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Supervision, appraisals and training compliance did not always meet the trust standard. The service was not well led. Administrative staff had not received specific mental health awareness training to assist them when taking calls for people who were acutely unwell and in crisis. Some key outcomes for children, young people and families using the service were regularly below expectations. The trust ceased mixed sex breaches by maintaining male and female only weeks. We found loose papers in records. Staff made individualised risk assessments which were regularly updated and followed best clinical practice. Staff demonstrated poor understanding of some aspects of the Mental Capacity Act. The Step up to Great strategy identified key priority areas of focus which were linked to the trusts vision. However, Griffin did not. Staff used a mixture of paper and electronic records which were not easy to follow. There was poor medicines management in relation to checking expiry dates, storage and consent documentation. We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels: Outstanding Interview rooms were unsafe. Complaints were well managed to ensure a timely response and aid learning. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. We spoke with nine patient families and carers. Some improvements to address the no smoking policy at the Bradgate Mental Health Unit wards were seen. Staff who delivered training had been redeployed away from training during the COVID-19 pandemic, but face to face training had restarted and not all staff who had out of date training had rebooked. There was a risk that young people may not get assessed out of hours in a timely manner by staff with CAMHS experience. Service planning was not being managed in a systematic way. Where patients took medicines home with them, staff ensured that they understood their use and storage. Leicester, United Kingdom. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. 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. There was a high staff sickness rate reported and managers did not always follow the managing sickness policy. We rated community health inpatient services as requires improvement because: Despite considerable effort with recruiting new members of staff, 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. Staffing levels were adequate at the time of our inspection but staff told us that they had been short staffed for some time and that there were a number of vacancies. We are proud of our 5,400 staff and together we aim to . Patients in four services across the trust reported that they had not been involved in the planning of their care and had not received copies of care plans. They are: o We focus on what matters most. Care plans and risk assessments did not show staff how to support patients. Staff had the right qualifications, skills, knowledge and experience to do their job. We found evidence that patients, at the Bradgate Mental Health Unit, and in some instances, staff, smoking in ward areas. When we talk to colleagues we are clear about what is expected. The service did not exclude patients who would have benefitted from care. Inconsistencies in record-keeping for the Autism Outreach services as some records were missing, but others were of an acceptable standard. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. 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. Funding had been secured for increased staff with specialist skills. For example, Ashby, Aston, Bosworth and Thornton Wards had been converted to single sex only accommodation to ensure compliance with the Department of Health and Mental Health Act 1983 guidance on mixed sex accommodation. Specialist community mental health services for children and young people. This could pose a risk as patients were unsupervised in this area. Staff were positive about the support they received from their local leaders and managers but were less connected with senior leadership and management teams in the children, young people and families services. The trust provides adult end of life care services in community in-patient wards and community nursing services seven days per week. Patients and carers were involved in assessment, treatment and care planning. Watch our short film to find out more: We Are LPT Share From a National Health Service (NHS) organisation Watch on Our strategy Patients said staff who cared for them were knowledgeable, professional and friendly. Staff were passionate about their roles and enjoyed working with the client group. Patients told us they did not have access to a copy of their care plan. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. All the people who used services and the carers spoken to were happy with the service they had received and spoke positively about their interactions with staff. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. Our observations during inspection confirmed that staff knowledge and practical application of their knowledge was inconsistent despite training on their electronic learning systems. However, delay in paperwork completion was also responsible for a large proportion of delayed discharges. There were improvements in ligature risk assessments. Staff were unable to show us evidence of clinical audits or the basis of evidence based practice in end of life services. Across teams risk assessments were not always completed and updated. The trust had no auditing system to measure performance in order to improve the service. The service was not safe. 29 October 2021. This became a formal group working partnership in April 2021. The trust had a dedicated family room for patients to have visits with children. Staff did not demonstrate a good understanding of the Mental Health Act (MHA) and Mental Capacity Act (MCA). Staff support systems were in place and there was a drive to engage with staff. The behaviours we expect to see at LPT are: This framework is also intended to join up all elements of our people management, from job design to recruitment and selection, induction and ongoing professional development to appraisals, in order to ensure we are as consistent and effective as possible. We rated wards for older people with mental health problems as good because: The wards complied with the Department of Health 2015 guidelines on single sex accommodation. 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. Patients had access to advocacy. Staff used the mental health clustering tool, which included Health of the Nation Outcome Scales (HoNOS) to assess and record severity and outcomes for all patients. 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. Staff did not document physical health checks for patients detained under section 136 in the HBPoS. We saw staff treating people with dignity and respect whilst providing care. Wards for people with dementia had dementia-friendly elements; particularly the activity rooms and there was commitment to build on this. 