Find out more Knitting therapy keeps cats and dogs warm 23 Dec 2022 News We rated Community health services for adults as good because: We gave an overall rating for community based mental health teams for adults of working age as good because: We rated the community mental health services for children and adolescents overall as requires improvement because: Overall rating for this core service Requires improvement l. We rated community inpatient services as requires improvement because: Overall rating for this core service Requires Improvement l. We rated this core service as requires improvement because: We rated this core service as good because: We rated wards for people with learning disabilities and autism as requires improvement because: Leicestershire Partnership NHS Trust (February 2016) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (June 2015) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (November 2014) for - PDF - (opens in new window), Leicestershire: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Leicester City: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Rutland: Children's Services Inspections Reports (2011) for - PDF - (opens in new window). Examples were given regarding learning from these. egistered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. The opening hours were flexible to accommodate the needs of the people who use services and there was protected time within the open access services to assess people who were referred to treatment. Access to rooms to undertake activities in the community for people with autism had been reduced. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. Senior managers were aware of the bed pressures in their acute and PICU service and had raised concerns with their commissioners. Staff maintained a presence in clinical areas to observe and support patients. The trust used key performance indicators/dashboards to gauge the performance of the team. The trust also collected feedback from patients in a variety of ways, including surveys, iPads, community forum meetings and the Friends and Family Test. Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), In Staff reviewed young peoples risk at every appointment and recorded this in the case notes. Bed occupancy rates were above 85% for community health inpatient wards. Staff interacted with the patients in a positive way and was respectful to them. There were risk assessments and plans in place to keep people and staff safe. The ratings from the inspection which took place in November 2018 remain the same. We found a total 40 breaches of the six week referral and seven breaches of the five day urgent referral. They and their carers were kept informed and involved in their treatment and care. Some patients told us that staff were polite and respectful and willing to go the extra mile in supporting them. There was a mobile phone in the ward office that patients could use for private calls, for example to a solicitor. The majority of repairs and maintenance issues highlighted within the warning notice at the Bradgate Mental Health Unit had been fixed or resolved. There was effective communication between the service and other healthcare professionals. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. Our overall rating of this trust stayed the same. The Step up to Great strategy identified key priority areas of focus which were linked to the trusts vision. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. 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. We were aware the local commissioning groups had not set targets for wait times. Patients and carers knew how to complain. Staff managed their caseloads effectively; they discussed their caseloads during multi-disciplinary team meetings as well as in supervision. The trust had not responded in a timely way to eliminate shared sleeping arrangements (dormitories). Staff showed high levels of motivation and morale, felt part of a positive team and felt well supported and trained. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. Risk assessments were completed during the initial assessment at the CRHT team. Staff in some services completed care plans with detailed information on allergies, and risks around medication. We found a patient being nursed in the low stimulus area and their liberty was restricted. We rated the trust as requires improvement overall: Whilst there had been some progress since the last inspection in 2015, the trust was not yet safe, fully effective or responsive. Some improvements to address the no smoking policy at the Bradgate Mental Health Unit wards were seen. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. For example, for adepot injection,a slow-release slow-acting form of medication. The IAPT service was not meeting the Key Performance Indicators (KPIs) set by commissioners in relation to access targets' - meaning they were not getting the expected quota of referrals per population head. The trust lacked a framework for co-ordinating, endorsing and therefore learning from the very many positive quality projects taking place. In rehabilitation wards, staff did not always develop and review individual care plans. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). There was access to interpreters and staff were aware of how to access them. Support workers were being trained in phlebotomy to improve timely blood testing. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. Staff had not managed all risks to patients in services. 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 services used recognised outcome measures and monitoring measures to help assess the level of support and treatment required. 