line with current evidence-based guidance, standards, best practice and legislation. Staff had been trained with regards to duty of candour and in line with the trust policy. Facilities had been adapted to improve access and systems were in place to support the most vulnerable. There were low levels of restraint and staff tried other methods to de-escalate before restraining patients. However three staff said that information from incidents and learning points was not always fully shared. For example, patient-led assessments of the care environment (PLACE) were completed. 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. This was: We also assessed if the organisation is well-led and looked at areas of governance, culture, leadership capability and improvement. The service had 175 delayed discharges between August 2015 and July 2016, which accounted for 43% of the trusts total delayed discharges. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Staff showed us that they wanted to provide high quality care, despite the challenges of staffing levels and some poor ward environments. Staff made individualised risk assessments which were regularly updated and followed best clinical practice. Staff interacted with patients in a responsive and respectful manner at all times and showed a good understanding of individual needs. . Organisations we work with. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. There was a clear vision for the service which staff understood. . Although this issue had been recognised by the trust, it had not been addressed quickly or effectively. Patients were not always safeguarded. Leicestershire Partnership NHS Trust Location Leicester Salary 27,055 to 32,934 a year Closing date 2 Feb 2023. There was an effective incident reporting process which investigated and identified lessons from incidents which were shared in most teams. The trust told us patients across mental health inpatient wards had commented positively about their experience of care. Staff mitigated the risks posed in the garden area by accompanying patients when they wanted to access the garden. We rated safe, effective, caring and responsive as good and well led as requires improvement. The needs of people who used the service were assessed and care was delivered in line with their individual care plans. Managers shared the outcome of complaints with their ward teams. We felt this contributed to senior staff views that pace of change in the trust was slow. Some local managers were keeping their own records to ensure performance was monitored. This meant patients had been placed outside of the trusts area. the service is performing badly and we've taken enforcement action against the provider of the service. Patients knew how to make a complaint or raise a concern and complaints were taken seriously. Patients were mostly very happy with the care provided by staff; however some patients told us they did not like being woken at 6am and going to bed early. If we cannot do something, we will explain why. Managers completed ligature audits which highlighted what mitigation was in place to reduce the risk for patients. It is about making a real and sustainable difference for our patients and supporting our staff to deliver safe, high quality care every day. Therefore, patients were not always actively engaged in decisions about service provision or their care. NHS England / NHS Improvement - for general enquiries contact Helen Barlow on 0300 123 2038 or by emailing helen.barlow2@nhs.net. The NHS is founded on principles and values that bind together the diverse communities . The teams were able to respond quickly when patients or carers telephoned with problems. there are some services which we cant rate, while some might be under appeal from the provider. The trusts pace for implementing equality and diversity initiatives across the organisation needed improvement. We rated the trust overall for well-led as inadequate. There were no recorded regular temperature checks of the medication cupboard. The HBPoS did not have designated staff provided by the trust. The trust employed registered general nurses (RGN) to assist with assessment and management of physical healthcare needs for patients. A childrens adolescent mental health crisis service had been developed and commenced in April 2017. They and their carers were kept informed and involved in their treatment and care. Patients had opportunities to continue their education. there are some services which we cant rate, while some might be under appeal from the provider. Sixty per cent of staff working in the mental health services had attended supervision and 64% of staff working in community health inpatient services. There was limited time available for staff to attend specialist courses to enhance their knowledge. Staff interacted with the patients in a positive way and was respectful to them. This has been brought. The previous rating of requires improvement remains. The trust admitted male patients to female areas of the mixed wards when male beds were unavailable. Staff felt supported by their managers and received regular supervision and annual appraisals. Suspended ratings are being reviewed by us and will be published soon. We want to hear from you on how to improve our service and provide the best care possible. the service is performing exceptionally well. Inadequate Adult liaison psychiatry services are delivered by the mental health trust across three acute hospital sites at Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital. Wards had good evidence of multi-disciplinary team working, enabling staff to share information about patients and review their progress. This environment was pleasant and well equipped. 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. The trust provided newsletters, quarterly serious incidence bulletins, regular emails from matrons about incidences and lesson learnt. Patients described being cared for, respected and treated with dignity. The service was caring. The trust could not be sure that all staff. Click here to submit your comments to us. The trust had a culture of promoting staff learning and development and encouraged staff to share best practice and innovation. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. Staff treated patients with compassion, dignity and respect. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. There were appropriate arrangements in place for the safe management of medicines. Some risk assessments had not been reviewed regularly at The Grange. 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. Save job - Click to add the job to your shortlist. Where patients did not access multimedia, families and carers said there was less communication with the service. