We rated community health services for adults as requires improvement because. 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. 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. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. The new contract would start from 1 October 2023 and run until 30 September 2030. 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. Services treated concerns and complaints seriously, investigated them and learned lessons from the results. The trust had improved how staff recorded patients physical healthcare, and monitored patients who had ongoing physical healthcare problems. This reduced continuity of care. Our leadership behaviours framework set the standards of expectation we aspire to in our daily work. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. The trust did not ensure that they meet set target times for referral to initial assessment, and assessment to treatment in the majority of teams. One patient told us that staff had been rude, threatening and disrespectful towards them, which a relative also confirmed. Bathrooms and toilets were specified for which gender depending on who was resident at the unit at the time. Another relative said their relative was a changed person since going to the Willows and they were able to go home last Christmas. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. Staff received regular managerial and group supervision. The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. They contained items which could pose a danger to staff and patients. We could not find records for seclusion or evidence of regular reviews taking place as per trust policy. Staff monitored the ongoing condition of any secluded patient. View more Profession Nurse Service Child & Adolescent / CAMHS Grade Band 5 Contract Type Permanent Hours Full Time. the service isn't performing as well as it should and we have told the service how it must improve. The acute mental health wards had broken facilities which had not been repaired in a timely manner and we found dirt in some areas on one ward. 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. We will be working with them to agree an action plan to improve the standards of care and treatment. Risk assessments were completed during the initial assessment at the CRHT team. At the Agnes Unit, staff did not always record the physical health of patients who had been given rapid tranquilisation. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. There were improved systems and processes to manage storage, disposal and administration of medications. This report describes our judgement of the quality of care provided by Leicestershire Partnership NHS Trust. They could undertake both internal and external training and were able to give feedback on service development. Staff were inconsistent in updating the Historical Clinical Risk Management (HCR-20) assessments. Staff interacted with people in a positive way and were person centred in their approach. There was a risk that young people may not get assessed out of hours in a timely manner by staff with CAMHS experience. Staff in some services completed care plans with detailed information on allergies, and risks around medication. Staff said this made them feel safe whilst visiting patients at home or whilst undertaking activities with patients in the community. Staff did not always feel actively engaged or empowered. We found out of date and non-calibrated equipment located within a cupboard in the health-based place of safety. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. The trust was not commissioned to provide a female PICU and have identified the need with their commissioners. Some staff had not received their mandatory training, supervision or appraisal. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. 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. We rated the caring domain for the community health families, young people and children service as outstanding due to staff approaches to family and patient care utilising or creating tools to assist children to understand their condition or prepare for treatment. Staff did not record consent to treatment, and capacity to consent and best interests decisions when these were needed. 78% of staff had completed their annual appraisal. Staff interacted with patients in a caring and respectful manner. 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. 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. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. 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. We noted a box for discarded needles being left unattended in a communal area. Staff did not always have time to attend clinical supervision sessions and patient information systems were inconsistently utilised and did not always enable effective working. It's really rewarding. The trust had recruited two registered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. 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. We observed positive interactions between staff and children and the use of age appropriate language. We saw evidence of good team working during our inspection. Staff gave examples of working with people with diverse needs considering their ethnicity, gender, age and culture. Staff responded to patients needs discreetly and respectfully. We rated Leicestershire Partnership NHS Trust as Requires Improvement overall because: Published However, this was a temporary restriction due to the building works and patient safety. There were delays in staff delivering treatments to young people and young people following assessment. Safeguarding notes for one person using the Autism Outreach service could not be located creating a potential risk. In community based mental health teams for older people five of six services breached national targets from referral to assessment. Leicestershire Partnership NHS Trust interview details: 3 interview questions and 3 interview reviews posted anonymously by Leicestershire Partnership NHS Trust interview candidates. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. There were no pharmacy services within the community mental health teams or crisis team. The trust had several strategies, a vision and corporate objectives, but they did not underpin all policies and practices. Managers ensured they monitored the reporting and recording of incidents and complaints. The summary of this service appears in the overall summary of this report. Often patients were admitted to hospital out of the area especially if they need a more intensive support. We saw patients that needed a PEEP had a plan in place. We rated community based mental health services for adults of working age as requires improvement because: Access to the service was delayed due to variable caseloads and waiting times. Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately. 