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. On Kirby ward there was no evidence of Section 132 rights read on detention in 54% of records reviewed. The trust employed registered general nurses (RGN) to assist with assessment and management of physical healthcare needs for patients. Leicestershire patient care project shortlisted in prestigious awards. These reports were presented in an accessible format. Staff demonstrated a good knowledge of the Mental Capacity Act and consent however this was not routinely documented in care records. People using the service may not be able to get the speed of telephone response they needed in a crisis. 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 reviewed data and documentation including three patients care records and risk assessments. There were risk assessments and plans in place to keep people and staff safe. 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. We found a high number of concerns not addressed from the previous inspections. Staff who delivered training had been redeployed away from training during the COVID-19 pandemic, but face to face training had restarted and not all staff who had out of date training had rebooked. 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. Updated 22 June 2022. Patient outcomes were not routinely collected so the quality of the clinical care being delivered could not be measured or benchmarked. The nurses we spoke with had specialist interests, including mindfulness and dementia. wards for people with a learning disability or autism. Local audits were not completed regularly. 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 worked with both internal and external agencies to coordinate care and discharge plans. o We are one team and we are best when we work together. Restraint was used only as a last resort. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. Lessons were learned from feedback and complaints from patients. We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. 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. 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. The trust delivered programmes for staff to develop into senior roles and had a clear career development programme for nursing staff. The dignity and privacy of patients across three services we visited was compromised. To find out more, review our cookie policy. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. 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. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. However, they were not updated regularly or following an incident. Wards did not have a list of stock items. Access to treatment for specialist community mental health services for children and young people, Maintaining the privacy and dignity of patients and concordance with mixed sex accommodation, Seclusion environments and seclusion paper work. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. We will be working with them to agree an action plan to improve the standards of care and treatment. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. Staff did not routinely complete detailed, person centred, individualised or holistic care plans about or with patients. Our rating of this service stayed the same. There was a mobile phone in the ward office that patients could use for private calls, for example to a solicitor. Services had supplies of emergency medication available and this was accessible to staff. The trust had recruited two registered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. CV6 6NY, In They showed a good understanding of peoples individual needs. The CRHT team did not have lockable bags to transport medication to patients homes; staff told us they transported medication in their handbags. Staff felt well supported and were able to raise concerns with their line manager and were listened to. The service did not have any out of area placements, readmissions or delayed discharges. Some patients told us that staff were polite and respectful and willing to go the extra mile in supporting them. The offer is for 250 to be paid through payroll and subject to tax and National Insurance and is non pensionable. The people who used services, carers and relatives we spoke with were all positive about the service they received. The environmental risks in the health based place of safety identified in our previous inspection remained. The most common reason for delayed discharges was due to family choices which were beyond the control of the trust. 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. Staff treated people who used the service with respect, listened to them and were compassionate. The trust set target times from referral to initial assessment against the national targets of 28 to 42 days. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. Staff told us they enjoyed working at the trust and thought they all worked well as a team. A childrens adolescent mental health crisis service had been developed and commenced in April 2017. Delivered through over 100 settings from inpatient wards to out in the community, our 6,500 staff serves over 1 million people living in Leicester, Leicestershire and Rutland. Staff communicated with patients in a calm, professional way and showed an understanding of patients needs. 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. Leicester City 0-19 Healthy Child Programme consultation, Children and adults with a learning disability are encouraged to get their Covid-19 vaccinations as the first specialist clinics of 2023 launch, Hospital visitors asked to wear facemasks once again, Rob Melling, Head of Community Development, "I love working for the local population - I'm passionate about helping the people of Leicester, Leicestershire and Rutland. Jan 4. Staff followed procedures to minimise risks where they could not easily observe patients. Managers shared the outcome of complaints with their ward teams. Some local managers were keeping their own records to ensure performance was monitored. For example relating to assessment of ligature points at Westcotes. Nursing staff interacted with patients in a caring and respectful manner. Staff did not always maintain the privacy and dignity of patients. 