We had a number of concerns about the safety of this trust. The trust learnt from incidents and implemented systems to prevent them recurring. This had been identified during the last Care Quality Commission inspection in 2015. Ward teams did not hold regular team meetings. 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. The environmental risks in the health based place of safety identified in our previous inspection remained. Staff had a good knowledge of safeguarding and incident reporting. 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. There were no children who had waited more than a year for treatment. On Ashby ward, the shower rooms did not have curtains fitted. Staff kept risk assessments up to date and carried out comprehensive assessments which were holistic and recovery focused. Two external governance reviews had been commissioned and undertaken. Where English was not the first language of patients, the service provided interpreters. Patients and their carers were not involved in care planning and care programme approach (CPA) reviews. Comprehensive assessments were being carried out and information was stored securely, except for one location and arrangements were in place to address this. In the same service, managers did not always review incidents in a timely way. 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. This did not protect the privacy and dignity of patients when staff undertook observations. Staffing levels were not consistent across the two sites. Staff interacted with patients in a caring and respectful manner. 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. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. Services were planned and delivered in a way that met the needs of the local population, for example the Diana Service and the Family Nurse Partnership. There was a risk that staff did not receive adequate support or that their capability was not reviewed. The electronic data held by the trust was currently being validated with large numbers of visit records not closed on the database. Some patients told us that staff were polite and respectful and willing to go the extra mile in supporting them. We spoke with carers; they all stated that staff responded well when they contacted the service. Two core services did not promote patient centred care in all aspects of care delivery. Access to rooms to undertake activities in the community for people with autism had been reduced. Care and treatment was planned and delivered in line with evidence based guidance and standards, and systems were in place to ensure trust policies reflectedthe latest guidance. 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. there are some services which we cant rate, while some might be under appeal from the provider. The service did not have a system in place to monitor the number of lighters each ward held. The trust did not provide data to demonstrate medical staff appraisal compliance. Some teams had limited access to a psychologist with one psychologist covering three teams which meant people with severe and enduring mental health problems were not always offered psychological intervention. Many staff we spoke with knew who their chief executive was and mentioned them by name. With the exception of the liaison psychiatry service and the mental health triage car, managers were not supervising or appraising staff within the trusts supervision policy. Our observations during inspection confirmed that staff knowledge and practical application of their knowledge was inconsistent despite training on their electronic learning systems. Staff knew the vision and values of the trust and agreed with these. 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. At the Willows, six out of 19 patients risk assessments had not been updated. The trust admitted male patients to female areas of the mixed wards when male beds were unavailable. Procedures for incident management and safeguarding where in place and well used. The trust had well-developed audits in place to monitor the quality of the service. Outcomes of care and treatment were not always consistently or robustly monitored. The trust provided newsletters, quarterly serious incidence bulletins, regular emails from matrons about incidences and lesson learnt. 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. The trust had a major incident policy to deal with any major incidents or breakdown in service provisions. There had been periods of understaffing. Staff mostly felt positive about their managers and said that the services provided were well-led. The trust had systems for promoting, monitoring and responding to complaints. Our HIV/AIDS Services program is in need of volunteers to help deliver . Patients were able to access hot and cold drinks any time during the day. We talk to patients, the public and colleagues about what matters most to them and we do not assume that we know best. The ratings from the inspection which took place in November 2018 remain the same. We are looking at different ways to indicate the outcomes of our monitoring in the future. The trust had new seclusion paperwork implemented in May 2019. A report on the inspection was . There were delays in staff delivering treatments to young people and young people following assessment. Leicestershire Partnership NHS Trust - NEU Professionals - UK Overseas Nurse Recruitment campaign from 2022 - ongoing Leicestershire Partnership NHS Trust (LPT) provides community and mental health services for Leicester, Leicestershire and Rutland. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. Between August 2015 and July 2016, there were 60 delayed discharges across the service. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. CV6 6NY, In For example, Ashby, Aston, Bosworth and Thornton Wards had been converted to single sex only accommodation to ensure compliance with the Department of Health and Mental Health Act 1983 guidance on mixed sex accommodation. Staff were visible in the communal ward areas and attentive to the needs of the patients they cared for. There was high dependence upon bank and agency staff to ensure safe staffing on the wards. 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. Staff provided psychological therapies as recommended by NICE such as group work and cognitive behavioural therapy. To find out more, review our cookie policy. Staff satisfaction varied greatly across the service with some staff feeling devalued. Staff were caring, compassionate and kind towards patients. The HBPoS had no designated resuscitation equipment and emergency medication and shared equipment with acute wards. Staff interacted with patients in a responsive and respectful manner at all times and showed a good understanding of individual needs. Staff told us they felt supported by their line managers, ward managers and matrons. Wards had well equipped clinic rooms with appropriate equipment which staff regularly checked. Staff did not demonstrate a good understanding of the Mental Health Act (MHA) and Mental Capacity Act (MCA). The majority of care plans were up to date. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. Data provided by the trust showed there were four episodes of seclusion from February 2016 to July 2016. We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. Teams were responsive and dealt with high levels of referrals. Staff demonstrated commitment to delivering high quality end of life care for their patients. