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. The trust had begun the process of replacing some beds with more suitable options for the patient group. Comprehensive relocation action plans were available. Staff were given feedback after incidents had been reported. At West Leicestershire there was a lack of psychology input. Staff were not aware of the trusts visions or values. The transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. The duty system enabled urgent referrals to be seen quickly. There was a blanket restriction. Staff did not record seclusion well. Mandatory training compliance for trust wide services was 91% against the trust target of 85%. We looked at the domains of safe, effective and responsive and we did not inspect all of the key lines of enquiry. Patient views on the quality of the food were variable. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. 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. Staff did not assess and record the risks posed by medicines stored in patents homes. We identified that in community mental health teams, wards and community inpatient hospitals, fridge temperatures were not recorded correctly; either single daily temperature readings were recorded rather than maximum and minimum levels or temperatures were not recorded on a daily basis. View more Profession Occupational Therapist Grade Band 5 Contract Type Permanent Hours Full Time. Staff were described as putting people who used services first and being person-centred. Community mental health services with learning disabilities or autism, Wards for older people with mental health problems. 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. Therefore, overall, eight of the trusts 15 services are now rated as good, five as requires improvement and two as inadequate. We saw that Advanced Nurse Practitioners were completing Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) forms having completed their training to do so; however we saw that these forms were not countersigned by a doctor or consultant. Staff did not record consent to treatment, and capacity to consent and best interests decisions when these were needed. Wards did not have a list of stock items. The service had not delivered timely care to a significant number of patients. This meant board members were not able to monitor the trusts assertions that there were strong systems and processes in place for identifying and reporting serious incidents, including deaths, or monitoring whether reviews and investigations were completed fully. We heard from most teams, positive examples of teamwork and multidisciplinary working within teams and services, and with external agencies and key stakeholders. Other professionals within the trust could not access this system. Published Patients said staff who cared for them were knowledgeable, professional and friendly. Staff did not always use the Mental Health Act and the accompanying Code of Practice correctly. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. Some records were over more than one database/system which could make locating information a problem. The people who used services, carers and relatives we spoke with were all positive about the service they received. Staff were de-briefed and supported after a serious incident; we saw that incidents were a standing agenda item for team meetings and were discussed with staff. We saw that patient numbers exceeded the number of beds available on wards. Patients who accessed the CRHT team told us that they felt their wishes and needs were taken in to consideration, staff could be accessed quickly and they felt safe when visiting the Bradgate Mental Health unit. We rated it as requires improvement because: Our rating of the trust stayed the same. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. Staff undertook comprehensive assessments and developed high quality care plans. Due to the large caseloads in community health service, the number of visits that were required was not always manageable. The dignity and privacy of patients across three services we visited was compromised. Staff gave examples of initiatives such as the chief executives blog and the presentation of the valued star award. The 30 bed unit at Stewart House was mixed sex and there were no doors to lock between the male and female sections. 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. Some improvements were seen in seclusion documentation and seclusion environments. There was no fridge to keep medicines cool when required. A dual paper and electronic recording system meant that some information was not accessible to all of the staff that might need it. The trust reported a 10% increase in the number of referrals received into the CAMHS service. We looked at how the adult liaison psychiatry service affected patient flow, admissions to hospital and discharges from the Leicester Royal Infirmary hospital as part of the system wide healthcare. The trust lacked a framework for co-ordinating, endorsing and therefore learning from the very many positive quality projects taking place. The waiting list had increased for those children and young people waitingfor thestart of treatment, following assessment. In rehabilitation wards, staff did not always develop and review individual care plans. The service employed care navigators to help families and carers negotiate their journey through the various services provided. There was highly visible, approachable and supportive leadership. We rated responsive and well led as requires improvement, and safe, effective and caring as good. The electronic data held by the trust was currently being validated with large numbers of visit records not closed on the database. We spoke with nine patient families and carers. Managers shared the outcome of complaints with their ward teams. Staff showed caring attitudes towards their patients. The trust had systems for staff to raise any concerns confidentially. This was: We also assessed if the organisation is well-led and looked at areas of governance, culture, leadership capability and improvement. This could have resulted in an increased risk of incorrect safe and secure handling of medicines and unsafe practice in relation to the administration and prescribing of medicines. Staff used "my care plan" documents to obtain patients views on their care. Specialist community mental health services for children and young people. Some improvements to address the no smoking policy at the Bradgate Mental Health Unit wards were seen. 30 April 2018. Staff were dedicated and passionate about the work that they undertook. Potential risks were taken into account when planning community health services. Staff were given opportunities to expand their knowledge and develop their roles. They told us that staff were kind and caring. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. We found a total 40 breaches of the six week referral and seven breaches of the five day urgent referral. Managers shared the outcomes and lessons learnt from incidents, complaints and service user feedback at regular staff meetings, where meetings took place. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. 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. ", "I like that I'm able to help both staff and service users. We would expect patient involvement to be embedded at all levels of the trust, across as many departments as possible, in planning, review, evaluation and delivery. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. There had been periods of understaffing. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. 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. There was minimal evidence of patient involvement in care plans. Staff moved acute patients to the rehabilitation wards when acute beds could not be located. There were improvements in ligature risk assessments. That's what building health equity means to us. They were reflected in the objectives of local teams. 42% of staff on Phoenix ward and 27% Griffin ward had received clinical supervision. Patients said they got bored at the weekends, as there were fewer activities on offer. 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 . There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. 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. Any other browser may experience partial or no support. Staff monitored those patients on the waiting list regarding risk levels. Patients in four services across the trust reported that they had not been involved in the planning of their care and had not received copies of care plans. 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. Staff felt that they had opportunities to develop and were supported to undertake further study. New systems were in place for staff to report any repairs or maintenance issues. On rehabilitation wards, staff did not care plan the needs of a patient with protected characteristics. We use cookies to improve your experience on our website. However staff did not appear to be fully aware of services provided and told us there were plans to implement a seven day service in end of life care. 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. There were systems for lone-working in place including a red folder process that kept workers safe. The trust told us patients across mental health inpatient wards had commented positively about their experience of care. The recording of discussions and assessments with people regarding consent to treatment was not always documented. We rated safe, effective, caring and responsive as good and well led as requires improvement. Restraint was used only as a last resort. The trust could not be sure that all staff. Our patients are at the heart of all we do and we believe that 'Caring at its Best' is not just about the . 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 did not have seclusion rooms on all wards. Staff explained to patients their rights under the Mental Health Act on admission and routinely thereafter, although we saw this was not always documented in the patients care notes. Three out of 18 staff interviewed said that supervision was irregular. Thy are entitled to receive a remuneration of 13,000 per annum each and have . Men using the laundry had to pass womens bathroom and bedrooms. There had been several serious incidents (SI) within this service in the last year and it was not clear that learning from investigations and actions consistently took place to prevent recurrence. Leicestershire Partnership NHS Trust | 5,409 followers on LinkedIn. Staff provided patients and carers with information in a way that they understood.At City West, City East, and South Leicestershire patients and their carers reported outstanding and good care. Patient had individualised risk assessments. In CAMHS community teams waiting times from referral to initial assessment was less than 13 weeks. There was good multi-disciplinary working within the teams and good communication with other organisations. Therefore, patients were not always actively engaged in decisions about service provision or their care. The trust had made significant improvements to develop a strengthened vision and strategy. Staff followed the trust policy on seclusion. 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. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. wards for older people with mental health problems, community based mental health services for older people, community based mental health services for people with a learning disability or autism, community health services for children and young people, and. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. Staff did not consistently promote dignity and respect as expected in all services. Managers did not have oversight of these issues. There was evidence of leadership at local and senior level. Patients needs were assessed and monitored individually. Some wards and community teams did not store or manage medicines safely. Patient access to psychology and occupational therapy was less than expected on acute wards and rehabilitation wards due to the number of staff vacancies in therapy positions. The trust had not responded in a timely way to eliminate shared sleeping arrangements (dormitories). Staff in four of the five services we inspected did not document patient involvement in their care. 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. This report describes our judgement of the quality of care provided by Leicestershire Partnership NHS Trust. This had continued during the pandemic. 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. 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. 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. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. ALT. Leicestershire Partnership NHS Trust Is this your company? There some gaps in staff receiving regular supervision. There was no funding for staff to provide activities so patients had limited access to activities of their choice during their stay. Staff in the community adult mental health teams did not protect patients dignity or privacy. The service was responsive. 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. People knew how to make a complaint as this information was provided in welcome packs. The trust provided newsletters, quarterly serious incidence bulletins, regular emails from matrons about incidences and lesson learnt. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. However, Griffin did not. View more Profession Nurse Service Child & Adolescent / CAMHS Grade Band 5 Contract Type Permanent Hours Full Time. There were improved systems and processes to manage storage, disposal and administration of medications. There was an unstructured, non-mandatory approach to formal end of life training for community hospital staff. Services treated concerns and complaints seriously, investigated them and learned lessons from the results. 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. The successful candidate will demonstrate they possess the same core values as our organisation, Compassion, Respect, Trust and Integrity in all aspects of their work. Governance structures were in place and risks registers were reviewed regularly. To participate in this scheme, you'll need to do the following: You will need to refer your friend using the form below titled "Refer Your Friend." Staff had received specialist child safeguarding training and were able to make referrals when appropriate. Lessons learnt were shared across the organisation via emails and the intranet. Patient Advice and Liaison Service (PALS). Records in the HBPoS did not clearly indicate if patients had their rights explained to them. Patients had their own copies of care plans and were involved in their care plan reviews. The trust had robust governance structures and they had assured any potential gaps or overlaps had been considered. We are proud of our 5,400 staff and together we aim to . Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. Care plans were not always holistic and person centred. Bank Band 6 Speech and Language Therapist. Wards employed additional healthcare support workers to meet patient needs when needed. The trust confirmed after our inspection Advanced Nurse Practitioners used a DNACPR form which had been agreed within NHS East Midlands. Medication management had improved significantly across the services. Staff showed a good awareness of patient rights. We rated acute wards for adults of working age and psychiatric intensive care units as requires improvement because: The trust had made improvements to the clinical environments but had not met all the required actions following the previous inspection of March 2015. Staff followed up on all people seen in by phone, post or face to face to help with any ongoing issues such as housing or benefits. Some families carers said that the meals were unhealthy. There's no need for the service to take further action. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 22 Jan 2023. We did not inspect the following areas of this core service: We did not rate this service at this inspection. Staff said the system was difficult to use and this had affected the information recorded in patients notes. 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. This does not comply with the guidance from the Royal College of Psychiatrists. Every team we spoke with knew who they reported to and what to report. Each priority within our approach is being led by an executive team member and progress is being monitored through our quality governance framework. This reduced continuity of care. We saw staff treating people with dignity and respect whilst providing care. The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. Fire safety was much improved, withfire drills carried out regularly. We did not inspect the following core services previously rated as requires improvement: We did not inspect the following core services previously rated as good: We are monitoring the progress of improvements to services and will re-inspect them as appropriate. The service was not safe. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. Risk assessments were completed and care plans implemented to keep patients safe and promote wellbeing. Our leadership behaviours framework set the standards of expectation we aspire to in our daily work. However, 323 were waiting for their first appointment through the access team, to complete a core mental health assessment. The service did not have any out of area placements, readmissions or delayed discharges. Managers had plans in place to address this issue. 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. 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. The services used recognised outcome measures and monitoring measures to help assess the level of support and treatment required. Ward matrons were looking into these alleged incidents. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. Patients privacy and dignity had been addressed at The Willows, Cedar and Acacia wards with changes made to male and female wards. Patients reported they were treated with dignity and respect. We did not rate this inspection. Seclusion environments were not an issue of concern at this inspection. The trust had a range of information displayed on the ward and the hospital site relating to activities, treatment, safeguarding, patients rights and complaint information. The trust had identified the lack of psychological therapies for patients, and support and training for staff, on their risk register. Following inspection, the trust submitted an action plan to review shared sleeping arrangements. This promotion is being run by Leicestershire Partnership NHS Trust. The trust had made improvements to the clinical environments since the last CQC inspection. Leicestershire patient care project shortlisted in prestigious awards. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. Resuscitation bag, defibrillator and fire drill checks in the CAMHS LD service were not recorded. A positive culture had developed since our last inspection. We found that staff across the service were committed to providing good quality care to the patients and showed care and compassion. The trust had long term plans to address this. 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. we have taken enforcement action. The trust had a culture of promoting staff learning and development and encouraged staff to share best practice and innovation. The process for monitoring patients on the waiting list in specialist community mental health services for children and young people had been strengthened since the last inspection. Meeting these standards and developing the capability to exceed them, will not only ensure that we continue to improve and respond flexibly to changing needs as an organisation, but will also help our staff to fulfil their potential, both in terms of personal achievement and career advancement. 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. CV6 6NY, In Assessed risks were well-managed and staff showed a good awareness of individual needs and how to respond to them. The community therapy rehabilitation unit at Hinckley did not have a defibrillator in the unit for staff to use in an emergency despite staff having been trained how to use one. We rated the caring domain for the community health families, young people and children service as outstanding due to staff approaches to family and patient care utilising or creating tools to assist children to understand their condition or prepare for treatment. The waiting times in community based mental health services for adults of working age were long and breached targets. Staff made individualised risk assessments which were regularly updated and followed best clinical practice. 8 February 2017. Staff managed their caseloads effectively; they discussed their caseloads during multi-disciplinary team meetings as well as in supervision. Wards for people with dementia had dementia-friendly elements; particularly the activity rooms and there was commitment to build on this. The longest wait was 108 weeks for four patients to access group work or outpatients. Ward matrons told us they shared outcomes from incident investigations in team meetings for shared leaning. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. The trust had a limited approach to patient involvement. Patients had the use of their mobile phones on the ward. There was a full complement of staff with no vacancies. Multidisciplinary team work both internal and external to the service was effective and patients were supported to make informed decisions about their care. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. The trust used key performance indicators/dashboards to gauge the performance of the team. Waiting times for referral to initial assessment appointments were good, although patients experienced delays for community paediatric clinic follow up appointments. The trust had addressed the issues previously identified with the health based place of safety. Nursing staff did not have a stock list to randomly check medication which meant they could not reconciliation check. Staff did not document physical health checks for patients detained under section 136 in the HBPoS. Staffing was on the risk register for many of the locations we visited. We observed positive interactions between patients and staff. Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. The trust had reviewed existing systems and processes identified improvements and implemented changes. The service was responding to complaints and implementing systems following these, however the trust waited for these complaints to prompt improvements in the service. However, the service was collecting data. Patients using the CRHT team had limited access to psychological therapies and there were no psychologists working within the CRHT team. The acute mental health wards had two and four bedded dormitories which did not promote privacy and dignity. Demand for neurodevelopment assessments remained high. Contacted the local region psychologists working within the trust was currently being validated with large of!, trust at the Willows was not always use the mental health services adults. Positively about their experience of care plans the health based place of.. Wards when acute beds could not access this system be sure that all staff did... Affected the information recorded in patients notes holistic, for example they did always! Occupational therapy they shared outcomes from incident investigations in team meetings for shared leaning community paediatric follow. The local hospice run by a charity for support being person-centred held by the trust overall, took. 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