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.) Engagement and joint planning between departments was well developed. Staff morale in some teams was low, with high levels of stress. The trust had not fully articulated their vision for how they operated as a trust. We strongly recommend an informal and confidential discussion with Cathy Ellis, the Chair of the trust. The trust had a dedicated family room for patients to have visits with children. Records about the use of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) were inconsistent. Complaints were well managed to ensure a timely response and aid learning. The trust learnt from incidents and implemented systems to prevent them recurring. Information on the trusts vision and values was available at the site and staff appraisals were linked to them. In rehabilitation wards, staff did not always develop and review individual care plans. Patients and carers knew how to complain and complaints were investigated and lessons identified. There was detailed discussion and consideration of patients and carers needs. Multi-disciplinary teams and inter agency working were effective in supporting patients. There was a risk that staff did not receive adequate support or that their capability was not reviewed. All areas were very clean, fresh smelling and fit for purpose. We looked at the domains of safe, effective and responsive and we did not inspect all of the key lines of enquiry. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. Staffing levels did not meet requirement in some community teams. This promotion is being run by Leicestershire Partnership 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. Engagement with external stakeholders had significantly improved since our last inspection. Palliative care nurses conducted holistic assessments for patients and provided advice around social issues, for example, blue badges for disabled parking. Data provided by the trust showed there were four episodes of seclusion from February 2016 to July 2016. We did not rate this inspection. The lack of psychology was an issue highlighted at our 2018 inspection. No rating/under appeal/rating suspended Infection prevention and control (IPC) was well managed and monitored and services were responsive to deal with frequent changes in IPC requirements during the pandemic. 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. The trust had several strategies, a vision and corporate objectives, but they did not underpin all policies and practices. We rated the four mental health core services as requires improvement and community health services for adults as good. The number of incidents reported by the trust had decreased since the last inspection and serious incident figures remained comparable. The trust had begun replacing hydraulic beds on the wards and had agreed plans for the replacement of further hydraulic beds across the site over a four-year period. Patients gave positive feedback regarding the care they received. Apply. Medicine management training sessions had been undertaken with inpatient ward sisters and charge nurses. Access to rooms to undertake activities in the community for people with autism had been reduced. 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. Mandatory training compliance for trust wide services was 91% against the trust target of 85%. Bank Band 6 Speech and Language Therapist. 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. 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. Staff involved patients in the ward review and community meetings. 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. 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. There could be risks posed by the use of different recording systems across teams as staff may not all have access to all records. Make a difference with a career at LPT. We found out of date and non-calibrated equipment located within a cupboard in the health-based place of safety. The trust provides adult end of life care services in community in-patient wards and community nursing services seven days per week. 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 were caring, compassionate and kind towards patients. In the dormitories, observation mirrors were situated so that staff could observe patients without having to disturb them. We did not speak to any patients using the service at the time of the inspection. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. Not all patients on acute wards for adults of working age could summon help from staff if required. They were supported to have training to help them to develop additional skills and expertise. Home - Leicestershire Partnership NHS Trust Creating high quality, compassionate care and wellbeing for all. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. Beds were not always available for people living in the trusts catchment area. Record keeping was poor in some services. Patients described being cared for, respected and treated with dignity. 83% of staff received mandatory training. Staff actively participated in clinical audits. Save job - Click to add the job to your shortlist. Staff were visible in the communal ward areas and attentive to the needs of the patients they cared for. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. In all instances police transported the patient to the HBPoS. 8 February 2017. This area of our site lists our partner organisations. There was effective communication between the service and other healthcare professionals. Managers completed ligature audits which highlighted what mitigation was in place to reduce the risk for patients. Staff were not in receipt of regular supervision in order to discuss training needs, developmental opportunities or performance issues. Some actions were required to ensure adherence with the Mental Health Act. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. 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. Nottingham, We noted a box for discarded needles being left unattended in a communal area. Reductions in social service provision had led to an increase in referrals to the Community Learning Disability Teams. There were appropriate lone working procedures in place. Staff had the right qualifications, skills, knowledge and experience to do their job. The service employed care navigators to help families and carers negotiate their journey through the various services provided. Following the appointment of a new chief executive a new trust board was formed. Patients had opportunities to continue their education. 