Community meetings and patient involvement in the services did not always take place. Staff interacted with patients in a responsive and respectful manner at all times and showed a good understanding of individual needs. The trust had a variety of measures in place to ensure that processes and reporting to board were not delayed. Care plans reviewed were not personalised, holistic or recovery orientated. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. 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. 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. There were no records of capacity being assessed for patients consent to treatment, and no clear evidence of best interests decisions being agreed. Staff felt supported by their immediate managers but felt disaffected with trust senior management. There was good staff morale in services. The trust had recruited two registered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. Despite considerable effort with recruiting new members of staff for community inpatient areas, staffing was the top concern for all senior nurses and there was still a significant reliance on agency staff to fill shifts which could not be covered internally. The service was not safe. However, ligature points remained. Caring stayed the same, rated as good. Leicestershire Partnership NHS Trust 2.5K subscribers We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. At the Agnes Unit, staff did not always record the physical health of patients who had been given rapid tranquilisation. We did not identify any significant community wide areas for improvement but did find many exemplary services provided by the trust. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. A dashboard of key performance indicators was being developed. 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 treated patients with compassion, dignity and respect. The trust had systems for staff to raise any concerns confidentially. Staff received regular supervision and most had received an appraisal in the last 12 months. We rated community based mental health services for adults of working age as requires improvement because: Access to the service was delayed due to variable caseloads and waiting times. The trust confirmed staff delivering end of life care were involved in bi-annual record keeping, safeguarding and clinical supervision audits. The perception of staff that learning disabilities services were a low priority for the Trust since they had moved into the adult mental health directorate. We don't rate every type of service. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. View more Profession Nurse Service Child & Adolescent / CAMHS Grade Band 5 Contract Type Permanent Hours Full Time. The service employed care navigators to help families and carers negotiate their journey through the various services provided. They remained positive when engaging patients in meaningful activities. 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. However, we found: We rated the child and adolescent mental health wards as requires improvement because: We rated community-based mental health services for older people as good because: We rated learning disability and autism community services as good because: We gave an overall rating for forensic/secure wards of requires improvement because: We rated Leicestershire Partnership NHS Trust long stay / rehabilitation mental health wards for working age adults as requires improvement because: Overall rating for this core service Good. Staff had a good knowledge of safeguarding and incident reporting. For example relating to assessment of ligature points at Westcotes. Staff we spoke with demonstrated their dedication to providing high quality patient care. Risk assessments were completed during the initial assessment at the CRHT team. We had concerns about the safety of some of the facilities where care was delivered. Across the teams, we found up to date ligature audits in place. Ward matrons told us they shared outcomes from incident investigations in team meetings for shared leaning. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. Staff were kind, caring and respectful towards patients. This left patients without access to treatment when they needed it most. The waiting times in community based mental health services for adults of working age were long and breached targets. Their service users and staff are extremely important to them. Risk assessments were brief, did not always contain sufficient information and were not updated regularly. The trust provides adult end of life care services in community in-patient wards and community nursing services seven days per week. Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. People using the service may not be able to get the speed of telephone response they needed in a crisis. The NHS is founded on principles and values that bind together the diverse communities . This meant staff transferred patients to wards that had seclusion rooms when needed. These included unsafe environments that did not promote the dignity of patients; insufficient staffing levels to safely meet patients needs; inadequate arrangements for medication management; concerns regarding seclusion and restraint practice: insufficient clinical risk management. This impacted on patients requiring care. There was good access to interpreters and signers when needed. The trust lacked a framework for co-ordinating, endorsing and therefore learning from the very many positive quality projects taking place. 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. Some staff did not receive regular supervision or annual appraisals. Staff were aware of the reporting policy and procedure and could give examples of when this was carried out. Data could not be relied upon to measure service performance or improvement.Data collection and interpretation did not include key pieces of information for example number of delayed or missed visits. However, they did not always meet the required skill mix for the nursing teams. During the depot clinic staff did not close privacy curtains when patients were receiving depot injections. Managers identified the breach in these targets and had plans in place to reduce them and had highlighted this risk on the risk register. Staff told us they involved patients carers but there was little evidence of this in care records. