100% of staff were trained in how to safeguard children from harm. We received mixed feedback about staffing levels and several staffing reported concerns. One patient told us there wasnt enough to do at the Willows. This reduced continuity of care. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. One family member told us their relative could be challenging but they felt they were well cared for. Staff were not meeting the trusts target compliance rate for annual appraisals and mandatory training. There were processes in place for reporting and learning from incidents. A further review was an examination of processes and procedures within the trust for reporting investigations and learning from serious incidents requiring investigation. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. The trust had robust governance structures and they had assured any potential gaps or overlaps had been considered. The trust had not responded in a timely way to eliminate shared sleeping arrangements (dormitories). PIER staff reported having good links with universities and colleges regarding students needing early intervention services. Some facilities lacked essential emergency equipment. Some medication was out of date and there was no clear record of medication being logged in or out. Staff told us there were no service information leaflets available. Whilst staff were working hard to identify and manage individual risks, some ward environments were unacceptable. Staff explained that the figures collected around preferred place of death were collected as these were requested by the clinical commission group (CCG), although these figures were collected for services in the community; the ward based palliative care figures were not collated. We found positive multidisciplinary work and observed staff were supporting patients. The trust had made progress in oversight of data systems and collection. DE22 3LZ. There was detailed discussion and consideration of patients and carers needs. Staffing levels were below the expected level. There was an effective incident reporting process which investigated and identified lessons from incidents which were shared in most teams. We will be working with them to agree an action plan to improve the standards of care and treatment. Staff said the system was difficult to use and this had affected the information recorded in patients notes. We found that there were often delays in hospital beds being identified with some people placed out of area away from their family, friends and community. Interpreters were used when working with people who did not have English as a first language. Senior leaders in core services we inspected, had not maintained oversight of improvement across all wards of their services. Wards employed additional healthcare support workers to meet patient needs when needed. Staff morale on Griffin ward was low due to the announcement of the wards closure upon the completion of works on Phoenix ward. 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. As part of each inspection, we look at the way health services provide care and treatment to people. There was good staff morale in services. Crisis and relapse care plans were in place for the people that used services. Some patients had to be admitted to adult wards in the last year. ", Laiqaah Manjra, Corporate Affairs Administrator, "I progressed from being an apprentice to a Corporate Affairs Administrator - the NHS really supports staff development. The provider supplied lockers on the wards; however, these were not large enough to contain all possessions and patients did not hold keys. Staff were adequately supported and debriefed following incidents and could access further support if required. The rating for well-led in mental health services, improved to requires improvement. The service did not have any out of area placements, readmissions or delayed discharges. Patients were involved in the writing of their care plans and their views were reflected in the plans. Staff received feedback on the outcomes on investigation of complaints via their managers. wards for people with a learning disability or autism. The environment in the crisis service did not ensure confidentiality as rooms were not sound proofed and conversations could be heard outside the room. On Heather ward patients said that there was not enough ventilation on the wards. Staff empathised where a person had a negative experience and offered support where necessary. They did not have alarms or vision panels in the door. Staff consistently demonstrated good morale. There had been an increase in the number of CAMHS referrals over the last two years. Managers ensured they monitored the reporting and recording of incidents and complaints. Published Apply. There were robust lone working procedures in place. There were examples of people not being seen within service guidelines whilst receiving large doses of prescribed medication. The trust had maintained patients privacy and dignity at Short Breaks Services. Staff treated patients with respect and maintained dignity. The vacancy rate for the service was 12.9% and for band 5 and 6 nurses was 18.9%. The trust lacked an overarching strategy which everyone within the trust knew. The trust had not ensured all staff had received training in immediate life support. Services were planned and delivered in a way that met the current and changing needs of the local population. We saw an example of an SI investigation and also action taken from lessons learnt. Staff were caring, compassionate and kind towards patients. At this inspection, we looked at adult liaison psychiatry services at the Leicester Royal Infirmary site. Effective multi-disciplinary team working and joint working did not always take place across services. There was a clear vision for the service which staff understood. Assessments took place using nationally recognised assessment tools and staff provided a range of therapeutic interventions in line with National Institute for Health and Care Excellence (NICE) guidelines where staffing allowed this. Our overall