Concerns in regards to Mental Capacity Act were identified at the last inspection as a breach of the HSCA regulation 9. Community meetings and patient involvement in the services did not always take place. One patient at Stewart House told us other patients made comments around their protected characteristics and staff had not care planned the needs of the patient. Where applicable, we have reported on each core service provided by Leicestershire Partnership NHS Trust and these are brought together to inform our overall judgement of Leicestershire Partnership NHS Trust. Significant vacancy rates and high sickness levels put additional pressure on substantive staff. The learning disability community team had not met the six week target for initial assessment on average it was six days over. 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. Clinic room temperatures were very hot, although one thermometer was above a radiator so would not give an accurate reading. Bed occupancy for the last two quarters of 2013/14 was around 89%. Some improvements to address the no smoking policy at the Bradgate Mental Health Unit wards were seen. Staff reported they felt supported by their colleagues and managers. Staff interacted with people in a positive way and were person centred in their approach. There was a high staff sickness rate reported and managers did not always follow the managing sickness policy. However at South Leicestershire clinical supervision take-up was low at 73%. Staff had a good knowledge of safeguarding. Staff treated patients with compassion, dignity and respect. Staff considered and supported patients with their physical health needs in CRHT and the liaison mental health triage service. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. 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. Care records showed that physical health examinations were completed upon admission and there was ongoing monitoring of physical health across the trust. A new chief executive was appointed as a shared role between the two trusts. Medication management systems were in place and followed to ensure that medicines were stored safely. Staff were given feedback after incidents had been reported. A childrens adolescent mental health crisis service had been developed and commenced in April 2017. Some improvements were seen in seclusion documentation and seclusion environments. The ovens were old and the dials were not visible and cupboards were broken. The HBPoS did not have access to a dedicated clinic room. Staff kept risk assessments up to date and carried out comprehensive assessments which were holistic and recovery focused. The trust had begun the process of replacing some beds with more suitable options for the patient group. ", "I like that I'm able to help both staff and service users. The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. 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 felt safe. Preventing infections Same sex accommodation Building better hospitals eHospital Programme Our values 'We treat people how we would like to be treated' 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 Staff did not record seclusion well. A family member spoke about enjoying regular meetings in the service gardens with their relative. They showed a good understanding of peoples individual needs. 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. At the Valentine Centre improvements had been made to the storage of cleaning materials. There was an effective duty system in place to provide rapid access to support. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. We heard positive reports of senior staff feeling able to approach the executive team and the board. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. Following the appointment of a new chief executive a new trust board was formed. There was no performance data dashboard to gauge the performance of the service. ", Daxa Mangia, Mental Health Nurse, The Willows, "I really enjoy my job, helping people to recover - I cannot imagine doing anything else.". Families and carers said the wards were clean. Staff did not demonstrate a good understanding of the Mental Health Act (MHA) and Mental Capacity Act (MCA). Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. 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. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. Staff did not always feel actively engaged or empowered. They later told us that this had been an ongoing concern for around five years. This was a focused, unannounced inspection, to follow up on enforcement action we issued to the trust after our last inspection in November 2018. There was detailed discussion and consideration of patients and carers needs. CAPTRUST for Institutions. Risk assessments were completed and care plans implemented to keep patients safe and promote wellbeing. The ward had an up to date ligature risk audit, staff mitigated the risks on the ward by observing patients. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. 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. The ratings from the inspection which took place in November 2018 remain the same. Staff did not routinely complete detailed, person centred, individualised or holistic care plans about or with patients. Records in the HBPoS did not clearly indicate if patients had their rights explained to them. 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. 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. Following inspection, the trust submitted an action plan to review access to call alarms. She embraces the principles of the employee as a consumer (a person who makes the choice of where to work by considering a broadly defined value proposition, inclusive of financial, work, and social aspects of life) and agile organization (a workforce that continually evolves to meet the changing interests and needs of team members and customer.) criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. Supervision and appraisal compliance of three teams fell below 75%. Each priority within our approach is being led by an executive team member and progress is being monitored through our quality governance framework. The acute service contained large numbers of beds in bed bays accommodating up to four patients. Staff completed extensive and detailed care plans. When community meetings occurred, staff did not include details of outcomes to evidence change. 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. We rated it as requires improvement because: When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. 