Staff were de-briefed and supported after a serious incident; we saw that incidents were a standing agenda item for team meetings and were discussed with staff. However, this was a temporary restriction due to the building works and patient safety. The HBPoS did not have access to a dedicated clinic room. Considerable numbers of records we reviewed during our inspection, were of a poor standard, with substantial and important clinical reviews missing, as recommended by the Mental Health Act Code of Practice. Carers told us they had regular contact with the CRHT team and they were kept involved with their loved ones care. We felt this contributed to senior staff views that pace of change in the trust was slow. 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. Staff knew how to report any incidents on the trusts electronic reporting system. There was a blanket restriction. Risk management in services required improvement. Patient had individualised risk assessments. 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. View more Profession Occupational Therapist Service Learning Disability Grade Band 6 Contract Type Permanent Hours Full Time. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. Staff told us they felt happy and enjoyed their work. We were pleased to hear about the trusts investment in well-being events and initiatives for staff, such as valued star award, choir, yoga and time out days. There were significant waiting times for a range of further assessments and treatments including psychology, school observations, psychiatric opinion and group work. Staff satisfaction varied greatly across the service with some staff feeling devalued. People using the service had limited access to psychological therapies and there were no psychologists working within the service. Record keeping was poor in some services. Mobility and healthcare equipment took up space in The Gillivers and 3Rubicon Close. Staff were consistently caring, respectful and supportive. Supervision and appraisal compliance of three teams fell below 75%. Care plans did not always reflect a person centred approach and people who used services and their carers were not routinely involved in CPA reviews. 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. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. Overall, the trusts compliance rates for mandatory training was 87%. Six staff expressed concerns about the proposed move and some said the trust had not communicated information to staff effectively. We found: However, we noted one issue that could be improved: We spoke with six members of staff including matrons, team leaders and mental health practitioners and reviewed all the assessment areas the adult psychiatric liaison team uses. Records were stored securely and well managed by staff to ensure that sensitive information about patients was protected. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. At Melton, Rutland and Harborough and Charnwood there was a lack of audits and little focus on quality and improvement. We rated child and adolescent mental health wards as good because: The ward had clear lines of sight in the main areas of the ward. Staff showed a good awareness of patient rights. This was because the EDU batch refer sending four or five referrals at a time rather than when they arrive. 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. Patients experiencing mental health crisis and distress did not have access to a fully private area in these environments. While staffing numbers were usually maintained, there was a high reliance on agency and bank staff to achieve this. Click here to submit your comments to us. 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. The trust had new seclusion paperwork implemented in May 2019. Concerns in regards to Mental Capacity Act were identified at the last inspection as a breach of the HSCA regulation 9. Patients waiting for their appointment in the specialist community mental health services for children and young people used a shared waiting room with the learning disabilities adults services. There were clear responsibilities, roles and systems of accountability to support good governance and management. Staff completed risk assessments that were thorough and had been reviewed following incidents. This could have resulted in an increased risk of incorrect safe and secure handling of medicines and unsafe practice in relation to the administration and prescribing of medicines. Staff explained to patients their rights under the Mental Health Act on admission and routinely thereafter, although we saw this was not always documented in the patients care notes. New systems were in place for staff to report any repairs or maintenance issues. Waiting times for referral to initial assessment appointments were good, although patients experienced delays for community paediatric clinic follow up appointments. Restraint was used only as a last resort. The trust had improved medicines management. Significant vacancy rates and high sickness levels put additional pressure on substantive staff. Staff empathised where a person had a negative experience and offered support where necessary. The vacancy rate for the service was 12.9% and for band 5 and 6 nurses was 18.9%. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. We rated it as requires improvement because: When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. Staff demonstrated a good knowledge of the Mental Capacity Act and consent however this was not routinely documented in care records. The trust had high numbers of vacancies for registered nurses. However at South Leicestershire clinical supervision take-up was low at 73%. Interview rooms were unsafe. Staff expressed pride in their ability to work as a team and managers told us they were proud of achievements. The rating for well-led in mental health services, improved to requires improvement. Trust staff working within the had remote access to electronic systems used by the trust. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels: Outstanding As one of the largest registered investment advisors in the U.S., we offer a broad range of services to institutional clients, including corporate and higher-education retirement plans, foundations and endowments, and religious organizations. A dashboard of key performance indicators was being developed. The trust had reviewed existing systems and processes identified improvements and implemented changes. We rated the trust as requires improvement overall: Whilst there had been some progress since the last inspection in 2015, the trust was not yet safe, fully effective or responsive. Care and treatment was planned and delivered in line with current evidence-based guidance, standards, best practice and legislation. There was no patient alarm access in four ward areas, including the dormitories. The ward had an up to date ligature risk audit, staff mitigated the risks on the ward by observing patients. Three patients told us of times when staff had been rude, threatening and disrespectful towards them. Staff had a good understanding of patients needs. Staff reviewed young peoples risk at every appointment and recorded this in the case notes. No rating/under appeal/rating suspended We rated well-led as inadequate, safe, effective, and responsive as requires improvement and caring, as good. Staff received regular managerial and group supervision. Medication management across four of the five services we inspected was poor, despite reported trust oversight and audit. Clinic room temperatures were very hot, although one thermometer was above a radiator so would not give an accurate reading. The ratings from the inspection which took place in November 2018 remain the same. To find out more, review our cookie policy. The trust did not have seclusion rooms on all wards. 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. The trust had identified the lack of psychological therapies for patients, and support and training for staff, on their risk register. Our judgement is based on a combination of what we found when we inspected, information from our Intelligent Monitoring system, and information given to us from people who use services, the public and other organisations. The trust had no psychiatric intensive care unit (PICU) for female patients. The trust had not fully articulated their vision for how they operated as a trust. We rated the trust overall for well-led as inadequate. Leicester; 33,706 to 40,588 a year (pro rata) Leicestershire Partnership NHS Trust; We are looking for a Bank Band 6 Speech and Language Therapist to join our innovative, friendly and well supported team working with children and y. Care and treatment was mostly planned and delivered in line with current evidence. We found a high number of concerns not addressed from the previous inspections. They did not have alarms or vision panels in the door. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. We saw evidence of multidisciplinary working, with staff, teams and services at this trust and external organisations working in partnership to deliver effective care and treatment. The cold chain processes to ensure optimal conditions during the transport, storage, and handling of vaccines was outstanding. Managers did not successfully cascade information down to all ward staff in acute mental health services. The adult psychiatric liaison service provides assessment and treatment for adults between the ages of 16 to 65, who experience mental health problems in the context of physical illness. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. 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. Find out more. Staff had been given lone worker safety devices to ensure their safety. Between August 2015 and July 2016 the trust had a total of 372 delayed discharges. We found multiple internal waiting lists where the longest wait for young people was 108 weeks. There was a lack of storage at Stewart House, the utility/laundry room was used to store cleaning equipment. Managers changed practice because of this. acute wards for adults of working age and psychiatric intensive care units and. 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. 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. We found concerns with the environment in all five core services we inspected. Engagement and joint planning between departments was well developed. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. Leicestershire Partnership NHS Trust Add a Review About 32 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. Some records were over more than one database/system which could make locating information a problem. It is about making a real and sustainable difference for our patients and supporting our staff to deliver safe, high quality care every day. the service is performing badly and we've taken enforcement action against the provider of the service. On Heather ward patients said that there was not enough ventilation on the wards. Staff were suitably trained with the relevant knowledge and skills to carry out their work, had regular appraisals and had access to the information they needed to perform their duties. Morale was found to be poor in some areas and some staff told us that they did not feel engaged by the trust. Where patients did not access multimedia, families and carers said there was less communication with the service. There was limited time available for staff to attend specialist courses to enhance their knowledge. There was a risk that staff did not receive adequate support or that their capability was not reviewed. Staff said this made them feel safe whilst visiting patients at home or whilst undertaking activities with patients in the community. Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), In Medicine management training sessions had been undertaken with inpatient ward sisters and charge nurses. Managers ensure that they acted on these findings to reduce the risk of reoccurrence. We looked at the domains of safe, effective and responsive and we did not inspect all of the key lines of enquiry. 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. The feedback from patients and relatives was mainly positive about the staff providing care for them. In all instances police transported the patient to the HBPoS. We are looking at different ways to indicate the outcomes of our monitoring in the future. Your skills are needed for the NHS Reservist project. A new chief executive was appointed as a shared role between the two trusts. We're here for you Learn More Scroll We've got you covered Use our service finder to find the right support for your mental health and physical health. criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. The trust could not be sure that all staff. They told us that staff were kind and caring. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. The trust had addressed the issues regarding the health based place of safety identified in the previous inspection. The trusts pace for implementing equality and diversity initiatives across the organisation needed improvement. On four wards in acute wards for adults of working age, there were shared sleeping arrangements for patients. The number of visits was not always manageable. Staff told us they involved patients carers but there was little evidence of this in care records. Staff knew and understood their role in compliance with the Mental Health Act and Mental Capacity Act. Apply. Consent to care and treatment was obtained in line with relevant guidance and legislation. Patient records were electronic, up to date and available to the multidisciplinary team to enable an integrated approach to care and treatment. There was an extensive wellbeing offer available to staff. Staff working within the CRHT team and the liaison mental health triage service had not clearly document in patient paperwork or case notes if the patient had capacity or not. It's a mission driven by our core values, and one that we try to achieve as a local provider, funder, and advocate. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. We're one team with shared values providing the best care possible. Some patients told us that staff were polite and respectful and willing to go the extra mile in supporting them. Please contact Sonja Whelan on 07525 723336 or email Sonja.whelan@leicspart.nhs.uk. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. There was high dependence upon bank and agency staff to ensure safe staffing on the wards. This had continued during the pandemic. Staff were up to date with mandatory training and had regular supervision and appraisals. Patients knew how to formally complain and could attend daily community meetings where they could raise any issues of concern. There were safe lone working practices embedded in practice. There was no evidence of patient involvement recorded in some of the notes. However there were significant problems with key areas of governance in relation to the management of prescriptions. Emails and the trust intranet also provided staff with this information. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. 100% of staff were trained in how to safeguard children from harm. Team managers could not be assured of local performance around record keeping, care planning and patient involvement. wards for people with a learning disability or autism. Due to the large caseloads in community health service, the number of visits that were required was not always manageable. Therefore there were no beds available if patients returned from leave. The trust ceased mixed sex breaches by maintaining male and female only weeks. Patients knew how to make a complaint or raise a concern and complaints were taken seriously. We saw evidence of good team working during our inspection. Jan 4. The governance processes had not picked up the issues around repairs, medicines and cleanliness. Cover arrangements for sickness, leave and vacant posts were in place. 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. Shifts were not always covered with sufficient staff, or with staff who had the appropriate qualification and experience for the role. Staff morale in some teams was low, with high levels of stress. The trust had a culture of promoting staff learning and development and encouraged staff to share best practice and innovation. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. Staff followed up on all people seen in by phone, post or face to face to help with any ongoing issues such as housing or benefits. We reviewed 267 case records and found that, generally, staff completed detailed individualised risk assessments for patients on admission. We rated all three mental health services inspected as requires improvement overall. 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. The trust had begun the process of replacing some beds with more suitable options for the patient group. Care plans reviewed were not personalised, holistic or recovery orientated. Not all patients on acute wards for adults of working age could summon help from staff if required. Leicestershire City Council are proposing to keep Leicestershire Partnership NHS Trust as the provider, as it is a high performing service, and to recommission 0-19HCP by using Section 75 of the National Health Services Act of 2006. 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 . 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. Staff did not always have time to attend clinical supervision sessions and patient information systems were inconsistently utilised and did not always enable effective working. The trust delivered programmes for staff to develop into senior roles and had a clear career development programme for nursing staff. 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