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. Please contact Sonja Whelan on 07525 723336 or email Sonja.whelan@leicspart.nhs.uk. Designated staff were not provided by the trust. This was a focused inspection. The school nurses used technology to communicate with young people. There was no fridge to keep medicines cool when required. Adult liaison psychiatry services are delivered by the mental health trust across three acute hospital sites at Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital. There were robust lone working procedures in place. Staff completed Mental Health Act 1983 (MHA) paperwork correctly and systems were in place for secure storage of legal paperwork, advice and regular audits. A dashboard of key performance indicators was being developed. We remain concerned that a significant period had passed and the trust had not improved access to psychology for patients and staff. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. To find out more, review our cookie policy. We found concerns with the environment in all five core services we inspected. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. The average bed occupancy was low. 100% of staff were trained in how to safeguard children from harm. This did not demonstrate a consistent temperature, had been maintained to assure the safety and efficacy of the medicines. Any other browser may experience partial or no support. The waiting areas and interview rooms where patients were seen were clean and well maintained. Through this collaborative working we are also building a culture of continuous improvement and learning, supported by a robust governance framework and more sustainable and efficient use of resources. Community mental health services with learning disabilities or autism, Wards for older people with mental health problems. Discharge planning was considered as part of board rounds although discharge planning paperwork was not used consistently. Urgent and emergency care services across England have been and continue to be under sustained pressure. Most people and carers gave positive feedback about staff. The team engaged with patients who found it difficult or were reluctant to engage with mental health services. In two services, staff were not always caring towards patients. Staff had a good knowledge of safeguarding. Ward teams did not hold regular team meetings. Staffing levels were not consistent across the two sites. We were concerned that information management systems did not always ensure the safe management of peoples risks and needs. Patients told us they did not have access to a copy of their care plan. Not all care plans reflected patients assessed needs, or were personalised, holistic and recovery oriented. Staff gave examples of working with people with diverse needs considering their ethnicity, gender, age and culture. 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. We rated community health services for adults as requires improvement because. 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. At Melton, Rutland and Harborough, City East and City West CMHTs m. At City West in conjunction with the young onset dementia assessment service staff developed a digital app for younger who were developing dementia. Risk assessments were completed and care plans implemented to keep patients safe and promote wellbeing. Specialist community mental health services for children and young people. Mandatory training that fell below 75% included adult immediate life support, adult basic life support, safeguarding children level 3 and fire safety awareness. The trust had set safe staffing levels and these were followed in practice. Assessments took place using nationally recognised assessment tools and staff provided a range of therapeutic interventions in line with National Institute for Health and Care Excellence (NICE) guidelines where staffing allowed this. The trust had developed new processes and redesigned and improved data validation. As part of each inspection, we look at the way health services provide care and treatment to people. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. At the Valentine Centre improvements had been made to the storage of cleaning materials. Staff were observed to be caring and responsive to patients. The trust had a patient involvement centre, which was pleasant, well-equipped and supported involvement from friends and family. Staff were kind, caring and compassionate and treated patients with dignity and respect. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. 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. Care records were up to date and holistic. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. Children and young people felt listened to in a non-judgmental way and told us they felt respected. We rated the trust as inadequate for well-led overall. There was a lack of storage at Stewart House, the utility/laundry room was used to store cleaning equipment. We found this across core services and within senior teams. The trust had systems for staff to raise any concerns confidentially. 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. 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. One patient on Thornton ward told us that while staff did knock, they did not wait for a response before entering, which had resulted in staff walking into their room while they were changing their clothes, compromising their privacy and dignity. 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. Patients were happy with the care they received and were very complimentary about the staff who cared for them. Equality diversity and inclusion matters had been a focus of the new trust leadership team. Safeguarding was a high priority with regular safeguarding reviews within each area of speciality and established systems for supporting staff dealing with distressing situations. There was no patient alarm access in four ward areas, including the dormitories. 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. The trust had long term plans to address this. Staff said morale was good and they felt supported by their managers. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. The HBPoS had no designated resuscitation equipment and emergency medication and shared equipment with acute wards. View more Profession Nurse Service Child & Adolescent / CAMHS Grade Band 5 Contract Type Permanent Hours Full Time. Staff knew how to report any incidents on the trusts electronic reporting system. The trusts Board Assurance Framework (BAF) was lengthy, was combined with a corporate risk register and had overdue actions. Since our 2017 inspection, the trust had not fully ensured that clinical premises where patients received care where safe, clean well equipped, well maintained and fit for purpose. Staff felt that they had opportunities to develop and were supported to undertake further study. Staff maintained a presence in clinical areas to observe and support patients. This meant some fundamental standards were not being met. There were effective methods for obtaining feedback from service users and carers and feedback was acted upon. 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. There were no recorded regular temperature checks of the medication cupboard. The recording of discussions and assessments with people regarding consent to treatment was not always documented. We carry out joint inspections with Ofsted. We found damaged fixings on one ward; that posed a risk to patients. The ward had an up to date ligature risk audit, staff mitigated the risks on the ward by observing patients. Staff satisfaction varied greatly across the service with some staff feeling devalued. The trust had systems for promoting, monitoring and responding to complaints. The trust told us patients across mental health inpatient wards had commented positively about their experience of care. -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 . Clinic rooms were overstocked with medications. They did not have alarms or vision panels in the door. Staff did not demonstrate a good understanding of the Mental Health Act (MHA) and Mental Capacity Act (MCA). Patient outcomes for people using trust services were very good and the trust was able to demonstrate that their services had a positive impact through good data collection and review mechanisms. the service isn't performing as well as it should and we have told the service how it must improve. 2020 University Hospitals of Leicester NHS Trust, We treat people how we would like to be treated, 'We are passionate and creative in our work'. Staff were not supervised in line with the trust's policy. Staff sourced PICU beds when needed from other providers, in some cases many miles away. 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. We were not assured that the trust risk register clearly documented action taken or progress of action, within agreed timescales. There were no children who had waited more than a year for treatment. Staff told us they felt happy and enjoyed their work. Mental Health Act documentation was not always up to date on the electronic system. In response, the Care Quality Commission undertook a series of coordinated inspections, monitoring calls and analysis of data to identify how services in a local area work together to ensure patients receive safe, effective and timely care. We had concerns about the environment but noted the service was due to move locations within two weeks. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. Another patient said on their comment card they did not see enough of the occupational therapist. Some seclusion rooms had environmental concerns at Belvoir and Griffinunits, and Watermead wards. The quality of some of the data was poor. We're one team with shared values providing the best care possible. There was access to interpreters and staff were aware of how to access them. Staffing numbers were met but not always the right skill mix. Staff did not effectively complete risk assessments for patients, manage a smoke free environment, or share information about incidents or share learning from incidents within teams, across services or between services in the trust. Patients occasionally attended the service. In rating the trust, we took into account the previous ratings of the core services we did not inspect on this occasion. Staff could not rely on performance reports being accurate. We heard from most teams, positive examples of teamwork and multidisciplinary working within teams and services, and with external agencies and key stakeholders. Staff described various ways in which they received information from the board and other governance meetings. We work in partnership with a range of NHS organisations, local government and other bodies and are ultimately accountable to the secretary of state for health. Improvements were noted in some wards in core services but not all. Apply. Patients waiting for their appointment in the specialist community mental health services for children and young people used a shared waiting room with the learning disabilities adults services. The trust was not commissioned to provide a female PICU and have identified the need with their commissioners. We saw staff treating people with dignity and respect whilst providing care. Information needed to deliver care was not always readily available when people using community mental health teams presented in crisis out of hours. 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. Patients privacy and dignity had been addressed at The Willows, Cedar and Acacia wards with changes made to male and female wards. Staff used "my care plan" documents to obtain patients views on their care. This was particularly relevant to protected characteristics. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. At West Leicestershire there was a lack of psychology input. Some families carers said that the meals were unhealthy. Managers changed practice because of this. 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. ALT. Managers had introduced a duty clinician to manage caseload sizes and reduce patients risks. Staff did not adhere to the Mental Capacity Act Code of Practice and the five principles of the Act. Patients did not have access to regular community meetings where they would discuss ward issues and concerns. Patients said staff who cared for them were knowledgeable, professional and friendly. 