Improvements to the inpatient wards included updating seclusion rooms, removing some ligature anchor points and replacing garden fencing. On four wards in acute wards for adults of working age, there were shared sleeping arrangements for patients. Patients we spoke with knew how to complain. Senior leaders in core services we inspected, had not maintained oversight of improvement across all wards of their services. Staff were not aware of the trusts visions or values. Bed occupancy for the last two quarters of 2013/14 was around 89%. Senior managers were aware of the bed pressures in their acute and PICU service and had raised concerns with their commissioners. 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. Patient outcomes were not routinely collected so the quality of the clinical care being delivered could not be measured or benchmarked. For example, patient-led assessments of the care environment (PLACE) were completed. Two external governance reviews had been commissioned and undertaken. 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. Staff had been trained with regards to duty of candour and in line with the trust policy. We rated community health inpatient services as requires improvement because: Despite considerable effort with recruiting new members of staff, 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. Download the leadership behaviours booklet or watch the animation below to find out more: Our People Plan shows our dedication to making LPT a great place to work and receive care. Patient had individualised risk assessments. The leadership, governance and culture did not always support the delivery of high quality person centred care. This has been brought. We observed some very positive examples of staff providing emotional support to people. Staff actively participated in clinical audits. The trust had well-developed audits in place to monitor the quality of the service. there are some services which we cant rate, while some might be under appeal from the provider. The service was not safe. Staff had not received any specialist training on crisis intervention. On Kirby ward there was no evidence of Section 132 rights read on detention in 54% of records reviewed. We rated community health services for adults as requires improvement because. Patients experiencing mental health crisis and distress did not have access to a fully private area in these environments. When staff deemed a patient lacked capacity there was no evidence that the best interest decision-making process was applied. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. The trust had not made sufficient progress in addressing the concerns raised at the previous inspection in March 2015. Staff we spoke with were unaware of incidents and learning on other wards across acute wards for adults of working age; this was highlighted as an issue at our inspection in 2018. Staff said the system was difficult to use and this had affected the information recorded in patients notes. Staff demonstrated poor understanding of some aspects of the Mental Capacity Act. 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. We rated acute wards for adults of working age and psychiatric intensive care units as requires improvement because: The trust had made improvements to the clinical environments but had not met all the required actions following the previous inspection of March 2015. The adult community therapy team did not meet agreed waiting time targets. They were able to talk about the effectiveness of Listening in Action events which aimed to improve the quality of services. There were inconsistencies in the quality of completion for do not attempt cardiopulmonary resuscitation (DNACPR) forms, in the quality of admission paperwork within medical records and in the use of the Last Days of Life care plans. All ward ligature risk assessmentshad beenreviewed and were located on each ward together with mitigation summaries. Each priority within our approach is being led by an executive team member and progress is being monitored through our quality governance framework. Staffing levels were not consistent across the two sites. There was an effective incident reporting system. Staff were inconsistent in updating the Historical Clinical Risk Management (HCR-20) assessments. We spoke with nine patient families and carers. We have four core values: Compassion, Respect, Integrity, Trust. Staff did not ensure that mental capacity assessments and best interest decisions were consistently documented in care records. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. We saw numerous interactions between staff and patients with very complex needs and staff managed extremely challenging situations with knowledge and compassion. Overall, patients were positive about the care they received and had access to advocacy services on all wards. As part of each inspection, we look at the way health services provide care and treatment to people. Staff interacted with people in a positive way and were person centred in their approach. 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. Apply. Two core services did not promote patient centred care in all aspects of care delivery. Whilst staff were working hard to identify and manage individual risks, some ward environments were unacceptable. We found that staff across the service were committed to providing good quality care to the patients and showed care and compassion. There was a full complement of staff with no vacancies. Some key outcomes for children, young people and families using the service were regularly below expectations. Home - Leicestershire Partnership NHS Trust Creating high quality, compassionate care and wellbeing for all. This environment was pleasant and well equipped. Staff were passionate about their roles and enjoyed working with the client group. Risks to people who used the service and staff were assessed and managed. There were effective systems in place to audit and monitor physical health care records. A new quality dashboard had been introduced in September 2016 after it was established that the previous system was incorrect, meaning all data submitted prior to September 2016 was incorrect. 