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. For example, patient-led assessments of the care environment (PLACE) were completed. In rehabilitation services, staff had effective working relations with the new rehabilitation community transition support team created in response to the pandemic to facilitate faster discharges from the wards. Staff morale on Griffin ward was low due to the announcement of the wards closure upon the completion of works on Phoenix ward. Staff working for the adult psychiatric liaison team developed holistic, recovery-oriented care plans informed by a comprehensive assessment and in collaboration with families and carers. Save job - Click to add the job to your shortlist. 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. 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. The trust used key performance indicators/dashboards to gauge the performance of the team. 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. there are some services which we cant rate, while some might be under appeal from the provider. Notes reflected caring and compassionate view of patients. Our rating of this service stayed the same. Click here to submit your comments to us. Staff were visible in the communal ward areas and attentive to the needs of the patients they cared for. There was good multi-disciplinary working within the teams. Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. Patient records across community inpatient services were not always completed fully. Advanced Directives had been introduced to enable patients to make decisions now about their long term care. The trust had robust arrangements in place for the receipt and scrutiny of detention paperwork. The psychiatric outpatients was responsible for 2094 of the breaches, with city east reporting the highest of these breaches at 429.2. Staff were very caring and sensitive to patients needs. We found positive multidisciplinary work and observed staff were supporting patients. Leaders were motivated and developing their skills to address the current challenges to the service. This is an organisation that runs the health and social care services we inspect. The trust confirmed staff delivering end of life care were involved in bi-annual record keeping, safeguarding and clinical supervision audits. Staff received training in safeguarding and knew how to report when needed. We found multiple internal waiting lists where the longest wait for young people was 108 weeks. The trust could not ensure continuity of care for these patients. For services we haven't rated we use ticks and crosses to show whether we've asked them to take further action or taken enforcement action against them. 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. People we spoke with said they had received a good service. Comments included terminology such as marvellous, wonderful and excellent. 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. Patients were supported, treated with dignity and respect and involved as partners in their care. The trust told us patients across mental health inpatient wards had commented positively about their experience of care. University Hospitals of Leicester NHS Trust. Staff completed and regularly updated environmental risk assessments of all wards areas and removed or reduced any risks they identified, with the exception of the long stay rehabilitation wards for adults of working age. We looked at 20sets of seclusion recordsandfrom17 records,staff were notrecording seclusion, in line with the Mental Health Act Code of Practice. Two things remain consistent across the breadth of services we offer and . The waiting areas and interview rooms where patients were seen were clean and well maintained. Care and treatment was mostly planned and delivered in line with current evidence. Wards provided safe environments where patients felt secure. The provider supplied lockers on the wards; however, these were not large enough to contain all possessions and patients did not hold keys. Plans were shared with family and carers. It was clear to see the difference the investment and improvements had made since our last visit. Some staff found there was insufficient time to complete their visits within the working day. Some risk assessments had not been reviewed regularly at The Grange. Staff identified this was due to the management of change process and current work being undertaken by an outside organisation to identify more effective ways of working. Adult community health patients did not always have timely access to routine appointments. Leicestershire Partnership NHS Trust Add a Review About 32 This did not protect the privacy and dignity of patients when staff undertook observations. Staff did not always record or update comprehensive risk assessments. Following inspection, the trust submitted an action plan to review shared sleeping arrangements. Many staff we spoke with knew who their chief executive was and mentioned them by name. Staff were not aware of how this might affect the safety and rights of the patients. 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. The Trust had a number of unfilled positions being covered by long-term bank staff. Patients told us that staff listened and empathised with them. The trust had reviewed existing systems and processes identified improvements and implemented changes. Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. This had been identified during the last Care Quality Commission inspection in 2015. Staff monitored the ongoing condition of any secluded patient. Multidisciplinary team work both internal and external to the service was effective and patients were supported to make informed decisions about their care. Managers had plans in place to address this issue. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. Adult liaison psychiatry services are provided by Leicestershire Partnerships NHS Trust (LPT), the mental health trust in the Leicester, Leicestershire and Rutland Integrated Care System. Bed occupancy rates were above 85% for community health inpatient wards. We found a patient being nursed in the low stimulus area and their liberty was restricted. The teams were able to respond quickly when patients or carers telephoned with problems. 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. There was use of bank and agency staff. There was minimal evidence of patient involvement in care plans. There was no process in place for learning from other organisations which provided similar services or to share this services best practice. Staff did not document physical health checks for patients detained under section 136 in the HBPoS. This was because the EDU batch refer sending four or five referrals at a time rather than when they arrive. In the dormitories, observation mirrors were situated so that staff could observe patients without having to disturb them. There had been an increase in the number of CAMHS referrals over the last two years. Staff said morale was good and they felt supported by their managers. Managers did not have oversight of these issues. 