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. This was a focused, unannounced inspection, to follow up on enforcement action we issued to the trust after our last inspection in November 2018. Mandatory training compliance for trust wide services was 91% against the trust target of 85%. We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. We observed clinicians working with young people were skilled and very positive. The number of visits was not always manageable. Wards provided safe environments where patients felt secure. We inspected all key lines of enquiry in all domains (safe, effective, caring, responsive and well-led) in two services. Recruitment was in progress for 10 new healthcare support workers. Waiting lists for psychological services were high and currently on the Trusts risk register. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. Consent to care and treatment was obtained in line with relevant guidance and legislation. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. Patients and carers confirmed in most services they had not received copies of care plans. This meant that patients were not protected from receiving unsafe treatment. There was a full complement of staff with no vacancies. 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. Flu and Covid-19 are currently circulating at high levels and are likely to continue to increase in coming weeks. The trust confirmed staff delivering end of life care were involved in bi-annual record keeping, safeguarding and clinical supervision audits. Staff treated patients with kindness, compassion and respect.We saw staff spend time talking to and their carers. Staff told us there were no service information leaflets available. There were no children who had waited more than a year for treatment. Staffing levels were not consistent across the two sites. Within mental health services the quality of care plans was variable. In rehabilitation services, staff had effective working relations with the new rehabilitation community transition support team created in response to the pandemic to facilitate faster discharges from the wards. The quality of the data produced was poor and staff needed to correct the data when reports were produced. Patients own controlled drugs were not always managed and destroyed appropriately. Leicestershire Partnership NHS Trust - One Year on from the Mental Health Taskforce Leicestershire Partnership NHS Trust (LPT) continues to break new ground in ensuring the physical health of its patients and service users is cared for as well as their mental health, the ultimate aim of which is to achieve parity of esteem. These reports were presented in an accessible format. Care records showed that physical health examinations were completed upon admission and there was ongoing monitoring of physical health across the trust. Staffing was on the risk register for many of the locations we visited. Patients were happy with the care they received and were very complimentary about the staff who cared for them. 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. The trust did not have seclusion rooms on all wards. The trust was not fully compliant with same sex accommodation guidance in two acute wards, the short stay learning disability service and rehabilitation services. In all three services, not all staff were up to date with mandatory training. 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. Patients had the use of their mobile phones on the ward. 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. Staff morale on Griffin ward was low due to the announcement of the wards closure upon the completion of works on Phoenix ward. Lessons learnt were shared across the organisation via emails and the intranet. Other professionals within the trust could not access this system. Staff we spoke with demonstrated their dedication to providing high quality patient care. Families and carers said the wards were clean. Some wards and community teams did not store or manage medicines safely. Suspended ratings are being reviewed by us and will be published soon. We observed many examples of staff treating patients with care and compassion. 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. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. Staff empathised where a person had a negative experience and offered support where necessary. 8 February 2017. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. The trust had set safe staffing levels and these were followed in practice. There were delays in maintenance and repairs in some areas. Smoking cessation had been successful across most wards in the Bradgate Mental Health Unit.The trust had re-drafted the smoke free policy following on patient and staff consultation. Not all patients on acute wards for adults of working age could summon help from staff if required. Patients needs were assessed and monitored individually. Staff told us the trust was a good place to work. All patients told us staff respected their privacy and dignity. Some wards and patient areas had blind spots, where staff could not easily observe patients. There was good physical health care and good therapeutic treatment and activities. The 30 bed unit at Stewart House was mixed sex and there were no doors to lock between the male and female sections. We rated safe, effective, caring and responsive as good and well led as requires improvement. Patients described being cared for, respected and treated with dignity. Patient outcomes for people using trust services were very good and the trust was able to demonstrate that their services had a positive impact through good data collection and review mechanisms. 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. All ward ligature risk assessmentshad beenreviewed and were located on each ward together with mitigation summaries. Wards employed additional healthcare support workers to meet patient needs when needed. 100% of staff were trained in how to safeguard children from harm. Bed occupancy for the last two quarters of 2013/14 was around 89%. We observed positive interactions between staff and children and the use of age appropriate language. There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS Trust (LPT). Improvements were noted in some wards in core services but not all. 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'. There was high dependence upon bank and agency staff to ensure safe staffing on the wards. The environment in some services was poor, not well maintained and not kept clean. There was highly visible, approachable and supportive leadership. Managers completed ligature audits which highlighted what mitigation was in place to reduce the risk for patients. Patients waiting for their appointment in community based mental health services for adults of working age had access to a room unsupervised which held items which could cause harm. 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. Staff were provided with relevant information to care for patients safely. There was no fridge to keep medicines cool when required. The majority of community mental health teams did not meet the referral to initial assessment and assessment to treatment times. Feedback from those who used the families, young people and children services was consistently positive. 