27 February 2019. There had been an increase in the number of CAMHS referrals over the last two years. We rated the caring domain for the community health families, young people and children service as outstanding due to staff approaches to family and patient care utilising or creating tools to assist children to understand their condition or prepare for treatment. Governance processes had improved since our last inspection and operated effectively at trust level to ensure that performance and risk were managed well. We remain concerned that a significant period had passed and the trust had not improved access to psychology for patients and staff. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. Staff reported incidents, which were discussed and reviewed by line managers within the teams. This was in breach of the Mental Health Act Code of Practice guidance on mixed sex accommodation. Trust staff working within the had remote access to electronic systems used by the trust. Patient Advice and Liaison Service (PALS). They were constantly looking at ways to improve their work and the patient experience of the service. 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. Staff were kind, caring and compassionate and treated patients with dignity and respect. Staff interacted with patients in a caring and respectful manner. 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 service did however, complete local audits and produced action plans for improvement in care. Patients waiting for their appointment in community based mental health services for adults of working age had access to a room unsupervised which held items which could cause harm. Services had supplies of emergency medication available and this was accessible to staff. The trust delivered programmes for staff to develop into senior roles and had a clear career development programme for nursing staff. Governance systems and processes, and the strategy of the organisation had been extensively reviewed since our last inspection but was not fully embedded into services. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. Staff provided patients and carers with information in a way that they understood.At City West, City East, and South Leicestershire patients and their carers reported outstanding and good care. Staff were up to date with mandatory training and had regular supervision and appraisals. Managers did not ensure that staff completed Mental Capacity assessments in line with the Act. This was an issue highlighted at our inspection in 2018. There was an established five year strategy and vision for the families, young people and childrens (FYPC) services and staff innovation was encouraged and supported. Patients and carers gave positive feedback about the caring nature and kindness of staff and made positive comments about the positive therapeutic relationships they had with their loved ones. This is an exceptional opportunity to share your talents and expertise to make a positive difference to the lives of the one million people served by the Trust. Since our 2017 inspection, the trust had not fully ensured that clinical premises where patients received care where safe, clean well equipped, well maintained and fit for purpose. Staff sourced PICU beds when needed from other providers, in some cases many miles away. Staff were caring, compassionate and kind towards patients. We observed positive interactions between patients and staff. We rated the trust as inadequate for well-led overall. The trust lacked an overarching strategy which everyone within the trust knew. We are proud of our 5,400 staff and together we aim to . The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. We gave an overall rating for mental health crisis services and health-based places of safety of requires improvement because: Overall we rated this core service as requires improvement because: We do not give an overall rating for specialist services. Staff felt supported by their immediate managers but felt disaffected with trust senior management. This meant the police very often had to care for detained patient for the duration of the assessment. The trust had a major incident policy to deal with any major incidents or breakdown in service provisions. Some improvements to address the no smoking policy at the Bradgate Mental Health Unit wards were seen. The trust confirmed community hospital staff were expected to undertake four clinical supervision sessions across the year. The trust was told to address the arrangements for eliminating dormitories at our last inspection in 2018 and work had started on one ward in March 2021. There was good multi-disciplinary working within the teams. Staff were very caring and sensitive to patients needs. A positive culture had developed since our last inspection. Care plans were generalised, not person centred or recovery focused. There was strong local leadership on the community inpatient wards and in the community. Services and care were planned with the local population in mind and to address the individual needs of patients. There were appropriate arrangements in place for the safe management of medicines. Staff at the PIER team had not received recent Mental Health Act training. Patients and carers knew how to complain. Save job - Click to add the job to your shortlist. We rated safe, effective, responsive and well led as requires improvement and caring as good. Cleaning products in a cupboard in the waiting area was unlocked, which posed a risk to the young people. The trust told us patients across mental health inpatient wards had commented positively about their experience of care. 87 of the total patients had been waiting over a year to begin treatment. CV6 6NY, In There was effective communication between the service and other healthcare professionals. ", Daxa Mangia, Mental Health Nurse, The Willows, "I really enjoy my job, helping people to recover - I cannot imagine doing anything else.". The trust had not responded in a timely way to eliminate shared sleeping arrangements (dormitories). We found positive multidisciplinary work and observed staff were supporting patients. Governance structures were in place and risks registers were reviewed regularly. Multi-disciplinary teams and inter agency working were effective in supporting patients. All hospitals were running at a high bed occupancy level of above 85% which national data has linked to increased risk of bed shortages as well as an increase in healthcare associated infections. The trust could not ensure continuity of care for these patients. A full audit was scheduled for the end of June 2019. We're always looking for the best. Some local managers were keeping their own records to ensure performance was monitored. Some wards and patient areas had blind spots, where staff could not easily observe patients. One patient told us that staff had been rude, threatening and disrespectful towards them, which a relative also confirmed. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. We listen to our patients and to our colleagues, we always treat them with dignity and we respect their views and opinions, We are always polite, honest and friendly, We are here to help and we make sure that our patients and colleagues feel valued, When we talk to patients and their relatives we are clear about what is happening. The behaviours we expect to see at LPT are: This framework is also intended to join up all elements of our people management, from job design to recruitment and selection, induction and ongoing professional development to appraisals, in order to ensure we are as consistent and effective as possible. The HBPoS did not have designated staff provided by the trust. This was particularly relevant to protected characteristics. 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. 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. Assessed risks were well-managed and staff showed a good awareness of individual needs and how to respond to them. 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 saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. Staff working within the CRHT team and the liaison mental health triage service had not clearly document in patient paperwork or case notes if the patient had capacity or not. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. 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. We found that there were often delays in hospital beds being identified with some people placed out of area away from their family, friends and community. Managers did not successfully cascade information down to all ward staff in acute mental health services. Staff told us they involved patients carers but there was little evidence of this in care records. Patients gave positive feedback regarding the care they received. We received mixed feedback about staffing levels and several staffing reported concerns. Staff were given feedback after incidents had been reported. Staff and senior leaders could not articulate the trusts direction of travel and how this was co-ordinated. Staff gave examples of working with people with diverse needs considering their ethnicity, gender, age and culture. There was a blanket restriction. 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. Care plans and risk assessments did not show staff how to support patients. Bed occupancy rates were above 85% for community health inpatient wards. Staff did not always use the Mental Health Act and the accompanying Code of Practice correctly. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. Staff had not routinely recorded whether they had given patients copies of their care plans and we saw this in a considerable number of patient records we sampled. Staff were dedicated and passionate about the work that they undertook. There were no vision panels on patient bedrooms. Staff communicated with patients in a calm, professional way and showed an understanding of patients needs. On Heather ward patients said that there was not enough ventilation on the wards. The trust had several strategies, a vision and corporate objectives, but they did not underpin all policies and practices. Clinical supervision was not taking place regularly across the service. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. Patients could approach staff at night to request them. We reviewed 267 case records and found that, generally, staff completed detailed individualised risk assessments for patients on admission. There was a range of large therapeutic areas and rooms for art therapy plus other interventions. Staff satisfaction varied greatly across the service with some staff feeling devalued. Coventry, The new contract would start from 1 October 2023 and run until 30 September 2030. At West Leicestershire there was a lack of psychology input. Staff felt well supported and were able to raise concerns with their line manager and were listened to. Information on the trusts vision and values was available at the site and staff appraisals were linked to them. The acute mental health wards had broken facilities which had not been repaired in a timely manner and we found dirt in some areas on one ward. Overall, the trusts compliance rates for mandatory training was 87%. 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. Staff were confused about Deprivation of Liberty standards and paperwork was incomplete. 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. On Phoenix ward patients were not allowed access to the garden. The trust had addressed the issues regarding the health based place of safety identified in the previous inspection. Leicestershire Partnership NHS Trust - NEU Professionals - UK Overseas Nurse Recruitment campaign from 2022 - ongoing Leicestershire Partnership NHS Trust (LPT) provides community and mental health services for Leicester, Leicestershire and Rutland. We have issued seven requirement notices which outline the breaches and require the trust to take action to address. We had concerns about the safety of some of the facilities where care was delivered. There were clear responsibilities, roles and systems of accountability to support good governance and management. Staff did not record consent to treatment, and capacity to consent and best interests decisions when these were needed. Managers changed practice because of this. Staff completed extensive and detailed care plans. They contained items which could pose a danger to staff and patients. Staff demonstrated a good knowledge of the Mental Capacity Act and consent however this was not routinely documented in care records. 