Find out more Knitting therapy keeps cats and dogs warm 23 Dec 2022 News Staff were not aware of how this might affect the safety and rights of the patients. The trust had developed new processes and redesigned and improved data validation. There were risk assessments and plans in place to keep people and staff safe. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS Trust (LPT). Improvements were needed to make them safer, including reducing ligatures, improving lines of sight and ensuring the safety and dignity of patients. They were supported to have training to help them to develop additional skills and expertise. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. Some risk assessments had not been reviewed regularly at The Grange. Record keeping at Stewart House was disorganised. The most common reason for delayed discharges was due to family choices which were beyond the control of the trust. There was high dependence upon bank and agency staff to ensure safe staffing on the wards. The service was responding to complaints and implementing systems following these, however the trust waited for these complaints to prompt improvements in the service. 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). Improvements were noted in some wards in core services but not all. People using the service had limited access to psychological therapies and there were no psychologists working within the service. Community meetings and patient involvement in the services did not always take place. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. Two patients we interviewed on Ashby and Heather wards told us that staff did not always knock on their bedroom doors before entering. One review was in response for the delivery of actions for the 2018 CQC inspection. 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. There had been periods of understaffing. We use cookies to improve your experience on our website. Staff treated patients with kindness, dignity, and respect. At the Willows, six out of 19 patients risk assessments had not been updated. 56% of individual care plans were not up to date, personalised or holistic. The trust had not met all the required actions to reduce and mitigate ligature points across wards following the previous inspection in March 2015. 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. We looked at 20sets of seclusion recordsandfrom17 records,staff were notrecording seclusion, in line with the Mental Health Act Code of Practice. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. Staff knew and understood their role in compliance with the Mental Health Act and Mental Capacity Act. Access to treatment for specialist community mental health services for children and young people, Maintaining the privacy and dignity of patients and concordance with mixed sex accommodation, Seclusion environments and seclusion paper work. Following the appointment of a new chief executive a new trust board was formed. Incidents were on the agenda at the clinical governance meetings. Risk assessments were brief, did not always contain sufficient information and were not updated regularly. Ward matrons told us they shared outcomes from incident investigations in team meetings for shared leaning. We received mixed feedback about staffing levels and several staffing reported concerns. Staff mitigated the risks posed in the garden area by accompanying patients when they wanted to access the garden. Leicestershire Partnership NHS Trust Location Leicester Salary 27,055 to 32,934 a year Closing date 2 Feb 2023. Staff had been given lone worker safety devices to ensure their safety. We found evidence that patients, at the Bradgate Mental Health Unit, and in some instances, staff, smoking in ward areas. At least one standard in this area was not being met when we inspected the service and The introduction of activities co-ordinators at Coalville Hospital had improved the patients experience on the ward and increased the activities that were conducted on a day to day basis. Staff were observed to be caring and responsive to patients. Governance structures were in place and risks registers were reviewed regularly. Staff usually met patients in their homes or in the community. Staff were confused about Deprivation of Liberty standards and paperwork was incomplete. We rated community health inpatient services as requires improvement because: Despite considerable effort with recruiting new members of staff, staffing was the top concern for all senior nurses and there was still a significant reliance on agency staff to fill shifts which could not be covered internally. There were safe lone working practices embedded in practice. Home - Leicestershire Partnership NHS Trust Creating high quality, compassionate care and wellbeing for all. There were not always enough staff who were suitably qualified and experienced to safely meet patients needs. We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. . Staff described managers as supportive and approachable. Patients were supported to meet their religious and cultural needs. The ratings from the inspection which took place in November 2018 remain the same. A childrens adolescent mental health crisis service had been developed and commenced in April 2017. Cover arrangements for sickness, leave and vacant posts were in place. However, staff did not consistently record patients views in their care plan or ensure they had received a copy. Many of the actions listed included plans to review process, establish an approach, or to develop areas. We rated the trust as inadequate for well-led overall. No rating/under appeal/rating suspended The trusts pace for implementing equality and diversity initiatives across the organisation needed improvement. Three patients told us of times when staff had been rude, threatening and disrespectful towards them. 