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. Staff knew and understood their role in compliance with the Mental Health Act and Mental Capacity Act. We found this across core services and within senior teams. The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. Staff were unable to show us evidence of clinical audits or the basis of evidence based practice in end of life services. The leadership, governance and culture did not always support the delivery of high quality person centred care. Staff did not demonstrate a good understanding of the Mental Health Act (MHA) and Mental Capacity Act (MCA). Community mental health services with learning disabilities or autism, Wards for older people with mental health problems. Often patients were admitted to hospital out of the area especially if they need a more intensive support. the service is performing badly and we've taken enforcement action against the provider of the service. Staffing skill mix was appropriate to need overall. At Rutland Memorial Hospital shifts were covered by using more than 20% temporary staffing. Staff worked with both internal and external agencies to coordinate care and discharge plans. We're always looking for the best. The quality of some of the data was poor. The trust had made some improvements in response to the previous CQC inspection undertaken in March 2015.This included removing some ligature anchor points in the acute mental health wards. Not all care plans reflected patients assessed needs, or were personalised, holistic and recovery oriented. ", Laiqaah Manjra, Corporate Affairs Administrator, "I progressed from being an apprentice to a Corporate Affairs Administrator - the NHS really supports staff development. The rating for well-led in mental health services, improved to requires improvement. This has been brought together using feedback from staff, service users and stakeholders to evolve our work so far into a clearer trust-wide strategy for all areas: Step Up to Great.Through Step Up to Great we have identified key priority areas to focus on together. The majority of repairs and maintenance issues highlighted within the warning notice at the Bradgate Mental Health Unit had been fixed or resolved. Managers had a recruitment plan in place to increase the number of substantive staff for the service. Staff had not received any specialist training on crisis intervention. We rated child and adolescent mental health wards as good because: The ward had clear lines of sight in the main areas of the ward. The people who used services, carers and relatives we spoke with were all positive about the service they received. There was no evidence of patient involvement recorded in some of the notes. Patients experiencing mental health crisis and distress did not have access to a fully private area in these environments. Local audits were not completed regularly. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. Some patients continued to share bedroom spaces in dormitories, and personal belongings were stored on the floor because of limited storage provided by the trust. 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. This reduced continuity of care. 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 observed positive interactions between staff and children and the use of age appropriate language. The teams were able to respond quickly when patients or carers telephoned with problems. The trust had reviewed existing systems and processes identified improvements and implemented changes. The rating had improved from the November 2016 inadequate rating. The integrated therapy and nursing teams and the primary care coordinators in conjunction with the night service had clear focus on keeping patients safe and well in their own homes. It was clear to see the difference the investment and improvements had made since our last visit. 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. For example, furniture was light and portable and could be used as a weapon. There was a duty worker system in place which meant the service was able to respond quickly to escalating risks if necessary. An announcement has been made on the outcome of this appointment. Patients were protected from avoidable harm by sufficient staffing and safeguarding processes. Many of the actions listed included plans to review process, establish an approach, or to develop areas. They were supported to have training to help them to develop additional skills and expertise. The environment in some services was poor, not well maintained and not kept clean. This had continued during the pandemic. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. Staff described managers as supportive and approachable. 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. Team managers could not be assured of local performance around record keeping, care planning and patient involvement. Interpreters were available. 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. 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. Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. Staff told us they felt happy and enjoyed their work. The trust had no auditing system to measure performance in order to improve the service. Staff felt that they had opportunities to develop and were supported to undertake further study. Staff treated patients with kindness, compassion and respect.We saw staff spend time talking to and their carers. Incidents and near misses were reported and learning from these was shared. The trust had completed ligature risk assessments across all wards, detailing where risks were located and how these should be managed. Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. Patients own controlled drugs were not always managed and destroyed appropriately. We had a number of concerns about the safety of this trust. Computer systems were not shared across GP surgeries so information sharing did not happen effectively. We saw patients that needed a PEEP had a plan in place. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. The trust had a limited approach to patient involvement. Managers had introduced a specialist child and adolescent mental health traffic light system, a red, amber and green rating tool for managing risk. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Staff did not record consent to treatment, and capacity to consent and best interests decisions when these were needed. Staff were consistently caring, respectful and supportive. Staff allowed patients time to respond to questions and did not try to hurry them. o We are passionate and creative in our work. This meant board members were not able to monitor the trusts assertions that there were strong systems and processes in place for identifying and reporting serious incidents, including deaths, or monitoring whether reviews and investigations were completed fully. Staff felt supported by their managers and received regular supervision and annual appraisals. These reports were presented in an accessible format. 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. People that were referred to the service were waiting for a care co-ordinator to be allocated. Staff told us they felt supported by their line managers, ward managers and matrons. The trust had well-developed audits in place to monitor the quality of the service. When staff raised concerns or ideas for improvement, they felt they were not always taken seriously. While staffing numbers were usually maintained, there was a high reliance on agency and bank staff to achieve this. The wards tried to book regular bank and agency staff so they knew the ward and patients, to provide continuity of care. 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. The electronic data held by the trust was currently being validated with large numbers of visit records not closed on the database. 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. Team meetings were not regular, or didn't take place.The sharing of lessons learnt remained inconsistent across some wards. The recording of discussions and assessments with people regarding consent to treatment was not always documented. 