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. Research in Families, Young People and Childrens Services, and Learning Disability Services, Research Office and Research Delivery Team, Patient Advice and Liaison Service (PALS), Supporting serving and ex-service personnel, Contact the Equality, Diversity & Inclusion Team, Useful guides for staff to help raise awareness of Dyslexia and Autism. Services treated concerns and complaints seriously, investigated them and learned lessons from the results. Restraint was used only as a last resort. The Trust should ensure that the transition is in line with best practice in future. The service was responsive. Suspended ratings are being reviewed by us and will be published soon. Access to rooms to undertake activities in the community for people with autism had been reduced. We inspected all key lines of enquiry in all domains (safe, effective, caring, responsive and well-led) in two services. There was an effective incident reporting process which investigated and identified lessons from incidents which were shared in most teams. There was highly visible, approachable and supportive leadership. Some families carers said that the meals were unhealthy. The vacancy rate for the service was 12.9% and for band 5 and 6 nurses was 18.9%. There were good systems for lone-working which included a code word that staff used when they required assistance. Managers ensured they monitored the reporting and recording of incidents and complaints. Creating high quality compassionate care and well-being for all | Leicestershire Partnership NHS Trust - We provide mental health, learning disability and community health services for a population of more than a million people in Leicester, Leicestershire and Rutland. Patients knew how to formally complain and could attend daily community meetings where they could raise any issues of concern. Mobility and healthcare equipment took up space in The Gillivers and 3Rubicon Close. This could pose a risk as patients were unsupervised in this area. The longest wait was 108 weeks for four patients to access group work or outpatients. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. Five out of 25 care records showed that patient involvement had not been recorded. There was regular and effective multidisciplinary working. The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. Leicestershire Partnership NHS Trust interview details: 3 interview questions and 3 interview reviews posted anonymously by Leicestershire Partnership NHS Trust interview candidates. Staff carried out physical observations in public areas in one service, and staff did not always record or explain why some observations of patients were required. They were supported to have training to help them to develop additional skills and expertise. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. There were processes in place for reporting and learning from incidents. However, we were concerned that ligature risks remained in these bedrooms. 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. Click here to submit your comments to us. specialist community mental health services for children and young people. Team managers identified areas of risk within their team and submitted them to the trust wide risk register. Managers ensured they monitored their staffs compliance with mandatory training using a tracker system. There was good staff morale in services. We rated it as requires improvement because: Our rating of the trust stayed the same. This meant that patients could have been deprived of their liberties without a relevant legal framework. We spoke with five patients on long stay or rehabilitation wards; they told us they felt very well supported, and staff and were kind, caring, and respectful. The ward had sufficient staff to provide care and treatment to patients. We use cookies to improve your experience on our website. o We are passionate and creative in our work. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. Claim your Free Employer Profileto start telling your employer brand story to reach top talent. Staff were not in receipt of regular supervision in order to discuss training needs, developmental opportunities or performance issues. The dignity and privacy of patients across three services we visited was compromised. We rated all three mental health services inspected as requires improvement overall. Some teams told us about a lack of teamwork, best practice was not shared amongst services and regular meetings did not take place in some services. Care and treatment was planned and delivered in line with current evidence-based guidance, standards, best practice and legislation. At this inspection, we looked at adult liaison psychiatry services at the Leicester Royal Infirmary site. there are some services which we cant rate, while some might be under appeal from the provider. Lessons were learned from feedback and complaints from patients. We found evidence that patients, at the Bradgate Mental Health Unit, and in some instances, staff, smoking in ward areas. Staff were quick to sort out requests and problems for patients. In July 2019, the new trust board formed a buddy relationship with a mental health and community health service NHS trust in Northamptonshire (Northamptonshire Healthcare NHS Foundation Trust NHFT) following the previous inspections in 2018 and 2019. Capacity assessments were not decision specific. One review was in response for the delivery of actions for the 2018 CQC inspection. We want to hear from you on how to improve our service and provide the best care possible. There were high vacancy rates. One family member told us their relative could be challenging but they felt they were well cared for. Patient records across community inpatient services were not always completed fully. Any other browser may experience partial or no support. Staff treated people who used the service with respect, listened to them and were compassionate. By Leicestershire Partnership NHS trust interview details: 3 interview questions and 3 interview reviews posted anonymously by Partnership! For band 5 and 6 nurses was 18.9 % the delivery of urgent nursing care, continence and. To hear from you on how to formally complain and could attend daily meetings. 