We found that staff across the service were committed to providing good quality care to the patients and showed care and compassion. The trust was not meeting its target rate of 85% for clinical supervision. Published The service did however, complete local audits and produced action plans for improvement in care. Staff allowed patients time to respond to questions and did not try to hurry them. Staff moved acute patients to the rehabilitation wards when acute beds could not be located. Medication management had improved significantly across the services. There was a blanket restriction. They could undertake both internal and external training and were able to give feedback on service development. Within mental health services the quality of care plans was variable. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. 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. Any other browser may experience partial or no support. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. Staff demonstrated poor understanding of some aspects of the Mental Capacity Act. Staff were suitably trained with the relevant knowledge and skills to carry out their work, had regular appraisals and had access to the information they needed to perform their duties. Through this collaborative working we are also building a culture of continuous improvement and learning, supported by a robust governance framework and more sustainable and efficient use of resources. At this inspection we found compliance levels with this type of training were still below the trusts target. Equality diversity and inclusion matters had been a focus of the new trust leadership team. Some managers had access to key performance data and could respond to areas of improvement, but this was not consistent in all aspects of care delivery and across all services. 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. However, the service was collecting data. Wards had good evidence of multi-disciplinary team working, enabling staff to share information about patients and review their progress. There was effective multidisciplinary working. The average bed occupancy was low. Some improvements were seen in seclusion documentation and seclusion environments. Staff did not always feel actively engaged or empowered. There was no process in place for learning from other organisations which provided similar services or to share this services best practice. Bank Band 6 Speech and Language Therapist. Staff were caring, compassionate and kind towards patients. The electronic prescribing system which the trust had implemented supported the safe administration of medicines to patients, with staff reporting very few medication errors as a result of this. The work in neighbourhoods reduced travel for people and reduced barriers for people to gain support. The service used a computer record system that differed from the rest of the trust. The trust had key roles in the development of health and social care system working, and collaboration with other care providers to improve provision of mental health services. Staff were open about their poor understanding around the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. A family member spoke about enjoying regular meetings in the service gardens with their relative. Clinic room temperatures were very hot, although one thermometer was above a radiator so would not give an accurate reading. At this inspection, two of the three mental health services we inspected improved overall. Staff were consistently caring, respectful and supportive. This was done by sliding signs to the door as needed. We rated families, young people and children services as good because: There were systems in place for reporting incidents and the service was able to demonstrate learning and sharing following incident investigations. The transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS Trust (LPT). Response times to maintenance request were variable. However, no time frame was set for the work to be completed. Patients had their own copies of care plans and were involved in their care plan reviews. Not all medicine records included allergy information. 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. Staff were very caring and sensitive to patients needs. 27 February 2019. Staff told us they felt happy and enjoyed their work. Staff were not always recording room and fridge temperatures in clinical rooms and out of date nutrional supplement drinks had not been appropriately disposed of. Patients and their relatives felt involved in the care provided. There were good systems for lone-working which included a code word that staff used when they required assistance. Shifts were not always covered with sufficient staff, or with staff who had the appropriate qualification and experience for the role. Staff felt supported by their immediate managers but felt disaffected with trust senior management. At the Agnes Unit, staff did not always record the physical health of patients who had been given rapid tranquilisation. In most services, we were concerned with the lack of evidence in care plans which showed patients and carers had been consulted and involved in their care. Patients and carers knew how to complain. Staff showed caring attitudes towards their patients. The trust was not fully compliant with same sex accommodation guidance in two acute wards, the short stay learning disability service and rehabilitation services. There was a high vacancy rate of 12.9% for band 5 and 6 nurses in community based mental health services for adults of working age, 18.9% for band 5 and 6 nurses in crisis service and 17.3% across community health services for adults. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. Staffing numbers were met but not always the right skill mix. Leicestershire City Council are proposing to keep Leicestershire Partnership NHS Trust as the provider, as it is a high performing service, and to recommission 0-19HCP by using Section 75 of the National Health Services Act of 2006. We talk to patients, the public and colleagues about what matters most to them and we do not assume that we know best. The trust had made progress in oversight of data systems and collection. All assessment rooms had good visibility. There was an effective duty system in place to provide rapid access to support. This was a focused inspection. Following inspection, the trust submitted an action plan to review access to call alarms. The HBPoS did not have designated staff provided by the trust. Wards for people with dementia had dementia-friendly elements; particularly the activity rooms and there was commitment to build on this. Despite the issues we found with storage, disposal, labelling and controlled drugs, the trust had made improvements to prescribing of medication and had successfully implemented e-prescribing processes trust wide. On Kirby ward there was no evidence of Section 132 rights read on detention in 54% of records reviewed. All ward ligature risk assessmentshad beenreviewed and were located on each ward together with mitigation summaries. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. There were appropriate arrangements in place for the safe management of medicines. Patients knew how to formally complain and could attend daily community meetings where they could raise any issues of concern. Two things remain consistent across the breadth of services we offer and . These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. We rated the trust overall for well-led as inadequate. the service is performing well and meeting our expectations. Staff were not aware of the trusts visions or values. A new chief executive was appointed as a shared role between the two trusts. The acute wards for adults of working age had not complied with all of the required actions following the previous inspection of September 2013. Mandatory training compliance for trust wide services was 91% against the trust target of 85%. There was a duty worker system in place which meant the service was able to respond quickly to escalating risks if necessary. Our overall rating of this trust stayed the same. Some medication was out of date and there was no clear record of medication being logged in or out. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. Leicestershire Partnership NHS Trust Add a Review About 32 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. Suspended ratings are being reviewed by us and will be published soon. New positions such as medicines administration assistants and link nurses to support wards were in place in certain areas, but ward staff still described irregular pharmacy visits and a lack of pharmacy oversight in medicines management. Managers had introduced a duty clinician to manage caseload sizes and reduce patients risks. Staff completed Mental Health Act 1983 (MHA) paperwork correctly and systems were in place for secure storage of legal paperwork, advice and regular audits. At Melton, Rutland and Harborough and Charnwood there was a lack of audits and little focus on quality and improvement. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. the service is performing badly and we've taken enforcement action against the provider of the service. Staff were observed to be caring and responsive to patients. Staff we spoke with demonstrated their dedication to providing high quality patient care. We rated child and adolescent mental health wards as good because: The ward had clear lines of sight in the main areas of the ward. Apply. All wards had developed their own systems to improve medicines management in their areas. The most common reason for delayed discharges was due to family choices which were beyond the control of the trust. Thy are entitled to receive a remuneration of 13,000 per annum each and have . Some staff had not received their mandatory training, supervision or appraisal. Crisis and relapse care plans were in place for the people that used services. Staff were quick to sort out requests and problems for patients. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. We use cookies to improve your experience on our website. Team managers identified areas of risk within their team and submitted them to the trust wide risk register. We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. Staff were unaware of any service specific strategic direction. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. There was no fridge to keep medicines cool when required. The trusts pace for implementing equality and diversity initiatives across the organisation needed improvement. Research in Families, Young People and Childrens Services, and Learning Disability Services, Research Office and Research Delivery Team, Patient Advice and Liaison Service (PALS), Supporting serving and ex-service personnel, Contact the Equality, Diversity & Inclusion Team, Useful guides for staff to help raise awareness of Dyslexia and Autism. 42% of staff on Phoenix ward and 27% Griffin ward had received clinical supervision. Patients reported they were treated with dignity and respect. 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. Staff were dedicated and passionate about the work that they undertook. The teams did not have waiting lists for care coordinators at the time of inspection. The service was caring. The wards tried to book regular bank and agency staff so they knew the ward and patients, to provide continuity of care. ", Daxa Mangia, Mental Health Nurse, The Willows, "I really enjoy my job, helping people to recover - I cannot imagine doing anything else.". Safeguarding was a high priority with regular safeguarding reviews within each area of speciality and established systems for supporting staff dealing with distressing situations. Waiting times for referral to initial assessment appointments were good, although patients experienced delays for community paediatric clinic follow up appointments. Lessons were learned from feedback and complaints from patients. The longest wait was 108 weeks for four patients to access group work or outpatients. Staff were kind, caring and compassionate and treated patients with dignity and respect. The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. That's what building health equity means to us. The community healthcare services provided by Leicestershire Partnership NHS Trust were judged to be good. Patients described being cared for, respected and treated with dignity. The trust set target times from referral to initial assessment against the national targets of 28 to 42 days. Staff were up to date with mandatory training. Staffs were dedicated, passionate and patient focused. Environments were visibly clean and welcoming. Community meetings and patient involvement in the services did not always take place. The quality of data was variable, for example training statistics were not always reliable. At this inspection, we visited the two mental health services previously rated inadequate and one mental health service previously rated as requires improvement. Staff working for the adult psychiatric liaison team developed holistic, recovery-oriented care plans informed by a comprehensive assessment and in collaboration with families and carers. 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. Following the appointment of a new chief executive a new trust board was formed. Managers had introduced a specialist child and adolescent mental health traffic light system, a red, amber and green rating tool for managing risk. Staff were not always recording their supervision on the electronic system so we could not be assured they were receiving it regularly. We found this across core services and within senior teams. Staff used strategies to maintain patients safety which had an adverse effect on their dignity and privacy. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. Patients and carers gave positive feedback about the caring nature and kindness of staff and made positive comments about the positive therapeutic relationships they had with their loved ones. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. There was a floating qualified unit coordinator to oversee the service requirement at the Willows. In 3Rubicon Close, it was not clear that information about providing physiotherapy to a patient had been communicated to all staff. In community based mental health teams for older people five of six services breached national targets from referral to assessment. Record keeping was poor in some services. 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. Coventry, Some wards did not meet the Department of Health and Mental Health Act Code of Practice requirements in relation to the arrangements for mixed sex accommodation. It was clear to see the difference the investment and improvements had made since our last visit. The short breaks service was primarily set up to meet the needs of relatives and carers. The provider supplied lockers on the wards; however, these were not large enough to contain all possessions and patients did not hold keys. Staff documented seclusion well in most services, compared to our last inspection. We have issued seven requirement notices which outline the breaches and require the trust to take action to address. Advanced Directives had been introduced to enable patients to make decisions now about their long term care. Patients said they got bored at the weekends, as there were fewer activities on offer. We spoke with carers; they all stated that staff responded well when they contacted the service. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. Another relative said their relative was a changed person since going to the Willows and they were able to go home last Christmas. Staff completed extensive and detailed care plans. We saw staff treating people with dignity and respect whilst providing care. Staff support systems were in place and there was a drive to engage with staff. Staff did not assess and record the risks posed by medicines stored in patents homes. The school nurses used technology to communicate with young people. 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. the service isn't performing as well as it should and we have told the service how it must improve. egistered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. Records were stored securely and well managed by staff to ensure that sensitive information about patients was protected. Staff and senior leaders could not articulate the trusts direction of travel and how this was co-ordinated. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. The trust did not always manage the admission of patients into mixed sex environments well. Staff did not record seclusion well. 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leicestershire partnership nhs trust values