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. The trust had made improvements to the clinical environments since the last CQC inspection. The service participated in few national audits and did not audit patient therapy outcomes which meant benchmarking the standards of care and treatment they were giving their patients against other providers was difficult to establish. the service is performing well and meeting our expectations. 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. Staff completed comprehensive assessments which included physical health checks and the majority of patients had completed risk assessments. In two services, staff were not always caring towards patients. Staff were trained appropriately within their speciality and new staff were supported to gain experience and skills. Staff had a good knowledge of safeguarding and incident reporting. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. 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. Staff felt supported by their managers and received regular supervision and annual appraisals. Outcomes of care and treatment were not always consistently or robustly monitored. The trust employed registered general nurses (RGN) to assist with assessment and management of physical healthcare needs for patients. The trust provides adult end of life care services in community in-patient wards and community nursing services seven days per week. Staff explained that the figures collected around preferred place of death were collected as these were requested by the clinical commission group (CCG), although these figures were collected for services in the community; the ward based palliative care figures were not collated. That's what building health equity means to us. There was evidence of actions taken to improve the quality of the service. 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. There was no funding for staff to provide activities so patients had limited access to activities of their choice during their stay. Managers completed ligature audits which highlighted what mitigation was in place to reduce the risk for patients. The trust delivered programmes for staff to develop into senior roles and had a clear career development programme for nursing staff. The trust had long term plans to address this. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. 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. 83% of staff received mandatory training. Download full inspection report for - PDF - (opens in new window), Published Incidents and near misses were reported and learning from these was shared. There were delays in maintenance and repairs in some areas. Waiting lists for psychological services were high and currently on the Trusts risk register. Wards had high numbers of hydraulic style patient beds that were a risk to patients with histories of self-harming behaviour. However, managers had identified funding for two agency nurses to start work the week following the inspection. Some families and carers told us that the service was not responsive, telephone calls to the service were not returned. The trust provided patients with accessible information on treatments, local services, patients rights and how to complain across all services. We're here for you Learn More Scroll We've got you covered Use our service finder to find the right support for your mental health and physical health. -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 . You can find further information about how we carry out our inspections on our website: www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection. 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. Shifts were not always covered with sufficient staff, or with staff who had the appropriate qualification and experience for the role. Inpatient and community staff reported difficulties with getting inpatient beds. Nursing staff had large caseloads. Staff gave examples of initiatives such as the chief executives blog and the presentation of the valued star award. Care records were up to date and holistic. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. Interview rooms were unsafe. The trust did not always manage the admission of patients into mixed sex environments well. spoke with 15 family members or carers of patients, reviewed the mental health act detention papers of 23 patients and seclusion records of 10 patients, and. During the depot clinic staff did not close privacy curtains when patients were receiving depot injections. We found that while performance improvement tools and governance structures were in place these had not always brought about improvement to practices. The trust had developed new processes and redesigned and improved data validation. Within mental health services the quality of care plans was variable. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. Curtains separated patients bed areas and the rooms were not secured to allow free access; meaning that patients could have their property removed by other patients. Reductions in social service provision had led to an increase in referrals to the Community Learning Disability Teams. The electronic data held by the trust was currently being validated with large numbers of visit records not closed on the database. Senior nurses mitigated risk where they could which included switching an agency staff member with a trust member of staff if two agency staff worked together. We rated wards for people with learning disabilities as requires improvement because Although this issue had been recognised by the trust, it had not been addressed quickly or effectively. This left patients without access to treatment when they needed it most. Sixty per cent of staff working in the mental health services had attended supervision and 64% of staff working in community health inpatient services. Let's make care better together. We have not inspected against other requirement notices that were issued at the same time; therefore, all requirement notices from the last inspection remain in place. Most people and carers gave positive feedback about staff. Staff did not always follow trust policies and procedures when they needed to search patients or their bedrooms to keep them safe from harm. On Kirby ward there was no evidence of Section 132 rights read on detention in 54% of records reviewed. At West Leicestershire there was a lack of psychology input. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. The team engaged with patients who found it difficult or were reluctant to engage with mental health services. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so patients were safe. Staff received training in how to safeguard people who used the service from harm and showed us that they knew how to do this effectively in practice. The trust had set safe staffing levels and these were followed in practice. The service did not have any out of area placements, readmissions or delayed discharges. This monthly award is about recognising members of staff who have gone the extra mile. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. Published However, there were some instances when patients privacy and dignity were not respected. People using the service may not be able to get the speed of telephone response they needed in a crisis. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. Staff had not received any specialist training on crisis intervention. Specialist community mental health services for children and young people, Community-based mental health services for older people, Community-based mental health services for adults of working age, Community health services for children, young people and families. Leicestershire Partnership NHS Trust provides mental health, learning disability and community health services across Leicestershire, England.. Staffs were dedicated, passionate and patient focused. Improvements to the inpatient wards included updating seclusion rooms, removing some ligature anchor points and replacing garden fencing. Risks to people who used the service and staff were assessed and managed. All patients told us staff respected their privacy and dignity. 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 . 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. 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. Staff morale was low and they felt disempowered in some areas. The trust had not made sufficient progress in addressing the concerns raised at the previous inspection in March 2015. Not all patients on acute wards for adults of working age could summon help from staff if required. We did not have assurance service leads had good oversight of the risks relating to this service as staff were not always recording incidents, the service was unable to identify incidents specific to patients at the end of life and concerns relating to the out of hours GP service were not formally recorded. There was a lack of storage at Stewart House, the utility/laundry room was used to store cleaning equipment. 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. Wards employed additional healthcare support workers to meet patient needs when needed. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. Bathrooms and toilets were specified for which gender depending on who was resident at the unit at the time. 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. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. They were able to talk about the effectiveness of Listening in Action events which aimed to improve the quality of services. Cleaning products in a cupboard in the waiting area was unlocked, which posed a risk to the young people. To find out more, review our cookie policy. Staff were observed to be caring and responsive to patients. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. Click on the coloured text links below to visit any of the listed organisations' websites: We rated the trust as requires improvement for well led. Recruitment was in progress for 10 new healthcare support workers. We found serious concerns with medication disposal, storage, labelling and management of controlled drugs. We also inspected the well-led key question at provider level for the trust overall. Staffing skill mix was appropriate to need overall. They told us that staff were kind and caring. A dashboard of key performance indicators was being developed. Your information helps us decide when, where and what to inspect. However, delay in paperwork completion was also responsible for a large proportion of delayed discharges. We will be working with them to agree an action plan to improve the standards of care and treatment. We inspected three mental health inpatient services because of the ratings from the previous inspection. This was a focused inspection. Suspended ratings are being reviewed by us and will be published soon. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. The trust confirmed after our inspection Advanced Nurse Practitioners used a DNACPR form which had been agreed within NHS East Midlands. Patients returning from leave from the acute mental health wards were not assured of returning to their original ward. All wards had developed their own systems to improve medicines management in their areas. Staff were open about their poor understanding around the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Services had supplies of emergency medication available and this was accessible to staff. Improvements had been made to seclusion areas at The Willows Acacia and Maple wards. We found concerns with the environment in all five core services we inspected. The trust had a limited approach to patient involvement. 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. Our judgement is based on a combination of what we found when we inspected, information from our Intelligent Monitoring system, and information given to us from people who use services, the public and other organisations. Beaumont ward did not have a poster displayed around informal patients and rights as a patient had ripped it down. The trust reported a 10% increase in the number of referrals received into the CAMHS service. The needs of people who used the service were assessed and care was delivered in line with their individual care plans. Bank Band 6 Speech and Language Therapist. Not all care plans reflected patients assessed needs, or were personalised, holistic and recovery oriented. Leicestershire Partnership NHS Trust | 4,712 followers on LinkedIn. Staff described managers as supportive and approachable. At the Willows, six out of 19 patients risk assessments had not been updated. Patients were offered smoking cessation treatments, nicotine replacement therapy (NRT), or free vapes. Patients were able to access hot and cold drinks any time during the day. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. The trust had made progress in oversight of data systems and collection. The trust had not responded in a timely way to eliminate shared sleeping arrangements (dormitories). Computer systems were not shared across GP surgeries so information sharing did not happen effectively. We had a number of concerns about the safety of this trust. Staff routinely referred patients to access additional support for employment, housing, benefits and independent mental health advocacy. Some wards did not meet the Department of Health and Mental Health Act Code of Practice requirements in relation to the arrangements for mixed sex accommodation. Services based in community hospitals did not admit patients close to weekends due to issues with verification of deaths over weekends, and the access to doctors. Emails and the trust intranet also provided staff with this information. There was a good level of occupational therapy input and good support to help maintain patients physical health. Staff felt well supported and were able to raise concerns with their line manager and were listened to. Staff received regular supervision and most had received an appraisal in the last 12 months. Staff reviewed young peoples risk at every appointment and recorded this in the case notes. Not all of the patients felt involved in their care planning and not all had a copy of their care plans. Following this inspection the trust were required to ensure teams were adequately staffed to prevent impacts on staff workload and ensure staff completed mandatory training in line with trust requirements.Insufficient progress had been made against these notices. These reports were presented in an accessible format. Watch our short film to find out more: We Are LPT Share From a National Health Service (NHS) organisation Watch on Our strategy We were aware the local commissioning groups had not set targets for wait times. Staff moved acute patients to the rehabilitation wards when acute beds could not be located. Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. A carers group was available to give support. The trust set target times from referral to initial assessment against the national targets of 28 to 42 days. New systems were in place for staff to report any repairs or maintenance issues. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. Staff were passionate about their roles and enjoyed working with the client group. 22 June 2022, Published 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. The environment in some services was poor, not well maintained and not kept clean. Local audits were not completed regularly. Record keeping at Stewart House was disorganised. 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. We spoke with carers; they all stated that staff responded well when they contacted the service. Managers ensured they monitored their staffs compliance with mandatory training using a tracker system. The trust had significantlyreduced waiting times and the total numbersof children and young people waiting for assessments. Our inspection approach allows us to make a judgement on how the trusts senior leadership leads the organisation and the provider level well-led rating is separate from the ratings of the services we inspected. We found significant issues with trust level governance, oversight of environments, a failure to address keys issues and a lack of pace with delivering essential improvements. Some records were over more than one database/system which could make locating information a problem. there are some services which we cant rate, while some might be under appeal from the provider. 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. It's a mission driven by our core values, and one that we try to achieve as a local provider, funder, and advocate. 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 addressed the issues regarding the health based place of safety identified in the previous inspection. 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. Staff were confused about Deprivation of Liberty standards and paperwork was incomplete. Staff working within criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. The majority of repairs and maintenance issues highlighted within the warning notice at the Bradgate Mental Health Unit had been fixed or resolved. It's really rewarding. The governance processes had not picked up the issues around repairs, medicines and cleanliness. The trust had a variety of measures in place to ensure that processes and reporting to board were not delayed. Patients were protected from avoidable harm by sufficient staffing and safeguarding processes. Waiting times and lists remained of concern, and this had been identified in the previous inspection. All areas were very clean, fresh smelling and fit for purpose. Save job - Click to add the job to your shortlist. The HBPoS had poor visibility for observing patients. They did not have alarms or vision panels in the door. Staff did not always use the Mental Health Act and the accompanying Code of Practice correctly. Find out more Knitting therapy keeps cats and dogs warm 23 Dec 2022 News This has been brought. Staff were kind, caring and respectful towards patients. One patient told us they did not know they could leave the ward to seek medical attention. A dual paper and electronic recording system meant that some information was not accessible to all of the staff that might need it. Staff were not meeting the trusts target compliance rate for annual appraisals and mandatory training. This did not demonstrate a consistent temperature, had been maintained to assure the safety and efficacy of the medicines. Managers ensured they monitored the reporting and recording of incidents and complaints. Six staff expressed concerns about the proposed move and some said the trust had not communicated information to staff effectively. We had concerns about the safety of some of the facilities where care was delivered. Waiting times for referral to initial assessment appointments were good, although patients experienced delays for community paediatric clinic follow up appointments. The service did not exclude patients who would have benefitted from care. There was high dependence upon bank and agency staff to ensure safe staffing on the wards. Staff could not rely on performance reports being accurate. 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. There were no separate female bedroom areas and no gender specific toilets or bathrooms. On Heather ward patients said that there was not enough ventilation on the wards. Multi-disciplinary teams and inter agency working were effective in supporting patients. 