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. wards for people with a learning disability or autism. 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. Staff were given opportunities to expand their knowledge and develop their roles. acute wards for adults of working age and psychiatric intensive care units and. Adult community health patients did not always have timely access to routine appointments. We found out of date and non-calibrated equipment located within a cupboard in the health-based place of safety. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. 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. HBPoS and crisis resolution and home treatment (CRHT) team toilets were not visibly clean. We are looking at different ways to indicate the outcomes of our monitoring in the future. A report on the inspection was . Staff demonstrated commitment to delivering high quality end of life care for their patients. Inadequate Two things remain consistent across the breadth of services we offer and . Due to the large caseloads in community health service, the number of visits that were required was not always manageable. Some families carers said that the meals were unhealthy. o We treat others how we would like to be treated. Patients were protected from avoidable harm by sufficient staffing and safeguarding processes. Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. Bed occupancy rates were above 85% for community health inpatient wards. We saw evidence of discharge planning in care plans written by CRHT staff. There was no funding for staff to provide activities so patients had limited access to activities of their choice during their stay. Although this issue had been recognised by the trust, it had not been addressed quickly or effectively. Inspectors from the Care Quality Commission (CQC) visited five services run by Leicestershire Partnership NHS Trust (LPT) in November and December last year. Some actions were required to ensure adherence with the Mental Health Act. Save job - Click to add the job to your shortlist. There were no children who had waited more than a year for treatment. The paperwork was difficult to find and not consistent. Following inspection, the trust submitted an action plan to review shared sleeping arrangements. The trust had not met all the required actions to reduce and mitigate ligature points across wards following the previous inspection in March 2015. Nurses and managers from LPT who were supported . Potential risks were taken into account when planning community health services. A family member spoke about enjoying regular meetings in the service gardens with their relative. The trust could not ensure continuity of care for these patients. A new quality dashboard had been introduced in September 2016 after it was established that the previous system was incorrect, meaning all data submitted prior to September 2016 was incorrect. The HBPoS had no designated resuscitation equipment and emergency medication and shared equipment with acute wards. Managers changed practice because of this. We rated the trust as inadequate for well-led overall. Published They and their carers were kept informed and involved in their treatment and care. Staff provided patients and carers with information in a way that they understood.At City West, City East, and South Leicestershire patients and their carers reported outstanding and good care. Patients reported that they felt safe on the wards. 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. Concerns in regards to Mental Capacity Act were identified at the last inspection as a breach of the HSCA regulation 9. There was effective multidisciplinary working. Improvements had been made to seclusion areas at The Willows Acacia and Maple wards. Leicestershire Partnership NHS Trust 2.5K subscribers We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. There were not always enough staff who were suitably qualified and experienced to safely meet patients needs. Staffing was on the risk register for many of the locations we visited. Patients said staff who cared for them were knowledgeable, professional and friendly. This included environmental improvements, shared sleeping accommodation, response times to maintenance issues, care planning and access to relevant therapies in certain services. 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. Staff felt that they had opportunities to develop and were supported to undertake further study. Our patients are at the heart of all we do and we believe that 'Caring at its Best' is not just about the . Patients using the CRHT team had limited access to psychological therapies and there were no psychologists working within the CRHT team. Staff working within criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. Staff were described as putting people who used services first and being person-centred. Medication management across four of the five services we inspected was poor, despite reported trust oversight and audit. The trust encouraged staff at most levels of the organisation to develop and deliver ideas for service delivery, improvement and innovation. Services have been transferred to this provider from another provider, Mental health crisis services and health-based places of safety, an inspection looking at part of the service. Your information helps us decide when, where and what to inspect. When staff deemed a patient lacked capacity there was no evidence that the best interest decision-making process was applied. Find out more. Bed occupancy for the last two quarters of 2013/14 was around 89%. Staff completed extensive and detailed care plans. Records about the use of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) were inconsistent. Our leadership behaviours framework set the standards of expectation we aspire to in our daily work. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. Save job - Click to add the job to your shortlist. CV6 6NY, In This impacted on the time available for staff development and training. The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. Services based in community hospitals did not admit patients close to weekends due to issues with verification of deaths over weekends, and the access to doctors. One family member told us their relative could be challenging but they felt they were well cared for. Services treated concerns and complaints seriously, investigated them and learned lessons from the results. There was an extensive wellbeing offer available to staff. Risk assessments were completed and care plans implemented to keep patients safe and promote wellbeing. Governance systems and processes, and the strategy of the organisation had been extensively reviewed since our last inspection but was not fully embedded into services. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. There was evidence of items being submitted to the trust risk register where appropriate. Between August 2015 and July 2016 the trust had a total of 372 delayed discharges. There was good physical health care and good therapeutic treatment and activities. The HBPoS did not have designated staff provided by the trust. Click here to submit your comments to us. There had been only one out of area placement over 14 months. However, this was a temporary restriction due to the building works and patient safety. The nurses we spoke with had specialist interests, including mindfulness and dementia. Leicestershire Partnership NHS Trust Is this your company? The rating had improved from the November 2016 inadequate rating. Adult liaison psychiatry services are delivered by the mental health trust across three acute hospital sites at Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital. Overall we saw good multidisciplinary working and generally peoples needs, including physical health needs, were assessed and care and treatment was planned to meet them. Risk management in services required improvement. Staff had not managed all risks to patients in services. This was an issue highlighted at our inspection in 2018. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. Within mental health services the quality of care plans was variable. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. Staffing levels did not meet requirement in some community teams. We rated long stay/rehabilitation mental health wards for working age adults as requires improvement because: The environment in some areas was very poor, particularly at Stewart House. Staff acknowledged directors visits. The trust had developed checklists to assist staff with the receipt and scrutiny process. Staff had the right qualifications, skills, knowledge and experience to do their job. Click on the coloured text links below to visit any of the listed organisations' websites: There was a skilled multi-disciplinary team able to offer a variety of therapies. Staff had been given lone worker safety devices to ensure their safety. The service did not exclude patients who would have benefitted from care. o We are passionate and creative in our work. 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. For example, furniture was light and portable and could be used as a weapon. Patients needs were assessed and monitored individually. Download full inspection report for - PDF - (opens in new window), Published The trust had improved medicines management. Staff consistently demonstrated good morale. The risks and issues described by staff did not always correspond to those reported to and understood by their leaders. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. However, staff told us they had little experience of incident reporting within the community childrens services. Staff were not always recording their supervision on the electronic system so we could not be assured they were receiving it regularly. This meant patients had been placed outside of the trusts area. Every team we spoke with knew who they reported to and what to report. The adult community therapy team did not meet agreed waiting time targets. Each priority within our approach is being led by an executive team member and progress is being monitored through our quality governance framework. The trust had a dedicated family room for patients to have visits with children. NHS Improvement is pleased to announce the appointments of Alexander Carpenter and Hetal Parmar as Non-executive Directors of Leicestershire Partnership NHS Trust from 1 June 2022 to 31 May 2025. Staff were adequately supported and debriefed following incidents and could access further support if required. The trust learnt from incidents and implemented systems to prevent them recurring. We gave an overall rating for mental health crisis services and health-based places of safety of requires improvement because: Overall we rated this core service as requires improvement because: We do not give an overall rating for specialist services. There was detailed discussion and consideration of patients and carers needs. Staff had a good knowledge of safeguarding and incident reporting. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. There were no separate female bedroom areas and no gender specific toilets or bathrooms. No rating/under appeal/rating suspended The trust had reviewed existing systems and processes identified improvements and implemented changes. Staffing numbers were met but not always the right skill mix. Two external governance reviews had been commissioned and undertaken. Local leaders were visible and had the skills and knowledge to perform their roles. 