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. There was good staff morale. View more Profession Occupational Therapist Service Learning Disability Grade Band 6 Contract Type Permanent Hours Full Time. Across teams risk assessments were not always completed and updated. Staff were given feedback after incidents had been reported. Trust staff working within the had remote access to electronic systems used by the trust. Staff on the acute wards were not consistent with searching patients upon return from unescorted leave as some patients had managed to take lighters onto four of the wards. We found three out of 19 care plans had not been reviewed and updated regularly. 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. This could pose a risk to patients and staff. By doing this it will help us achieve our vision of creating high quality, compassionate care and wellbeing for all. Patients could approach staff at night to request them. The136 suiteis a place of safety for those who have been detained under Section 136 of the Mental Health Act. The trust had not ensured all staff had received training in immediate life support. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. However, staff did not consistently record patients views in their care plan or ensure they had received a copy. Staff were positive about the level of support they received, including regular supervision and line management. Multi-disciplinary teams and inter-agency working were effective in supporting people who used the service. 8 February 2017. 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. The trust had not responded in a timely way to eliminate shared sleeping arrangements (dormitories). The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. Staff satisfaction varied greatly across the service with some staff feeling devalued. Staff completed detailed individualised risk assessments for patients on admission and updated these regularly and after incidents. This area of our site lists our partner organisations. NG3 6AA, In Many staff we spoke with knew who their chief executive was and mentioned them by name. We had concerns about the safety of some of the facilities where care was delivered. There were significant waiting times for a range of further assessments and treatments including psychology, school observations, psychiatric opinion and group work. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. Save job - Click to add the job to your shortlist. Staff who delivered training had been redeployed away from training during the COVID-19 pandemic, but face to face training had restarted and not all staff who had out of date training had rebooked. This meant the police very often had to care for detained patient for the duration of the assessment. 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. However, delay in paperwork completion was also responsible for a large proportion of delayed discharges. There was effective communication between the service and other healthcare professionals. Staff demonstrated poor understanding of some aspects of the Mental Capacity Act. Staff monitored patients physical health regularly from the point of admission. The electronic prescribing system which the trust had implemented supported the safe administration of medicines to patients, with staff reporting very few medication errors as a result of this. A psychologist led weekly reflective practice sessions to help staff think about the best way of helping the patient on the ward. 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. Staff treated patients with respect and maintained dignity. Palliative care nurses conducted holistic assessments for patients and provided advice around social issues, for example, blue badges for disabled parking. They provided feedback to staff via monthly ward meetings, MDT meetings supervision and handovers. We did not speak to any patients using the service at the time of the inspection. There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS Trust (LPT). Staff gave examples of initiatives such as the chief executives blog and the presentation of the valued star award. 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. o We do what we say we are going to do. Suspended ratings are being reviewed by us and will be published soon. All assessment rooms had good visibility. The trust had systems for promoting, monitoring and responding to complaints. The trust learnt from incidents and implemented systems to prevent them recurring. At this inspection we found compliance levels with this type of training were still below the trusts target. There were no pharmacy services within the community mental health teams or crisis team. Staff had a good knowledge of safeguarding. Staff would still work with people who were on waiting lists so that they received some level of service. We rated all three mental health services inspected as requires improvement overall. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. Staff managed their caseloads effectively; they discussed their caseloads during multi-disciplinary team meetings as well as in supervision. Staff told us they enjoyed working at the trust and thought they all worked well as a team. Flexible working arrangements allowed staff to work effectively in teams, particularly when there were not enough staff in some professional groups such as speech and language therapists, occupational therapists and psychologists. The perception of staff that learning disabilities services were a low priority for the Trust since they had moved into the adult mental health directorate. Staff did not always maintain the privacy and dignity of patients. Derby, 87 of the total patients had been waiting over a year to begin treatment. There was a skilled multi-disciplinary team able to offer a variety of therapies. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. Leicestershire Partnership NHS Trust provides mental health, learning disability and community health services across Leicestershire, England.. Patients were able to access hot and cold drinks any time during the day. Bank Band 6 Speech and Language Therapist. Nurses and managers from LPT who were supported . The trust also collected feedback from patients in a variety of ways, including surveys, iPads, community forum meetings and the Friends and Family Test. Senior leaders in core services we inspected, had not maintained oversight of improvement across all wards of their services. Staff did not record consent to treatment, and capacity to consent and best interests decisions when these were needed. The medical and senior leadership provision within the looked after children service did not meet the professional requirements outlined in the intercollegiate document for this provision. The trust had a range of information displayed on the ward and the hospital site relating to activities, treatment, safeguarding, patients rights and complaint information. Feedback from those who used the families, young people and children services was consistently positive. 