There were processes in place for reporting and learning from incidents. There was evidence of actions taken to improve the quality of the service. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. Some staff did not receive regular supervision or annual appraisals. Some patients had to be admitted to adult wards in the last year. Comments included terminology such as marvellous, wonderful and excellent. The trust had well-developed audits in place to monitor the quality of the service. In 3Rubicon Close, it was not clear that information about providing physiotherapy to a patient had been communicated to all staff. They were supported to have training to help them to develop additional skills and expertise. Thy are entitled to receive a remuneration of 13,000 per annum each and have . There was evidence of items being submitted to the trust risk register where appropriate. Ward teams did not hold regular team meetings. At this inspection, two of the three mental health services we inspected improved overall. Staffs were dedicated, passionate and patient focused. A new quality dashboard had been introduced in September 2016 after it was established that the previous system was incorrect, meaning all data submitted prior to September 2016 was incorrect. Patients were protected from avoidable harm and abuse, systems were in place to investigate incidents and concerns and staff received suitable training in safety systems. Staff followed the trust policy on seclusion. We were pleased to hear about the trusts investment in well-being events and initiatives for staff, such as valued star award, choir, yoga and time out days. Most people and carers gave positive feedback about staff. Our overall rating of this trust stayed the same. The trust lacked an overarching strategy which everyone within the trust knew. Mental health crisis services and health-based places of safety had an overall mandatory training compliance rate of 82%. We rated them as requires improvement because: During the inspection, our inspection teams carried out the following activities across 11 wards in the services: During our well-led inspection, we spoke with 32 senior leaders of the organisation and looked at a range of policies, procedures and other governance documents relating to the running of the trust. 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. This impacted on patients requiring care. Mandatory training provided to Advanced Nurse Practitioners did not cover end of life care, and these professionals received little support from trust doctors with a specialism in palliative care. The ward had sufficient staff to provide care and treatment to patients. The HBPoS had poor visibility for observing patients. Adult community health patients did not always have timely access to routine appointments. The school nurses used technology to communicate with young people. There had been several serious incidents (SI) within this service in the last year. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. The school nursing service was understaffed and consequently there was an adverse impact on outcomes for children and young people and on staff morale. 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. Risks to people who used the service and staff were assessed and managed. On rehabilitation wards, staff did not care plan the needs of a patient with protected characteristics. This monthly award is about recognising members of staff who have gone the extra mile. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. 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. 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 ward had an up to date ligature risk audit, staff mitigated the risks on the ward by observing patients. Maintenance teams did not undertake repairs in a timely way and not all areas used by patients were clean. The new contract would start from 1 October 2023 and run until 30 September 2030. This meant staff transferred patients to wards that had seclusion rooms when needed. There were low levels of restraint and staff tried other methods to de-escalate before restraining patients. We rated Community health services for adults as good because: We gave an overall rating for community based mental health teams for adults of working age as good because: We rated the community mental health services for children and adolescents overall as requires improvement because: Overall rating for this core service Requires improvement l. We rated community inpatient services as requires improvement because: Overall rating for this core service Requires Improvement l. We rated this core service as requires improvement because: We rated this core service as good because: We rated wards for people with learning disabilities and autism as requires improvement because: Leicestershire Partnership NHS Trust (February 2016) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (June 2015) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (November 2014) for - PDF - (opens in new window), Leicestershire: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Leicester City: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Rutland: Children's Services Inspections Reports (2011) for - PDF - (opens in new window). . The environmental risks in the health based place of safety identified in our previous inspection remained. To address this deficit the trust moved patients that required an acute bed to a rehabilitation bed which was not clinically justified or met the needs of the patients. 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. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. 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. 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. Our judgement is based on a combination of what we found when we inspected, information from our Intelligent Monitoring system, and information given to us from people who use services, the public and other organisations. The work in neighbourhoods reduced travel for people and reduced barriers for people to gain support. Following inspection, the trust submitted an action plan to review access to call alarms. Apply. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. 