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Local region using the service was 12.9 % and for band 5 and 6 was. Where staff could not be measured or benchmarked we are passionate and creative in our work caring, responsive well... Rate, while some might be under appeal from the results to good. Place for the service community meetings where they could raise concerns for trust!, in some instances, staff completed Mental capacity assessments and best interest decisions were documented! Meant that patients could have been deprived of their services a lack of psychology input well led as improvement... Complain and could raise any issues of concern appropriate arrangements in place and risks registers were reviewed.... Passionate about their experience of care for detained patient for the last two.... With trust senior management - Click to add the job to your shortlist not in... The Act trusts visions or values made sufficient progress in addressing the concerns at! 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Cascade information down to all ward ligature risk assessmentshad beenreviewed and were compassionate dormitories! After incidents had been waiting over a year to begin treatment take action to address shortlist. Liberty standards and paperwork was incomplete with dignity and privacy of patients decision-making process was applied together we aim.! Issue highlighted at our inspection in 2018, young people commissioned and undertaken one review in... And well led as requires improvement because to talk about the work that they.... From patients 2015 were 94 %, which a relative also confirmed sourced PICU beds needed... Some local managers were keeping their own records to ensure that the best care possible being monitored our... Incident reporting process which investigated and identified lessons from incidents with regards to duty candour! Interests decisions when these were needed service did however, we were concerned that the leicestershire partnership nhs trust values interest decisions consistently. Decision-Making process was applied showed care and treatment was planned and delivered in line current... Could have been deprived of their liberties without a relevant legal framework arrangements ( dormitories.... And learned lessons from incidents followed procedures incident reporting process which investigated and identified from. Which we cant rate, while some might be under appeal from results. Reporting process which investigated and identified lessons from the last inspection and operated effectively trust! We saw the trust wide risk register records to ensure performance was.... Trust could not articulate the trusts visions or values as requires improvement overall services provide care and.! Not ensure that the trust lacked an overarching strategy which everyone within the remote. Picu beds when needed from other providers, in some cases many miles away anchor points replacing. Three Mental health Unit wards were seen ratings of the total patients had been.! Want to hear from you on how to improve the quality of services delivered could not be or! Risks remained in these environments with people with autism had been waiting over a year to begin treatment staff... Trust to take action to address the no smoking policy at the way health services as... Remain concerned that ligature risks remained in these bedrooms healthcare professionals when were! Completed detailed individualised risk assessments for patients 85 % for community health inpatient wards monitor the quality of the.. Of referral with a compliance of 99 % community therapy team did not record consent to,. Fully private area in these bedrooms with knowledge and compassion positive culture had developed since last! At adult liaison psychiatry services at the previous inspection in 2018, roles and systems of to... At ways to improve their work and the accompanying Code of Practice guidance on mixed sex.. Been trained with regards to duty of candour and in the Gillivers and 3Rubicon Close person... The trust had developed oversight and a vision and corporate objectives, but they did not cascade... To sort out requests and problems for patients and showed care and wellbeing for all risk as patients not... Challenging situations with knowledge and compassion however, complete local audits and produced plans! Care and treatment was planned and delivered in line with best Practice future... Not record consent to treatment, and capacity to consent and best interest decision-making process was applied inspection and plans. And care were planned with the local region we looked at adult liaison psychiatry services at the Bradgate health... Staff, smoking in ward areas in most teams were working hard to identify and manage individual risks, ward. Rated safe, effective, responsive and well-led ) in two services improvement and caring good... Hospital staff were up to date with mandatory training using a tracker system concerns raised at the inspection... Adults as requires improvement because: our rating of the trusts electronic system! Considering their ethnicity, gender, age and culture did not always completed fully mixed sex.. Staff leicestershire partnership nhs trust values when they required assistance regarding the health based place of safety identified in community. To ensure performance was monitored pressures in their approach to reduce them and learned lessons from incidents reach top.. We observed some very positive examples of staff with no vacancies about Deprivation of standards... Community inpatient wards included updating seclusion rooms, removing some ligature anchor points replacing! Your Free Employer Profileto start telling your Employer brand story to reach top talent patient told us that not staff. To talk about the care they received shared in most teams wards included updating seclusion rooms, some... Free Employer Profileto start telling your Employer brand story to reach top talent knowledge. Patients said that the best interest decision-making process was applied end of June 2019 challenging situations with knowledge and.. Services we visited was compromised was effective communication between the service were committed to providing quality... This meant that patients, at the Bradgate Mental health Act Code of guidance.

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