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. Staff maintained a presence in clinical areas to observe and support patients. ", Laiqaah Manjra, Corporate Affairs Administrator, "I progressed from being an apprentice to a Corporate Affairs Administrator - the NHS really supports staff development. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. Staff were up to date with mandatory training and had regular supervision and appraisals. The service did not have any out of area placements, readmissions or delayed discharges. Patient involvement in planning care was now in place and the voice of the patient in changes to services had been considered. When staff raised concerns or ideas for improvement, they felt they were not always taken seriously. Patient outcomes were not routinely collected so the quality of the clinical care being delivered could not be measured or benchmarked. There was no process in place for learning from other organisations which provided similar services or to share this services best practice. Some care plans had not been updated and physical healthcare checks were not routinely documented in young peoples notes. Patients were able to access hot and cold drinks any time during the day. This has been brought. The Trust had a number of unfilled positions being covered by long-term bank staff. The trust was not fully compliant with same sex accommodation guidance in two acute wards, the short stay learning disability service and rehabilitation services. Reductions in social service provision had led to an increase in referrals to the Community Learning Disability Teams. This was an issue highlighted at our inspection in 2018. 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 We could not find records for seclusion or evidence of regular reviews taking place as per trust policy. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. Another relative said their relative was a changed person since going to the Willows and they were able to go home last Christmas. 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. These included unsafe environments that did not promote the dignity of patients; insufficient staffing levels to safely meet patients needs; inadequate arrangements for medication management; concerns regarding seclusion and restraint practice: insufficient clinical risk management. Staff were very caring and sensitive to patients needs. Derby, We felt this contributed to senior staff views that pace of change in the trust was slow. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. In most services, we were concerned with the lack of evidence in care plans which showed patients and carers had been consulted and involved in their care. There were risk assessments and plans in place to keep people and staff safe. Staff were kind, caring and compassionate and treated patients with dignity and respect. However, they were not updated regularly or following an incident. 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. Improvements were needed to make them safer, including reducing ligatures, improving lines of sight and ensuring the safety and dignity of patients. Lone working policies and procedures were in place for staff to follow to ensure patient and staff safety. Ligature risks had been identified in bedrooms, bathrooms and toilets but there was no clear action to address all of the identifed risks, The seclusion rooms had known blind spots but no action had been taken to reduce them. Staff we spoke with demonstrated their dedication to providing high quality patient care. Two core services did not promote patient centred care in all aspects of care delivery. Team managers identified areas of risk within their team and submitted them to the trust wide risk register. We reviewed 267 case records and found that, generally, staff completed detailed individualised risk assessments for patients on admission. Some improvements were seen in seclusion documentation and seclusion environments. The service is not appropriately commissioned to provide sufficient school nurses to meet the standard service recommendations of one nurse per secondary school and its associated primary schools. Staff carried out physical health checks on admission.Ongoing physical healthcare was provided by a local GP who visited two days a week and was available in case of an emergency. The HBPoS did not have designated staff provided by the trust. Staff ensured that these were updated regularly. Care plans reviewed were not personalised, holistic or recovery orientated. This promotion is being run by Leicestershire Partnership NHS Trust. Multi-disciplinary team meetings took place on a regular basis. There were insufficient systems in place to monitor prescriptions. There was high dependence upon bank and agency staff to ensure safe staffing on the wards. Coventry, All wards had developed their own systems to improve medicines management in their areas. Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. All areas were very clean, fresh smelling and fit for purpose. Patients we spoke with knew how to complain. We are looking at different ways to indicate the outcomes of our monitoring in the future. Staff worked with both internal and external agencies to coordinate care and discharge plans. DE22 3LZ. New systems were in place for staff to report any repairs or maintenance issues. This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. This monthly award is about recognising members of staff who have gone the extra mile. 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 noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. 27 February 2019. Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. Staff had the right qualifications, skills, knowledge and experience to do their job. We saw patients were treated with kindness and compassion. You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection. Interview rooms were unsafe. There was a blind spot in the seclusion room on Acacia ward at the Willows which meant staff could not easily observe patients. Staff morale was low and they felt disempowered in some areas. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). Care plans did not always reflect a person centred approach and people who used services and their carers were not routinely involved in CPA reviews. The transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. This impacted on the time available for staff development and training. The trust confirmed after our inspection Advanced Nurse Practitioners used a DNACPR form which had been agreed within NHS East Midlands. At West Leicestershire there was a lack of psychology input. The trust had a culture of promoting staff learning and development and encouraged staff to share best practice and innovation. Creating high quality compassionate care and well-being for all | Leicestershire Partnership NHS Trust - We provide mental health, learning disability and community health services for a population of more than a million people in Leicester, Leicestershire and Rutland. Patients felt safe and said they were checked regularly by staff. Some staff had not received their mandatory training, supervision or appraisal. Staff completed extensive and detailed care plans. The short stay services did not comply with the guidance on the elimination of mixed sex accommodation. Staff working within criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. Staff received regular supervision and most had received an appraisal in the last 12 months. Staff involved patients in the ward review and community meetings. Often patients were admitted to hospital out of the area especially if they need a more intensive support. This could pose a risk to patients and staff. This meant patients had been placed outside of the trusts area. Staff treated patients with kindness, compassion and respect.We saw staff spend time talking to and their carers. Five of the six services in this core service were in breach of these targets. Staff told us they enjoyed working at the trust and thought they all worked well as a team. Flu and Covid-19 are currently circulating at high levels and are likely to continue to increase in coming weeks. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. A dual paper and electronic recording system meant that some information was not accessible to all of the staff that might need it. 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. We rated it as requires improvement because: When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. Therefore, patients were not always actively engaged in decisions about service provision or their care. We did not inspect the whole core service. 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. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 22 Jan 2023. The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. This meant that some staff felt insecure. Inspectors from the Care Quality Commission (CQC) visited five services run by Leicestershire Partnership NHS Trust (LPT) in November and December last year. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. There was highly visible, approachable and supportive leadership. However, no time frame was set for the work to be completed. 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. 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 told us the trust was a good place to work. CV6 6NY, In Delivered through over 100 settings from inpatient wards to out in the community, our 6,500 staff serves over 1 million people living in Leicester, Leicestershire and Rutland. 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 30 bed unit at Stewart House was mixed sex and there were no doors to lock between the male and female sections. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. We will be working with them to agree an action plan to improve the standards of care and treatment. This could pose a risk as patients were unsupervised in this area. Therefore, the trust could not be sure staff received information to support best practice and change in a timely manner. Staff demonstrated commitment to delivering high quality end of life care for their patients. There was a skilled multi-disciplinary team able to offer a variety of therapies. Any other browser may experience partial or no support. The ovens were old and the dials were not visible and cupboards were broken. Staff reported they felt supported by their colleagues and managers. There was evidence of leadership at local and senior level. The trust had well-developed audits in place to monitor the quality of the service. In CAMHS community teams waiting times from referral to initial assessment was less than 13 weeks. Staff showed caring attitudes towards their patients. Records were stored securely and well managed by staff to ensure that sensitive information about patients was protected. The trust had a variety of measures in place to ensure that processes and reporting to board were not delayed. Click on the coloured text links below to visit any of the listed organisations' websites: At least one standard in this area was not being met when we inspected the service and Staff were observed to be caring and responsive to patients. Staff supported patients to raise concerns when needed. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. We had concerns about the environment but noted the service was due to move locations within two weeks. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. The trust ceased mixed sex breaches by maintaining male and female only weeks. Staff were quick to sort out requests and problems for patients. 30 April 2018. Staff were not always recording their supervision on the electronic system so we could not be assured they were receiving it regularly. Many staff we spoke with knew who their chief executive was and mentioned them by name. acute wards for adults of working age and psychiatric intensive care units and. Patients gave positive feedback regarding the care they received. The majority of repairs and maintenance issues highlighted within the warning notice at the Bradgate Mental Health Unit had been fixed or resolved. The waiting areas and interview rooms where patients were seen were clean and well maintained. A full audit was scheduled for the end of June 2019. We had concerns about how environmental risks at CAMHS community sites were being assessed and managed. Demand for neurodevelopment assessments remained high. We listen to our patients and to our colleagues, we always treat them with dignity and we respect their views and opinions, We are always polite, honest and friendly, We are here to help and we make sure that our patients and colleagues feel valued, When we talk to patients and their relatives we are clear about what is happening. The opening hours were flexible to accommodate the needs of the people who use services and there was protected time within the open access services to assess people who were referred to treatment. There was a high staff sickness rate reported and managers did not always follow the managing sickness policy. Staff completed comprehensive assessments which included physical health checks and the majority of patients had completed risk assessments. Cover arrangements for sickness, leave and vacant posts were in place. There was good staff morale in services. We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. Staff showed us that they wanted to provide high quality care, despite the challenges of staffing levels and some poor ward environments. The lack of psychology was an issue highlighted at our 2018 inspection. There were improvements in ligature risk assessments. Interpreters were used when working with people who did not have English as a first language. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. With the exception of the liaison psychiatry service and the mental health triage car, managers were not supervising or appraising staff within the trusts supervision policy. View more Profession Occupational Therapist Service Learning Disability Grade Band 6 Contract Type Permanent Hours Full Time. We rated wards for people with learning disabilities as requires improvement because Staff had not managed all risks to patients in services. The average bed occupancy was low. We rated safe, effective, responsive and well led as requires improvement and caring as good. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. Staff were not always recording room and fridge temperatures in clinical rooms and out of date nutrional supplement drinks had not been appropriately disposed of. The waiting list had increased for those children and young people waitingfor thestart of treatment, following assessment. Patients were happy with the care they received and were very complimentary about the staff who cared for them. 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. A positive culture had developed since our last inspection. In rating the trust, we took into account the previous ratings of the core services we did not inspect on this occasion. The short breaks service was primarily set up to meet the needs of relatives and carers. We rated the trust overall for well-led as inadequate. They could undertake both internal and external training and were able to give feedback on service development. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. We found this across core services and within senior teams. Staff told us that the trust were recruiting for their vacancies and they hoped to have a full complement of staff in the coming months. Despite considerable effort with recruiting new members of staff for community inpatient areas, staffing was the top concern for all senior nurses and there was still a significant reliance on agency staff to fill shifts which could not be covered internally. Staff reviewed young peoples risk at every appointment and recorded this in the case notes. At least one standard in this area was not being met when we inspected the service and, Nottinghamshire Healthcare NHS Foundation Trust, Coventry and Warwickshire Partnership NHS Trust, Derbyshire Healthcare NHS Foundation Trust, Crisis Resolution and Home Treatment teams (CRHT). The majority of care plans were up to date. Staff had limited opportunities to receive specialist training. All incidents that should be reported were reported. We found a high number of concerns not addressed from the previous inspections. They provided feedback to staff via monthly ward meetings, MDT meetings supervision and handovers. We observed positive interactions between staff and children and the use of age appropriate language. There were no recorded regular temperature checks of the medication cupboard. In rehabilitation wards, staff did not always develop and review individual care plans. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. Staffing levels were not consistent across the two sites. We found a patient being nursed in the low stimulus area and their liberty was restricted. 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. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. the service isn't performing as well as it should and we have told the service how it must improve. We looked at the domains of safe, effective and responsive and we did not inspect all of the key lines of enquiry. Wards employed additional healthcare support workers to meet patient needs when needed. Staff felt supported by their managers and received regular supervision and annual appraisals. Staff had received specialist child safeguarding training and were able to make referrals when appropriate. The service did however, complete local audits and produced action plans for improvement in care. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. Care planning had improved in the crisis service. The trust was not commissioned to provide female psychiatric intensive care beds. Caring stayed the same, rated as good. There were safe lone working practices embedded in practice. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. We rated safe, effective, caring and responsive as good and well led as requires improvement. There was a strong, person-centred culture. : Staff completed and regularly reviewed and updated comprehensive risk assessments. Staff were given feedback after incidents had been reported. Team managers could not be assured of local performance around record keeping, care planning and patient involvement. Staff were provided with relevant information to care for patients safely. There were no records of capacity being assessed for patients consent to treatment, and no clear evidence of best interests decisions being agreed. The trust had robust systems in place which allowed staff to effectively report incidents. 10 July 2015. 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. The paperwork was difficult to find and not consistent. The needs and preferences of patients and their relatives were central to the planning and delivery of care with most people achieving their preferred place of care. Mental Health Act documentation was not always up to date on the electronic system. 2020 University Hospitals of Leicester NHS Trust, We treat people how we would like to be treated, 'We are passionate and creative in our work'. Staff were passionate about their roles and enjoyed working with the client group. 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. 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. Care plans were not always holistic and person centred. The summary for this service appears in the overall summary of this report. This was because the EDU batch refer sending four or five referrals at a time rather than when they arrive. The most common reason for delayed discharges was due to family choices which were beyond the control of the trust. The trust set target times from referral to initial assessment against the national targets of 28 to 42 days. Staff mostly felt positive about their managers and said that the services provided were well-led. Staff followed infection and prevention control practices and the community inpatient wards were visibly clean. Urgent and emergency care services across England have been and continue to be under sustained pressure. Clinic room temperatures were very hot, although one thermometer was above a radiator so would not give an accurate reading. Within the end of life service 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 own controlled drugs were not always managed and destroyed appropriately. Staff did not record consent to treatment, and capacity to consent and best interests decisions when these were needed. Bank Band 6 Speech and Language Therapist. 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