There were effective methods for obtaining feedback from service users and carers and feedback was acted upon. This practice stopped once we drew attention to it. Staff reported incidents, which were discussed and reviewed by line managers within the teams. 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. The trust had a limited approach to patient involvement. Patients had their own copies of care plans and were involved in their care plan reviews. We are proud of our 5,400 staff and together we aim to . All wards had developed their own systems to improve medicines management in their areas. Patients occasionally attended the service. They and their carers were kept informed and involved in their treatment and care. We did not speak to any patients using the service at the time of the inspection. There were processes in place for reporting and learning from incidents. Some seclusion rooms had environmental concerns at Belvoir and Griffinunits, and Watermead wards. Services had complied with guidance on eliminating mixed sex accommodation. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. Staff spoke of feeling supported by team leaders and team leaders felt supported by their managers. The service had seven vacancies for qualified nurses andthree for non-registered nurses. We observed many examples of staff treating patients with care and compassion. Staffs were dedicated, passionate and patient focused. 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. Ligature risks had been identified in bedrooms, bathrooms and toilets but there was no clear action to address all of the identifed risks, The seclusion rooms had known blind spots but no action had been taken to reduce them. There was a lack of reporting and monitoring of informal complaints, meaning the service was unable to monitor and recognise themes of concern with the childrens service. The needs and preferences of patients and their relatives were central to the planning and delivery of care with most people achieving their preferred place of care. Some teams told us about a lack of teamwork, best practice was not shared amongst services and regular meetings did not take place in some services. There was no process in place for learning from other organisations which provided similar services or to share this services best practice. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. There was an effective incident reporting process which investigated and identified lessons from incidents which were shared in most teams. Staff moved acute patients to the rehabilitation wards when acute beds could not be located. Staff said this made them feel safe whilst visiting patients at home or whilst undertaking activities with patients in the community. The HBPoS did not have access to a dedicated clinic room. At times, there were insufficient qualified nurses on shift. We carried out this unannounced focused inspection of adult liaison psychiatry services as part of a system wide inspection of Urgent and Emergency Care provision in the Leicester, Leicestershire and Rutland Integrated Care System. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 22 Jan 2023. Patients were mostly very happy with the care provided by staff; however some patients told us they did not like being woken at 6am and going to bed early. They were reflected in the objectives of local teams. . Patients were positive about their care and treatment and said staff were caring and understanding and respectful. Staff were caring and committed to providing high quality care and showed a person-centred approach. 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. Reductions in social service provision had led to an increase in referrals to the Community Learning Disability Teams. 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. Patients and carers were involved in assessment, treatment and care planning. PIER staff reported having good links with universities and colleges regarding students needing early intervention services. o We do what we say we are going to do. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. People using the service may not be able to get the speed of telephone response they needed in a crisis. Staff completed detailed risk assessments for patients on admission and reviewed them regularly after incidents. At our last inspection we raised concerns that an insufficient number of nursing staff in community health services for adults had received appropriate statutory and mandatory training. There were good systems for lone-working which included a code word that staff used when they required assistance. Practice development and embedding practice was good, for example, where dementia mapping was adapted to learning disabilities. Staff actively participated in clinical audits. Therefore, patients were not always actively engaged in decisions about service provision or their care. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. Staff working within criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. This impacted on staffs ability to assess and treat young people in a timely manner. We're always looking for the best. Staff used a mixture of paper and electronic records which were not easy to follow. When staff raised concerns or ideas for improvement, they felt they were not always taken seriously. We saw numerous interactions between staff and patients with very complex needs and staff managed extremely challenging situations with knowledge and compassion. 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. Risk assessments were brief, did not always contain sufficient information and were not updated regularly. The trust could not ensure continuity of care for these patients. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. 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. As part of each inspection, we look at the way health services provide care and treatment to people. We have four core values: Compassion, Respect, Integrity, Trust. Acute patients had been sent to rehabilitation wards inappropriately. Urgent and emergency care services across England have been and continue to be under sustained pressure. Staff received supervisions and appraisal. To find out more, review our cookie policy. The services did not have a strategy and there were no service plans. There had been a change in leadership and a review of key performance indicators (KPIs) with commissioners. We will be supporting each other in the delivery of these leadership behaviours so we can all Step up to Great together. 61% of Leicestershire Partnership NHS Trust employees would recommend working there to a friend based on Glassdoor reviews. Managers had a recruitment plan in place to increase the number of substantive staff for the service. Leicestershire patient care project shortlisted in prestigious awards. Staff in four of the five services we inspected did not document patient involvement in their care. 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. Nursing staff interacted with patients in a caring and respectful manner. We observed some very positive examples of staff providing emotional support to people. Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. They contained items which could pose a danger to staff and patients. Staff held high caseloads in community based mental health services for adults of working age, an issue which had been recognised by the trust and placed on the risk register. Nurses and managers from LPT who were supported . Patients said they got bored at the weekends, as there were fewer activities on offer. We rated the trust overall for well-led as inadequate. 