Patients returning from leave from the acute mental health wards were not assured of returning to their original ward. Team managers could not be assured of local performance around record keeping, care planning and patient involvement. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. 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. Nursing staff interacted with patients in a caring and respectful manner. The short stay services did not comply with the guidance on the elimination of mixed sex accommodation. 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. However, staff told us they had little experience of incident reporting within the community childrens services. Oct 2015 - Apr 20193 years 7 months. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. There were not always enough staff who were suitably qualified and experienced to safely meet patients needs. 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. The trust confirmed the service line was contracted to provide bed occupancy at 93%. However, managers had identified funding for two agency nurses to start work the week following the inspection. Staff and senior leaders could not articulate the trusts direction of travel and how this was co-ordinated. o We are one team and we are best when we work together. This was in breach of the Mental Health Act Code of Practice guidance on mixed sex accommodation. Record keeping at Stewart House was disorganised. We looked at the domains of safe, effective and responsive and we did not inspect all of the key lines of enquiry. Some managers had access to key performance data and could respond to areas of improvement, but this was not consistent in all aspects of care delivery and across all services. In community based mental health teams for older people five of six services breached national targets from referral to assessment. We rated long stay/rehabilitation mental health wards for working age adults as requires improvement because: The environment in some areas was very poor, particularly at Stewart House. The behaviours we expect to see at LPT are: This framework is also intended to join up all elements of our people management, from job design to recruitment and selection, induction and ongoing professional development to appraisals, in order to ensure we are as consistent and effective as possible. Staff worked with both internal and external agencies to coordinate care and discharge plans. There had been periods of understaffing. Click on the coloured text links below to visit any of the listed organisations' websites: Staff were passionate about their roles and enjoyed working with the client group. We saw information in the service reception areas about older peoples care. There was no evidence of patient involvement recorded in some of the notes. 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. However, 323 were waiting for their first appointment through the access team, to complete a core mental health assessment. 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. Care records for patients using the CRHT teams were not holistic or personalised. 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. We rated community health services for adults as requires improvement because. The Trust should ensure that the transition is in line with best practice in future. We're always looking for the best. Waiting times for referral to initial assessment appointments were good, although patients experienced delays for community paediatric clinic follow up appointments. Clinic room temperatures were very hot, although one thermometer was above a radiator so would not give an accurate reading. Staff felt supported by their managers and received regular supervision and annual appraisals. A dashboard of key performance indicators was being developed. Staff did not routinely complete detailed, person centred, individualised or holistic care plans about or with patients. Plans were shared with family and carers. Staff were not in receipt of regular supervision in order to discuss training needs, developmental opportunities or performance issues. Patients had the use of their mobile phones on the ward. The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. 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 nurses we spoke with had specialist interests, including mindfulness and dementia. 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. The community nursing service could not measure its performance in relation to response times for unplanned care. Staff involved patients in the ward review and community meetings. Improvements to the inpatient wards included updating seclusion rooms, removing some ligature anchor points and replacing garden fencing. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. Patients and their carers were not involved in care planning and care programme approach (CPA) reviews. The governance processes had not picked up the issues around repairs, medicines and cleanliness. The phones on each ward were in communal areas; the phone on Griffin ward had not been moved since the last inspection, although it had a privacy hood installed. Patients were frequently not discharged when ready due to transport problems or difficulties putting care packages in place. Any other browser may experience partial or no support. There was an effective incident reporting process which investigated and identified lessons from incidents which were shared in most teams. Overall, patients were positive about the care they received and had access to advocacy services on all wards. We rated safe, effective, responsive and well led as requires improvement and caring as good. Comprehensive relocation action plans were available. 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. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. Environments were visibly clean and welcoming. Effective multi-disciplinary team working and joint working did not always take place across services. Managers identified the breach in these targets and had plans in place to reduce them and had highlighted this risk on the risk register. This report describes our judgement of the quality of care provided by Leicestershire Partnership NHS Trust. It has been developed within the context of the area we serve in Leicester, Leicestershire and Rutland and the new Integrated Care Partnership. Ligature risks had been identified in bedrooms, bathrooms and toilets but there was no clear action to address all of the identifed risks, The seclusion rooms had known blind spots but no action had been taken to reduce them. Staff had not routinely recorded whether they had given patients copies of their care plans and we saw this in a considerable number of patient records we sampled. Staff received regular managerial and group supervision. Some staff found there was insufficient time to complete their visits within the working day. Due to the large caseloads in community health service, the number of visits that were required was not always manageable. They were reflected in the objectives of local teams. The trust could not ensure continuity of care for these patients. The HBPoS had poor visibility for observing patients. Staff told us they worked as a team and enjoyed their jobs. We inspected three mental health inpatient services because of the ratings from the previous inspection. The people who used services, carers and relatives we spoke with were all positive about the service they received. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. The single point of access made contacting the service easy for both patients and health professionals and enabled referrals into the service to be triaged and assigned from one central point. They contained items which could pose a danger to staff and patients. Local leaders were visible and had the skills and knowledge to perform their roles. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service. At this inspection the well-led provider rating improved from inadequate to requires improvement. Staff had a good knowledge of safeguarding. 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. Feedback from those who used the families, young people and children services was consistently positive. Restraint was used only as a last resort. 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 trust had robust governance structures and they had assured any potential gaps or overlaps had been considered. Our HIV/AIDS Services program is in need of volunteers to help deliver . People that were referred to the service were waiting for a care co-ordinator to be allocated. Staff followed infection control practices and maintained equipment through regular servicing. Mandatory training compliance for trust wide services was 91% against the trust target of 85%. 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. Fire safety was much improved, withfire drills carried out regularly. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service. Leadership behaviours were fostered, and development of staff was encouraged. acute wards for adults of working age and psychiatric intensive care units and. There was no performance data dashboard to gauge the performance of the service. Staff we spoke with were proud to work within the adult psychiatric liaison team and proud to show us the work they did and the service they provided. There was a floating qualified unit coordinator to oversee the service requirement at the Willows. Staff were not meeting the trusts target compliance rate for annual appraisals and mandatory training. This environment was pleasant and well equipped. The policy for rapid tranquillisation was not in line with national guidance. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. Staff demonstrated good knowledge of the Mental Capacity Act 2005. Leicestershire Partnership NHS Trust 2.5K subscribers We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. 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. Patients occasionally attended the service. 83% of staff received mandatory training. ", "I like that I'm able to help both staff and service users. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. They remained positive when engaging patients in meaningful activities. Risk management in services required improvement. Multi-disciplinary team meetings took place on a regular basis. Staff provided psychological therapies as recommended by NICE such as group work and cognitive behavioural therapy. A new leadership structure had been introduced since the last inspection and had not yet fully embedded in the service. The summary of this service appears in the overall summary of this report. Patients were protected from avoidable harm by sufficient staffing and safeguarding processes. One ward matron told us that a patient had recently alleged that a staff member had assaulted them. The quality of clinical supervision was variable across the trust. We found the average wait times for patients presenting with a mental health crisis or specific mental health needs were between 1.5 hours and 1.9 hours. Five out of 25 care records showed that patient involvement had not been recorded. there are some services which we cant rate, while some might be under appeal from the provider. However, they did not always meet the required skill mix for the nursing teams. 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. 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. Engagement and joint planning between departments was well developed. At the Willows, six out of 19 patients risk assessments had not been updated. The trust confirmed community hospital staff were expected to undertake four clinical supervision sessions across the year. 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. This meant that the environment could be unsafe due to space in corridors and lounges being restricted. Staff were provided with relevant information to care for patients safely. 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 ward had sufficient staff to provide care and treatment to patients. The acute mental health wards had two and four bedded dormitories which did not promote privacy and dignity. This was done by sliding signs to the door as needed. 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. Some families carers said that the meals were unhealthy. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. 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. Our observations during inspection confirmed that staff knowledge and practical application of their knowledge was inconsistent despite training on their electronic learning systems. There was an on-call rota system for access to a psychiatrist 24 hours a day. Coventry, 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 appropriate lone working procedures in place. We spoke with six patients who all told us that the staff were very kind and looked after them well. Staff interacted with patients in a caring and respectful manner. The 30 bed unit at Stewart House was mixed sex and there were no doors to lock between the male and female sections. The service was responsive. The136 suiteis a place of safety for those who have been detained under Section 136 of the Mental Health Act. 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. We found damaged fixings on one ward; that posed a risk to patients. We saw an example of an SI investigation and also action taken from lessons learnt. The trust was not fully compliant with same sex accommodation guidance in two acute wards, the short stay learning disability service and rehabilitation services. This meant the police very often had to care for detained patient for the duration of the assessment. We're one team with shared values providing the best care possible. Patients reported they were treated with dignity and respect. Between August 2015 and July 2016, there were 60 delayed discharges across the service. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. Some actions were required to ensure adherence with the Mental Health Act. We rated the trust as requires improvement for well led. The risks and issues described by staff did not always correspond to those reported to and understood by their leaders. The summary for this service appears in the overall summary of this report. Staff did not always record or update comprehensive risk assessments. Supervision and appraisal compliance of three teams fell below 75%. Staff were given feedback after incidents had been reported. the service is performing well and meeting our expectations. Staff described various ways in which they received information from the board and other governance meetings. The overall average compliance rate for supervision of staff in the learning disability wards was 46%. We rated Leicestershire Partnership NHS Trust as Requires Improvement overall because: Published Clinical supervision rates were low. Staff were trained appropriately within their speciality and new staff were supported to gain experience and skills. 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. There could be risks posed by the use of different recording systems across teams as staff may not all have access to all records. The new contract would start from 1 October 2023 and run until 30 September 2030. The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. This has been brought together using feedback from staff, service users and stakeholders to evolve our work so far into a clearer trust-wide strategy for all areas: Step Up to Great.Through Step Up to Great we have identified key priority areas to focus on together. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. Patient views on the quality of the food were variable. 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. If we cannot do something, we will explain why. There were improved systems and processes to manage storage, disposal and administration of medications. We saw that patient numbers exceeded the number of beds available on wards. Staff did not always feel connected to the wider trust. o We are passionate and creative in our work. Regular team meetings took place and staff told us that they felt supported by colleagues. 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. Patients said they got bored at the weekends, as there were fewer activities on offer. To find out more, review our cookie policy. The transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. Staff were unable to show us evidence of clinical audits or the basis of evidence based practice in end of life services. 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. Save job - Click to add the job to your shortlist. This has been brought. Save job - Click to add the job to your shortlist. Staff had not managed all risks to patients in services. Staff were not always recording room and fridge temperatures in clinical rooms and out of date nutrional supplement drinks had not been appropriately disposed of. This meant that patients could have been deprived of their liberties without a relevant legal framework. This area of our site lists our partner organisations. Staff were visible in the communal ward areas and attentive to the needs of the patients they cared for. Staff interacted with the patients in a positive way and was respectful to them. Bathrooms and toilets were specified for which gender depending on who was resident at the unit at the time. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. We saw evidence of good team working during our inspection. Apply. Staff said the system was difficult to use and this had affected the information recorded in patients notes. In addition to this, risk assessments were comprehensive and reviewed as per the trust policy, six monthly or after risk incidents. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. Interpreters were used when working with people who did not have English as a first language. Good communication skills are key. We looked at 20sets of seclusion recordsandfrom17 records,staff were notrecording seclusion, in line with the Mental Health Act Code of Practice. Published Nottingham, Download the leadership behaviours booklet or watch the animation below to find out more: Our People Plan shows our dedication to making LPT a great place to work and receive care. The trust had several strategies, a vision and corporate objectives, but they did not underpin all policies and practices. Care and treatment was planned and delivered in line with current evidence-based guidance, standards, best practice and legislation. On Heather ward patients said that there was not enough ventilation on the wards. Not all care plans reflected patients assessed needs, or were personalised, holistic and recovery oriented. Some staff had not received their mandatory training, supervision or appraisal. This was highlighted in the previous inspection. It promises that we will lead with compassion and inclusivity, with the health and wellbeing of our staff at the heart of all we do. Browser Support Staff sourced PICU beds when needed from other providers, in some cases many miles away. Patients and carers knew how to complain. Medication management across four of the five services we inspected was poor, despite reported trust oversight and audit. There were delays in staff delivering treatments to young people and young people following assessment. The principles will normally apply but will be balanced by inspection teams using their discretion and professional judgement in the light of all of the available evidence. We had concerns about the safety of some of the facilities where care was delivered. Managers did not have oversight of these issues. Staff at the PIER team had not received recent Mental Health Act training. Care plans were generalised, not person centred or recovery focused. Staff had a good understanding of patients needs. The HBPoS did not have access to a dedicated clinic room. Staff knew the vision and values of the trust and agreed with these. This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. The trust supported a BAME network (black and minority ethnic) however, given the diversity of the geographical area of the trust, they had not significantly developed its agenda or work streams since our last inspection. The trust had maintained patients privacy and dignity at Short Breaks Services. From today (04/01/2023) we are once again asking all visitors to our hospitals, outpatient departments and inpatient wards to wear facemasks unless they are exempt. We rated the trust as inadequate for well-led overall. Home - Leicestershire Partnership NHS Trust Creating high quality, compassionate care and wellbeing for all. 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