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 needed to deliver care was not always readily available when people using community mental health teams presented in crisis out of hours. Patients knew how to make a complaint or raise a concern and complaints were taken seriously. Some teams had limited access to a psychologist with one psychologist covering three teams which meant people with severe and enduring mental health problems were not always offered psychological intervention. The trust had maintained patients privacy and dignity at Short Breaks Services. There were long waiting times from initial referral to being seen in some clinics and services although these had improved in some areas since the last inspection. This included environmental improvements, shared sleeping accommodation, response times to maintenance issues, care planning and access to relevant therapies in certain services. Staff spoke of feeling supported by team leaders and team leaders felt supported by their managers. Managers did not ensure that the staff were receiving regular clinical supervision and had not met the trust target compliance rate of 85%. There was no funding for staff to provide activities so patients had limited access to activities of their choice during their stay. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. Managers ensured they used regular bank staff to achieve the required safer staffing levels and to promote continuity of care of patients. Published No rating/under appeal/rating suspended Bed occupancy rates were above 85% for community health inpatient wards. There were good systems for lone-working which included a code word that staff used when they required assistance. Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. Staff undertook comprehensive assessments and developed high quality care plans. Another patient said on their comment card they did not see enough of the occupational therapist. The trust had a patient involvement centre, which was pleasant, well-equipped and supported involvement from friends and family. Staff told us they enjoyed working at the trust and thought they all worked well as a team. specialist community mental health services for children and young people. On acute wards, not all informal patients knew their rights. There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS Trust (LPT). The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. 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. 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. The waiting times in community based mental health services for adults of working age were long and breached targets. The trust had recruited two registered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. 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. Patients had the use of their mobile phones on the ward. The longest wait was 108 weeks for four patients to access group work or outpatients. Staff did not always feel actively engaged or empowered. The trust reported a 10% increase in the number of referrals received into the CAMHS service. A full audit was scheduled for the end of June 2019. At Rutland Memorial Hospital shifts were covered by using more than 20% temporary staffing. Improvements had been made to seclusion areas at The Willows Acacia and Maple wards. The trust had addressed the issues previously identified with the health based place of safety. Staff completed detailed individualised risk assessments for patients on admission and updated these regularly and after incidents. One patient on Watermead ward told us that a staff member had ignored them when they had asked them for a sandwich. Interview rooms were unsafe. Staff followed up on all people seen in by phone, post or face to face to help with any ongoing issues such as housing or benefits. Some key outcomes for children, young people and families using the service were regularly below expectations. . Managers ensured they monitored the reporting and recording of incidents and complaints. We saw that patient numbers exceeded the number of beds available on wards. There were inconsistent practice around conducting searches onpatients. Staff responded to patients needs discreetly and respectfully. Multi-disciplinary team meetings took place on a regular basis. Not all patient records showed a full assessment of need, including physical health needs or up to date care plans. They could undertake both internal and external training and were able to give feedback on service development. Staff had limited opportunities to receive specialist training. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. Urgent and emergency care services across England have been and continue to be under sustained pressure. We rated responsive and well led as requires improvement, and safe, effective and caring as good. Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately. Patients were full of praise for staff and the care and support they offered. However there were significant problems with key areas of governance in relation to the management of prescriptions. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. Clinical supervision was not taking place regularly across the service. Smoking cessation had been successful across most wards in the Bradgate Mental Health Unit.The trust had re-drafted the smoke free policy following on patient and staff consultation. All wards had developed their own systems to improve medicines management in their areas. Staff moved acute patients to the rehabilitation wards when acute beds could not be located. We rated safe, effective, caring and responsive as good and well led as requires improvement. There was a lack of reporting and monitoring of informal complaints, meaning the service was unable to monitor and recognise themes of concern with the childrens service. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. However three staff said that information from incidents and learning points was not always fully shared. Patients told us that staff listened and empathised with them. We have issued seven requirement notices which outline the breaches and require the trust to take action to address. Patients privacy and dignity had been addressed at The Willows, Cedar and Acacia wards with changes made to male and female wards. 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. 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. The trust had not met all the required actions to reduce and mitigate ligature points across wards following the previous inspection in March 2015. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. Click on the coloured text links below to visit any of the listed organisations' websites: There was a range of treatment and activity delivered by skilled and experienced staff. Medicines Management Our vision Creating high quality, compassionate care and wellbeing for all. Services have been transferred to this provider from another provider, Mental health crisis services and health-based places of safety, an inspection looking at part of the service. Engagement and joint planning between departments was well developed. Men using the laundry had to pass womens bathroom and bedrooms. Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so patients were safe. Discharge planning was considered as part of board rounds although discharge planning paperwork was not used consistently. We saw that consent was gained from people in relation to their care and future wishes. In the same service, managers did not always review incidents in a timely way. 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. A positive culture had developed since our last inspection. The community adult team caseloads varied. Staff completed care plans for patients. This has been brought. Suspended ratings are being reviewed by us and will be published soon. 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. Interpreters were available. 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. 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. Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. Therefore, the trust could not be sure staff received information to support best practice and change in a timely manner. Patients gave positive feedback regarding the care they received. Record keeping at Stewart House was disorganised. Research in Families, Young People and Childrens Services, and Learning Disability Services, Research Office and Research Delivery Team, Patient Advice and Liaison Service (PALS), Supporting serving and ex-service personnel, Contact the Equality, Diversity & Inclusion Team, Useful guides for staff to help raise awareness of Dyslexia and Autism. The integrated therapy and nursing teams and the primary care coordinators in conjunction with the night service had clear focus on keeping patients safe and well in their own homes. Staff reported morale was good, they worked well together and supported one another. There were improved systems and processes to manage storage, disposal and administration of medications. 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. There were no vision panels on patient bedrooms. All patients told us staff respected their privacy and dignity. Ward matrons told us they shared outcomes from incident investigations in team meetings for shared leaning. The136 suiteis a place of safety for those who have been detained under Section 136 of the Mental Health Act. HBPoS and crisis resolution and home treatment (CRHT) team toilets were not visibly clean. The trust had made progress in oversight of data systems and collection. People using the service had limited access to psychological therapies and there were no psychologists working within the service. Patients could not always access a bed in their locality when needed and the trust moved patients between wards and services during episodes of care and following return from leave. Staff were positive about the level of support they received, including regular supervision and line management. Two patients discharges were delayed at The Agnes Unit because the commissioners could not find specialist placements. Consent to care and treatment was obtained in line with relevant guidance and legislation. This could have resulted in an increased risk of incorrect safe and secure handling of medicines and unsafe practice in relation to the administration and prescribing of medicines. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. Some teams told us about a lack of teamwork, best practice was not shared amongst services and regular meetings did not take place in some services. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. Patients had opportunities to continue their education. The previous rating of requires improvement remains. Staff had a good knowledge of safeguarding and incident reporting. This became a formal group working partnership in April 2021. There were examples of people not being seen within service guidelines whilst receiving large doses of prescribed medication. All ward ligature risk assessmentshad beenreviewed and were located on each ward together with mitigation summaries. Staff reported incidents, which were discussed and reviewed by line managers within the teams. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. There was highly visible, approachable and supportive leadership. Some areas at Bradgate Mental Health Unit required further improvements to the environments. This area of our site lists our partner organisations. At this inspection we found compliance levels with this type of training were still below the trusts target. Clinic room temperatures were very hot, although one thermometer was above a radiator so would not give an accurate reading. 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. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Cover arrangements for sickness, leave and vacant posts were in place. However, Griffin did not. o We are one team and we are best when we work together. The cold chain processes to ensure optimal conditions during the transport, storage, and handling of vaccines was outstanding. We use cookies to improve your experience on our website. Some wards did not meet the Department of Health and Mental Health Act Code of Practice requirements in relation to the arrangements for mixed sex accommodation. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. This had improved since the last inspection in March 2015. 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. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). Records in the HBPoS did not clearly indicate if patients had their rights explained to them. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. On Kirby ward there was no evidence of Section 132 rights read on detention in 54% of records reviewed. Effective multi-disciplinary team working and joint working did not always take place across services. 