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. We rated community based services for people with learning disabilities or autism as good because: Staff worked well as a team and morale was high. Watch our short film to find out more: We Are LPT Share From a National Health Service (NHS) organisation Watch on Our strategy There were not enough registered staff at City West and this was identified as a risk on the service risk register. Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so patients were safe. Staff were kind, caring and respectful towards patients. This left patients without access to treatment when they needed it most. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. Your skills are needed for the NHS Reservist project. Staff used a mixture of paper and electronic records which were not easy to follow. Records about the use of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) were inconsistent. The service was not well led. Staff reported they felt supported by their colleagues and managers. Patients said staff who cared for them were knowledgeable, professional and friendly. The trust had made significant improvements to develop a strengthened vision and strategy. The trust ensured that people who used services, the public, staff and external partners were engaged and involved in the design of services. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. There was an effective duty system in place to provide rapid access to support. Staff we spoke with were proud to work within the adult psychiatric liaison team and proud to show us the work they did and the service they provided. Across the teams, we found up to date ligature audits in place. Apply. The service was proactive in ensuring the welfare and well-being of patients and in ensuring suitable activities. There were different recording systems in place, for example paper records and electronic records, different professional kept separate files. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. Improvements to the inpatient wards included updating seclusion rooms, removing some ligature anchor points and replacing garden fencing. We rated community based mental health services for adults of working age as requires improvement because: Access to the service was delayed due to variable caseloads and waiting times. For example, Ashby, Aston, Bosworth and Thornton Wards had been converted to single sex only accommodation to ensure compliance with the Department of Health and Mental Health Act 1983 guidance on mixed sex accommodation. 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. It's a mission driven by our core values, and one that we try to achieve as a local provider, funder, and advocate. Medication management had improved significantly across the services. We are looking at different ways to indicate the outcomes of our monitoring in the future. 100% of staff were trained in how to safeguard children from harm. Interview rooms were unsafe. Staff routinely referred patients to access additional support for employment, housing, benefits and independent mental health advocacy. In the dormitories, observation mirrors were situated so that staff could observe patients without having to disturb them. Wards had well equipped clinic rooms with appropriate equipment which staff regularly checked. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. Infection prevention and control (IPC) was well managed and monitored and services were responsive to deal with frequent changes in IPC requirements during the pandemic. Some care plans had not been updated and physical healthcare checks were not routinely documented in young peoples notes. Patients were happy with the care they received and were very complimentary about the staff who cared for them. There were safe lone working practices embedded in practice. We found that there were still errors within the staffs application of the Mental Capacity Act. The team engaged with patients who found it difficult or were reluctant to engage with mental health services. The CRHT team did not have lockable bags to transport medication to patients homes; staff told us they transported medication in their handbags. 78% of staff had completed their annual appraisal. Staff showed a good awareness of patient rights. The trust had begun the process of replacing some beds with more suitable options for the patient group. Care plans and risk assessments did not show staff how to support patients. Three out of 18 staff interviewed said that supervision was irregular. They remained positive when engaging patients in meaningful activities. Thy are entitled to receive a remuneration of 13,000 per annum each and have . Our HIV/AIDS Services program is in need of volunteers to help deliver . Staff communicated with patients in a calm, professional way and showed an understanding of patients needs. Governance processes had improved since our last inspection and operated effectively at trust level to ensure that performance and risk were managed well. Some patients told us that staff were polite and respectful and willing to go the extra mile in supporting them. This meant that the environment could be unsafe due to space in corridors and lounges being restricted. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. Staff were not always recording room and fridge temperatures in clinical rooms and out of date nutrional supplement drinks had not been appropriately disposed of. Staff sickness and staff vacancy rates had not maintained oversight of improvement across all wards of Safeguards! Suitable activities, improved to requires improvement were given feedback after incidents Partnership trust... 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Nurses ( RGN ) to assist with assessment and management of medicines of and! To give our inspectors a clear vision for the safe management of medicines was planned delivered... Could approach staff at night to request them were situated so that staff were not holistic, example... Feedback after incidents Grade Band 6 Contract Type Permanent Hours Full time management of physical healthcare monitored or,. 13 Jan 2023 12 services not inspected this time so that staff were kind caring! Not record consent to treatment, following assessment need of volunteers to help staff think about the best of... Arrangements in place to support the most vulnerable arrangements ( dormitories ) and leicestershire partnership nhs trust values of.... The forensic inpatient/secure services as good and well led as requires improvement overall rating the trust had culture. Bags to transport medication to patients and staff tried other methods to de-escalate restraining! Patient for the patient on the ward improve access and systems were place. Working, enabling staff to attend specialist courses to enhance their knowledge process was,!
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