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. Staff completed detailed individualised risk assessments for patients on admission and updated these regularly and after incidents. For example, for adepot injection,a slow-release slow-acting form of medication. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). The Health Trust HIV/AIDS Services program delivers groceries to homebound seniors and adults throughout Santa Clara County. At this inspection, we looked at adult liaison psychiatry services at the Leicester Royal Infirmary site. We observed many examples of staff treating patients with care and compassion. There was a clear vision for the service which staff understood. We had concerns about the safety of some of the facilities where care was delivered. Managers did not have oversight of these issues. Staff told us they felt supported by their line managers, ward managers and matrons. We found a patient being nursed in the low stimulus area and their liberty was restricted. In five of the six community nursing teams attendance on some mandatory training courses was below 70%. The new contract would start from 1 October 2023 and run until 30 September 2030. 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. Staff had been given lone worker safety devices to ensure their safety. 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. The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. 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. 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. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. For example, issues found in risk assessments, care plans and environmental concerns had been addressed in some services, but not all since our last inspection. 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. Where relevant we provide detail of each location or area of service visited. The waiting list had increased for those children and young people waitingfor thestart of treatment, following assessment. Use our service finder to find the right support for your mental health and physical health. Some wards and community teams had low staffing levels, or an absence of specialist staff, and this had an impact on care.Staffing levels remained low at the Bradgate mental health unit. We found positive multidisciplinary work and observed staff were supporting patients. Improvements had been made to seclusion areas at The Willows Acacia and Maple wards. Record keeping at Stewart House was disorganised. 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 HBPoS did not have designated staff provided by the trust. The teams were able to respond quickly when patients or carers telephoned with problems. This monthly award is about recognising members of staff who have gone the extra mile. Shifts were not always covered with sufficient staff, or with staff who had the appropriate qualification and experience for the role. Ward matrons were looking into these alleged incidents. Staff were confused about Deprivation of Liberty standards and paperwork was incomplete. We are proud of our 5,400 staff and together we aim to . The136 suiteis a place of safety for those who have been detained under Section 136 of the Mental Health Act. Care records for patients using the CRHT teams were not holistic or personalised. Staff were unable to show us evidence of clinical audits or the basis of evidence based practice in end of life services. Patients felt safe and said they were checked regularly by staff. Staff mostly felt positive about their managers and said that the services provided were well-led. There were problems with access to the electronic system owing to ongoing building works. Care and treatment was planned and delivered in line with current evidence-based guidance, standards, best practice and legislation. Your information helps us decide when, where and what to inspect. 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. The trust had not fully addressed the issues of poor lines of sight in wards. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. Maintenance teams did not undertake repairs in a timely way and not all areas used by patients were clean. People felt they had benefited from the service and told us how caring staff were. Inpatient and community staff reported difficulties with getting inpatient beds. Regular team meetings took place and staff told us that they felt supported by colleagues. Through effective workforce planning we will nurture and support our staff to progress and flourish, offer them opportunities to deliver care through new models and in new roles. The majority of repairs and maintenance issues highlighted within the warning notice at the Bradgate Mental Health Unit had been fixed or resolved. The trust reported a 10% increase in the number of referrals received into the CAMHS service. The acute service contained large numbers of beds in bed bays accommodating up to four patients. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. Managers did not successfully cascade information down to all ward staff in acute mental health services. Staff interacted with the patients in a positive way and was respectful to them. 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. 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. The trust did not always manage the admission of patients into mixed sex environments well. Staff told us there were no service information leaflets available. Families and carers said the wards were clean. We inspected three mental health inpatient services because of the ratings from the previous inspection. 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. Claim your Free Employer Profileto start telling your employer brand story to reach top talent. All the people who used services and the carers spoken to were happy with the service they had received and spoke positively about their interactions with staff. Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. Bathrooms and toilets were specified for which gender depending on who was resident at the unit at the time. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. Response times to maintenance request were variable. Some families and carers told us that the service was not responsive, telephone calls to the service were not returned. Consent to care and treatment was obtained in line with relevant guidance and legislation. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. We want to hear from you on how to improve our service and provide the best care possible. Suspended ratings are being reviewed by us and will be published soon. The NHS is founded on principles and values that bind together the diverse communities . However, this was a temporary restriction due to the building works and patient safety. Many staff we spoke with knew who their chief executive was and mentioned them by name. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. The HBPoS had poor visibility for observing patients. Click here to submit your comments to us. Staff were provided with relevant information to care for patients safely. Assessed risks were well-managed and staff showed a good awareness of individual needs and how to respond to them. Examples were given regarding learning from these. Acute patients had been sent to rehabilitation wards inappropriately. There were no separate female bedroom areas and no gender specific toilets or bathrooms. The rating had improved from the November 2016 inadequate rating. Some staff found there was insufficient time to complete their visits within the working day. There's no need for the service to take further action. 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 would still work with people who were on waiting lists so that they received some level of service. The work in neighbourhoods reduced travel for people and reduced barriers for people to gain support. We rated community health inpatient services as requires improvement because: Despite considerable effort with recruiting new members of staff, staffing was the top concern for all senior nurses and there was still a significant reliance on agency staff to fill shifts which could not be covered internally. On one ward, female shower rooms did not contain shower curtains. 9 August 2019, Leicestershire Partnership NHS Trust: Evidence appendix published 27 February 2019 for - PDF - (opens in new window), Published Staff held multidisciplinary team meetings weekly and these were attended by a range of mental health professionals. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. ", "I have developed so many new skills over the years working in the NHS, going from a healthcare assistant to a nursing associate. On Heather ward patients said that there was not enough ventilation on the wards. received 41 comment cards from patients that were available for patients to complete during the time of our inspection. 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. There was a blind spot in the seclusion room on Acacia ward at the Willows which meant staff could not easily observe patients. Thy are entitled to receive a remuneration of 13,000 per annum each and have . The clinic rooms across sites had all the equipment calibrated. The medical and senior leadership provision within the looked after children service did not meet the professional requirements outlined in the intercollegiate document for this provision. The environment in some services was poor, not well maintained and not kept clean. The trust had completed ligature risk assessments across all wards, detailing where risks were located and how these should be managed. Leicester; 33,706 to 40,588 a year (pro rata) Leicestershire Partnership NHS Trust; We are looking for a Bank Band 6 Speech and Language Therapist to join our innovative, friendly and well supported team working with children and y. Emails and the trust intranet also provided staff with this information. There was minimal evidence of patient involvement in care plans. 78% of staff had completed their annual appraisal. Staff were up to date with mandatory training and had regular supervision and appraisals. Patients social, emotional and religious needs were met and relatives valued the emotional support they received. 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. All hospitals were running at a high bed occupancy level of above 85% which national data has linked to increased risk of bed shortages as well as an increase in healthcare associated infections. 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. This was a focused, unannounced inspection, to follow up on enforcement action we issued to the trust after our last inspection in November 2018. 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. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately. That's what building health equity means to us. University Hospitals of Leicester NHS Trust. The policy for rapid tranquillisation was not in line with national guidance. Staff were inconsistent in updating the Historical Clinical Risk Management (HCR-20) assessments. Managers had a recruitment plan in place to increase the number of substantive staff for the service. Managers ensured they used regular bank staff to achieve the required safer staffing levels and to promote continuity of care of patients. Every team we spoke with knew who they reported to and what to report. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. Procedures for incident management and safeguarding where in place and well used. We could not find records for seclusion or evidence of regular reviews taking place as per trust policy. Concerns about high bed occupancy, record keeping and delayed discharges were identified in the March 2015 inspection and had not been sufficiently addressed. Leicestershire Partnership NHS Trust provides mental health, learning disability and community health services across Leicestershire, England.. The assessment and resulting care plans were personalised, holistic and recovery focussed. The longest wait was 108 weeks for four patients to access group work or outpatients. We spoke with five patients on long stay or rehabilitation wards; they told us they felt very well supported, and staff and were kind, caring, and respectful. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. The community nursing service could not measure its performance in relation to response times for unplanned care. ", John Barnes, Charge Nurse, LD Short Breaks, "I really enjoy the human interaction on a daily basis - with colleagues, patients, relatives. There was good multi-disciplinary working within the teams and good communication with other organisations. This is an organisation that runs the health and social care services we inspect. We don't rate every type of service. 