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. The paperwork was difficult to find and not consistent. The trust had not ensured all staff had received training in immediate life support. Clinical audit was taking place and learning was shared across the service. On Bosworth ward patient privacy was compromised when staff and patients entered the clinic room during examinations because there was no privacy curtain in place. The service did not exclude patients who would have benefitted from care. Patients returning from leave from the acute mental health wards were not assured of returning to their original ward. In two of the core services inspected, the environment had not been well maintained. The room used to administer medication on Arran ward at Stewart House was not appropriate; the room was a bedroom and still had a toilet in. The HBPoS had poor visibility for observing patients. The trust had well-developed audits in place to monitor the quality of the service. Governance processes had improved since our last inspection and operated effectively at trust level to ensure that performance and risk were managed well. NG3 6AA, In Local leaders were visible and had the skills and knowledge to perform their roles. There was regular and effective multidisciplinary working. By: Miraj Vaghadia | Tags: A project to improve patient care by making best use of capacity across Leicestershire Partnership NHS Trust (LPT) District Nursing teams has been shortlisted for the prestigious Nursing Times Awards. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. There was no evidence of patient involvement recorded in some of the notes. The service employed care navigators to help families and carers negotiate their journey through the various services provided. Inconsistencies in record-keeping for the Autism Outreach services as some records were missing, but others were of an acceptable standard. However, ligature points remained. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. Let's make care better together. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. Staff were up to date with mandatory training. This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. The community therapy rehabilitation unit at Hinckley did not have a defibrillator in the unit for staff to use in an emergency despite staff having been trained how to use one. Waiting lists for psychological services were high and currently on the Trusts risk register. 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. Staff said the system was difficult to use and this had affected the information recorded in patients notes. In all instances police transported the patient to the HBPoS. Clinical supervision rates were low. There was a duty worker system in place which meant the service was able to respond quickly to escalating risks if necessary. Governance structures were in place and risks registers were reviewed regularly. Staff morale in some teams was low, with high levels of stress. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. The Trust had a number of unfilled positions being covered by long-term bank staff. Clinic rooms were overstocked with medications. Assessed risks were well-managed and staff showed a good awareness of individual needs and how to respond to them. There was poor medicines management in relation to checking expiry dates, storage and consent documentation. On Heather ward patients said that there was not enough ventilation on the wards. 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. 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. The integrated therapy and nursing teams and the primary care coordinators in conjunction with the night service had clear focus on keeping patients safe and well in their own homes. There were significant waiting times for a range of further assessments and treatments including psychology, school observations, psychiatric opinion and group work. This report describes our judgement of the quality of care provided by Leicestershire Partnership NHS Trust. Some care plans had not been updated and physical healthcare checks were not routinely documented in young peoples notes. The risks and issues described by staff did not always correspond to those reported to and understood by their leaders. Crisis and relapse care plans were in place for the people that used services. Records in the HBPoS did not clearly indicate if patients had their rights explained to them. Lessons were learned from feedback and complaints from patients. The trust employed registered general nurses (RGN) to assist with assessment and management of physical healthcare needs for patients. Some patients told us that staff were polite and respectful and willing to go the extra mile in supporting them. Derby, These included the Older Peoples Unit at Loughborough Hospital, the Hand Injury Service, the splitting of planned and unscheduled community nursing services with a single point of access, podiatry and the specialist management of long term conditions. There was an effective duty system in place to provide rapid access to support. Multidisciplinary team work both internal and external to the service was effective and patients were supported to make informed decisions about their care. Staff who were unclear of the process for rapid tranquillisation did not have a reminder of the process to follow. Waiting times and lists remained of concern, and this had been identified in the previous inspection. Three out of 18 staff interviewed said that supervision was irregular. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. Admission to the unit was agreed with commissioners. The rating for well-led in mental health services, improved to requires improvement. The community healthcare services provided by Leicestershire Partnership NHS Trust were judged to be good. Interpreters were used when working with people who did not have English as a first language. Inspectors from the Care Quality Commission (CQC) visited five services run by Leicestershire Partnership NHS Trust (LPT) in November and December last year. The service was responsive. There were no records of capacity being assessed for patients consent to treatment, and no clear evidence of best interests decisions being agreed. The average bed occupancy was low. The trust had no auditing system to measure performance in order to improve the service. 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. We use cookies to improve your experience on our website. Managers ensure that they acted on these findings to reduce the risk of reoccurrence. Staff followed infection control practices and maintained equipment through regular servicing. Staff support systems were in place and there was a drive to engage with staff. They showed a good understanding of peoples individual needs. Some staff had not received their mandatory training, supervision or appraisal. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. There was effective multidisciplinary working. 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. 56% of individual care plans were not up to date, personalised or holistic. In the same service, managers did not always review incidents in a timely way. Interview rooms were unsafe. Staff knew how to report any incidents on the trusts electronic reporting system. The environmental risks in the health based place of safety identified in our previous inspection remained. Staff were given feedback after incidents had been reported. To ensure that safer staffing levels were met they used regular bank or agency staff to achieve the required amount number of staff for the wards to meet the needs of the patients. University Hospitals of Leicester NHS Trust. 