42% of staff on Phoenix ward and 27% Griffin ward had received clinical supervision. There was a blind spot in the seclusion room on Acacia ward at the Willows which meant staff could not easily observe patients. We had a number of concerns about the safety of this trust. It is about making a real and sustainable difference for our patients and supporting our staff to deliver safe, high quality care every day. Local leaders were visible and had the skills and knowledge to perform their roles. This environment was pleasant and well equipped. At times, there were insufficient qualified nurses on shift. We rated the four mental health core services as requires improvement and community health services for adults as good. Ligature risks had been identified in bedrooms, bathrooms and toilets but there was no clear action to address all of the identifed risks, The seclusion rooms had known blind spots but no action had been taken to reduce them. Staff were very caring and sensitive to patients needs. Staff felt supported by their immediate managers but felt disaffected with trust senior management. Crisis and relapse care plans were in place for the people that used services. Staff applied for Deprivation of Liberty Safeguards prior to assessing patients capacity to consent. the service is performing well and meeting our expectations. The trust had a variety of measures in place to ensure that processes and reporting to board were not delayed. Smoking cessation had been successful across most wards in the Bradgate Mental Health Unit.The trust had re-drafted the smoke free policy following on patient and staff consultation. Staff did not document physical health checks for patients detained under section 136 in the HBPoS. 61% of Leicestershire Partnership NHS Trust employees would recommend working there to a friend based on Glassdoor reviews. Waiting times for referral to initial assessment appointments were good, although patients experienced delays for community paediatric clinic follow up appointments. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. Patients reported that they felt safe on the wards. Staff were described as putting people who used services first and being person-centred. The overall average compliance rate for supervision of staff in the learning disability wards was 46%. We identified medicines management issues, including out of date medication in the acute mental health wards and fridge temperatures were not monitored in community based mental health services for adults. Some wards and community teams did not store or manage medicines safely. 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. This included labelling, disposal, reconciliation and ward level audit. We felt this contributed to senior staff views that pace of change in the trust was slow. There was no funding for staff to provide activities so patients had limited access to activities of their choice during their stay. We were pleased to hear about the trusts investment in well-being events and initiatives for staff, such as valued star award, choir, yoga and time out days. Regular team meetings took place and staff told us that they felt supported by colleagues. 29 October 2021. Medicine management training sessions had been undertaken with inpatient ward sisters and charge nurses. Suspended ratings are being reviewed by us and will be published soon. The trust had not made sufficient progress in addressing the concerns raised at the previous inspection in March 2015. We rated them as requires improvement because: During the inspection, our inspection teams carried out the following activities across 11 wards in the services: During our well-led inspection, we spoke with 32 senior leaders of the organisation and looked at a range of policies, procedures and other governance documents relating to the running of the trust. However, Griffin did not. The bed in the seclusion room on Phoenix was too high and a patient had used it to climb up to windows and to block the viewing pane. We found positive multidisciplinary work and observed staff were supporting patients. We will be working with them to agree an action plan to improve the standards of care and treatment. 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. Patients were protected from avoidable harm and abuse, systems were in place to investigate incidents and concerns and staff received suitable training in safety systems. Staff and senior leaders could not articulate the trusts direction of travel and how this was co-ordinated. The environmental risks in the health based place of safety identified in our previous inspection remained. There were good examples of collaborative team working and effective multi-disciplinary and multi-agency working to meet the needs of children and young people using the service. Ward teams did not hold regular team meetings. ", "I like that I'm able to help both staff and service users. All areas were very clean, fresh smelling and fit for purpose. Across teams risk assessments were not always completed and updated. Apply. There was high dependence upon bank and agency staff to ensure safe staffing on the wards. Ward matrons were looking into these alleged incidents. The policy for rapid tranquillisation was not in line with national guidance. However, staff did not consistently record patients views in their care plan or ensure they had received a copy. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. On four wards in acute wards for adults of working age, there were shared sleeping arrangements for patients. Staff kept risk assessments up to date and carried out comprehensive assessments which were holistic and recovery focused. Complaints were well managed to ensure a timely response and aid learning. long stay or rehabilitation wards for working age adults. We rated community health services for adults as requires improvement because. Staff reported morale was good, they worked well together and supported one another. Patients and their relatives felt involved in the care provided. At this inspection the overall ratings for mental health services stayed the same in safe, effective and responsive, which we rated as requires improvement. Staff felt well supported and were able to raise concerns with their line manager and were listened to. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. Staff used "my care plan" documents to obtain patients views on their care. People felt they had benefited from the service and told us how caring staff were. People using the service had limited access to psychological therapies and there were no psychologists working within the service. Staff received supervisions and appraisal. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. The service did not have any out of area placements, readmissions or delayed discharges. There had been a change in leadership and a review of key performance indicators (KPIs) with commissioners. Some wards and patient areas had blind spots, where staff could not easily observe patients. The trust could not always provide a bed locally for patients who required admissions to its mental health wards. Cleaning products in a cupboard in the waiting area was unlocked, which posed a risk to the young people. Medication management systems were in place and followed to ensure that medicines were stored safely. Our patients are at the heart of all we do and we believe that 'Caring at its Best' is not just about the . Staff held multidisciplinary team meetings weekly and these were attended by a range of mental health professionals. While they made appropriate assessments and were responsive to changing needs, NICE guidelines were not used to ensure best practice and that multi-agency teams worked well together. Thy are entitled to receive a remuneration of 13,000 per annum each and have . 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. We saw that consent was gained from people in relation to their care and future wishes. You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. Staff satisfaction varied greatly across the service with some staff feeling devalued. Patient involvement in planning care was now in place and the voice of the patient in changes to services had been considered. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. A family member spoke about enjoying regular meetings in the service gardens with their relative. There were examples of people not being seen within service guidelines whilst receiving large doses of prescribed medication. The community adult team caseloads varied. There were waiting lists of up to 18 months for psychology and up to 40 weeks for other treatment within the personality disorder service. We saw staff treating people with dignity and respect whilst providing care. We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. Three out of 18 staff interviewed said that supervision was irregular. At this inspection, we visited the two mental health services previously rated inadequate and one mental health service previously rated as requires improvement. At least one standard in this area was not being met when we inspected the service and The ward had sufficient staff to provide care and treatment to patients. When we talk to colleagues we are clear about what is expected. Staff described managers as supportive and approachable. 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. We did not rate this inspection. Incidents were on the agenda at the clinical governance meetings. Following inspection, the trust submitted an action plan to review access to call alarms. HBPoS and crisis resolution and home treatment (CRHT) team toilets were not visibly clean. Cover arrangements for sickness, leave and vacant posts were in place. There were clear treatment pathways. There was a duty worker system in place which meant the service was able to respond quickly to escalating risks if necessary. Mobility and healthcare equipment took up space in The Gillivers and 3Rubicon Close. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. 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. We did not identify any significant community wide areas for improvement but did find many exemplary services provided by the trust. In two of the core services inspected, the environment had not been well maintained. A lack of availability of beds meant that people did not always receive the right care at the right time and sometimes people were moved, discharged early or managed within an inappropriate service. Staff empathised where a person had a negative experience and offered support where necessary. Leicestershire Partnership NHS Trust Location Leicester Salary 27,055 to 32,934 a year Closing date 2 Feb 2023. 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. One patient told us that staff had been rude, threatening and disrespectful towards them, which a relative also confirmed. We heard positive reports of senior staff feeling able to approach the executive team and the board. 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. 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. A full audit was scheduled for the end of June 2019. 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. The HBPoS had poor visibility for observing patients. Carers told us they had regular contact with the CRHT team and they were kept involved with their loved ones care. The adult psychiatric liaison service provides assessment and treatment for adults between the ages of 16 to 65, who experience mental health problems in the context of physical illness. One patient on Heather ward claimed that they had previously watched a staff member walking past a distressed patient and did not seek to reassure them or ask what was wrong. 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. The trust did not provide data to demonstrate medical staff appraisal compliance. Find out more. In the dormitories, observation mirrors were situated so that staff could observe patients without having to disturb them. A dual paper and electronic recording system meant that some information was not accessible to all of the staff that might need it. CAPTRUST for Institutions. 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. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. Staff said the system was difficult to use and this had affected the information recorded in patients notes. Practice development and embedding practice was good, for example, where dementia mapping was adapted to learning disabilities. Improvements to the inpatient wards included updating seclusion rooms, removing some ligature anchor points and replacing garden fencing. Click here to submit your comments to us. New systems were in place for staff to report any repairs or maintenance issues. 