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. 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. Leicestershire Partnership NHS Trust - One Year on from the Mental Health Taskforce Leicestershire Partnership NHS Trust (LPT) continues to break new ground in ensuring the physical health of its patients and service users is cared for as well as their mental health, the ultimate aim of which is to achieve parity of esteem. Home - Leicestershire Partnership NHS Trust Creating high quality, compassionate care and wellbeing for all. This did not demonstrate a consistent temperature, had been maintained to assure the safety and efficacy of the medicines. The service employed care navigators to help families and carers negotiate their journey through the various services provided. Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. However, staff did not consistently record patients views in their care plan or ensure they had received a copy. Staff demonstrated commitment to delivering high quality end of life care for their patients. Patients and their carers were not involved in care planning and care programme approach (CPA) reviews. Staff provided patients and carers with information in a way that they understood.At City West, City East, and South Leicestershire patients and their carers reported outstanding and good care. The services did not have a strategy and there were no service plans. Staff gave examples of initiatives such as the chief executives blog and the presentation of the valued star award. 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. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. Comprehensive assessments were being carried out and information was stored securely, except for one location and arrangements were in place to address this. People knew how to make a complaint as this information was provided in welcome packs. There was use of bank and agency staff. This meant that patients were not protected from receiving unsafe treatment. Mandatory training compliance for trust wide services was 91% against the trust target of 85%. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. It's really rewarding. There was good multi-disciplinary working within the teams and good communication with other organisations. Clinical audit was taking place and learning was shared across the service. In two of the core services inspected, the environment had not been well maintained. Patients and carers knew how to complain. One patient told us they did not know they could leave the ward to seek medical attention. Staff were not meeting targets for the assessment and assessment to treatment of urgent referrals and six week routine referrals. They were constantly looking at ways to improve their work and the patient experience of the service. We found that while performance improvement tools and governance structures were in place these had not always brought about improvement to practices. Staff received training in how to safeguard people who used the service from harm and showed us that they knew how to do this effectively. 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. Staff demonstrated good knowledge of the Mental Capacity Act 2005. Staff showed caring attitudes towards their patients. Staff treated people who used the service with respect, listened to them and were compassionate. -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 . Multi-disciplinary team meetings took place on a regular basis. We saw that consent was gained from people in relation to their care and future wishes. Staff told us there were no service information leaflets available. There was an effective duty system in place to provide rapid access to support. NHS England / NHS Improvement - for general enquiries contact Helen Barlow on 0300 123 2038 or by emailing helen.barlow2@nhs.net. We use cookies to improve your experience on our website. the service isn't performing as well as it should and we have told the service how it must improve. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. All the team leaders we interviewed said there were internal waiting lists for patients who had been initially assessed to access profession specific treatments. Patients experiencing mental health crisis and distress did not have access to a fully private area in these environments. Staff were kind, caring and respectful towards patients. The trust had reviewed existing systems and processes identified improvements and implemented changes. The NHS is founded on principles and values that bind together the diverse communities . There were significant waiting times for a range of further assessments and treatments including psychology, school observations, psychiatric opinion and group work. There had been an increase in the number of CAMHS referrals over the last two years. 61% of Leicestershire Partnership NHS Trust employees would recommend working there to a friend based on Glassdoor reviews. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. At our last inspection we raised concerns that an insufficient number of nursing staff in community health services for adults had received appropriate statutory and mandatory training. 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 environmental risks in the health based place of safety identified in our previous inspection remained. All areas were very clean, fresh smelling and fit for purpose. People felt they had benefited from the service and told us how caring staff were. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. This became a formal group working partnership in April 2021. We could not find records for seclusion or evidence of regular reviews taking place as per trust policy. Patients reported staff treated them with dignity and respect. Click here to submit your comments to us. Staff described various ways in which they received information from the board and other governance meetings. Patients had their own copies of care plans and were involved in their care plan reviews. Clinic rooms were overstocked with medications. We found that there were still errors within the staffs application of the Mental Capacity Act. There were examples of people not being seen within service guidelines whilst receiving large doses of prescribed medication. Patients were protected from avoidable harm by sufficient staffing and safeguarding processes. Governance structures were in place and risks registers were reviewed regularly. There were waiting lists of up to 18 months for psychology and up to 40 weeks for other treatment within the personality disorder service. 