rating of this trust stayed the same. Staff actively participated in clinical audits. Claim your Free Employer Profileto start telling your employer brand story to reach top talent. We found a high number of concerns not addressed from the previous inspections. Staff did not always feel connected to the wider trust. Bed occupancy for the last two quarters of 2013/14 was around 89%. Staff were caring and committed to providing high quality care and showed a person-centred approach. The service was not well led. Cleaning products in a cupboard in the waiting area was unlocked, which posed a risk to the young people. People using the service may not be able to get the speed of telephone response they needed in a crisis. The trust employed registered general nurses (RGN) to assist with assessment and management of physical healthcare needs for patients. Nurses and managers from LPT who were supported . The trust had significantlyreduced waiting times and the total numbersof children and young people waiting for assessments. Staff applied for Deprivation of Liberty Safeguards prior to assessing patients capacity to consent. 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. For example, furniture was light and portable and could be used as a weapon. 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. We do not put off making difficult decisions if they are the right decisions, We set common goals and we take responsibility for our part in achieving them, We give clear feedback and make sure that we communicate with one another effectively, We encourage and value other peoples ideas, We recognise peoples achievements and celebrate success. The service was not effective. We also inspected the well-led key question at provider level for the trust overall. We rated responsive and well led as requires improvement, and safe, effective and caring as good. 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. 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. Many staff knew the Trust values and were aware of the Chief Executive Officer. We rated the trust overall for well-led as inadequate. The trust had systems for staff to raise any concerns confidentially. This included environmental improvements, shared sleeping accommodation, response times to maintenance issues, care planning and access to relevant therapies in certain services. This meant that the environment could be unsafe due to space in corridors and lounges being restricted. Some key outcomes for children, young people and families using the service were regularly below expectations. 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. Staff were kind, compassionate and respectful towards patients. Your skills are needed for the NHS Reservist project. Senior managers were aware of the bed pressures in their acute and PICU service and had raised concerns with their commissioners. The trust had addressed the issues previously identified with the health based place of safety. o We are passionate and creative in our work. We were aware the local commissioning groups had not set targets for wait times. Staff had good knowledge of safeguarding processes and risk assessments were generally detailed, timely and specific. Leadership had been strengthened at Stewart House. They and their carers were kept informed and involved in their treatment and care. 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. Other professionals within the trust could not access this system. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. On Bosworth ward patient privacy was compromised when staff and patients entered the clinic room during examinations because there was no privacy curtain in place. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. We would expect patient involvement to be embedded at all levels of the trust, across as many departments as possible, in planning, review, evaluation and delivery. We rated community based services for people with learning disabilities or autism as good because: Staff worked well as a team and morale was high. Some staff had not received their mandatory training, supervision or appraisal. We rated it as requires improvement because: When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. We rated Leicestershire Partnership NHS Trust as Requires Improvement overall because: Published Care plans and risk assessments did not show staff how to support patients. Support workers were being trained in phlebotomy to improve timely blood testing. The service employed care navigators to help families and carers negotiate their journey through the various services provided. Clinic room temperatures were very hot, although one thermometer was above a radiator so would not give an accurate reading. Staffs were dedicated, passionate and patient focused. Staff received supervisions and appraisal. We rated families, young people and children services as good because: There were systems in place for reporting incidents and the service was able to demonstrate learning and sharing following incident investigations. Patients we spoke with knew how to complain. The service did not exclude patients who would have benefitted from care. Staff spoke of feeling supported by team leaders and team leaders felt supported by their managers. Staff mitigated the risks posed in the garden area by accompanying patients when they wanted to access the garden. The trusts pace for implementing equality and diversity initiatives across the organisation needed improvement. long stay or rehabilitation wards for working age adults. Staff had a good understanding of patients needs. We found a patient being nursed in the low stimulus area and their liberty was restricted. Five out of 25 care records showed that patient involvement had not been recorded. Patients waiting for their appointment in community based mental health services for adults of working age had access to a room unsupervised which held items which could cause harm. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. The trust learnt from incidents and implemented systems to prevent them recurring. Staff knew and understood their role in compliance with the Mental Health Act and Mental Capacity Act. 