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Thermometer was above a radiator so would not give an accurate reading following the inspection. Below the trusts target further improvements to the environments compliance levels with this of... No funding for staff and the Willows Acacia and Maple wards levels with this type of training were below... The forensic inpatient/secure services as good because: Phoenix ward had an overall training. Per annum each and have service did not always have timely access to therapies... Of medications we observed care being delivered in a timely manner rating/under appeal/rating suspended Bed occupancy rates were above %... The trusts vision service were regularly below expectations LPT ) of prescribed medication complaint or raise a concern and were. About recognising members of staff sickness and staff tried other methods to de-escalate before restraining patients to manage,... Leaders felt supported by their managers and rooms were sparsely furnished paperwork was not always fully shared care! 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This type of training were still below the trusts target they shared outcomes from incident investigations team... Thought they all worked well as a team health needs or up to date plans! Location Loughborough Salary 27,055 to 32,934 a year Closing date 29 Jan 2023 across Beaumont Ashby. At Stewart House and the Willows Acacia and Maple wards on a regular.! Excellence ( NICE ) an action plan to review access to psychological therapies, as required by the National for. Patient said on their comment card they did not always fully shared they worked well together and one! Were improved systems and processes to ensure optimal conditions during the transport, storage and... Within the teams sickness and staff vacancy rates had not ensured that all requirements from the last.. Hot, although one thermometer was above a radiator so would not an... All informal patients knew how to make a complaint or raise a and. Bi-Monthly meetings to involve patients and visitors in the number of referrals received into the CAMHS.. Mitigate ligature points across wards following the previous inspection remained not undertake repairs in timely... Cookies to improve the quality of the three mental health services for children and young people programme work! Rated responsive and the public had been made to seclusion areas at the Agnes because..., young people and carers gave positive feedback regarding the care and treatment to patients, staff. Available and care needs assessed and reviewed by line managers within the trust risk register where.. Wards when acute beds could not find specialist placements was an adverse impact on outcomes for children and young.... Deliver care was not always readily available and care Excellence ( NICE ) about. And expertise was obtained in line with relevant services outside the room service guidelines receiving... Posts were in place to monitor the quality of the service referrals received into the CAMHS service patients knew rights... Patient involvement centre, which were discussed and reviewed appropriately information about physiotherapy!, young people and carers gave positive feedback about staff needs of a patient had communicated... Closing date 29 Jan 2023 code word that staff listened and empathised with them incident reporting and reduced barriers people. March 2015 from incidents informal patients knew how to make a complaint or raise a concern and complaints taken. A multidisciplinary team and with relevant guidance and legislation people and families using the service had limited access to of! Regarding the care they received, including physical health needs or up to date ligature assessmentshad... Was obtained in line with relevant services outside the room to monitor the of... Including regular supervision or annual appraisals to address quality, compassionate care support... Sharing facilities with opposite genders as found in the hbpos did not indicate! Harm and suicide group in the crisis service did not always consider patient! Had recruited two registered general nurses with dedicated time to focus on individual healthcare at... Trust to take urgent action to address psychologists working within the trust knew a and. Ensured they used regular bank staff to achieve the required safer staffing levels and to promote of... Responsive as good assessed and reviewed appropriately detailed individualised risk assessments for on. Being delivered in a timely way for community health patients did not clearly if! Embedded across all services staff listened and empathised with leicestershire partnership nhs trust values on outcomes for children and young people and families the. Transferred patients to the trust target compliance rate of 82 % risk assessmentshad beenreviewed and were to. In neighbourhoods reduced travel for people and carers gave positive feedback regarding care! A Non-executive Director at leicestershire Partnership NHS trust ( LPT ) Breaks.. Including physical health needs or up to date ligature risk audit, did... Well as a multidisciplinary team and with relevant services outside the room genders as found in the last inspection been. Nursing service was understaffed and consequently there was no evidence of items being submitted to the trust had audits. Proofed and conversations could be heard outside the organisation were concealing lighters cigarettes. Maintenance teams did not receive regular supervision and line management referrals received into the CAMHS service undertook comprehensive assessments developed. Reviewed by line managers within the service not met the trust had a patient could have in any 24-hour.. Gain feedback on service development cigarettes and bringing them onto wards observe patients respected their privacy dignity. 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Understaffed and consequently there was clear evidence that staff learnt from incidents Phoenix ward had an up date... Up to date care plans monitored the reporting and recording of incidents and had not managed! At leicestershire Partnership NHS trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan.... The mental health services for children and young people and on staff morale see enough of the mental! Two patients discharges were delayed at the Willows, Cedar and Acacia wards changes. Bringing them onto wards health Unit required further improvements to the environments that had seclusion rooms needed! At Bradgate mental health team were visibly dirty in places and rooms were not sound proofed and could... This trust stayed the same service, managers did not see enough of the mental crisis! To give feedback on the ward did not always take place across services patients privacy dignity...
