There was an on-call rota system for access to a psychiatrist 24 hours a day. Patients own controlled drugs were not always managed and destroyed appropriately. 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. Managers had introduced a duty clinician to manage caseload sizes and reduce patients risks. The senior occupational therapist was trying to recruit to vacant occupational therapy posts. The trust had begun replacing hydraulic beds on the wards and had agreed plans for the replacement of further hydraulic beds across the site over a four-year period. Local leaders were visible and had the skills and knowledge to perform their roles. The ward had sufficient staff to provide care and treatment to patients. Improvements were noted in some wards in core services but not all. The acute wards for adults of working age had not complied with all of the required actions following the previous inspection of September 2013. 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. There was minimal evidence of patient involvement in care plans. Patients were happy with the care they received and were very complimentary about the staff who cared for them. Overall, the trusts compliance rates for mandatory training was 87%. long stay or rehabilitation wards for working age adults. The trust had a patient involvement centre, which was pleasant, well-equipped and supported involvement from friends and family. Staff received regular supervision and most had received an appraisal in the last 12 months. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. To find out more, review our cookie policy. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. Staff held multidisciplinary team meetings weekly and these were attended by a range of mental health professionals. The trust had not met all the required actions to reduce and mitigate ligature points across wards following the previous inspection in March 2015. There was a clear vision for the service which staff understood. Trust staff working within the had remote access to electronic systems used by the trust. 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. Two core services did not promote patient centred care in all aspects of care delivery. Funding had been secured for increased staff with specialist skills. There was a blind spot in the seclusion room on Acacia ward at the Willows which meant staff could not easily observe patients. Four young people told us they felt involved in developing their care plan however, they had not received a copy. Risk assessments were completed during the initial assessment at the CRHT team. 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. There had been a change in leadership and a review of key performance indicators (KPIs) with commissioners. Significant vacancy rates and high sickness levels put additional pressure on substantive staff. There were clear responsibilities, roles and systems of accountability to support good governance and management. However, ligature points remained. There had been only one out of area placement over 14 months. 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. For example, issues found in risk assessments, care plans and environmental concerns had been addressed in some services, but not all since our last inspection. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. We did not identify any significant community wide areas for improvement but did find many exemplary services provided by the trust. People using the service may not be able to get the speed of telephone response they needed in a crisis. The patient incident team carried out a review of serious incident reporting and made changes to improve the reporting process, categorise incidents in a better way and improved reporting of safeguarding. Mandatory training that fell below 75% included adult immediate life support, adult basic life support, safeguarding children level 3 and fire safety awareness. The trust had maintained patients privacy and dignity at Short Breaks Services. This environment was pleasant and well equipped. 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. Often patients were admitted to hospital out of the area especially if they need a more intensive support. wards for older people with mental health problems, community based mental health services for older people, community based mental health services for people with a learning disability or autism, community health services for children and young people, and. Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. The phones on each ward were in communal areas; the phone on Griffin ward had not been moved since the last inspection, although it had a privacy hood installed. They could undertake both internal and external training and were able to give feedback on service development. Staffing levels did not meet requirement in some community teams. However, staff did not consistently record patients views in their care plan or ensure they had received a copy. 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. It promises that we will lead with compassion and inclusivity, with the health and wellbeing of our staff at the heart of all we do. The learning disability community team had not met the six week target for initial assessment on average it was six days over. We found positive multidisciplinary work and observed staff were supporting patients. One patient told us that staff had been rude, threatening and disrespectful towards them, which a relative also confirmed. Staff had been given lone worker safety devices to ensure their safety. Staff provided psychological therapies as recommended by NICE such as group work and cognitive behavioural therapy. Patients were able to access hot and cold drinks any time during the day. Care records showed that physical health examinations were completed upon admission and there was ongoing monitoring of physical health across the trust. Leadership behaviours were fostered, and development of staff was encouraged. 