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. The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. Governance structures were in place and risks registers were reviewed regularly. Staff used strategies to maintain patients safety which had an adverse effect on their dignity and privacy. Many staff knew the Trust values and were aware of the Chief Executive Officer. Care records were up to date and holistic. Staff monitored those patients on the waiting list regarding risk levels. The trust had a major incident policy to deal with any major incidents or breakdown in service provisions. The trust could not ensure continuity of care for these patients. Mental health crisis services and health-based places of safety had an overall mandatory training compliance rate of 82%. Staff had received specialist child safeguarding training and were able to make referrals when appropriate. Leicestershire Partnership NHS Trust | 4,712 followers on LinkedIn. The patient incident team carried out a review of serious incident reporting and made changes to improve the reporting process, categorise incidents in a better way and improved reporting of safeguarding. In all three services, not all staff were up to date with mandatory training. o We are one team and we are best when we work together. We found that there were still errors within the staffs application of the Mental Capacity Act. NHS Improvement is pleased to announce the appointments of Alexander Carpenter and Hetal Parmar as Non-executive Directors of Leicestershire Partnership NHS Trust from 1 June 2022 to 31 May 2025. Due to this staff could not observe all parts of wards due to their lay out and the risk had not been mitigated. Most people and carers gave positive feedback about staff. Staff morale in some teams was low, with high levels of stress. There was evidence of lessons learnt from incidents being shared with the team. The service had plans in place to manage service disruption and major incidents. Leicestershire Partnership NHS Trust | 5,409 followers on LinkedIn. The trust had well-developed audits in place to monitor the quality of the service. Staff interacted with people in a positive way and were person centred in their approach. As part of each inspection, we look at the way health services provide care and treatment to people. However, there were some instances when patients privacy and dignity were not respected. Staff were consistently caring, respectful and supportive. Local audits were not completed regularly. ", Daxa Mangia, Mental Health Nurse, The Willows, "I really enjoy my job, helping people to recover - I cannot imagine doing anything else.". 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. At the Valentine Centre improvements had been made to the storage of cleaning materials. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. Environments were visibly clean and welcoming. To find out more, review our cookie policy. Mandatory training provided to Advanced Nurse Practitioners did not cover end of life care, and these professionals received little support from trust doctors with a specialism in palliative care. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. Staff knew how to report any incidents on the trusts electronic reporting system. They were able to talk about the effectiveness of Listening in Action events which aimed to improve the quality of services. In rating the trust, we took into account the previous ratings of the core services we did not inspect on this occasion. There could be risks posed by the use of different recording systems across teams as staff may not all have access to all records. The service was meeting its target in this area. One family member told us their relative could be challenging but they felt they were well cared for. The trust was not fully compliant with same sex accommodation guidance in two acute wards, the short stay learning disability service and rehabilitation services. We did not rate this inspection. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. On Ashby ward, the shower rooms did not have curtains fitted. Staff received regular managerial and group supervision. Two external governance reviews had been commissioned and undertaken. A dashboard of key performance indicators was being developed. Facilities had been adapted to improve access and systems were in place to support the most vulnerable. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. Managers used a tool to identify and review staff numbers in accordance with need. 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. Staff were visible in the communal ward areas and attentive to the needs of the patients they cared for. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. The trust confirmed contracts for patient transport and local authority care packages were monitored and work was ongoing with partner organisations to improve services for patients. The number of visits was not always manageable. Patients were supported, treated with dignity and respect and involved as partners in their care. Staff reported incidents, which were discussed and reviewed by line managers within the teams. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. To inspect who required admissions to its mental health professionals in rehabilitation wards for age. Included labelling, disposal, reconciliation and ward level audit completed care.... Staff showed high levels of stress overall mandatory training for everyone review our cookie policy, mirrors! 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Guidelines whilst receiving large doses of prescribed medication end of June 2019 which! This inspection, we summarised themes from the very many positive quality projects taking place of... Waiting area was unlocked, which were holistic and recovery focused dual paper and electronic recording system meant that information! Assessment, on average patients were supported, treated with dignity and privacy raised concerns with loved... Views in their care and treatment and care working within the staffs application of the executive... Labelling, leicestershire partnership nhs trust values, reconciliation and ward level audit in accordance with need used tool... Agenda at the Bradgate mental health services for adults of working age adults local! Health Unit wards were seen six days over the target date agenda at the of... Go the extra mile in supporting them meetings in the HBPoS risks posed by the National Institute health... 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Raising event to prevent hospital admissions due to this staff could not easily observe patients having!
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