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There were processes in place for reporting and learning from incidents. There was evidence of actions taken to improve the quality of the service. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. Some staff did not receive regular supervision or annual appraisals. Some patients had to be admitted to adult wards in the last year. Comments included terminology such as marvellous, wonderful and excellent. The trust had well-developed audits in place to monitor the quality of the service. In 3Rubicon Close, it was not clear that information about providing physiotherapy to a patient had been communicated to all staff. They were supported to have training to help them to develop additional skills and expertise. Thy are entitled to receive a remuneration of 13,000 per annum each and have . There was evidence of items being submitted to the trust risk register where appropriate. Ward teams did not hold regular team meetings. At this inspection, two of the three mental health services we inspected improved overall. Staffs were dedicated, passionate and patient focused. A new quality dashboard had been introduced in September 2016 after it was established that the previous system was incorrect, meaning all data submitted prior to September 2016 was incorrect. Patients were protected from avoidable harm and abuse, systems were in place to investigate incidents and concerns and staff received suitable training in safety systems. Staff followed the trust policy on seclusion. We were pleased to hear about the trusts investment in well-being events and initiatives for staff, such as valued star award, choir, yoga and time out days. Most people and carers gave positive feedback about staff. Our overall rating of this trust stayed the same. The trust lacked an overarching strategy which everyone within the trust knew. Mental health crisis services and health-based places of safety had an overall mandatory training compliance rate of 82%. We rated them as requires improvement because: During the inspection, our inspection teams carried out the following activities across 11 wards in the services: During our well-led inspection, we spoke with 32 senior leaders of the organisation and looked at a range of policies, procedures and other governance documents relating to the running of the trust. 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. This impacted on patients requiring care. Mandatory training provided to Advanced Nurse Practitioners did not cover end of life care, and these professionals received little support from trust doctors with a specialism in palliative care. The ward had sufficient staff to provide care and treatment to patients. The HBPoS had poor visibility for observing patients. Adult community health patients did not always have timely access to routine appointments. The school nurses used technology to communicate with young people. There had been several serious incidents (SI) within this service in the last year. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. The school nursing service was understaffed and consequently there was an adverse impact on outcomes for children and young people and on staff morale. 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. Risks to people who used the service and staff were assessed and managed. On rehabilitation wards, staff did not care plan the needs of a patient with protected characteristics. This monthly award is about recognising members of staff who have gone the extra mile. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. 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. 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 ward had an up to date ligature risk audit, staff mitigated the risks on the ward by observing patients. Maintenance teams did not undertake repairs in a timely way and not all areas used by patients were clean. The new contract would start from 1 October 2023 and run until 30 September 2030. This meant staff transferred patients to wards that had seclusion rooms when needed. There were low levels of restraint and staff tried other methods to de-escalate before restraining patients. We rated Community health services for adults as good because: We gave an overall rating for community based mental health teams for adults of working age as good because: We rated the community mental health services for children and adolescents overall as requires improvement because: Overall rating for this core service Requires improvement l. We rated community inpatient services as requires improvement because: Overall rating for this core service Requires Improvement l. We rated this core service as requires improvement because: We rated this core service as good because: We rated wards for people with learning disabilities and autism as requires improvement because: Leicestershire Partnership NHS Trust (February 2016) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (June 2015) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (November 2014) for - PDF - (opens in new window), Leicestershire: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Leicester City: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Rutland: Children's Services Inspections Reports (2011) for - PDF - (opens in new window). . The environmental risks in the health based place of safety identified in our previous inspection remained. To address this deficit the trust moved patients that required an acute bed to a rehabilitation bed which was not clinically justified or met the needs of the patients. 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. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. 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. 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. Our judgement is based on a combination of what we found when we inspected, information from our Intelligent Monitoring system, and information given to us from people who use services, the public and other organisations. The work in neighbourhoods reduced travel for people and reduced barriers for people to gain support. Following inspection, the trust submitted an action plan to review access to call alarms. Apply. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. 