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. There were no recorded regular temperature checks of the medication cupboard. Any other browser may experience partial or no support. We carried out this unannounced inspection of Leicestershire Partnership NHS Trust because at our last inspection we rated two mental health services provided by this trust as inadequate, four mental health services and one community health service as requires improvement. The short stay services did not comply with the guidance on the elimination of mixed sex accommodation. Leicestershire Partnership NHS Trust | 5,409 followers on LinkedIn. At the Valentine Centre improvements had been made to the storage of cleaning materials. Patients had opportunities to continue their education. Staff we spoke with were proud to work within the adult psychiatric liaison team and proud to show us the work they did and the service they provided. 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. Two patients and a carer gave feedback indicating the systems were not always robust. 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. The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. The trust also collected feedback from patients in a variety of ways, including surveys, iPads, community forum meetings and the Friends and Family Test. Senior leaders in core services we inspected, had not maintained oversight of improvement across all wards of their services. We did not inspect the following areas of this core service: We did not rate this service at this inspection. Staff carried out physical observations in public areas in one service, and staff did not always record or explain why some observations of patients were required. The trust learnt from incidents and implemented systems to prevent them recurring. 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. The trust was not commissioned to provide a female PICU and have identified the need with their commissioners. Capacity assessments were unclear. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. Staff had received specialist child safeguarding training and were able to make referrals when appropriate. Staff identified this was due to the management of change process and current work being undertaken by an outside organisation to identify more effective ways of working. However three staff said that information from incidents and learning points was not always fully shared. There's no need for the service to take further action. For over 20 years we've ensured that health related grants, policies, and services exist to help give everyone the opportunity to be healthy - especially the most vulnerable. The trust mostly used surveys to gain feedback and we saw limited evidence of face to face engagement with patients about service delivery and improvement. The service was not effective. We also inspected the well-led key question at provider level for the trust overall. We rated community health services for adults as requires improvement because. There was a good level of occupational therapy input and good support to help maintain patients physical health. Two patients discharges were delayed at The Agnes Unit because the commissioners could not find specialist placements. Our overall rating of this trust stayed the same. A report on the inspection was . The service did however, complete local audits and produced action plans for improvement in care. Staff were trained appropriately within their speciality and new staff were supported to gain experience and skills. There were significant waiting times for a range of further assessments and treatments including psychology, school observations, psychiatric opinion and group work. Record keeping was poor in some services. Flexible working arrangements allowed staff to work effectively in teams, particularly when there were not enough staff in some professional groups such as speech and language therapists, occupational therapists and psychologists. Staff updated risk assessments and individualised care plans regularly. Our rating of this service improved. Whilst there was a plan to eradicate the dormitories across the trust, there were delays to the timetable and patients continued to share sleeping accommodation which compromised their privacy. Staff support systems were in place and there was a drive to engage with staff. People we spoke with said they had received a good service. Mobility and healthcare equipment took up space in The Gillivers and 3Rubicon Close. Following this inspection the trust were required to ensure teams were adequately staffed to prevent impacts on staff workload and ensure staff completed mandatory training in line with trust requirements.Insufficient progress had been made against these notices. Services had complied with guidance on eliminating mixed sex accommodation. 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. A family member spoke about enjoying regular meetings in the service gardens with their relative. Oct 2015 - Apr 20193 years 7 months. Leicestershire Partnership NHS Trust provides mental health, learning disability and community health services across Leicestershire, England.. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. Engagement with external stakeholders had significantly improved since our last inspection. Care planning had improved in the crisis service. Most patients spoke positively about their care and said they were involved. This has been brought. 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. . Due to the lack of a trust overarching strategy, the BAF did not provide an effective oversight against strategic objectives, gaps in control and assurance. We inspected three mental health inpatient services because of the ratings from the previous inspection. Leadership had been strengthened at Stewart House. Three out of 18 staff interviewed said that supervision was irregular. Governance structures were in place and risks registers were reviewed regularly. 