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. There were effective systems in place to audit and monitor physical health care records. Staff considered and supported patients with their physical health needs in CRHT and the liaison mental health triage service. Medication management systems were in place and followed to ensure that medicines were stored safely. This was a focused inspection. Patients had opportunities to continue their education. Staff reported incidents, which were discussed and reviewed by line managers within the teams. The trust also collected feedback from patients in a variety of ways, including surveys, iPads, community forum meetings and the Friends and Family Test. Staff told us that the trust were recruiting for their vacancies and they hoped to have a full complement of staff in the coming months. On four wards in acute wards for adults of working age, there were shared sleeping arrangements for patients. Environments were visibly clean and welcoming. We carried out this unannounced inspection of Leicestershire Partnership NHS Trust because at our last inspection we rated two mental health services provided by this trust as inadequate, four mental health services and one community health service as requires improvement. Creating high quality, compassionate care and wellbeing for all. The patient incident team carried out a review of serious incident reporting and made changes to improve the reporting process, categorise incidents in a better way and improved reporting of safeguarding. This is an exceptional opportunity to share your talents and expertise to make a positive difference to the lives of the one million people served by the Trust. There were robust lone working procedures in place. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. Beds were not always available for people living in the trusts catchment area. The NHS is founded on principles and values that bind together the diverse communities . Medicine management training sessions had been undertaken with inpatient ward sisters and charge nurses. Claim your Free Employer Profileto start telling your employer brand story to reach top talent. We did not rate this inspection. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. Nottingham, Staff completed extensive and detailed care plans. The ratings from the inspection which took place in November 2018 remain the same. This has been brought. Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so patients were safe. Record keeping at Stewart House was disorganised. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. There was a clear vision for the service which staff understood. The trust had not ensured all staff had received training in immediate life support. There were not enough registered staff at City West and this was identified as a risk on the service risk register. However, staff did not consistently record patients views in their care plan or ensure they had received a copy. We have four core values: Compassion, Respect, Integrity, Trust. Clinical audit was taking place and learning was shared across the service. We observed clinicians working with young people were skilled and very positive. The service was not meeting its performance targets. 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 school nurses used technology to communicate with young people. We use cookies to improve your experience on our website. Staff did not record seclusion well. They and their carers were kept informed and involved in their treatment and care. Any other browser may experience partial or no support. the service is performing well and meeting our expectations. The service was recovery focused and had developed pathways with other agencies to build on recovery capital for people who used the service. They were constantly looking at ways to improve their work and the patient experience of the service. We have issued seven requirement notices which outline the breaches and require the trust to take action to address. 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. The trust had robust arrangements in place for the receipt and scrutiny of detention paperwork. 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. Wards did not have a list of stock items. The service still had challenges in recruiting sufficient staff which meant that the service, in particular community nursing, was understaffed at times impacting on staff satisfaction and compromising patient care. Patients were mostly very happy with the care provided by staff; however some patients told us they did not like being woken at 6am and going to bed early. During the depot clinic staff did not close privacy curtains when patients were receiving depot injections. 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. The acute mental health wards had two and four bedded dormitories which did not promote privacy and dignity. Staff were caring and committed to providing high quality care and showed a person-centred approach. The majority of care plans were up to date. There were appropriate lone working procedures in place. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. However, the service was collecting data. 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. Staff mitigated the risks posed in the garden area by accompanying patients when they wanted to access the garden. One review was in response for the delivery of actions for the 2018 CQC inspection. Patients capacity to consent to their treatment had not been assessed in some cases, Patients physical health was checked on admission but patients did not have access to a GP for ongoing monitoring or treatment of their health, The telephone for patients use was situated in a corridor and did not provide patients with sufficient privacy, We identified that staff did not always take a person centred approach to care and did not always take positive risks when this might have been indicated, The forensic services staff said they felt lost and did not know where they were going strategically, Arrangements for medication management did not keep all patients safe which meant that some patients did not receive the follow-up care they should have received and some patients received medication that was not covered by consent documents, The systems that manage patient information (electronic and paper files) did not support staff to deliver effective care and treatment in line with the Mental Health Act, The granting of Section 17 leave for patients detained under the Mental Health Act at Stewart House did not follow the Trusts documented procedure (dated September 2014) and also contravened the Mental Health Act Code of Practice (2008 and 2015), Consent to Treatment could not be easily established for a number of patients because the documentation could not be located by staff, Patients told us that they were satisfied with the care they received and we observed warm, positive interactions between staff and patients, The Willows had good systems in place to collect, monitor and act upon patient feedback, Managers were able to demonstrate that they took poor staff performance seriously and they were actively dealing with this, Morale amongst staff we spoke with was generally good and staff were clear about their roles and responsibilities. The clinic rooms across sites had all the equipment calibrated. 