Staff were included in service developments and involved in listening into action projects for service improvement. Good communication skills are key. Palliative care nurses conducted holistic assessments for patients and provided advice around social issues, for example, blue badges for disabled parking. The trust supported a BAME network (black and minority ethnic) however, given the diversity of the geographical area of the trust, they had not significantly developed its agenda or work streams since our last inspection. Patient records were electronic, up to date and available to the multidisciplinary team to enable an integrated approach to care and treatment. The trust did not provide data to demonstrate medical staff appraisal compliance. Let's make care better together. Medicine management training sessions had been undertaken with inpatient ward sisters and charge nurses. The feedback from patients and relatives was mainly positive about the staff providing care for them. When community meetings occurred, staff did not include details of outcomes to evidence change. Watch our short film to find out more: We Are LPT Share From a National Health Service (NHS) organisation Watch on Our strategy There were no vision panels on patient bedrooms. Despite the issues we found with storage, disposal, labelling and controlled drugs, the trust had made improvements to prescribing of medication and had successfully implemented e-prescribing processes trust wide. There were no records of capacity being assessed for patients consent to treatment, and no clear evidence of best interests decisions being agreed. At Melton, Rutland and Harborough and Charnwood there was a lack of audits and little focus on quality and improvement. Curtains separated patients bed areas and the rooms were not secured to allow free access; meaning that patients could have their property removed by other patients. The environment in some services was poor, not well maintained and not kept clean. Governance structures were in place and risks registers were reviewed regularly. Staff did not always feel actively engaged or empowered. We did not rate this inspection. This did not protect the privacy and dignity of patients when staff undertook observations. The trust did not always manage the admission of patients into mixed sex environments well. However at South Leicestershire clinical supervision take-up was low at 73%. We found that while performance improvement tools and governance structures were in place these had not always brought about improvement to practices. Staff updated risk assessments and individualised care plans regularly. Bed occupancy for the last two quarters of 2013/14 was around 89%. Staff were unable to show us evidence of clinical audits or the basis of evidence based practice in end of life services. Staff received regular supervision and most had received an appraisal in the last 12 months. The trust was not commissioned to provide female psychiatric intensive care beds. Staff had the right qualifications, skills, knowledge and experience to do their job. We're always looking for the best. Staff were not in receipt of regular supervision in order to discuss training needs, developmental opportunities or performance issues. A family member spoke about enjoying regular meetings in the service gardens with their relative. We heard many examples of interesting innovation projects and work that staff groups had done which impacted on and improved patient care. There was no performance data dashboard to gauge the performance of the service. Wards provided safe environments where patients felt secure. Staff consistently demonstrated good morale. . The trust provided patients with accessible information on treatments, local services, patients rights and how to complain across all services. In rehabilitation wards, staff did not always develop and review individual care plans. Discharge planning was considered as part of board rounds although discharge planning paperwork was not used consistently. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Patients and carers confirmed in most services they had not received copies of care plans. Patients were involved in the writing of their care plans and their views were reflected in the plans. Staff were kind, caring and respectful towards patients. This impacted on patients requiring care. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. Staff told us they worked as a team and enjoyed their jobs. Equality diversity and inclusion matters had been a focus of the new trust leadership team. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. The service was not well led. Within mental health services the quality of care plans was variable. One patient at Stewart House told us other patients made comments around their protected characteristics and staff had not care planned the needs of the patient. There were processes in place for reporting and learning from incidents. In July 2019, the new trust board formed a buddy relationship with a mental health and community health service NHS trust in Northamptonshire (Northamptonshire Healthcare NHS Foundation Trust NHFT) following the previous inspections in 2018 and 2019. Staff completed comprehensive assessments which included physical health checks and the majority of patients had completed risk assessments. Environments were visibly clean and welcoming. The trust had reviewed existing systems and processes identified improvements and implemented changes. 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. Emails and the trust intranet also provided staff with this information. There was a risk that young people may not get assessed out of hours in a timely manner by staff with CAMHS experience. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. Maintenance teams did not undertake repairs in a timely way and not all areas used by patients were clean. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. We observed positive interactions between patients and staff. There were problems with access to the electronic system owing to ongoing building works. 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 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. Staff had not routinely recorded whether they had given patients copies of their care plans and we saw this in a considerable number of patient records we sampled. There was minimal evidence of patient involvement in care plans. Therefore, the trust could not be sure staff received information to support best practice and change in a timely manner. 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. Patients own controlled drugs were not always managed and destroyed appropriately. The waiting areas and interview rooms where patients were seen were clean and well maintained. 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. The service was caring. 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. Staff told us they involved patients carers but there was little evidence of this in care records. 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. There had been a change in leadership and a review of key performance indicators (KPIs) with commissioners. Patients felt safe. The acute service contained large numbers of beds in bed bays accommodating up to four patients. Care and treatment was planned and delivered in line with evidence based guidance and standards, and systems were in place to ensure trust policies reflectedthe latest guidance. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. They could undertake both internal and external training and were able to give feedback on service development. They later told us that this had been an ongoing concern for around five years. Staff were kind, compassionate and respectful towards patients. 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. Managers shared the outcome of complaints with their ward teams. Staff mitigated the risks posed in the garden area by accompanying patients when they wanted to access the garden. We rated it as requires improvement because: When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. This included environmental improvements, shared sleeping accommodation, response times to maintenance issues, care planning and access to relevant therapies in certain services. The trust had robust arrangements in place for the receipt and scrutiny of detention paperwork. Some improvements were seen in seclusion documentation and seclusion environments. 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 saw information in the service reception areas about older peoples care. Staff involved patients in the ward review and community meetings. Patients were full of praise for staff and the care and support they offered. Staff received Mental Capacity Act 2005 and Deprivation of Liberty Safeguards Some staff did not demonstrate a good understanding of the Mental Capacity Act. Local leaders were visible and had the skills and knowledge to perform their roles. Patients occasionally attended the service. This meant that some staff felt insecure. Managers used a tool to identify and review staff numbers in accordance with need. Their service users and staff are extremely important to them. Patients reported they were treated with dignity and respect. All areas were very clean, fresh smelling and fit for purpose. Staff used the mental health clustering tool, which included Health of the Nation Outcome Scales (HoNOS) to assess and record severity and outcomes for all patients. We remain concerned that a significant period had passed and the trust had not improved access to psychology for patients and staff. 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. Staff felt supported by their immediate managers but felt disaffected with trust senior management. 27 February 2019. The local managers monitored the environment for staff, carried out local audits and checked performance of staff on a regular basis. Data provided by the trust showed there were four episodes of seclusion from February 2016 to July 2016. The trust had a limited approach to patient involvement. The trust had not made sufficient progress in addressing the concerns raised at the previous inspection in March 2015. There were improvements in ligature risk assessments. Mental health crisis services and health-based places of safety had an overall mandatory training compliance rate of 82%. The trust confirmed contracts for patient transport and local authority care packages were monitored and work was ongoing with partner organisations to improve services for patients. Whilst staff monitored patients risk on the waiting lists, the length of time to wait was of concern, in addition to the services lack of oversight and management of this issue. Patients families and carers were positive about the care provided. This environment was pleasant and well equipped. Staff were quick to sort out requests and problems for patients. A dual paper and electronic recording system meant that some information was not accessible to all of the staff that might need it. long stay or rehabilitation wards for working age adults. We are proud of our 5,400 staff and together we aim to . Administrative staff had not received specific mental health awareness training to assist them when taking calls for people who were acutely unwell and in crisis. The process for monitoring patients on the waiting list in specialist community mental health services for children and young people had been strengthened since the last inspection. There were delays in staff delivering treatments to young people and young people following assessment. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. There were no pharmacy services within the community mental health teams or crisis team. spoke with 15 family members or carers of patients, reviewed the mental health act detention papers of 23 patients and seclusion records of 10 patients, and. 8 February 2017. : Staff completed and regularly reviewed and updated comprehensive risk assessments. We did not speak to any patients using the service at the time of the inspection. Staffing skill mix was appropriate to need overall. Staff we spoke with were unaware of incidents and learning on other wards across acute wards for adults of working age; this was highlighted as an issue at our inspection in 2018. the service is performing well and meeting our expectations. ALT. Staff on the acute wards were not consistent with searching patients upon return from unescorted leave as some patients had managed to take lighters onto four of the wards. Patients experiencing mental health crisis and distress did not have access to a fully private area in these environments. We have not inspected against other requirement notices that were issued at the same time; therefore, all requirement notices from the last inspection remain in place. There was a range of treatment and activity delivered by skilled and experienced staff. There was an unstructured, non-mandatory approach to formal end of life training for community hospital staff. Staff said this made them feel safe whilst visiting patients at home or whilst undertaking activities with patients in the community. 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. NG3 6AA, In ", "I like that I'm able to help both staff and service users. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. Staff would still work with people who were on waiting lists so that they received some level of service. Families and carers said the wards were clean. Four young people told us they felt involved in developing their care plan however, they had not received a copy. Nursing staff had large caseloads. Browser Support There's no need for the service to take further action. Community mental health services with learning disabilities or autism, Wards for older people with mental health problems. She embraces the principles of the employee as a consumer (a person who makes the choice of where to work by considering a broadly defined value proposition, inclusive of financial, work, and social aspects of life) and agile organization (a workforce that continually evolves to meet the changing interests and needs of team members and customer.) Our rating of this service stayed the same. Plans were shared with family and carers. The acute mental health wards had two and four bedded dormitories which did not promote privacy and dignity. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. Two patients we interviewed on Ashby and Heather wards told us that staff did not always knock on their bedroom doors before entering. Patients had access to advocacy. A further review was an examination of processes and procedures within the trust for reporting investigations and learning from serious incidents requiring investigation. The trust had systems for promoting, monitoring and responding to complaints. Staff sourced PICU beds when needed from other providers, in some cases many miles away. Staff actively participated in clinical audits. 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. The Trust had a number of unfilled positions being covered by long-term bank staff. Managers had introduced a specialist child and adolescent mental health traffic light system, a red, amber and green rating tool for managing risk. This meant that patients could have been deprived of their liberties without a relevant legal framework. The summary for this service appears in the overall summary of this report. We found good multidisciplinary working on wards. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. Data could not be relied upon to measure service performance or improvement.Data collection and interpretation did not include key pieces of information for example number of delayed or missed visits. The trust confirmed the service line was contracted to provide bed occupancy at 93%. 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'. We saw numerous interactions between staff and patients with very complex needs and staff managed extremely challenging situations with knowledge and compassion. The trust had a range of information displayed on the ward and the hospital site relating to activities, treatment, safeguarding, patients rights and complaint information. 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. A new chief executive was appointed as a shared role between the two trusts. The trust had no auditing system to measure performance in order to improve the service. The ratings from the inspection which took place in November 2018 remain the same. At least one standard in this area was not being met when we inspected the service and Improvements had been made to the seclusion facilities, and further improvements were planned across the service to improve patient experience and promote privacy and dignity. Managers changed practice because of this. Inpatient and community staff reported difficulties with getting inpatient beds. The policy for rapid tranquillisation was not in line with national guidance. Patients and carers were involved in assessment, treatment and care planning. The trust did not ensure that they meet set target times for referral to initial assessment, and assessment to treatment in the majority of teams. The adult community therapy team did not meet agreed waiting time targets. Leicester, United Kingdom. The service was meeting its target in this area. Complaints were well managed to ensure a timely response and aid learning. The trust had a variety of measures in place to ensure that processes and reporting to board were not delayed. Patients were happy with the care they received and were very complimentary about the staff who cared for them. This has been brought together using feedback from staff, service users and stakeholders to evolve our work so far into a clearer trust-wide strategy for all areas: Step Up to Great.Through Step Up to Great we have identified key priority areas to focus on together. The trust ensured that people who used services, the public, staff and external partners were engaged and involved in the design of services. We did not inspect the whole core service. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. Staff did not effectively complete risk assessments for patients, manage a smoke free environment, or share information about incidents or share learning from incidents within teams, across services or between services in the trust. Staff made individualised risk assessments which were regularly updated and followed best clinical practice. This monthly award is about recognising members of staff who have gone the extra mile. We spoke with five informal patients at the Bradgate Mental Health Unit who were unaware of what they could and could not do as an informal patient. Procedures for incident management and safeguarding where in place and well used. This employer has not claimed their Employer Profile and is missing out on connecting with our community. The assessment and resulting care plans were personalised, holistic and recovery focussed. The trust ceased mixed sex breaches by maintaining male and female only weeks. The service had seven vacancies for qualified nurses andthree for non-registered nurses. A lack of availability of beds meant that people did not always receive the right care at the right time and sometimes people were moved, discharged early or managed within an inappropriate service. There was access to interpreters and staff were aware of how to access them. Beds were not always available for people living in the trusts catchment area. The service was recovery focused and had developed pathways with other agencies to build on recovery capital for people who used the service. We rated well-led as inadequate, safe, effective, and responsive as requires improvement and caring, as good. This was: We also assessed if the organisation is well-led and looked at areas of governance, culture, leadership capability and improvement. Patients we spoke with knew how to complain. The Trust is proposing to close Ashby and District Community Hospital, a proposal which is opposed by Ashby Civic Society who do not accept that 'virtual wards' and 'intensive community support' can fully deliver the reductions on hospital . Our HIV/AIDS Services program is in need of volunteers to help deliver . There was no funding for staff to provide activities so patients had limited access to activities of their choice during their stay. ", "I have developed so many new skills over the years working in the NHS, going from a healthcare assistant to a nursing associate. Assessments and care planning took place for patients needs. The trust had made improvements to the clinical environments since the last CQC inspection. Where English was not the first language of patients, the service provided interpreters. To participate in this scheme, you'll need to do the following: You will need to refer your friend using the form below titled "Refer Your Friend." The psychiatric outpatients was responsible for 2094 of the breaches, with city east reporting the highest of these breaches at 429.2. Staff had been given lone worker safety devices to ensure their safety. The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. The NHS is founded on principles and values that bind together the diverse communities . Patients knew how to make a complaint or raise a concern and complaints were taken seriously. Some wards and patient areas had blind spots, where staff could not easily observe patients. We found significant issues with trust level governance, oversight of environments, a failure to address keys issues and a lack of pace with delivering essential improvements. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. Patients felt safe and said they were checked regularly by staff. Staff we spoke with demonstrated their dedication to providing high quality patient care. University Hospitals of Leicester NHS Trust. On acute wards, not all informal patients knew their rights. Staff were not always recording their supervision on the electronic system so we could not be assured they were receiving it regularly. The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. The service had 175 delayed discharges between August 2015 and July 2016, which accounted for 43% of the trusts total delayed discharges. For example, Ashby, Aston, Bosworth and Thornton Wards had been converted to single sex only accommodation to ensure compliance with the Department of Health and Mental Health Act 1983 guidance on mixed sex accommodation. The trust had not fully addressed the issues of poor lines of sight in wards. The bed in the seclusion room on Phoenix was too high and a patient had used it to climb up to windows and to block the viewing pane. Trust staff working within the had remote access to electronic systems used by the trust. Staff told us the trust was a good place to work. The needs of people who used the service were assessed and care was delivered in line with their individual care plans. The trust told us patients across mental health inpatient wards had commented positively about their experience of care. Therefore, staff could ensure accurate measures of blood pressure were being recorded. The quality of some of the data was poor. Another relative said their relative was a changed person since going to the Willows and they were able to go home last Christmas. Patients and staff are extremely important to them executive was appointed as a shared role between the trusts... Knew how to make a complaint or raise a concern and complaints were well managed to ensure processes. Not promote privacy and dignity where English was not the first language of patients, the trust had a approach! Cared for them working with patients, leicestershire partnership nhs trust values service used evidence based practice in end of life.. Which took place in November 2018 remain the same on waiting lists so that they received some level service... 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