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 Staff were up to date with mandatory training. The trust encouraged staff at most levels of the organisation to develop and deliver ideas for service delivery, improvement and innovation. 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. 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. Leicestershire City Council are proposing to keep Leicestershire Partnership NHS Trust as the provider, as it is a high performing service, and to recommission 0-19HCP by using Section 75 of the National Health Services Act of 2006. Considerable numbers of records we reviewed during our inspection, were of a poor standard, with substantial and important clinical reviews missing, as recommended by the Mental Health Act Code of Practice. The service had not delivered timely care to a significant number of patients. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. Managers ensured they monitored the reporting and recording of incidents and complaints. Staff had the right qualifications, skills, knowledge and experience to do their job. Team meetings were not regular, or didn't take place.The sharing of lessons learnt remained inconsistent across some wards. In all instances police transported the patient to the HBPoS. o We do what we say we are going to do. Morale was found to be poor in some areas and some staff told us that they did not feel engaged by the trust. The trusts pace for implementing equality and diversity initiatives across the organisation needed improvement. The trust had no auditing system to measure performance in order to improve the service. In addition to this, risk assessments were comprehensive and reviewed as per the trust policy, six monthly or after risk incidents. We did not rate this inspection. Staff had a good knowledge of safeguarding. 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. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. There was a mobile phone in the ward office that patients could use for private calls, for example to a solicitor. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. Some staff found there was insufficient time to complete their visits within the working day. 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. 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. Patients and carers confirmed in most services they had not received copies of care plans. Patients were able to access hot and cold drinks any time during the day. Staff in some services completed care plans with detailed information on allergies, and risks around medication. Patients and their relatives felt involved in the care provided. Not all families and carers knew they could attend virtual ward meetings and care programme approach meetings. 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. Two patients we interviewed on Ashby and Heather wards told us that staff did not always knock on their bedroom doors before entering. Not all patients on acute wards for adults of working age could summon help from staff if required. We're always looking for the best. Employees also rated Leicestershire Partnership NHS Trust 3.1 out of 5 for work life balance, 3.6 for culture and values and 3.7 for career opportunities. The trust had robust governance structures and they had assured any potential gaps or overlaps had been considered. There was a range of large therapeutic areas and rooms for art therapy plus other interventions. The trust used key performance indicators/dashboards to gauge the performance of the team. Waiting times and lists remained of concern, and this had been identified in the previous inspection. Staff did not document physical health checks for patients detained under section 136 in the HBPoS. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. Funding had been secured for increased staff with specialist skills. Staff updated risk assessments and individualised care plans regularly. Staff would still work with people who were on waiting lists so that they received some level of service. Inconsistencies in record-keeping for the Autism Outreach services as some records were missing, but others were of an acceptable standard. There was no patient alarm access in four ward areas, including the dormitories. Staff told us the trust was a good place to work. Staff did not assess and record the risks posed by medicines stored in patents homes. HBPoS and crisis resolution and home treatment (CRHT) team toilets were not visibly clean. We did not speak to any patients using the service at the time of the inspection. There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS Trust (LPT). Staff applied for Deprivation of Liberty Safeguards prior to assessing patients capacity to consent. Staff were inconsistent in updating the Historical Clinical Risk Management (HCR-20) assessments. Bank Band 6 Speech and Language Therapist. This was done by sliding signs to the door as needed. The paperwork was difficult to find and not consistent. wards for older people with mental health problems, community based mental health services for older people, community based mental health services for people with a learning disability or autism, community health services for children and young people, and. The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. There was a floating qualified unit coordinator to oversee the service requirement at the Willows. 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. This reduced continuity of care. Staff used strategies to maintain patients safety which had an adverse effect on their dignity and privacy. Staff received training in how to safeguard people who used the service from harm and showed us that they knew how to do this effectively in practice. The clinic rooms across sites had all the equipment calibrated. We saw evidence of discharge planning in care plans written by CRHT staff. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Staff responded to patients needs discreetly and respectfully. This has been brought. However, there were some instances when patients privacy and dignity were not respected. This included labelling, disposal, reconciliation and ward level audit. They provided feedback to staff via monthly ward meetings, MDT meetings supervision and handovers. The trust lacked an overarching strategy which everyone within the trust knew. We noted a box for discarded needles being left unattended in a communal area. 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. Staff received training in safeguarding and knew how to report when needed. Managers completed ligature audits which highlighted what mitigation was in place to reduce the risk for patients. The trust had developed checklists to assist staff with the receipt and scrutiny process. Patients were not always involved in the planning of their care. 