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. In addition to this, risk assessments were comprehensive and reviewed as per the trust policy, six monthly or after risk incidents. A psychologist led weekly reflective practice sessions to help staff think about the best way of helping the patient on the ward. Patient access to psychology and occupational therapy was less than expected on acute wards and rehabilitation wards due to the number of staff vacancies in therapy positions. Sixty per cent of staff working in the mental health services had attended supervision and 64% of staff working in community health inpatient services. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. We rated it as good because: Leicestershire Partnership NHS Trust: Evidence appendix published 30 April 2018 for - PDF - (opens in new window), Published At the time of inspection, there were a total of 647 children and young people currently waiting to be seen in specialised treatment pathways. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. They told us that staff were kind and caring. 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. 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. Staff referred to having reflective practice peer meetings when they were concerned about the risk to a young person. Medicines Management Our vision Creating high quality, compassionate care and wellbeing for all. We inspected all key lines of enquiry in all domains (safe, effective, caring, responsive and well-led) in two services. Patients were full of praise for staff and the care and support they offered. Care records for patients using the CRHT teams were not holistic or personalised. On Ashby ward, the shower rooms did not have curtains fitted. NHS England / NHS Improvement - for general enquiries contact Helen Barlow on 0300 123 2038 or by emailing helen.barlow2@nhs.net. The teams did not have waiting lists for care coordinators at the time of inspection. Staff were observed to be caring and responsive to patients. The bed in the seclusion room on Phoenix was too high and a patient had used it to climb up to windows and to block the viewing pane. The service was recovery focused and had developed pathways with other agencies to build on recovery capital for people who used the service. The trust encouraged staff at most levels of the organisation to develop and deliver ideas for service delivery, improvement and innovation. Recruitment was in progress for 10 new healthcare support workers. Suspended ratings are being reviewed by us and will be published soon. -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 . This was a breach of the patients privacy and dignity to patients as staff might be required to enter the shower rooms to check patients were safe. Some wards and patient areas had blind spots, where staff could not easily observe patients. 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. The transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. Staff showed a good awareness of patient rights. People we spoke with said they had received a good service. Record keeping was poor in some services. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. 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 were constantly looking at ways to improve their work and the patient experience of the service. 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. At this inspection, we visited the two mental health services previously rated inadequate and one mental health service previously rated as requires improvement. Admission to the unit was agreed with commissioners. 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. The trust confirmed after our inspection Advanced Nurse Practitioners used a DNACPR form which had been agreed within NHS East Midlands. 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. Leaders were motivated and developing their skills to address the current challenges to the service. Managers changed practice because of this. Following the national withdrawal of the Liverpool Care Pathway the trust has developed an alternative care plan; however this has not yet been implemented. Two core services did not promote patient centred care in all aspects of care delivery. One family member told us their relative could be challenging but they felt they were well cared for. Service planning was not being managed in a systematic way. Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so patients were safe. Find out more Knitting therapy keeps cats and dogs warm 23 Dec 2022 News We had a number of concerns about the safety of this trust. The majority of care plans were up to date. The wards tried to book regular bank and agency staff so they knew the ward and patients, to provide continuity of care. However there was no evidence of clinical audits or monitoring of the service in order to improve care provided to patients and staff were unable to talk about this to inspectors. The HBPoS had no designated resuscitation equipment and emergency medication and shared equipment with acute wards. 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. Staff were unable to show us evidence of clinical audits or the basis of evidence based practice in end of life services. The service was meeting its target in this area. 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. The service was responsive. The trust was not commissioned to provide female psychiatric intensive care beds. An escape plan was developed with patients (PEEP)who may not be able to reach an ultimate place of safety unaided, or within a satisfactory period of time in the event of any emergency. This impacted on the time available for staff development and training. This was a focused inspection. People using the service had limited access to psychological therapies and there were no psychologists working within the service. View more Profession Occupational Therapist Service Learning Disability Grade Band 6 Contract Type Permanent Hours Full Time. Administrative staff had not received specific mental health awareness training to assist them when taking calls for people who were acutely unwell and in crisis. We rated the four mental health core services as requires improvement and community health services for adults as good. This meant that some staff felt insecure. 9 August 2019, Leicestershire Partnership NHS Trust: Evidence appendix published 27 February 2019 for - PDF - (opens in new window), Published Click here to submit your comments to us. 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. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. People using the service may not be able to get the speed of telephone response they needed in a crisis. Some staff used tools and approaches to rate patient severity and monitor their health. Patient had individualised risk assessments. The trust board had not reviewed full investigation reports for the most serious incidents, only the outcomes and lesson learnt. All three service inspections were unannounced. Staff treated patients with kindness, compassion and respect.We saw staff spend time talking to and their carers. Designated staff were not provided by the trust. Staff did not adhere to the Mental Capacity Act Code of Practice and the five principles of the Act. The trust had addressed the issues previously identified with the health based place of safety. Updated 22 June 2022. There was a duty worker system in place which meant the service was able to respond quickly to escalating risks if necessary. Engagement with external stakeholders had significantly improved since our last inspection. Patients were not always involved in the planning of their care. 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 trust had recruited two registered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. 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. There was good multi-disciplinary working within the teams and good communication with other organisations. However, they were not updated regularly or following an incident. This was highlighted in the previous inspection. The NHS is founded on principles and values that bind together the diverse communities . For example, issues found in risk assessments, care plans and environmental concerns had been addressed in some services, but not all since our last inspection. 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. There were no vision panels on patient bedrooms. The trust had improved how staff recorded patients physical healthcare, and monitored patients who had ongoing physical healthcare problems. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. ", Daxa Mangia, Mental Health Nurse, The Willows, "I really enjoy my job, helping people to recover - I cannot imagine doing anything else.". We rated the trust overall for well-led as inadequate. The trust had improved medicines management. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. However, this was a temporary restriction due to the building works and patient safety. 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. There were issues within the trust of a bullying culture despite evidence that staff knew the trust values. Staff reported incidents, which were discussed and reviewed by line managers within the teams. Local leaders were visible and had the skills and knowledge to perform their roles. Some facilities lacked essential emergency equipment. Staff informed us there was a safeguarding lead to refer to when guidance was needed. Staff had been given lone worker safety devices to ensure their safety. The quality of clinical supervision was variable across the trust. Staff completed comprehensive assessments which included physical health checks and the majority of patients had completed risk assessments. Adult liaison psychiatry is categorised under Mental Health Core service of Mental Health Crisis and Health Based Places of Safety (HBPoS), as it is provided by the mental health trust, Leicestershire Partnership NHS Trust. 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. 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 said morale was good and they felt supported by their managers. The policy for rapid tranquillisation was not in line with national guidance. We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. The HBPoS had poor visibility for observing patients. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. the service is performing exceptionally well. When staff raised concerns or ideas for improvement, they felt they were not always taken seriously. There was highly visible, approachable and supportive leadership. Staff were kind, caring and respectful towards patients. 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. There were good systems for lone-working which included a code word that staff used when they required assistance. Requires improvement New positions such as medicines administration assistants and link nurses to support wards were in place in certain areas, but ward staff still described irregular pharmacy visits and a lack of pharmacy oversight in medicines management. Patient views on the quality of the food were variable. Inadequate This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. Staff described various ways in which they received information from the board and other governance meetings. Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. New systems were in place for staff to report any repairs or maintenance issues. Outcomes of care and treatment were not always consistently or robustly monitored. Many of the actions listed included plans to review process, establish an approach, or to develop areas. Staff managed their caseloads effectively; they discussed their caseloads during multi-disciplinary team meetings as well as in supervision. When we talk to colleagues we are clear about what is expected. 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. Some areas at Bradgate Mental Health Unit required further improvements to the environments. The service was proactive in ensuring the welfare and well-being of patients and in ensuring suitable activities. Whilst staff were working hard to identify and manage individual risks, some ward environments were unacceptable. Staff did not always maintain the privacy and dignity of patients. 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. In 3Rubicon Close, it was not clear that information about providing physiotherapy to a patient had been communicated to all staff. The CRHT team did not have lockable bags to transport medication to patients homes; staff told us they transported medication in their handbags. 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. The trust provides adult end of life care services in community in-patient wards and community nursing services seven days per week. Adult liaison psychiatry services are delivered by the mental health trust across three acute hospital sites at Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital. 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. Staff were trained appropriately within their speciality and new staff were supported to gain experience and skills. Leicester, United Kingdom. We found concerns with the environment in all five core services we inspected. Acute patients had been sent to rehabilitation wards inappropriately. We spoke with six patients who all told us that the staff were very kind and looked after them well. The trust had ensured patients privacy and dignity were maintained when receiving physical health observations at the Bradgate Mental Health Unit. Our rating of this service improved. Thy are entitled to receive a remuneration of 13,000 per annum each and have . The waiting list had increased for those children and young people waitingfor thestart of treatment, following assessment. Between August 2015 and July 2016, there were 60 delayed discharges across the service. Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), In Following inspection, the trust submitted an action plan to review access to call alarms. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. Following inspection, the trust submitted an action plan to review shared sleeping arrangements. Often patients were admitted to hospital out of the area especially if they need a more intensive support. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. The room used to administer medication on Arran ward at Stewart House was not appropriate; the room was a bedroom and still had a toilet in. We did not speak to any patients using the service at the time of the inspection. There was limited time available for staff to attend specialist courses to enhance their knowledge. The community nursing service could not measure its performance in relation to response times for unplanned care. Across the teams, we found up to date ligature audits in place. 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. 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. We're always looking for the best. The environment in the crisis service did not ensure confidentiality as rooms were not sound proofed and conversations could be heard outside the room. We carry out joint inspections with Ofsted. Staff completed extensive and detailed care plans. The community therapy rehabilitation unit at Hinckley did not have a defibrillator in the unit for staff to use in an emergency despite staff having been trained how to use one. We have issued seven requirement notices which outline the breaches and require the trust to take action to address. Leicestershire Partnership NHS Trust Is this your company? Patients told us they did not have access to a copy of their care plan. Our patients are at the heart of all we do and we believe that 'Caring at its Best' is not just about the . Patients said they got bored at the weekends, as there were fewer activities on offer. They did not have alarms or vision panels in the door. Staff satisfaction varied greatly across the service with some staff feeling devalued. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. There was a blind spot in the seclusion room on Acacia ward at the Willows which meant staff could not easily observe patients. 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. The process for monitoring patients on the waiting list in specialist community mental health services for children and young people had been strengthened since the last inspection. there are some services which we cant rate, while some might be under appeal from the provider. The HBPoS did not have designated staff provided by the trust. Staff were visible in the communal ward areas and attentive to the needs of the patients they cared for. Staff completed care plans for patients. The school nurses used technology to communicate with young people. There were good examples of collaborative team working and effective multi-disciplinary and multi-agency working to meet the needs of children and young people using the service. Engagement and joint planning between departments was well developed. We're one team with shared values providing the best care possible. 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