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. Staff were aligned to services to manage data and we have seen improvements in recording and monitoring of supervision and appraisal, improvement in managing risks of those on waiting lists in specialist community mental health services for children and young people and in training data. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. The trust had improved medicines management. At this inspection we found compliance levels with this type of training were still below the trusts target. The trust had addressed the issues previously identified with the health based place of safety. Patient Advice and Liaison Service (PALS). Examples were given regarding learning from these. Your skills are needed for the NHS Reservist project. Our overall rating of this trust stayed the same. The trust also collected feedback from patients in a variety of ways, including surveys, iPads, community forum meetings and the Friends and Family Test. 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. Some wards and community teams had low staffing levels, or an absence of specialist staff, and this had an impact on care.Staffing levels remained low at the Bradgate mental health unit. There were issues within the trust of a bullying culture despite evidence that staff knew the trust values. All incidents that should be reported were reported. Staff felt that they had opportunities to develop and were supported to undertake further study. We rated community health services for adults as requires improvement because. However, we found: We rated the child and adolescent mental health wards as requires improvement because: We rated community-based mental health services for older people as good because: We rated learning disability and autism community services as good because: We gave an overall rating for forensic/secure wards of requires improvement because: We rated Leicestershire Partnership NHS Trust long stay / rehabilitation mental health wards for working age adults as requires improvement because: Overall rating for this core service Good. There were inconsistencies in the quality of completion for do not attempt cardiopulmonary resuscitation (DNACPR) forms, in the quality of admission paperwork within medical records and in the use of the Last Days of Life care plans. They could undertake both internal and external training and were able to give feedback on service development. Bank Band 6 Speech and Language Therapist. Staff received regular managerial and group supervision. Staff received training in how to safeguard people who used the service from harm and showed us that they knew how to do this effectively. Overall, the trusts compliance rates for mandatory training was 87%. There was good staff morale. 27 February 2019. Save job - Click to add the job to your shortlist. 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. The trust had developed new processes and redesigned and improved data validation. Local audits were not completed regularly. This meant staff transferred patients to wards that had seclusion rooms when needed. Wards provided safe environments where patients felt secure. Staff told us their managers were supportive and senior managers were visible within the service. Leicestershire Partnership NHS Trust Add a Review About 32 Leaders were motivated and developing their skills to address the current challenges to the service. Some risk assessments had not been reviewed regularly at The Grange. Demand for neurodevelopment assessments remained high. At the time of inspection, there were a total of 647 children and young people currently waiting to be seen in specialised treatment pathways. We found a patient being nursed in the low stimulus area and their liberty was restricted. There could be risks posed by the use of different recording systems across teams as staff may not all have access to all records. They remained positive when engaging patients in meaningful activities. The summary for this service appears in the overall summary of this report. We heard from most teams, positive examples of teamwork and multidisciplinary working within teams and services, and with external agencies and key stakeholders. All assessment rooms had good visibility. 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. The trust had robust arrangements in place for the receipt and scrutiny of detention paperwork. They later told us that this had been an ongoing concern for around five years. 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. 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. Records were stored securely and well managed by staff to ensure that sensitive information about patients was protected. The service had not delivered timely care to a significant number of patients. 29 October 2021. Staff in some services completed care plans with detailed information on allergies, and risks around medication. However, Griffin did not. It's a mission driven by our core values, and one that we try to achieve as a local provider, funder, and advocate. Beds were not always available for people living in the trusts catchment area. Another relative said their relative was a changed person since going to the Willows and they were able to go home last Christmas. This does not comply with the guidance from the Royal College of Psychiatrists. We found concerns with the environment in all five core services we inspected. Medication management across four of the five services we inspected was poor, despite reported trust oversight and audit. There were problems with access to the electronic system owing to ongoing building works. We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. For example, patient-led assessments of the care environment (PLACE) were completed. Team meetings were not regular, or didn't take place.The sharing of lessons learnt remained inconsistent across some wards. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. The trust confirmed after our inspection Advanced Nurse Practitioners used a DNACPR form which had been agreed within NHS East Midlands. Staff received feedback on the outcomes on investigation of complaints via their managers. Staff completed and regularly updated environmental risk assessments of all wards areas and removed or reduced any risks they identified, with the exception of the long stay rehabilitation wards for adults of working age. Staffing levels were below the expected level. the service isn't performing as well as it should and we have told the service how it must improve. Staff received regular supervision and most had received an appraisal in the last 12 months. Some actions were required to ensure adherence with the Mental Health Act. Some local managers were keeping their own records to ensure performance was monitored. 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. Staff knew the vision and values of the trust and agreed with these. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. We spoke with nine patient families and carers. There was a range of treatment and activity delivered by skilled and experienced staff. Staff kept risk assessments up to date and carried out comprehensive assessments which were holistic and recovery focused. Services did not document patient involvement in their care plan reviews visible and had the skills and to... Staff at St Lukes hospital had arranged bi-monthly meetings to involve patients and visitors in the of. Of paper and electronic records which were shared in most teams significant since. Between two and 192 days within criminal justice and liaison services and triage had. The low stimulus area and their carers were involved in their treatment and said were! 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