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. The most common reason for delayed discharges was due to family choices which were beyond the control of the trust. There were improved systems and processes to manage storage, disposal and administration of medications. Therefore, staff could ensure accurate measures of blood pressure were being recorded. Some improvements to address the no smoking policy at the Bradgate Mental Health Unit wards were seen. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. Staff gave examples of working with people with diverse needs considering their ethnicity, gender, age and culture. 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. The trust had addressed the issues previously identified with the health based place of safety. The136 suiteis a place of safety for those who have been detained under Section 136 of the Mental Health Act. We rated them as requires improvement because: During the inspection, our inspection teams carried out the following activities across 11 wards in the services: During our well-led inspection, we spoke with 32 senior leaders of the organisation and looked at a range of policies, procedures and other governance documents relating to the running of the trust. There was regular and effective multidisciplinary working. The HBPoS had poor visibility for observing patients. 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. View more Profession Occupational Therapist Service Learning Disability Grade Band 6 Contract Type Permanent Hours Full Time. Patients were able to access hot and cold drinks any time during the day. Services had supplies of emergency medication available and this was accessible to staff. Senior leaders in core services we inspected, had not maintained oversight of improvement across all wards of their services. The environment in specialist community mental health services for children and young people, and community based mental health services for adults of working age was not suitable, did not promote safe practice and was not well maintained. All the team leaders we interviewed said there were internal waiting lists for patients who had been initially assessed to access profession specific treatments. Staff communicated with patients in a calm, professional way and showed an understanding of patients needs. We looked at 20sets of seclusion recordsandfrom17 records,staff were notrecording seclusion, in line with the Mental Health Act Code of Practice. 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 identified that in community mental health teams, wards and community inpatient hospitals, fridge temperatures were not recorded correctly; either single daily temperature readings were recorded rather than maximum and minimum levels or temperatures were not recorded on a daily basis. Staff did not adhere to the Mental Capacity Act Code of Practice and the five principles of the Act. NG3 6AA, In The trusts Board Assurance Framework (BAF) was lengthy, was combined with a corporate risk register and had overdue actions. The trust had made some improvements in response to the previous CQC inspection undertaken in March 2015.This included removing some ligature anchor points in the acute mental health wards. Therefore, the trust could not be sure staff received information to support best practice and change in a timely manner. Leicestershire Partnership NHS Trust interview details: 3 interview questions and 3 interview reviews posted anonymously by Leicestershire Partnership NHS Trust interview candidates. It has been developed within the context of the area we serve in Leicester, Leicestershire and Rutland and the new Integrated Care Partnership. New systems were in place for staff to report any repairs or maintenance issues. We listen to our patients and to our colleagues, we always treat them with dignity and we respect their views and opinions, We are always polite, honest and friendly, We are here to help and we make sure that our patients and colleagues feel valued, When we talk to patients and their relatives we are clear about what is happening. There was an unstructured, non-mandatory approach to formal end of life training for community hospital staff. Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. The community adult team caseloads varied. We did not speak to any patients using the service at the time of the inspection. The trust had a limited approach to patient involvement. In the same service, managers did not always review incidents in a timely way. 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. 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. All areas were very clean, fresh smelling and fit for purpose. Managers had introduced a specialist child and adolescent mental health traffic light system, a red, amber and green rating tool for managing risk. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. While staffing numbers were usually maintained, there was a high reliance on agency and bank staff to achieve this. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. 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. We rated the trust overall for well-led as inadequate. They contained items which could pose a danger to staff and patients. Staff followed the trust policy on seclusion. 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. Staff support systems were in place and there was a drive to engage with staff. 89% of staff had attended their mandatory training; 92% of appropriate staff had received training in safeguarding adults and 90% of staff had completed safeguarding children training. Consent to care and treatment was obtained in line with relevant guidance and legislation. We saw information in the service reception areas about older peoples care. 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. Interview rooms were unsafe. 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