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. Staff did not routinely complete detailed, person centred, individualised or holistic care plans about or with patients. Staff were quick to sort out requests and problems for patients. Ward matrons were looking into these alleged incidents. ", Daxa Mangia, Mental Health Nurse, The Willows, "I really enjoy my job, helping people to recover - I cannot imagine doing anything else.". The school nursing service was understaffed and consequently there was an adverse impact on outcomes for children and young people and on staff morale. The HBPoS did not have designated staff provided by the trust. There were effective methods for obtaining feedback from service users and carers and feedback was acted upon. The trust had identified the lack of psychological therapies for patients, and support and training for staff, on their risk register. Some wards and patient areas had blind spots, where staff could not easily observe patients. Staff were described as putting people who used services first and being person-centred. There was access to interpreters and staff were aware of how to access them. Staff were up to date with mandatory training. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. Patients and carers knew how to complain. 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 service was caring. We heard many examples of interesting innovation projects and work that staff groups had done which impacted on and improved patient care. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. 42% of staff on Phoenix ward and 27% Griffin ward had received clinical supervision. Maintenance teams did not undertake repairs in a timely way and not all areas used by patients were clean. Patients knew how to make a complaint or raise a concern and complaints were taken seriously. 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. All three service inspections were unannounced. Flexible working arrangements allowed staff to work effectively in teams, particularly when there were not enough staff in some professional groups such as speech and language therapists, occupational therapists and psychologists. There were clear responsibilities, roles and systems of accountability to support good governance and management. Men using the laundry had to pass womens bathroom and bedrooms. Staff in some services completed care plans with detailed information on allergies, and risks around medication. 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 given feedback after incidents had been reported. At Melton, Rutland and Harborough and Charnwood there was a lack of audits and little focus on quality and improvement. The service is not appropriately commissioned to provide sufficient school nurses to meet the standard service recommendations of one nurse per secondary school and its associated primary schools. The 30 bed unit at Stewart House was mixed sex and there were no doors to lock between the male and female sections. There was evidence of items being submitted to the trust risk register where appropriate. 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. Staff empathised where a person had a negative experience and offered support where necessary. There was minimal evidence of patient involvement in care plans. Crisis and relapse care plans were in place for the people that used services. Staffing levels were below the expected level. Staff completed detailed individualised risk assessments for patients on admission and updated these regularly and after incidents. The environment in some services was poor, not well maintained and not kept clean. 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. There were different recording systems in place, for example paper records and electronic records, different professional kept separate files. Risk assessments were completed and care plans implemented to keep patients safe and promote wellbeing. 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. Facilities had been adapted to improve access and systems were in place to support the most vulnerable. Safeguarding notes for one person using the Autism Outreach service could not be located creating a potential risk. We rated it as requires improvement because: When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. This could pose a risk as patients were unsupervised in this area. They did not have alarms or vision panels in the door. There was no performance data dashboard to gauge the performance of the service. There was good access to interpreters and signers when needed. The trust had completed ligature risk assessments across all wards, detailing where risks were located and how these should be managed. Whilst staff were working hard to identify and manage individual risks, some ward environments were unacceptable. Lessons learnt were shared across the organisation via emails and the intranet. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. Staff felt supported by their immediate managers but felt disaffected with trust senior management. Staff considered and supported patients with their physical health needs in CRHT and the liaison mental health triage service. Staff did not record seclusion well. Staff morale in some teams was low, with high levels of stress. Patients had the use of their mobile phones on the ward. Staff did not always follow trust policies and procedures when they needed to search patients or their bedrooms to keep them safe from harm. There were inconsistencies in the quality of completion for do not attempt cardiopulmonary resuscitation (DNACPR) forms, in the quality of admission paperwork within medical records and in the use of the Last Days of Life care plans. However, this was a temporary restriction due to the building works and patient safety. Support workers were being trained in phlebotomy to improve timely blood testing. 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. Staff had not received any specialist training on crisis intervention. One patient told us that staff had been rude, threatening and disrespectful towards them, which a relative also confirmed. Staff completed detailed risk assessments for patients on admission and reviewed them regularly after incidents. We saw evidence of discharge planning in care plans written by CRHT staff. 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. The service was not meeting its performance targets. Staff were consistently caring, respectful and supportive. Staff were dedicated and passionate about the work that they undertook. Improvements had been made to the seclusion facilities, and further improvements were planned across the service to improve patient experience and promote privacy and dignity. 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. On many wards, the trust had not supplied sufficient numbers of lounge and dining chairs to accommodate all patients and some wards did not have sufficient quiet rooms for care and treatment or for patients to receive visitors. 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. This was an issue highlighted at our inspection in 2018. There were long waiting times from initial referral to being seen in some clinics and services although these had improved in some areas since the last inspection. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the patients. The local managers monitored the environment for staff, carried out local audits and checked performance of staff on a regular basis. Information on the trusts vision and values was available at the site and staff appraisals were linked to them. NHS England / NHS Improvement - for general enquiries contact Helen Barlow on 0300 123 2038 or by emailing helen.barlow2@nhs.net. Any other browser may experience partial or no support. We observed many examples of staff treating patients with care and compassion. The services did not have a strategy and there were no service plans. The short stay services did not comply with the guidance on the elimination of mixed sex accommodation. The learning disability community team had not met the six week target for initial assessment on average it was six days over. They could undertake both internal and external training and were able to give feedback on service development. We saw evidence of good team working during our inspection. Significant vacancy rates and high sickness levels put additional pressure on substantive staff. Staff used a mixture of paper and electronic records which were not easy to follow. On four wards in acute wards for adults of working age, there were shared sleeping arrangements for patients. In the health based place of safety resuscitation equipment and emergency medication were not available and staff had not calibrated equipment to monitor patients physical health. Patients said staff who cared for them were knowledgeable, professional and friendly. Staff would still work with people who were on waiting lists so that they received some level of service. Staff told us there were no service information leaflets available. They remained positive when engaging patients in meaningful activities. The electronic prescribing system which the trust had implemented supported the safe administration of medicines to patients, with staff reporting very few medication errors as a result of this. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. Services had complied with guidance on eliminating mixed sex accommodation. Where patients took medicines home with them, staff ensured that they understood their use and storage. Overall we saw good multidisciplinary working and generally peoples needs, including physical health needs, were assessed and care and treatment was planned to meet them. No rating/under appeal/rating suspended A full audit was scheduled for the end of June 2019. The feedback from patients and relatives was mainly positive about the staff providing care for them. Some improvements to address the no smoking policy at the Bradgate Mental Health Unit wards were seen. Patients told us they did not have access to a copy of their care plan. The nurses we spoke with had specialist interests, including mindfulness and dementia. ALT. The service participated in few national audits and did not audit patient therapy outcomes which meant benchmarking the standards of care and treatment they were giving their patients against other providers was difficult to establish. The adult psychiatric liaison service provides assessment and treatment for adults between the ages of 16 to 65, who experience mental health problems in the context of physical illness. This promotion is being run by Leicestershire Partnership NHS Trust. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. 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. Therefore, staff could ensure accurate measures of blood pressure were being recorded. There was a skilled multi-disciplinary team able to offer a variety of therapies. Adult liaison psychiatry services are provided by Leicestershire Partnerships NHS Trust (LPT), the mental health trust in the Leicester, Leicestershire and Rutland Integrated Care System. By: Miraj Vaghadia | Tags: A project to improve patient care by making best use of capacity across Leicestershire Partnership NHS Trust (LPT) District Nursing teams has been shortlisted for the prestigious Nursing Times Awards. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. This meant that patients could have been deprived of their liberties without a relevant legal framework. Staff referred to having reflective practice peer meetings when they were concerned about the risk to a young person. This meant some fundamental standards were not being met. Clinical audit was taking place and learning was shared across the service. 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. A high number of outpatient appointments were cancelled. Any other browser may experience partial or no support. Recruitment was in progress for 10 new healthcare support workers. ", "I like that I'm able to help both staff and service users. 56% of individual care plans were not up to date, personalised or holistic. Not all of the patients felt involved in their care planning and not all had a copy of their care plans. 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 Managers had a system in place for tracking and learning from safeguarding incidents and other reportable events. The majority of community mental health teams did not meet the referral to initial assessment and assessment to treatment times. The recording of discussions and assessments with people regarding consent to treatment was not always documented. Risk management in services required improvement. There was an established five year strategy and vision for the families, young people and childrens (FYPC) services and staff innovation was encouraged and supported. On Phoenix ward patients were not allowed access to the garden. Staff followed the trust policy on seclusion. We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels: Outstanding 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. 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. 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. The offer is for 250 to be paid through payroll and subject to tax and National Insurance and is non pensionable. Staff usually met patients in their homes or in the community. 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. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. This meant that some staff felt insecure. The trust had significantlyreduced waiting times and the total numbersof children and young people waiting for assessments. Staff completed comprehensive assessments which included physical health checks and the majority of patients had completed risk assessments. We heard positive reports of senior staff feeling able to approach the executive team and the board. 87 of the total patients had been waiting over a year to begin treatment. Patients had access to advocacy. Save job - Click to add the job to your shortlist. There were inconsistent practice around conducting searches onpatients. The leadership, governance and culture did not always support the delivery of high quality person centred care. 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. Jan 4. The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. The trust had long term plans to address this. The previous rating of requires improvement remains. We had concerns about how environmental risks at CAMHS community sites were being assessed and managed. Interview rooms were unsafe. 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