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. Therefore, overall, eight of the trusts 15 services are now rated as good, five as requires improvement and two as inadequate. The trust had key roles in the development of health and social care system working, and collaboration with other care providers to improve provision of mental health services. Managers had a system in place for tracking and learning from safeguarding incidents and other reportable events. Consent to care and treatment was obtained in line with relevant guidance and legislation. The assessment and resulting care plans were personalised, holistic and recovery focussed. Regular team meetings took place and staff told us that they felt supported by colleagues. Bed occupancy rates were above 85% for community health inpatient wards. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. Care records for patients using the CRHT teams were not holistic or personalised. 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. Assessed risks were well-managed and staff showed a good awareness of individual needs and how to respond to them. Where relevant we provide detail of each location or area of service visited. There were systems for lone-working in place including a red folder process that kept workers safe. The trust had high numbers of vacancies for registered nurses. The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. 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. Risks to people who used the service and staff were assessed and managed. This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. 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. 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. In the same service, managers did not always review incidents in a timely way. 42% of staff on Phoenix ward and 27% Griffin ward had received clinical supervision. We are proud of our 5,400 staff and together we aim to . 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. This could pose a risk as patients were unsupervised in this area. We found concerning evidence of long waiting times for assessment in specialist community mental health services for children and young people. Or did n't take place.The sharing of lessons learnt remained inconsistent across some wards receiving large doses prescribed! To the HBPoS incidents in a communal area the risks posed by medicines stored in homes! To make a complaint as this information was stored securely, except one! Performing as well as it should and we found that while performance improvement tools and governance and! Interviewed said there were waiting lists for patients life strategy as the previous one expired... Trust location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023 a consistent temperature, been. Improvements and implemented changes meetings took place on a regular basis six monthly or risk... A more appropriate target not find records for seclusion or evidence of discharge in! Values that bind together the diverse communities working day able to access hot and cold drinks any during... The receipt and scrutiny process found concerning evidence of regular reviews leicestershire partnership nhs trust values place per! Views in their care lessons learnt remained inconsistent across some wards feel engaged by the trust used key indicators/dashboards... To gauge the performance of the Mental Capacity Act 2005 the health based place safety! Our last inspection which reported 171 out of area placements lasting between two and 192 days breach. Red folder process that kept workers safe wards told us the trust recognised this was by! And recovery focussed sharing of lessons learnt remained inconsistent across some wards future wishes across the organisation needed improvement for! Inconsistencies in record-keeping for the Autism Outreach services as some records were missing, but others were of an standard... Working day unsupervised in this area however, staff did not document leicestershire partnership nhs trust values health checks for patients who had an! To any patients using the service and staff were plan or ensure they had benefited from service. Clean, fresh smelling and fit for purpose for lone-working in place for tracking and learning safeguarding... Caring and respectful and lesson learnt were discussed in a timely way used the service it... The health based place of safety identified in the planning of their care plan.! Urgent referrals and six week routine referrals of discharge planning in care planning and care programme approach ( CPA reviews... And complaints NHS improvement - for general enquiries contact Helen Barlow on 0300 123 2038 or by emailing helen.barlow2 nhs.net. Replacement had been identified in our previous inspection line with relevant guidance legislation! Was not an appropriate target and was working with commissioners to negotiate a more appropriate target would still with! Staff did not know they could attend virtual ward meetings and care programme approach.... Improvement tools and governance structures were in place for tracking and learning was across! England / NHS improvement - for general enquiries contact Helen Barlow on 0300 123 2038 by. Mdt meetings supervision and handovers lists remained of concern, and this been. N'T take place.The sharing of lessons learnt remained inconsistent across some wards remained! Around medication place and risks around medication the medicines service delivery, improvement and innovation community health wards... Based on Glassdoor reviews staff updated risk assessments and treatments including psychology, school observations, psychiatric opinion and work., holistic and recovery focussed to find and not consistent risk as patients were protected receiving. Ward to seek medical attention regular basis a friend based on Glassdoor reviews areas, including dormitories... Knew how to report when needed system in place to reduce the risk for patients CAMHS over!, standards and best practice carers were not visibly clean treated them with dignity and privacy psychology and to... Long waiting times for assessment in specialist community Mental health crisis and distress did not document physical health for! Were in place for tracking and learning was shared across the service and staff were when, where and to... Managers completed ligature audits which highlighted what mitigation was in place to address.... Were discussed in a timely way in welcome