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. 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. For example, patient-led assessments of the care environment (PLACE) were completed. 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. Fire safety was much improved, withfire drills carried out regularly. 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. The trust encouraged staff at most levels of the organisation to develop and deliver ideas for service delivery, improvement and innovation. Staff reviewed young peoples risk at every appointment and recorded this in the case notes. Save job - Click to add the job to your shortlist. The trust had improved how staff recorded patients physical healthcare, and monitored patients who had ongoing physical healthcare problems. Staff were consistently caring, respectful and supportive. Staff did not record consent to treatment, and capacity to consent and best interests decisions when these were needed. 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. All ward ligature risk assessmentshad beenreviewed and were located on each ward together with mitigation summaries. 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. Some facilities lacked essential emergency 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. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. We have issued seven requirement notices which outline the breaches and require the trust to take action to address. The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. Often patients were admitted to hospital out of the area especially if they need a more intensive support. We noted how much time the new executive team had invested in making and implementing improvements during the COVID-19 pandemic. 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. We're always looking for the best. 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. There were effective systems in place to audit and monitor physical health care records. The trust provided patients with accessible information on treatments, local services, patients rights and how to complain across all services. Staff we spoke with demonstrated their dedication to providing high quality patient care. We saw evidence of discharge planning in care plans written by CRHT staff. The needs of people who used the service were assessed and care was delivered in line with their individual care plans. Wards had well equipped clinic rooms with appropriate equipment which staff regularly checked. Patients said they got bored at the weekends, as there were fewer activities on offer. They and their carers were kept informed and involved in their treatment and care. Leicestershire Partnership NHS Trust | 4,712 followers on LinkedIn. However, we saw evidence this was not always achieved. 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 service was not effective. specialist community mental health services for children and young people. 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. The trust had robust governance structures and they had assured any potential gaps or overlaps had been considered. As one of the largest registered investment advisors in the U.S., we offer a broad range of services to institutional clients, including corporate and higher-education retirement plans, foundations and endowments, and religious organizations. There were not enough registered staff at City West and this was identified as a risk on the service risk register. Following the national withdrawal of the Liverpool Care Pathway the trust has developed an alternative care plan; however this has not yet been implemented. The trust used key performance indicators/dashboards to gauge the performance of the team. Leicestershire Partnership NHS Trust This is an organisation that runs the health and social care services we inspect Overall: Requires improvement Services have been transferred to this provider from another provider Services have been transferred to this provider from another provider All Inspections 12 April 2022 The trust had improved medicines management. There were high vacancy rates. Staff informed us there was a safeguarding lead to refer to when guidance was needed. There were clear responsibilities, roles and systems of accountability to support good governance and management. Clinical supervision rates were low. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. 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. The electronic data held by the trust was currently being validated with large numbers of visit records not closed on the database. Whilst there was a plan to eradicate the dormitories across the trust, there were delays to the timetable and patients continued to share sleeping accommodation which compromised their privacy. 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 introduction of activities co-ordinators at Coalville Hospital had improved the patients experience on the ward and increased the activities that were conducted on a day to day basis. View more Profession Occupational Therapist Grade Band 5 Contract Type Permanent Hours Full Time. The trust did not provide data to demonstrate medical staff appraisal compliance. 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. We observed positive interactions between staff and children and the use of age appropriate language. 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. Staff were positive about the level of support they received, including regular supervision and line management. This impacted on patients requiring care. We reviewed 267 case records and found that, generally, staff completed detailed individualised risk assessments for patients on admission. Staff felt supported by their immediate managers but felt disaffected with trust senior management. This report describes our judgement of the quality of care provided by Leicestershire Partnership NHS Trust. Due to this staff could not observe all parts of wards due to their lay out and the risk had not been mitigated. 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