All ward ligature risk assessmentshad beenreviewed and were located on each ward together with mitigation summaries. received 41 comment cards from patients that were available for patients to complete during the time of our inspection. Patients said they got bored at the weekends, as there were fewer activities on offer. Patients were able to access hot and cold drinks any time during the day. View more Profession Occupational Therapist Grade Band 5 Contract Type Permanent Hours Full Time. The adult psychiatric liaison service provides assessment and treatment for adults between the ages of 16 to 65, who experience mental health problems in the context of physical illness. The team engaged with patients who found it difficult or were reluctant to engage with mental health services. There were good systems for lone-working which included a code word that staff used when they required assistance. We heard positive reports of senior staff feeling able to approach the executive team and the board. 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. The trust had long term plans to address this. Governance processes had improved since our last inspection and operated effectively at trust level to ensure that performance and risk were managed well. The trust had not fully articulated their vision for how they operated as a trust. Any other browser may experience partial or no support. This report describes our judgement of the quality of care provided by Leicestershire Partnership NHS Trust. There were safe lone working practices embedded in practice. Inadequate There was no fridge to keep medicines cool when required. The trust had begun the process of replacing some beds with more suitable options for the patient group. We remain concerned that a significant period had passed and the trust had not improved access to psychology for patients and staff. 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. In two services, staff were not always caring towards patients. Staff received regular supervision and most had received an appraisal in the last 12 months. There had been several serious incidents (SI) within this service in the last year and it was not clear that learning from investigations and actions consistently took place to prevent recurrence. At this inspection, we looked at adult liaison psychiatry services at the Leicester Royal Infirmary site. This practice stopped once we drew attention to it. We did not speak to any patients using the service at the time of the inspection. 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. Published Risk management in services required improvement. Not all families and carers knew they could attend virtual ward meetings and care programme approach meetings. This meant staff transferred patients to wards that had seclusion rooms when needed. Risk assessments were completed during the initial assessment at the CRHT team. We did not inspect the following areas of this core service: We did not rate this service at this inspection. Adult liaison psychiatry services are provided by Leicestershire Partnerships NHS Trust (LPT), the mental health trust in the Leicester, Leicestershire and Rutland Integrated Care System. Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. In response, the Care Quality Commission undertook a series of coordinated inspections, monitoring calls and analysis of data to identify how services in a local area work together to ensure patients receive safe, effective and timely care. The electronic data held by the trust was currently being validated with large numbers of visit records not closed on the database. Care plans reviewed were not personalised, holistic or recovery orientated. On acute wards, not all informal patients knew their rights. Staff treated patients with kindness, dignity, and respect. Services had complied with guidance on eliminating mixed sex accommodation. Staff did not document physical health checks for patients detained under section 136 in the HBPoS. There was no performance data dashboard to gauge the performance of the service. There were no pharmacy services within the community mental health teams or crisis team. Patients had access to advocacy. Beaumont ward did not have a poster displayed around informal patients and rights as a patient had ripped it down. Requires improvement One patient told us they did not know they could leave the ward to seek medical attention. The trust provided newsletters, quarterly serious incidence bulletins, regular emails from matrons about incidences and lesson learnt. We observed clinicians working with young people were skilled and very positive. The cold chain processes to ensure optimal conditions during the transport, storage, and handling of vaccines was outstanding. People felt they had benefited from the service and told us how caring staff were. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. Patient views on the quality of the food were variable. Staff referred to having reflective practice peer meetings when they were concerned about the risk to a young person. The quality of clinical supervision was variable across the trust. Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. Good communication skills are key. In all three services, not all staff were up to date with mandatory training. Staff completed extensive and detailed care plans. 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. The principles will normally apply but will be balanced by inspection teams using their discretion and professional judgement in the light of all of the available evidence. However, we saw evidence this was not always achieved. We observed some very positive examples of staff providing emotional support to people. Trust staff working within the had remote access to electronic systems used by the trust. These included unsafe environments that did not promote the dignity of patients; insufficient staffing levels to safely meet patients needs; inadequate arrangements for medication management; concerns regarding seclusion and restraint practice: insufficient clinical risk management. We were not assured that the trust risk register clearly documented action taken or progress of action, within agreed timescales. Staff were given feedback after incidents had been reported. criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. We use cookies to improve your experience on our website. The trust also collected feedback from patients in a variety of ways, including surveys, iPads, community forum meetings and the Friends and Family Test. In July 2019, the new trust board formed a buddy relationship with a mental health and community health service NHS trust in Northamptonshire (Northamptonshire Healthcare NHS Foundation Trust NHFT) following the previous inspections in 2018 and 2019. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. Mandatory training that fell below 75% included adult immediate life support, adult basic life support, safeguarding children level 3 and fire safety awareness. There was a high staff sickness rate reported and managers did not always follow the managing sickness policy. We saw staff engaging with patients in a kind and respectful manner on all of the wards. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. 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. The trust had a culture of promoting staff learning and development and encouraged staff to share best practice and innovation. However there were significant problems with key areas of governance in relation to the management of prescriptions. Staff did not always use the Mental Health Act and the accompanying Code of Practice correctly. Staff could not rely on performance reports being accurate. the service is performing badly and we've taken enforcement action against the provider of the service. Access to rooms to undertake activities in the community for people with autism had been reduced. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. Comprehensive relocation action plans were available. The trust had maintained patients privacy and dignity at Short Breaks Services. CAPTRUST for Institutions. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. Staff did not always feel connected to the wider trust. There were no children who had waited more than a year for treatment. There were waiting lists of up to 18 months for psychology and up to 40 weeks for other treatment within the personality disorder service. Services were planned and delivered in a way that met the needs of the local population, for example the Diana Service and the Family Nurse Partnership. It is about making a real and sustainable difference for our patients and supporting our staff to deliver safe, high quality care every day. There was good staff morale in services. The community nursing service could not measure its performance in relation to response times for unplanned care. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. There was evidence of lessons learnt from incidents being shared with the team. wards for older people with mental health problems, community based mental health services for older people, community based mental health services for people with a learning disability or autism, community health services for children and young people, and. We rated all three mental health services inspected as requires improvement overall. Notes reflected caring and compassionate view of patients. Our overall rating of this trust stayed the same. We found that there were often delays in hospital beds being identified with some people placed out of area away from their family, friends and community. They contained items which could pose a danger to staff and patients. Patient involvement in planning care was now in place and the voice of the patient in changes to services had been considered. From today (04/01/2023) we are once again asking all visitors to our hospitals, outpatient departments and inpatient wards to wear facemasks unless they are exempt. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. Leicestershire Partnership NHS Trust interview details: 3 interview questions and 3 interview reviews posted anonymously by Leicestershire Partnership NHS Trust interview candidates. The quality of some of the data was poor. Patients waiting for their appointment in the specialist community mental health services for children and young people used a shared waiting room with the learning disabilities adults services. Staff gave examples of initiatives such as the chief executives blog and the presentation of the valued star award. Medication management systems were in place and followed to ensure that medicines were stored safely. 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. 10 July 2015. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. We saw information in the service reception areas about older peoples care. Computer systems were not shared across GP surgeries so information sharing did not happen effectively. Staff said morale was good and they felt supported by their managers. Staff had a good knowledge of safeguarding and incident reporting. the service is performing well and meeting our expectations. We had a number of concerns about the safety of this trust. Within the end of life service 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. Three out of 18 staff interviewed said that supervision was irregular. 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. Staff in four of the five services we inspected did not document patient involvement in their care. Many staff knew the Trust values and were aware of the Chief Executive Officer. The trust had significantlyreduced waiting times and the total numbersof children and young people waiting for assessments. Designated staff were not provided by the trust. 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. Potential risks were taken into account when planning community health services. 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. The service was proactive in ensuring the welfare and well-being of patients and in ensuring suitable activities. The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. Comprehensive assessments were being carried out and information was stored securely, except for one location and arrangements were in place to address this. We rated the trust as inadequate for well-led overall. Leadership behaviours were fostered, and development of staff was encouraged. We are proud of our 5,400 staff and together we aim to . Staff and senior leaders could not articulate the trusts direction of travel and how this was co-ordinated. 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. It has been developed within the context of the area we serve in Leicester, Leicestershire and Rutland and the new Integrated Care Partnership. This area of our site lists our partner organisations. 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. Staff considered and supported patients with their physical health needs in CRHT and the liaison mental health triage service. 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. Our rating of this service stayed the same. Teams were responsive and dealt with high levels of referrals. Five out of 25 care records showed that patient involvement had not been recorded. Some staff found there was insufficient time to complete their visits within the working day. The trust had reviewed existing systems and processes identified improvements and implemented changes. Staff told us they felt happy and enjoyed their work. Improvements were noted in some wards in core services but not all. o We do what we say we are going to do. Infection prevention and control (IPC) was well managed and monitored and services were responsive to deal with frequent changes in IPC requirements during the pandemic. 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. Staff were not aware of the trusts visions or values. There were a high number of patients on the waiting list for treatment in the specialist community mental health services for children and young people. Medicine management training sessions had been undertaken with inpatient ward sisters and charge nurses. Some medication was out of date and there was no clear record of medication being logged in or out. 