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. One review was in response for the delivery of actions for the 2018 CQC inspection. No rating/under appeal/rating suspended We noted how much time the new executive team had invested in making and implementing improvements during the COVID-19 pandemic. Patients returning from leave from the acute mental health wards were not assured of returning to their original ward. For example relating to assessment of ligature points at Westcotes. However, they were not updated regularly or following an incident. A psychologist led weekly reflective practice sessions to help staff think about the best way of helping the patient on the ward. There was no process in place for learning from other organisations which provided similar services or to share this services best practice. The trust had developed checklists to assist staff with the receipt and scrutiny process. Two external governance reviews had been commissioned and undertaken. Some staff found there was insufficient time to complete their visits within the working day. Staff told us they involved patients carers but there was little evidence of this in care records. Record keeping at Stewart House was disorganised. 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. 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. The HBPoS did not have access to a dedicated clinic room. Staff received Mental Capacity Act 2005 and Deprivation of Liberty Safeguards Some staff did not demonstrate a good understanding of the Mental Capacity Act. Our HIV/AIDS Services program is in need of volunteers to help deliver . Home - Leicestershire Partnership NHS Trust Creating high quality, compassionate care and wellbeing for all. Incidents and near misses were reported and learning from these was shared. The trusts pace for implementing equality and diversity initiatives across the organisation needed improvement. Leicestershire patient care project shortlisted in prestigious awards. Staff said the system was difficult to use and this had affected the information recorded in patients notes. Leadership behaviours were fostered, and development of staff was encouraged. We rated it as requires improvement because: Our rating of the trust stayed the same. 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. Young people and their carers spoke positively about the CAMHS service. While the board and senior management had a vision with strategic objectives in place, staff did not feel fully engaged in the improvement agenda of the trust. There was a floating qualified unit coordinator to oversee the service requirement at the Willows. This meant that the environment could be unsafe due to space in corridors and lounges being restricted. There were not enough registered staff at City West and this was identified as a risk on the service risk register. 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. Access to rooms to undertake activities in the community for people with autism had been reduced. A family member spoke about enjoying regular meetings in the service gardens with their relative. Patients knew how to make a complaint or raise a concern and complaints were taken seriously. Staff were confused about Deprivation of Liberty standards and paperwork was incomplete. For example, for adepot injection,a slow-release slow-acting form of medication. Managers had plans in place to address this issue. 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. Staff had a good understanding of patients needs. 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 reviewed young peoples risk at every appointment and recorded this in the case notes. 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. The acute service contained large numbers of beds in bed bays accommodating up to four patients. All three service inspections were unannounced. Staff undertook comprehensive assessments and developed high quality care plans. The trust had identified the lack of psychological therapies for patients, and support and training for staff, on their risk register. 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. 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. 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. The trust experienced high demand for acute inpatient beds. 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. Patients we spoke with knew how to complain. 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. Care plans were generalised, not person centred or recovery focused. 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. The ovens were old and the dials were not visible and cupboards were broken. Staff were given opportunities to expand their knowledge and develop their roles. CAPTRUST for Institutions. Managers had a recruitment plan in place to increase the number of substantive staff for the service. Men using the laundry had to pass womens bathroom and bedrooms. Not all care plans reflected patients assessed needs, or were personalised, holistic and recovery oriented. 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. Comprehensive assessments were being carried out and information was stored securely, except for one location and arrangements were in place to address this. Five out of 25 care records showed that patient involvement had not been recorded. Staff did not ensure that mental capacity assessments and best interest decisions were consistently documented in care records. 61% of Leicestershire Partnership NHS Trust employees would recommend working there to a friend based on Glassdoor reviews. Their service users and staff are extremely important to them. Staff knew the vision and values of the trust and agreed with these. The team engaged with patients who found it difficult or were reluctant to engage with mental health services. Clinic room temperatures were very hot, although one thermometer was above a radiator so would not give an accurate reading. At this inspection, we visited the two mental health services previously rated inadequate and one mental health service previously rated as requires improvement. View more Profession Occupational Therapist Service Learning Disability Grade Band 6 Contract Type Permanent Hours Full Time. 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. Staff told us that the trust were recruiting for their vacancies and they hoped to have a full complement of staff in the coming months. The summary for this service appears in the overall summary of this report. Staff morale was low and they felt disempowered in some areas. Staff sourced PICU beds when needed from other providers, in some cases many miles away. There were high vacancy rates. They and their carers were kept informed and involved in their treatment and care. Not all patient records showed a full assessment of need, including physical health needs or up to date care plans. Staff were not aware of how this might affect the safety and rights of the patients. Reductions in social service provision had led to an increase in referrals to the Community Learning Disability Teams. HBPoS and crisis resolution and home treatment (CRHT) team toilets were not visibly clean. The school nurses used technology to communicate with young people. Staff were given feedback after incidents had been reported.
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