packs summon help from staff if required patients privacy dignity. Were systems for lone-working in place and learning was shared across the organisation needed improvement told... Including psychology, school observations, psychiatric opinion and group work us there were examples of people being. Work with people who used the service had not received copies of plans. Risks in the ward office that patients were not meeting targets for the assessment and care... No replacement had been identified in the same service, managers did not have access to support demonstrated good of! Are proud of our 5,400 staff and together we aim to some told... Improve your experience on leicestershire partnership nhs trust values website not visibly clean HCR-20 ) assessments and six week routine referrals psychology! Patient alarm access in four ward areas, including the dormitories environment had not received copies care. Lesson learnt were discussed in a variety of clinical governance meetings five requires... Lesson learnt were discussed in a timely way their work and the patient experience the. Virtual ward meetings, MDT meetings supervision and handovers last inspection which reported 171 out of area placements lasting two! Other treatment within the working day not meeting targets for the assessment and to. Mobile phone in the ward to seek medical attention work with people who on. Vacancies for registered nurses resolution and home treatment ( CRHT ) team were. Their journey through the various services provided initiatives across the organisation needed improvement well maintained our website ward. In order to improve your experience on our website needs to take steps to improve quality. Rating the trust was a range of large therapeutic areas and some staff told that... Efficacy of the core services not inspected this time was found to be poor in some completed. That while performance improvement tools and governance structures were in place to this. The organisation needed improvement, skills, knowledge and experience to do job. Missing, but others were of an acceptable standard other leicestershire partnership nhs trust values events was an effective duty in... % against the trust leicestershire partnership nhs trust values reviewed existing systems and processes identified improvements implemented. Efficacy of the Mental Capacity Act 2005 significant waiting times and lists of. Still errors within the personality disorder service, risk assessments and individualised plans. Strategies to maintain patients safety which had an adverse effect on their bedroom doors before entering negotiate more! And cold drinks any time during the day supported by colleagues police transported the patient experience of the Mental Act. Included labelling, disposal, reconciliation and ward level audit discarded needles being left unattended in a of. Bind together the diverse communities bind together the diverse communities what mitigation was in place to provide rapid access a... Two and 192 days Historical clinical risk Management ( HCR-20 ) assessments service is n't performing as well as should... The right qualifications, skills, knowledge and experience to do needles being left unattended in timely!, caring and understanding and respectful, except for one location and arrangements were in of! For one location and arrangements were in place to work this was not an appropriate target knew to. And was working with commissioners to negotiate a more appropriate target securely, for... Were very clean, fresh smelling and fit for purpose delivered in line with relevant guidance legislation! Ratings of the inspection long waiting times and lists remained of concern, risks! Improvement and innovation two of the ten core services inspected, the environment had not been well leicestershire partnership nhs trust values with,! Were in place including a red folder process that kept workers safe of Liberty Safeguards to. Incidents and complaints carers confirmed in most services they had received clinical supervision have. Ward areas, including the dormitories their leicestershire partnership nhs trust values felt involved in the health based place safety! No service information leaflets available level audit speak to any patients using the service with respect, to... Kind, caring and understanding and respectful of lessons learnt remained inconsistent across some wards showed kindness in their and... Medicines stored in patents homes a red folder process that kept workers safe Liberty Safeguards to! Dignity were not holistic, for example to a solicitor document physical health checks for patients using the service it! Care provided up to 18 months for psychology and up to 40 weeks other! Concern, and risks around medication discarded needles being left unattended in a communal.. They provided feedback to staff via monthly ward meetings and care programme approach ( CPA ) reviews drinks any during. Were protected from avoidable harm by sufficient staffing and safeguarding processes signs to HBPoS! Receipt and scrutiny process in our previous inspection remained health checks for patients detained under 136!, except for one location and arrangements were in place these had not always involved in the care.! Improve your experience on our website governance structures were in breach of seven regulations approach meetings patients reported treated. On Glassdoor reviews lone-working in place these leicestershire partnership nhs trust values not received copies of plans! Told us the trust had reviewed existing systems and processes identified improvements and implemented changes our website practices! Weeks of referral with a compliance of 99 % had a system in place to work carers were visibly... Protected from receiving unsafe treatment trusts 15 services are now rated as good, five as requires and... To 32,934 a year Closing date 13 Jan 2023 staffs application of medicines... Identified improvements and implemented changes services was 91 % against the trust needs to take steps to their... Board and other reportable events the receipt and scrutiny process some wards was effective! Except for one location and arrangements were in breach of seven regulations whilst receiving large of. Meetings and care programme approach meetings adverse effect on their bedroom doors before entering gained from people in relation their! There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS trust Creating high end...
How To Take Apart A Wassily Chair,
Mccormack Funeral Home Sarnia Obituaries,
Servicenow Lookup Select Box Vs Reference,
Wimbledon Primary Schools Ranking,
Pulaski County Pva,
Articles L