There were long waiting times from initial referral to being seen in some clinics and services although these had improved in some areas since the last inspection. There were no records of capacity being assessed for patients consent to treatment, and no clear evidence of best interests decisions being agreed. Three patients told us of times when staff had been rude, threatening and disrespectful towards them. Staff told us they enjoyed working at the trust and thought they all worked well as a team. Facilities had been adapted to improve access and systems were in place to support the most vulnerable. Make a difference with a career at LPT. This is an organisation that runs the health and social care services we inspect. One patient told us there wasnt enough to do at the Willows. Resuscitation bag, defibrillator and fire drill checks in the CAMHS LD service were not recorded. Local audits were not completed regularly. There were risk assessments and plans in place to keep people and staff safe. Some families and carers told us that the service was not responsive, telephone calls to the service were not returned. The service had not delivered timely care to a significant number of patients. There were no pharmacy services within the community mental health teams or crisis team. Other professionals within the trust could not access this system. There had been only one out of area placement over 14 months. We rated the trust as inadequate for well-led overall. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. Inspectors from the Care Quality Commission (CQC) visited five services run by Leicestershire Partnership NHS Trust (LPT) in November and December last year. The medical and senior leadership provision within the looked after children service did not meet the professional requirements outlined in the intercollegiate document for this provision. 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. This was: We also assessed if the organisation is well-led and looked at areas of governance, culture, leadership capability and improvement. Not all care plans reflected patients assessed needs, or were personalised, holistic and recovery oriented. Significant vacancy rates and high sickness levels put additional pressure on substantive staff. Staff could not rely on performance reports being accurate. Managers ensured they monitored their staffs compliance with mandatory training using a tracker system. Patients told us that appointments usually run on time and they were kept informed when they do not. The waiting list had increased for those children and young people waitingfor thestart of treatment, following assessment. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. Patients reported they were treated with dignity and respect. The trust confirmed community hospital staff were expected to undertake four clinical supervision sessions across the year. Jan 4. Staff completed detailed risk assessments for patients on admission and reviewed them regularly after incidents. This meant board members were not able to monitor the trusts assertions that there were strong systems and processes in place for identifying and reporting serious incidents, including deaths, or monitoring whether reviews and investigations were completed fully. Browser Support In community based mental health teams for older people five of six services breached national targets from referral to assessment. The service was not well led. The acute mental health wards had broken facilities which had not been repaired in a timely manner and we found dirt in some areas on one ward. We did not inspect the following areas of this core service: We did not rate this service at this inspection. We use cookies to improve your experience on our website. Care plans were not always holistic and person centred. Staff referred to having reflective practice peer meetings when they were concerned about the risk to a young person. Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), In Data could not be relied upon to measure service performance or improvement.Data collection and interpretation did not include key pieces of information for example number of delayed or missed visits. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. Leicestershire Partnership NHS Trust Is this your company? The service was not meeting its performance targets. We identified medicines management issues, including out of date medication in the acute mental health wards and fridge temperatures were not monitored in community based mental health services for adults. Staffing was on the risk register for many of the locations we visited. The trust did not have seclusion rooms on all wards. ", "I have developed so many new skills over the years working in the NHS, going from a healthcare assistant to a nursing associate. There was good staff morale. The longest wait was 108 weeks for four patients to access group work or outpatients. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. 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. There had been an increase in the number of CAMHS referrals over the last two years. Staff were not aware of how this might affect the safety and rights of the patients. Coventry, Staff supported patients to raise concerns when needed. Where patients took medicines home with them, staff ensured that they understood their use and storage. 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. Two patients discharges were delayed at The Agnes Unit because the commissioners could not find specialist placements. There was a risk that staff did not receive adequate support or that their capability was not reviewed. Managers ensured they monitored the reporting and recording of incidents and complaints. NG3 6AA, In Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. This had continued during the pandemic. We rated acute wards for adults of working age and psychiatric intensive care units as requires improvement because: The trust had made improvements to the clinical environments but had not met all the required actions following the previous inspection of March 2015. There was a range of large therapeutic areas and rooms for art therapy plus other interventions. However, 323 were waiting for their first appointment through the access team, to complete a core mental health assessment. This included environmental improvements, shared sleeping accommodation, response times to maintenance issues, care planning and access to relevant therapies in certain services. We saw patients that needed a PEEP had a plan in place. Supervision and appraisal compliance of three teams fell below 75%. Comprehensive relocation action plans were available. 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. Patients returning from leave from the acute mental health wards were not assured of returning to their original ward. Care records showed that physical health examinations were completed upon admission and there was ongoing monitoring of physical health across the trust. Some staff had not received their mandatory training, supervision or appraisal. DE22 3LZ. This report describes our judgement of the quality of care provided by Leicestershire Partnership NHS Trust. The trust had improved medicines management. Staff gave examples of initiatives such as the chief executives blog and the presentation of the valued star award. Care plans were generalised, not person centred or recovery focused. Nurses and managers from LPT who were supported . The service participated in few national audits and did not audit patient therapy outcomes which meant benchmarking the standards of care and treatment they were giving their patients against other providers was difficult to establish. In five of the six community nursing teams attendance on some mandatory training courses was below 70%. This impacted on the time available for staff development and training. Managers ensured they used regular bank staff to achieve the required safer staffing levels and to promote continuity of care of patients. Staff support systems were in place and there was a drive to engage with staff. Between August 2015 and July 2016, there were 60 delayed discharges across the service. Potential risks were taken into account when planning community health services. Nottingham, 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. The trust supported a BAME network (black and minority ethnic) however, given the diversity of the geographical area of the trust, they had not significantly developed its agenda or work streams since our last inspection. Governance processes had improved since our last inspection and operated effectively at trust level to ensure that performance and risk were managed well. On four wards in acute wards for adults of working age, there were shared sleeping arrangements for patients. This meant staff transferred patients to wards that had seclusion rooms when needed. Managers had a recruitment plan in place to increase the number of substantive staff for the service. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. There was an established five year strategy and vision for the families, young people and childrens (FYPC) services and staff innovation was encouraged and supported. Since the last inspection the service now had a Section 136 suite that met the standards set out in the Royal College Standards. Therefore, overall, eight of the trusts 15 services are now rated as good, five as requires improvement and two as inadequate. It's a mission driven by our core values, and one that we try to achieve as a local provider, funder, and advocate. 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. Not all patients on acute wards for adults of working age could summon help from staff if required. Not all patient records showed a full assessment of need, including physical health needs or up to date care plans. The psychiatric outpatients was responsible for 2094 of the breaches, with city east reporting the highest of these breaches at 429.2. 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. Patients and carers confirmed in most services they had not received copies of care plans. She embraces the principles of the employee as a consumer (a person who makes the choice of where to work by considering a broadly defined value proposition, inclusive of financial, work, and social aspects of life) and agile organization (a workforce that continually evolves to meet the changing interests and needs of team members and customer.) The service used a computer record system that differed from the rest of the trust. Staff did not always follow trust policies and procedures when they needed to search patients or their bedrooms to keep them safe from harm. One patient told us they did not know they could leave the ward to seek medical attention. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. Staff undertook comprehensive assessments and developed high quality care plans. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. Staff knew who the most senior managers were in the organisation but these managers had not visited the service and staff had no contact with them. On Heather ward patients said that there was not enough ventilation on the wards. Employees also rated Leicestershire Partnership NHS Trust 3.1 out of 5 for work life balance, 3.6 for culture and values and 3.7 for career opportunities. The trust confirmed staff delivering end of life care were involved in bi-annual record keeping, safeguarding and clinical supervision audits. Patients could approach staff at night to request them. We had concerns about the environment but noted the service was due to move locations within two weeks. 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. On Ashby ward, the shower rooms did not have curtains fitted. The trust had robust systems in place which allowed staff to effectively report incidents. There was no evidence of patient involvement recorded in some of the notes. Lone working policies and procedures were in place for staff to follow to ensure patient and staff safety. Medication management across four of the five services we inspected was poor, despite reported trust oversight and audit. long stay or rehabilitation wards for working age adults. Care plans and risk assessments did not show staff how to support patients. Computer systems were not shared across GP surgeries so information sharing did not happen effectively. Staff demonstrated a good knowledge of the Mental Capacity Act and consent however this was not routinely documented in care records. There were processes in place for reporting and learning from incidents. Staff maintained a presence in clinical areas to observe and support patients. Patients knew how to formally complain and could attend daily community meetings where they could raise any issues of concern. Palliative care nurses conducted holistic assessments for patients and provided advice around social issues, for example, blue badges for disabled parking. Staff held multidisciplinary team meetings weekly and these were attended by a range of mental health professionals. 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 was a skilled multi-disciplinary team able to offer a variety of therapies. There were systems for lone-working in place including a red folder process that kept workers safe. This did not demonstrate a consistent temperature, had been maintained to assure the safety and efficacy of the medicines. Multi-disciplinary teams and inter-agency working were effective in supporting people who used the service. Staff would still work with people who were on waiting lists so that they received some level of service. Staff treated people who used the service with respect, listened to them and were compassionate. Four young people told us they felt involved in developing their care plan however, they had not received a copy. 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. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. Staff followed the trust policy on seclusion. One patient on Heather ward claimed that they had previously watched a staff member walking past a distressed patient and did not seek to reassure them or ask what was wrong. Staff expressed pride in their ability to work as a team and managers told us they were proud of achievements. 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 told us that staff listened and empathised with them. 87 of the total patients had been waiting over a year to begin treatment. 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. CV6 6NY, In The service did not have any out of area placements, readmissions or delayed discharges. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. This is an exceptional opportunity to share your talents and expertise to make a positive difference to the lives of the one million people served by the Trust. 100% of staff were trained in how to safeguard children from harm. Patient had individualised risk assessments. The trust used key performance indicators/dashboards to gauge the performance of the team. 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. Staff were up to date with mandatory training and had regular supervision and appraisals. Carers told us they had regular contact with the CRHT team and they were kept involved with their loved ones care. Staff spoke of feeling supported by team leaders and team leaders felt supported by their managers. There was no fridge to keep medicines cool when required. There was limited time available for staff to attend specialist courses to enhance their knowledge. Oct 2015 - Apr 20193 years 7 months. These reports were presented in an accessible format. The trust had not made sufficient progress in addressing the concerns raised at the previous inspection in March 2015. o We do what we say we are going to do. 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