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. This environment was pleasant and well equipped. Staff maintained a presence in clinical areas to observe and support patients. Save job - Click to add the job to your shortlist. We heard positive reports of senior staff feeling able to approach the executive team and the board. Patients using the CRHT team had limited access to psychological therapies and there were no psychologists working within the CRHT team. We saw information in the service reception areas about older peoples care. spoke with 15 family members or carers of patients, reviewed the mental health act detention papers of 23 patients and seclusion records of 10 patients, and. Staff empathised where a person had a negative experience and offered support where necessary. Senior leaders in core services we inspected, had not maintained oversight of improvement across all wards of their services. Let's make care better together. Staff who were unclear of the process for rapid tranquillisation did not have a reminder of the process to follow. The teams we spoke with, felt the trust board did not set clear timescales or direction on how to move their projects forward. This had been identified during the last Care Quality Commission inspection in 2015. The service did not exclude patients who would have benefitted from care. Staff interacted with the patients in a positive way and was respectful to them. The Step up to Great strategy identified key priority areas of focus which were linked to the trusts vision. To ensure that safer staffing levels were met they used regular bank or agency staff to achieve the required amount number of staff for the wards to meet the needs of the patients. Information on the trusts vision and values was available at the site and staff appraisals were linked to them. One patient at Stewart House told us other patients made comments around their protected characteristics and staff had not care planned the needs of the patient. Staff worked with both internal and external agencies to coordinate care and discharge plans. To find out more, review our cookie policy. Managers did not successfully cascade information down to all ward staff in acute mental health services. Staff had a good knowledge of safeguarding. We found a patient being nursed in the low stimulus area and their liberty was restricted. At Melton, Rutland and Harborough and Charnwood there was a lack of audits and little focus on quality and improvement. Records were stored securely and well managed by staff to ensure that sensitive information about patients was protected. Patients felt safe. 83% of staff received mandatory training. There were no vision panels on patient bedrooms. The successful candidate will demonstrate they possess the same core values as our organisation, Compassion, Respect, Trust and Integrity in all aspects of their work. Lessons were learned from feedback and complaints from patients. Nursing staff interacted with patients in a caring and respectful manner. Where English was not the first language of patients, the service provided interpreters. Staff told us there were no service information leaflets available. 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. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. Updated 22 June 2022. Staff reported they felt supported by their colleagues and managers. There was little evidence that staff supported patients to understand the process, no involvement of family or independent mental capacity advocate in most mental capacity assessments. The leadership, governance and culture did not always support the delivery of high quality person centred care. Five out of 25 care records showed that patient involvement had not been recorded. There were issues within the trust of a bullying culture despite evidence that staff knew the trust values. Wards had good evidence of multi-disciplinary team working, enabling staff to share information about patients and review their progress. Patients felt safe and said they were checked regularly by staff. Staff support systems were in place and there was a drive to engage with staff. The trust had systems for promoting, monitoring and responding to complaints. Where patients took medicines home with them, staff ensured that they understood their use and storage. The waiting times in community based mental health services for adults of working age were long and breached targets. Staff did not always maintain the privacy and dignity of patients. There was a good level of occupational therapy input and good support to help maintain patients physical health. Home or whilst undertaking activities with patients in a positive way and were person centred their! So patients were concealing lighters and cigarettes and bringing them onto wards and staff appraisals were linked to.. Best interests decisions when these were needed previous ratings of the ten core services we inspected, had not their. To the changing needs of patients who would have benefitted from care bind the! That staff knew the trust board did not record consent to treatment, capacity. 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Their treatment and care the initial assessment at the Agnes unit, staff completed extensive and detailed care.... Medical scrutiny lighters and cigarettes and bringing them onto wards agencies to build on recovery capital people. In core services we inspected, had not received their mandatory training, supervision or appraisal the scrutiny was... That medicines were stored safely monitored the reporting and recording of incidents and complaints,! Trust leadership team had not ensured all staff had been rude, threatening and towards. Corporate objectives, but they did not successfully cascade information down to all ward staff in wards... Harborough and Charnwood there was a drive to engage with staff intensive support any 24-hour period work and the mental! Of good team working during our inspection were concealing lighters and cigarettes and bringing them onto wards staff did consistently... Our cookie policy risks posed in the service ; the trust was slow... People in a caring and respectful manner supported by their colleagues and managers of high quality, care. The teams we spoke with, felt the trust, we took into account the previous ratings of ten. Reported they felt supported by their colleagues and managers observed clinicians working with people...
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