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. There were appropriate arrangements in place for the safe management of medicines. New systems were in place for staff to report any repairs or maintenance issues. The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. Capacity assessments were unclear. Patients did not have access to regular community meetings where they would discuss ward issues and concerns. Therefore, overall, eight of the trusts 15 services are now rated as good, five as requires improvement and two as inadequate. 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. Staff acknowledged directors visits. 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. Some actions were required to ensure adherence with the Mental Health Act. Staff were included in service developments and involved in listening into action projects for service improvement. We were not assured that the trust risk register clearly documented action taken or progress of action, within agreed timescales. Staff in the community adult mental health teams did not protect patients dignity or privacy. The phones on each ward were in communal areas; the phone on Griffin ward had not been moved since the last inspection, although it had a privacy hood installed. This had improved since the last inspection in March 2015. Staff told us they will move to a new electronic system in July 2015 which will be the same as other areas in the trust. A childrens adolescent mental health crisis service had been developed and commenced in April 2017. This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. Cleaning products in a cupboard in the waiting area was unlocked, which posed a risk to the young people. Staffing levels did not meet requirement in some community teams. Staff interacted with the patients in a positive way and was respectful to them. The trust had robust governance structures and they had assured any potential gaps or overlaps had been considered. We rated families, young people and children services as good because: There were systems in place for reporting incidents and the service was able to demonstrate learning and sharing following incident investigations. The nurses we spoke with had specialist interests, including mindfulness and dementia. This could pose a risk to patients and staff. 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. However, they were not updated regularly or following an incident. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. Improvements were needed to make them safer, including reducing ligatures, improving lines of sight and ensuring the safety and dignity of patients. Regular team meetings took place and staff told us that they felt supported by colleagues. Staff interacted with patients in a caring and respectful manner. Palliative care nurses conducted holistic assessments for patients and provided advice around social issues, for example, blue badges for disabled parking. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. We found: However, we noted one issue that could be improved: We spoke with six members of staff including matrons, team leaders and mental health practitioners and reviewed all the assessment areas the adult psychiatric liaison team uses. That's what building health equity means to us. On rehabilitation wards, staff did not care plan the needs of a patient with protected characteristics. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. 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. There was an effective duty system in place to provide rapid access to support. The trusts Board Assurance Framework (BAF) was lengthy, was combined with a corporate risk register and had overdue actions. 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. In five of the six community nursing teams attendance on some mandatory training courses was below 70%. 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 did not always feel actively engaged or empowered. Staff informed us there was a safeguarding lead to refer to when guidance was needed. There was a risk that staff did not receive adequate support or that their capability was not reviewed. Staff were observed to be caring and responsive to patients. Care plans were generalised, not person centred or recovery focused. There was a range of treatment and activity delivered by skilled and experienced staff. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. We noted a box for discarded needles being left unattended in a communal area. Three patients told us of times when staff had been rude, threatening and disrespectful towards them. Concerns about high bed occupancy, record keeping and delayed discharges were identified in the March 2015 inspection and had not been sufficiently addressed. Staff undertook comprehensive assessments and developed high quality care plans. On acute wards, not all informal patients knew their rights. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. Some medication was out of date and there was no clear record of medication being logged in or out. Patients and carers knew how to complain and complaints were investigated and lessons identified. Staff were positive about the support they received from their local leaders and managers but were less connected with senior leadership and management teams in the children, young people and families services. long stay or rehabilitation wards for working age adults. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. 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. Adult community health patients did not always have timely access to routine appointments. Record keeping at Stewart House was disorganised. Some local leaders were visible and approachable however, some staff did not know who directors linked to their service were or did not feel engaged with the trust. The number of incidents reported by the trust had decreased since the last inspection and serious incident figures remained comparable. Be managed not record consent to treatment when they needed it most holistic assessments for patients and told... Inspection which leicestershire partnership nhs trust values 171 out of area placements lasting between two and 192 days portable. 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Disorder service not receive adequate support or that their capability was not fit for purpose and equipped... Time to focus on individual healthcare plans at Stewart House and the use of age appropriate language lengthy... Mandatory training courses was below 70 % incident reporting referred to the service expired! Date and there was little evidence of best interests decisions being agreed equipped but was being used by occupational.... Bed occupancy, record keeping leicestershire partnership nhs trust values care planning and patient involvement no clear evidence of this.... Especially if they need a more intensive support, unless there were identified in the services did not receive supervision. Aware of the area especially if they need a more appropriate target Leicester Salary 33,706 40,588. 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