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. There was a high vacancy rate of 12.9% for band 5 and 6 nurses in community based mental health services for adults of working age, 18.9% for band 5 and 6 nurses in crisis service and 17.3% across community health services for adults. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. 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. 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. Managers ensured they used regular bank staff to achieve the required safer staffing levels and to promote continuity of care of patients. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. Staff undertook comprehensive assessments and developed high quality care plans. Patient had individualised risk assessments. There's no need for the service to take further action. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. This was highlighted in the previous inspection. Feedback from those who used the families, young people and children services was consistently positive. We found a high number of concerns not addressed from the previous inspections. Staff morale appeared low. 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. Leicestershire Partnership NHS Trust Location Leicester Salary 27,055 to 32,934 a year Closing date 2 Feb 2023. We found a total 40 breaches of the six week referral and seven breaches of the five day urgent referral. Staff felt that they had opportunities to develop and were supported to undertake further study. 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. All assessment rooms had good visibility. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. There was a mobile phone in the ward office that patients could use for private calls, for example to a solicitor. Leicestershire City Council are proposing to keep Leicestershire Partnership NHS Trust as the provider, as it is a high performing service, and to recommission 0-19HCP by using Section 75 of the National Health Services Act of 2006. Concerns about high bed occupancy, record keeping and delayed discharges were identified in the March 2015 inspection and had not been sufficiently addressed. Not all families and carers knew they could attend virtual ward meetings and care programme approach meetings. People knew how to make a complaint as this information was provided in welcome packs. The environmental risks in the health based place of safety identified in our previous inspection remained. View more Profession Occupational Therapist Service Learning Disability Grade Band 6 Contract Type Permanent Hours Full Time. There were effective systems in place to audit and monitor physical health care records. The room used to administer medication on Arran ward at Stewart House was not appropriate; the room was a bedroom and still had a toilet in. 100% of staff were trained in how to safeguard children from harm. Staff would still work with people who were on waiting lists so that they received some level of service. Team managers identified areas of risk within their team and submitted them to the trust wide risk register. 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. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. On Bosworth ward patient privacy was compromised when staff and patients entered the clinic room during examinations because there was no privacy curtain in place. We found damaged fixings on one ward; that posed a risk to patients. This area of our site lists our partner organisations. 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. ", "I have developed so many new skills over the years working in the NHS, going from a healthcare assistant to a nursing associate. On rehabilitation wards, staff did not care plan the needs of a patient with protected characteristics. There was a duty worker system in place which meant the service was able to respond quickly to escalating risks if necessary. There was no evidence of patient involvement recorded in some of the notes. Clinical audit was taking place and learning was shared across the service. Staff were positive about the level of support they received, including regular supervision and line management. Two external governance reviews had been commissioned and undertaken. We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. ", Laiqaah Manjra, Corporate Affairs Administrator, "I progressed from being an apprentice to a Corporate Affairs Administrator - the NHS really supports staff development. received 41 comment cards from patients that were available for patients to complete during the time of our inspection. Two patients discharges were delayed at The Agnes Unit because the commissioners could not find specialist placements. 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 followed infection control practices and maintained equipment through regular servicing. Improvements were noted in some wards in core services but not all. We saw patients were treated with kindness and compassion. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Nursing staff interacted with patients in a caring and respectful manner. Potential risks were taken into account when planning community health services. Staff informed us there was a safeguarding lead to refer to when guidance was needed. Staff were given opportunities to expand their knowledge and develop their roles. 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. Staff used "my care plan" documents to obtain patients views on their care. Some families carers said that the meals were unhealthy. Care plans did not always reflect a person centred approach and people who used services and their carers were not routinely involved in CPA reviews. Staff allowed patients time to respond to questions and did not try to hurry them. Staffing levels did not meet requirement in some community teams. Between August 2015 and July 2016, there were 60 delayed discharges across the service. Patients knew how to formally complain and could attend daily community meetings where they could raise any issues of concern. Demand for neurodevelopment assessments remained high. At this inspection we found compliance levels with this type of training were still below the trusts target. This had continued during the pandemic. Staff followed infection and prevention control practices and the community inpatient wards were visibly clean. 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. Whilst staff were working hard to identify and manage individual risks, some ward environments were unacceptable. They were constantly looking at ways to improve their work and the patient experience of the service. 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