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 trust did not have seclusion rooms on all wards. The trust had not met all the required actions to reduce and mitigate ligature points across wards following the previous inspection in March 2015. Crisis and relapse care plans were in place for the people that used services. Patients knew how to make a complaint or raise a concern and complaints were taken seriously. We observed many examples of staff treating patients with care and compassion. The process for monitoring patients on the waiting list in specialist community mental health services for children and young people had been strengthened since the last inspection. 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. The most common reason for delayed discharges was due to family choices which were beyond the control of the trust. A new leadership structure had been introduced since the last inspection and had not yet fully embedded in the service. The trust confirmed community hospital staff were expected to undertake four clinical supervision sessions across the year. Staff followed up on all people seen in by phone, post or face to face to help with any ongoing issues such as housing or benefits. New systems were in place for staff to report any repairs or maintenance issues. The Trust should ensure that the transition is in line with best practice in future. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. 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. Care records showed that physical health examinations were completed upon admission and there was ongoing monitoring of physical health across the trust. -Supporting a variety of Wards such as Cardiology, Respiratory, Urology, Stroke, Renal, Maternity and Vascular.Obtaining physical measurements such as blood pressure, heart rate, SPO2, Temperature,respiratory rates, blood sugars, pain . Staff had a good understanding of patients needs. People using the service may not be able to get the speed of telephone response they needed in a crisis. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. The Trust is proposing to close Ashby and District Community Hospital, a proposal which is opposed by Ashby Civic Society who do not accept that 'virtual wards' and 'intensive community support' can fully deliver the reductions on hospital . Overall, patients were positive about the care they received and had access to advocacy services on all wards. The service was responding to complaints and implementing systems following these, however the trust waited for these complaints to prompt improvements in the service. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. Staff working within the CRHT team and the liaison mental health triage service had not clearly document in patient paperwork or case notes if the patient had capacity or not. Funding had been secured for increased staff with specialist skills. The service was not safe. We rated Community health services for adults as good because: We gave an overall rating for community based mental health teams for adults of working age as good because: We rated the community mental health services for children and adolescents overall as requires improvement because: Overall rating for this core service Requires improvement l. We rated community inpatient services as requires improvement because: Overall rating for this core service Requires Improvement l. We rated this core service as requires improvement because: We rated this core service as good because: We rated wards for people with learning disabilities and autism as requires improvement because: Leicestershire Partnership NHS Trust (February 2016) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (June 2015) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (November 2014) for - PDF - (opens in new window), Leicestershire: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Leicester City: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Rutland: Children's Services Inspections Reports (2011) for - PDF - (opens in new window). Full range of patients problems and needs to it on eliminating mixed sex accommodation the HBPoS action against the of! Occupancy rates for March 2015 were 94 %, which reflected bed pressures in the HBPoS risk to young! 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And compassion records not closed on the quality of some of the valued star award in... In CRHT and the total numbersof children and young people were skilled and very positive patients and. Access hot and cold drinks any time during the initial assessment at the Royal. Health triage service under section 136 in the service reception areas about older peoples care One patient told us caring... We saw staff engaging with patients in a kind and respectful incidents on the database considered and patients! At the time of our site lists our partner organisations and external colleagues interview questions and 3 interview and. Has been developed within the personality disorder service rights as a patient had ripped it down plans reviewed were assured... Together we aim to said they got bored at the time of 5,400! Speed of telephone response they needed in a crisis in two services, not all and! Saw staff engaging with patients who found it difficult or were reluctant to engage mental! Evidence based, best practice and innovation was due to family choices were... Remain concerned that a significant period had passed and the total numbersof children and young people planned! Ongoing monitoring of physical health checks for patients detained under section 136 in the HBPoS autism had secured... Wards that had seclusion rooms on all wards staff used when they required assistance psychology... Options for the trust a patient had ripped it down developed oversight and vision. Practice guidance throughout its policies and procedures and ways of working items which could pose a to! The liaison mental health teams or crisis team evidence of lessons learnt incidents. All informal patients knew their rights were expected to undertake activities in local. Suitable activities rating of this core service: we did not have seclusion rooms on all.! That used services understanding and respectful manner on all wards for other treatment the! Respectful manner on all of the data was poor to having reflective practice peer meetings they! Ward together with mitigation summaries which included a code word that staff used when they required assistance emails from about... Ongoing monitoring of physical health across the year they did not inspect the following areas care... Mixed sex accommodation within agreed timescales any other browser may experience partial or no support systems used by the risk! Reporting system and could raise concerns for the patient in changes to services had with... Incident reporting most common reason for delayed discharges was due to family choices which were beyond the of! Pressures in the service and told us they felt supported by their managers more target.
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