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 transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. This was highlighted in the previous inspection. Staff were not meeting targets for the assessment and assessment to treatment of urgent referrals and six week routine referrals. The trust confirmed staff delivering end of life care were involved in bi-annual record keeping, safeguarding and clinical supervision audits. Watch our short film to find out more: Find out about how we are improving the quality and safety of our services through our Step up to Great strategy, and watch our animation to see more: We are also pleased to present our clinical plan for the trust. Therefore, staff could ensure accurate measures of blood pressure were being recorded. The trust had ensured patients privacy and dignity were maintained when receiving physical health observations at the Bradgate Mental Health Unit. Supervision, appraisals and training compliance did not always meet the trust standard. Managers had introduced a duty clinician to manage caseload sizes and reduce patients risks. All hospitals were running at a high bed occupancy level of above 85% which national data has linked to increased risk of bed shortages as well as an increase in healthcare associated infections. The trust board, heads of departments and senior leaders had access to the information they needed to manage risk, issues and performance across the trust. Recruitment was in progress for 10 new healthcare support workers. There were systems for lone-working in place including a red folder process that kept workers safe. Nursing staff had large caseloads. The dignity and privacy of patients across three services we visited was compromised. Managers did not ensure that the staff were receiving regular clinical supervision and had not met the trust target compliance rate of 85%. Staff maintained a presence in clinical areas to observe and support patients. The trust was told to address the arrangements for eliminating dormitories at our last inspection in 2018 and work had started on one ward in March 2021. Staff had been trained with regards to duty of candour and in line with the trust policy. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. 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. There was an on-call rota system for access to a psychiatrist 24 hours a day. There was a mobile phone in the ward office that patients could use for private calls, for example to a solicitor. The governance processes had not picked up the issues around repairs, medicines and cleanliness. The cold chain processes to ensure optimal conditions during the transport, storage, and handling of vaccines was outstanding. The trust had not fully articulated their vision for how they operated as a trust. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. The service had seven vacancies for qualified nurses andthree for non-registered nurses. Shifts were not always covered with sufficient staff, or with staff who had the appropriate qualification and experience for the role. Where applicable, we have reported on each core service provided by Leicestershire Partnership NHS Trust and these are brought together to inform our overall judgement of Leicestershire Partnership NHS Trust. Some actions were required to ensure adherence with the Mental Health Act. A carers group was available to give support. 100% of staff were trained in how to safeguard children from harm. This did not protect the privacy and dignity of patients when staff undertook observations. Staff described various ways in which they received information from the board and other governance meetings. The Trust should ensure that the transition is in line with best practice in future. Five out of 25 care records showed that patient involvement had not been recorded. The trust had systems for staff to raise any concerns confidentially. Incidents and near misses were reported and learning from these was shared. Staff were adequately supported and debriefed following incidents and could access further support if required. To find out more, review our cookie policy. Services were planned and delivered in a way that met the needs of the local population, for example the Diana Service and the Family Nurse Partnership. Governance processes had improved since our last inspection and operated effectively at trust level to ensure that performance and risk were managed well. Staff were not aware of the trusts visions or values. Patient records were electronic, up to date and available to the multidisciplinary team to enable an integrated approach to care and treatment. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. Admission to the unit was agreed with commissioners. Staff used strategies to maintain patients safety which had an adverse effect on their dignity and privacy. The trust admitted male patients to female areas of the mixed wards when male beds were unavailable. Staff demonstrated commitment to delivering high quality end of life care for their patients. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. Our leadership behaviours framework set the standards of expectation we aspire to in our daily work. Consent to care and treatment was obtained in line with relevant guidance and legislation. The quality of data was variable, for example training statistics were not always reliable. This meant board members were not able to monitor the trusts assertions that there were strong systems and processes in place for identifying and reporting serious incidents, including deaths, or monitoring whether reviews and investigations were completed fully. Staff working within criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. We observed positive interactions between patients and staff. Staff sourced PICU beds when needed from other providers, in some cases many miles away. Staff were given opportunities to expand their knowledge and develop their roles. Waiting lists for psychological services were high and currently on the Trusts risk register. Adult liaison psychiatry services are provided by Leicestershire Partnerships NHS Trust (LPT), the mental health trust in the Leicester, Leicestershire and Rutland Integrated Care System. 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. The service was meeting its target in this area. This meant some fundamental standards were not being met. Therefore, overall, eight of the trusts 15 services are now rated as good, five as requires improvement and two as inadequate. Were being recorded three patients told us they shared outcomes from incident investigations in team meetings for leaning... In November 2018 remain the same for psychological services were high and currently on the trusts oversight ward. No medicines management input from pharmacy within the service used evidence based, best guidance. 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