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. It's a mission driven by our core values, and one that we try to achieve as a local provider, funder, and advocate. 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. Supervision and appraisal compliance of three teams fell below 75%. We saw that Advanced Nurse Practitioners were completing Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) forms having completed their training to do so; however we saw that these forms were not countersigned by a doctor or consultant. Through this collaborative working we are also building a culture of continuous improvement and learning, supported by a robust governance framework and more sustainable and efficient use of resources. Through effective workforce planning we will nurture and support our staff to progress and flourish, offer them opportunities to deliver care through new models and in new roles. Leicestershire Partnership NHS Trust Add a Review About 32 We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. However, they did not always meet the required skill mix for the nursing teams. There was limited time available for staff to attend specialist courses to enhance their knowledge. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. Staff in the community adult mental health teams did not protect patients dignity or privacy. The trust had not made sufficient progress in addressing the concerns raised at the previous inspection in March 2015. There were systems for lone-working in place including a red folder process that kept workers safe. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. Patient Advice and Liaison Service (PALS). The environment in some services was poor, not well maintained and not kept clean. All the team leaders we interviewed said there were internal waiting lists for patients who had been initially assessed to access profession specific treatments. Care plans were generalised, not person centred or recovery focused. 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. The local managers monitored the environment for staff, carried out local audits and checked performance of staff on a regular basis. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. The trust had not ensured all staff had received training in immediate life support. The trust had several strategies, a vision and corporate objectives, but they did not underpin all policies and practices. Staff usually met patients in their homes or in the community. Wards did not have a list of stock items. To address this deficit the trust moved patients that required an acute bed to a rehabilitation bed which was not clinically justified or met the needs of the patients. Staff felt they had good local leadership and felt the governance was better with the introduction of a service line. Staff were confused about Deprivation of Liberty standards and paperwork was incomplete. 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. Wards had good evidence of multi-disciplinary team working, enabling staff to share information about patients and review their progress. Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. 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. Where patients did not access multimedia, families and carers said there was less communication with the service. For example, furniture was light and portable and could be used as a weapon. Patients gave positive feedback regarding the care they received. We noted how much time the new executive team had invested in making and implementing improvements during the COVID-19 pandemic. 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. We heard from most teams, positive examples of teamwork and multidisciplinary working within teams and services, and with external agencies and key stakeholders. 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. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. Leicestershire Partnership NHS Trust | 4,712 followers on LinkedIn. This meant the police very often had to care for detained patient for the duration of the assessment. The school nurses used technology to communicate with young people. Patients and carers knew how to complain and complaints were investigated and lessons identified. The service had plans in place to manage service disruption and major incidents. At this inspection, two of the three mental health services we inspected improved overall. In two of the core services inspected, the environment had not been well maintained. The ratings from the inspection which took place in November 2018 remain the same. The dignity and privacy of patients across three services we visited was compromised. Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. Managers used a tool to identify and review staff numbers in accordance with need. Some seclusion rooms had environmental concerns at Belvoir and Griffinunits, and Watermead wards. Staff were not meeting the trusts target compliance rate for annual appraisals and mandatory training. Waiting times and lists remained of concern, and this had been identified in the previous inspection. There were risk assessments and plans in place to keep people and staff safe. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. The Trust had a number of unfilled positions being covered by long-term bank staff. Our patients are at the heart of all we do and we believe that 'Caring at its Best' is not just about the . Staff used a mixture of paper and electronic records which were not easy to follow. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. There was a blanket restriction. 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. However, the service was collecting data. Our inspection approach allows us to make a judgement on how the trusts senior leadership leads the organisation and the provider level well-led rating is separate from the ratings of the services we inspected. ", Laiqaah Manjra, Corporate Affairs Administrator, "I progressed from being an apprentice to a Corporate Affairs Administrator - the NHS really supports staff development. This was because the EDU batch refer sending four or five referrals at a time rather than when they arrive. This monthly award is about recognising members of staff who have gone the extra mile. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. People using the service had limited access to psychological therapies and there were no psychologists working within the service. 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 said they got bored at the weekends, as there were fewer activities on offer. Two patients told us they had experienced cancelled leave, and numerous staff confirmed that facilitating escorted leave had been difficult at times which had led to either a cancellation, or where possible delayed leave. The transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. This meant that patients could have been deprived of their liberties without a relevant legal framework. The trust lacked a framework for co-ordinating, endorsing and therefore learning from the very many positive quality projects taking place. This meant patients had been placed outside of the trusts area. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. There some gaps in staff receiving regular supervision. Staff referred to having reflective practice peer meetings when they were concerned about the risk to a young person. This included labelling, disposal, reconciliation and ward level audit. 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. Discharge planning was considered as part of board rounds although discharge planning paperwork was not used consistently. Some wards and patient areas had blind spots, where staff could not easily observe patients. We are looking at different ways to indicate the outcomes of our monitoring in the future. The average bed occupancy was low. 61% of Leicestershire Partnership NHS Trust employees would recommend working there to a friend based on Glassdoor reviews. A dashboard of key performance indicators was being developed. Patients reported they were treated with dignity and respect. there are some services which we cant rate, while some might be under appeal from the provider. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. Staffing levels were below the expected level. Use our service finder to find the right support for your mental health and physical health. Team meetings were not regular, or didn't take place.The sharing of lessons learnt remained inconsistent across some wards. Care and treatment was mostly planned and delivered in line with current evidence. Staff told us they felt supported by their line managers, ward managers and matrons. Staff and senior leaders could not articulate the trusts direction of travel and how this was co-ordinated. We saw patients were treated with kindness and compassion. A further review was an examination of processes and procedures within the trust for reporting investigations and learning from serious incidents requiring investigation. Their service users and staff are extremely important to them. Some key outcomes for children, young people and families using the service were regularly below expectations. There was an effective duty system in place to provide rapid access to support. The trust had a dedicated family room for patients to have visits with children. 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. Click here to submit your comments to us. Staff did not adhere to the Mental Capacity Act Code of Practice and the five principles of the Act. Staff morale in some teams was low, with high levels of stress. 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'. Comments included terminology such as marvellous, wonderful and excellent. Staff morale appeared low. The wards tried to book regular bank and agency staff so they knew the ward and patients, to provide continuity of care. The environmental risks in the health based place of safety identified in our previous inspection remained. We saw staff engaging with patients in a kind and respectful manner on all of the wards. We carry out joint inspections with Ofsted. The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. Managers changed practice because of this. This meant that some staff felt insecure. However at South Leicestershire clinical supervision take-up was low at 73%. Although this issue had been recognised by the trust, it had not been addressed quickly or effectively. There was poor medicines management in relation to checking expiry dates, storage and consent documentation. wards for people with a learning disability or autism. There were problems with access to the electronic system owing to ongoing building works. Staff made individualised risk assessments which were regularly updated and followed best clinical practice. View more Profession Occupational Therapist Grade Band 5 Contract Type Permanent Hours Full Time. There was a duty worker system in place which meant the service was able to respond quickly to escalating risks if necessary. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. Teams were responsive and dealt with high levels of referrals. The trust had no auditing system to measure performance in order to improve the service. These reports were presented in an accessible format. We were not assured that the trust risk register clearly documented action taken or progress of action, within agreed timescales. Acute patients had been sent to rehabilitation wards inappropriately. 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. Ward matrons told us they shared outcomes from incident investigations in team meetings for shared leaning. Patients said staff who cared for them were knowledgeable, professional and friendly. live tilapia for sale uk, Acute wards for adults of working age had not ensured that all from... Not inspect the following areas of this core service: we did not adhere to the of! We were not regular, or did n't take place.The sharing of lessons learnt remained across! 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leicestershire partnership nhs trust values