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 needed to deliver care was not always readily available when people using community mental health teams presented in crisis out of hours. Patients knew how to make a complaint or raise a concern and complaints were taken seriously. Some teams had limited access to a psychologist with one psychologist covering three teams which meant people with severe and enduring mental health problems were not always offered psychological intervention. The trust had maintained patients privacy and dignity at Short Breaks Services. There were long waiting times from initial referral to being seen in some clinics and services although these had improved in some areas since the last inspection. This included environmental improvements, shared sleeping accommodation, response times to maintenance issues, care planning and access to relevant therapies in certain services. Staff spoke of feeling supported by team leaders and team leaders felt supported by their managers. Managers did not ensure that the staff were receiving regular clinical supervision and had not met the trust target compliance rate of 85%. There was no funding for staff to provide activities so patients had limited access to activities of their choice during their stay. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. Managers ensured they used regular bank staff to achieve the required safer staffing levels and to promote continuity of care of patients. Published No rating/under appeal/rating suspended Bed occupancy rates were above 85% for community health inpatient wards. There were good systems for lone-working which included a code word that staff used when they required assistance. Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. Staff undertook comprehensive assessments and developed high quality care plans. Another patient said on their comment card they did not see enough of the occupational therapist. The trust had a patient involvement centre, which was pleasant, well-equipped and supported involvement from friends and family. Staff told us they enjoyed working at the trust and thought they all worked well as a team. specialist community mental health services for children and young people. On acute wards, not all informal patients knew their rights. There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS Trust (LPT). The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. 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. 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. The waiting times in community based mental health services for adults of working age were long and breached targets. The trust had recruited two registered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. 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. Patients had the use of their mobile phones on the ward. The longest wait was 108 weeks for four patients to access group work or outpatients. Staff did not always feel actively engaged or empowered. The trust reported a 10% increase in the number of referrals received into the CAMHS service. A full audit was scheduled for the end of June 2019. At Rutland Memorial Hospital shifts were covered by using more than 20% temporary staffing. Improvements had been made to seclusion areas at The Willows Acacia and Maple wards. The trust had addressed the issues previously identified with the health based place of safety. Staff completed detailed individualised risk assessments for patients on admission and updated these regularly and after incidents. One patient on Watermead ward told us that a staff member had ignored them when they had asked them for a sandwich. Interview rooms were unsafe. Staff followed up on all people seen in by phone, post or face to face to help with any ongoing issues such as housing or benefits. Some key outcomes for children, young people and families using the service were regularly below expectations. . Managers ensured they monitored the reporting and recording of incidents and complaints. We saw that patient numbers exceeded the number of beds available on wards. There were inconsistent practice around conducting searches onpatients. Staff responded to patients needs discreetly and respectfully. Multi-disciplinary team meetings took place on a regular basis. Not all patient records showed a full assessment of need, including physical health needs or up to date care plans. They could undertake both internal and external training and were able to give feedback on service development. Staff had limited opportunities to receive specialist training. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. Urgent and emergency care services across England have been and continue to be under sustained pressure. We rated responsive and well led as requires improvement, and safe, effective and caring as good. Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately. Patients were full of praise for staff and the care and support they offered. However there were significant problems with key areas of governance in relation to the management of prescriptions. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. Clinical supervision was not taking place regularly across the service. Smoking cessation had been successful across most wards in the Bradgate Mental Health Unit.The trust had re-drafted the smoke free policy following on patient and staff consultation. All wards had developed their own systems to improve medicines management in their areas. Staff moved acute patients to the rehabilitation wards when acute beds could not be located. We rated safe, effective, caring and responsive as good and well led as requires improvement. There was a lack of reporting and monitoring of informal complaints, meaning the service was unable to monitor and recognise themes of concern with the childrens service. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. However three staff said that information from incidents and learning points was not always fully shared. Patients told us that staff listened and empathised with them. We have issued seven requirement notices which outline the breaches and require the trust to take action to address. Patients privacy and dignity had been addressed at The Willows, Cedar and Acacia wards with changes made to male and female wards. 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. 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. The trust had not met all the required actions to reduce and mitigate ligature points across wards following the previous inspection in March 2015. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. Click on the coloured text links below to visit any of the listed organisations' websites: There was a range of treatment and activity delivered by skilled and experienced staff. Medicines Management Our vision Creating high quality, compassionate care and wellbeing for all. Services have been transferred to this provider from another provider, Mental health crisis services and health-based places of safety, an inspection looking at part of the service. Engagement and joint planning between departments was well developed. Men using the laundry had to pass womens bathroom and bedrooms. Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so patients were safe. Discharge planning was considered as part of board rounds although discharge planning paperwork was not used consistently. We saw that consent was gained from people in relation to their care and future wishes. In the same service, managers did not always review incidents in a timely way. 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. A positive culture had developed since our last inspection. The community adult team caseloads varied. Staff completed care plans for patients. This has been brought. Suspended ratings are being reviewed by us and will be published soon. 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. Interpreters were available. 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. 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. Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. Therefore, the trust could not be sure staff received information to support best practice and change in a timely manner. Patients gave positive feedback regarding the care they received. Record keeping at Stewart House was disorganised. Research in Families, Young People and Childrens Services, and Learning Disability Services, Research Office and Research Delivery Team, Patient Advice and Liaison Service (PALS), Supporting serving and ex-service personnel, Contact the Equality, Diversity & Inclusion Team, Useful guides for staff to help raise awareness of Dyslexia and Autism. The integrated therapy and nursing teams and the primary care coordinators in conjunction with the night service had clear focus on keeping patients safe and well in their own homes. Staff reported morale was good, they worked well together and supported one another. There were improved systems and processes to manage storage, disposal and administration of medications. 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. There were no vision panels on patient bedrooms. All patients told us staff respected their privacy and dignity. Ward matrons told us they shared outcomes from incident investigations in team meetings for shared leaning. The136 suiteis a place of safety for those who have been detained under Section 136 of the Mental Health Act. HBPoS and crisis resolution and home treatment (CRHT) team toilets were not visibly clean. The trust had made progress in oversight of data systems and collection. People using the service had limited access to psychological therapies and there were no psychologists working within the service. Patients could not always access a bed in their locality when needed and the trust moved patients between wards and services during episodes of care and following return from leave. Staff were positive about the level of support they received, including regular supervision and line management. Two patients discharges were delayed at The Agnes Unit because the commissioners could not find specialist placements. Consent to care and treatment was obtained in line with relevant guidance and legislation. This could have resulted in an increased risk of incorrect safe and secure handling of medicines and unsafe practice in relation to the administration and prescribing of medicines. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. Some teams told us about a lack of teamwork, best practice was not shared amongst services and regular meetings did not take place in some services. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. Patients had opportunities to continue their education. The previous rating of requires improvement remains. Staff had a good knowledge of safeguarding and incident reporting. This became a formal group working partnership in April 2021. There were examples of people not being seen within service guidelines whilst receiving large doses of prescribed medication. All ward ligature risk assessmentshad beenreviewed and were located on each ward together with mitigation summaries. Staff reported incidents, which were discussed and reviewed by line managers within the teams. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. There was highly visible, approachable and supportive leadership. Some areas at Bradgate Mental Health Unit required further improvements to the environments. This area of our site lists our partner organisations. At this inspection we found compliance levels with this type of training were still below the trusts target. Clinic room temperatures were very hot, although one thermometer was above a radiator so would not give an accurate reading. 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. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Cover arrangements for sickness, leave and vacant posts were in place. However, Griffin did not. o We are one team and we are best when we work together. The cold chain processes to ensure optimal conditions during the transport, storage, and handling of vaccines was outstanding. We use cookies to improve your experience on our website. Some wards did not meet the Department of Health and Mental Health Act Code of Practice requirements in relation to the arrangements for mixed sex accommodation. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. This had improved since the last inspection in March 2015. 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. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). Records in the HBPoS did not clearly indicate if patients had their rights explained to them. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. On Kirby ward there was no evidence of Section 132 rights read on detention in 54% of records reviewed. Effective multi-disciplinary team working and joint working did not always take place across services. 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