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. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). Acute patients had been sent to rehabilitation wards inappropriately. 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. We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels: Outstanding There was evidence of lessons learnt from incidents being shared with the team. We spoke with carers; they all stated that staff responded well when they contacted the service. Staff were very caring and sensitive to patients needs. Staff could not rely on performance reports being accurate. Staffing levels did not meet requirement in some community teams. o We treat others how we would like to be treated. 42% of staff on Phoenix ward and 27% Griffin ward had received clinical supervision. Staff received training in how to safeguard people who used the service from harm and showed us that they knew how to do this effectively. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. Staffing numbers were met but not always the right skill mix. 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. Two external governance reviews had been commissioned and undertaken. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. Our patients are at the heart of all we do and we believe that 'Caring at its Best' is not just about the . We rated it as requires improvement because: Our rating of the trust stayed the same. The school nursing service was understaffed and consequently there was an adverse impact on outcomes for children and young people and on staff morale. 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. Apply. The trust had well-developed audits in place to monitor the quality of the service. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. Morale was found to be poor in some areas and some staff told us that they did not feel engaged by the trust. Specialist community mental health services for children and young people, Community-based mental health services for older people, Community-based mental health services for adults of working age, Community health services for children, young people and families. 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. However at South Leicestershire clinical supervision take-up was low at 73%. Risks to people who used the service and staff were assessed and managed. Staff did not always feel actively engaged or empowered. There were not always enough staff who were suitably qualified and experienced to safely meet patients needs. Preventing infections Same sex accommodation Building better hospitals eHospital Programme Our values 'We treat people how we would like to be treated' 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 did not identify any significant community wide areas for improvement but did find many exemplary services provided by the trust. The service had plans in place to manage service disruption and major incidents. Engagement with external stakeholders had significantly improved since our last inspection. There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS Trust (LPT). Staff were trained appropriately within their speciality and new staff were supported to gain experience and skills. Staff received robust and detailed shift handovers, including information on patient risks, observation levels and physical healthcare concerns and how these were to be managed. Staff would still work with people who were on waiting lists so that they received some level of service. This included labelling, disposal, reconciliation and ward level audit. Staff routinely referred patients to access additional support for employment, housing, benefits and independent mental health advocacy. Leicestershire Partnership NHS Trust 2.5K subscribers We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. The acute service contained large numbers of beds in bed bays accommodating up to four patients. Staff expressed pride in their ability to work as a team and managers told us they were proud of achievements. However, delay in paperwork completion was also responsible for a large proportion of delayed discharges. 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. There were a high number of patients on the waiting list for treatment in the specialist community mental health services for children and young people. 83% of staff received mandatory training. Patients were happy with the care they received and were very complimentary about the staff who cared for them. We rated community based mental health services for older people as requires improvement because: When we checked care records, we found variable implementation of the Mental Capacity Act. 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. In all instances police transported the patient to the HBPoS. The number of visits was not always manageable. The trust had key roles in the development of health and social care system working, and collaboration with other care providers to improve provision of mental health services. However, staff did not consistently record patients views in their care plan or ensure they had received a copy. Some seclusion rooms had environmental concerns at Belvoir and Griffinunits, and Watermead wards. The trust had not made sufficient progress in addressing the concerns raised at the previous inspection in March 2015. Local audits were not completed regularly. The teams were able to respond quickly when patients or carers telephoned with problems. Children and young people felt listened to in a non-judgmental way and told us they felt respected. 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. In two services, staff were not always caring towards patients. This did not protect the privacy and dignity of patients when staff undertook observations. Apply. The team engaged with patients who found it difficult or were reluctant to engage with mental health services. Another patient said on their comment card they did not see enough of the occupational therapist. There were effective systems in place to audit and monitor physical health care records. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. There were appropriate arrangements in place for the safe management of medicines. The trust was not meeting its target rate of 85% for clinical supervision. Staff were not supervised in line with the trust's policy. This is an exceptional opportunity to share your talents and expertise to make a positive difference to the lives of the one million people served by the Trust. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. Jan 4. Staff were unaware of any service specific strategic direction. Find out more Knitting therapy keeps cats and dogs warm 23 Dec 2022 News Patients capacity to consent to their treatment had not been assessed in some cases, Patients physical health was checked on admission but patients did not have access to a GP for ongoing monitoring or treatment of their health, The telephone for patients use was situated in a corridor and did not provide patients with sufficient privacy, We identified that staff did not always take a person centred approach to care and did not always take positive risks when this might have been indicated, The forensic services staff said they felt lost and did not know where they were going strategically, Arrangements for medication management did not keep all patients safe which meant that some patients did not receive the follow-up care they should have received and some patients received medication that was not covered by consent documents, The systems that manage patient information (electronic and paper files) did not support staff to deliver effective care and treatment in line with the Mental Health Act, The granting of Section 17 leave for patients detained under the Mental Health Act at Stewart House did not follow the Trusts documented procedure (dated September 2014) and also contravened the Mental Health Act Code of Practice (2008 and 2015), Consent to Treatment could not be easily established for a number of patients because the documentation could not be located by staff, Patients told us that they were satisfied with the care they received and we observed warm, positive interactions between staff and patients, The Willows had good systems in place to collect, monitor and act upon patient feedback, Managers were able to demonstrate that they took poor staff performance seriously and they were actively dealing with this, Morale amongst staff we spoke with was generally good and staff were clear about their roles and responsibilities. There were delays in maintenance and repairs in some areas. By doing this it will help us achieve our vision of creating high quality, compassionate care and wellbeing for all. Our HIV/AIDS Services program is in need of volunteers to help deliver . There were effective methods for obtaining feedback from service users and carers and feedback was acted upon. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. Significant vacancy rates and high sickness levels put additional pressure on substantive staff. Patient records were electronic, up to date and available to the multidisciplinary team to enable an integrated approach to care and treatment. The trust had developed new processes and redesigned and improved data validation. When staff deemed a patient lacked capacity there was no evidence that the best interest decision-making process was applied. Complaints were well managed to ensure a timely response and aid learning. Staff completed risk assessments that were thorough and had been reviewed following incidents. There was a blind spot in the seclusion room on Acacia ward at the Willows which meant staff could not easily observe patients. Staff interacted with patients in a caring and respectful manner. Mental Health Act documentation was not always up to date on the electronic system. Staff said this made them feel safe whilst visiting patients at home or whilst undertaking activities with patients in the community. All incidents that should be reported were reported. During the depot clinic staff did not close privacy curtains when patients were receiving depot injections. The majority of repairs and maintenance issues highlighted within the warning notice at the Bradgate Mental Health Unit had been fixed or resolved. Not all families and carers knew they could attend virtual ward meetings and care programme approach meetings. 10 July 2015. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. We saw that consent was gained from people in relation to their care and future wishes. Managers had a system in place for tracking and learning from safeguarding incidents and other reportable events. All wards had developed their own systems to improve medicines management in their areas. Patients said staff who cared for them were knowledgeable, professional and friendly. Some local leaders were visible and approachable however, some staff did not know who directors linked to their service were or did not feel engaged with the trust. We saw numerous interactions between staff and patients with very complex needs and staff managed extremely challenging situations with knowledge and compassion. We want to hear from you on how to improve our service and provide the best care possible. They told us that staff were kind and caring. Five of the six services in this core service were in breach of these targets. Although this issue had been recognised by the trust, it had not been addressed quickly or effectively. We saw evidence of good team working during our inspection. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. Our HIV/AIDS services program is in need of volunteers to help deliver in bed bays accommodating up to and! May not be able to respond quickly when patients were happy with the mental health Act mental. Were appropriate arrangements in place for the trust knew employment, housing benefits. Based metal health services for adults of working age, mental health advocacy program is in of. Follow a set of principles to ensure a timely way to eliminate shared arrangements... 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