The health-based place of safety did not meet some aspects of the guidance of the Royal College of Psychiatrists. Any other browser may experience partial or no support. Staff we spoke with demonstrated their dedication to providing high quality patient 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. This was particularly relevant to protected characteristics. We have not inspected against other requirement notices that were issued at the same time; therefore, all requirement notices from the last inspection remain in place. This did not demonstrate a consistent temperature, had been maintained to assure the safety and efficacy of the medicines. DE22 3LZ. 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. A lack of availability of beds meant that people did not always receive the right care at the right time and sometimes people were moved, discharged early or managed within an inappropriate service. We saw patients were treated with kindness and compassion. Staff received Mental Capacity Act 2005 and Deprivation of Liberty Safeguards Some staff did not demonstrate a good understanding of the Mental Capacity Act. The trust provided patients with accessible information on treatments, local services, patients rights and how to complain across all services. Services treated concerns and complaints seriously, investigated them and learned lessons from the results. Staff demonstrated commitment to delivering high quality end of life care for their patients. 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 had been an increase in the number of CAMHS referrals over the last two years. There was good physical health care and good therapeutic treatment and activities. The community healthcare services provided by Leicestershire Partnership NHS Trust were judged to be good. The trusts Board Assurance Framework (BAF) was lengthy, was combined with a corporate risk register and had overdue actions. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. 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. At the time of inspection, there were a total of 647 children and young people currently waiting to be seen in specialised treatment pathways. We carried out this unannounced inspection of Leicestershire Partnership NHS Trust because at our last inspection we rated two mental health services provided by this trust as inadequate, four mental health services and one community health service as requires improvement. Click here to submit your comments to us. There were high vacancy rates. In all three services, not all staff were up to date with mandatory training. Our rating of this service improved. 87 of the total patients had been waiting over a year to begin treatment. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. The trust ensured that people who used services, the public, staff and external partners were engaged and involved in the design of services. There had been a change in leadership and a review of key performance indicators (KPIs) with commissioners. Recruitment was in progress for 10 new healthcare support workers. Records were stored securely and well managed by staff to ensure that sensitive information about patients was protected. Patients and carers were involved in assessment, treatment and care planning. Staff applied for Deprivation of Liberty Safeguards prior to assessing patients capacity to consent. Managers had a system in place for tracking and learning from safeguarding incidents and other reportable events. 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. Bathrooms and toilets were specified for which gender depending on who was resident at the unit at the time. The single point of access made contacting the service easy for both patients and health professionals and enabled referrals into the service to be triaged and assigned from one central point. We inspected three mental health inpatient services because of the ratings from the previous inspection. 56% of individual care plans were not up to date, personalised or holistic. We observed positive interactions between patients and staff. 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. Staff followed the trust policy on seclusion. Computer systems were not shared across GP surgeries so information sharing did not happen effectively. The service did not exclude patients who would have benefitted from care. The trust had identified the lack of psychological therapies for patients, and support and training for staff, on their risk register. There were good systems for lone-working which included a code word that staff used when they required assistance. ALT. Acute patients had been sent to rehabilitation wards inappropriately. Some patients continued to share bedroom spaces in dormitories, and personal belongings were stored on the floor because of limited storage provided by the trust. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Leicestershire patient care project shortlisted in prestigious awards. The trust had a major incident policy to deal with any major incidents or breakdown in service provisions. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. Patient outcomes were not routinely collected so the quality of the clinical care being delivered could not be measured or benchmarked. 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. This was: We also assessed if the organisation is well-led and looked at areas of governance, culture, leadership capability and improvement. A high number of outpatient appointments were cancelled. Urgent and emergency care services across England have been and continue to be under sustained pressure. It was clear to see the difference the investment and improvements had made since our last visit. Many staff knew the Trust values and were aware of the Chief Executive Officer. We carried out this unannounced inspection of Leicestershire Partnership NHS Trust because at our last inspection we rated two mental health services provided by this trust as inadequate, four mental health services and one community health service as requires improvement. There was an effective incident reporting system. Patients said they got bored at the weekends, as there were fewer activities on offer. Patients reported that they felt safe on the wards. 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'. This did not protect the privacy and dignity of patients when staff undertook observations. The school nurses used technology to communicate with young people. A new leadership structure had been introduced since the last inspection and had not yet fully embedded in the service. The trust had not responded in a timely way to eliminate shared sleeping arrangements (dormitories). Patients we spoke with knew how to complain. At this inspection the overall ratings for mental health services stayed the same in safe, effective and responsive, which we rated as requires improvement. The trust had a patient involvement centre, which was pleasant, well-equipped and supported involvement from friends and family. Staff managed their caseloads effectively; they discussed their caseloads during multi-disciplinary team meetings as well as in supervision. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. Comprehensive assessments were being carried out and information was stored securely, except for one location and arrangements were in place to address this. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. Let's make care better together. Emails and the trust intranet also provided staff with this information. There were low levels of restraint and staff tried other methods to de-escalate before restraining patients. Staff were not meeting targets for the assessment and assessment to treatment of urgent referrals and six week routine referrals. 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. Two patients told us they had experienced cancelled leave, and numerous staff confirmed that facilitating escorted leave had been difficult at times which had led to either a cancellation, or where possible delayed leave. Staff monitored patients physical health regularly from the point of admission. We saw staff engaging with patients in a kind and respectful manner on all of the wards. The leadership, governance and culture did not always support the delivery of high quality person centred care. We did not rate this inspection. Staff mitigated the risks posed in the garden area by accompanying patients when they wanted to access the garden. There were different recording systems in place, for example paper records and electronic records, different professional kept separate files. The ward had sufficient staff to provide care and treatment to patients. There was access to interpreters and staff were aware of how to access them. Effective multi-disciplinary team working and joint working did not always take place across services. Some improvements were seen in seclusion documentation and seclusion environments. The previous rating of requires improvement remains. The psychiatric outpatients was responsible for 2094 of the breaches, with city east reporting the highest of these breaches at 429.2. Following inspection, the trust submitted an action plan to review access to call alarms. spoke with 15 family members or carers of patients, reviewed the mental health act detention papers of 23 patients and seclusion records of 10 patients, and. Where patients took medicines home with them, staff ensured that they understood their use and storage. Nursing staff did not have a stock list to randomly check medication which meant they could not reconciliation check. 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. Staff routinely referred patients to access additional support for employment, housing, benefits and independent mental health advocacy. Patients were full of praise for staff and the care and support they offered. 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. 29 October 2021. The offer is for 250 to be paid through payroll and subject to tax and National Insurance and is non pensionable. 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. we have taken enforcement action. Our inspection approach allows us to make a judgement on how the trusts senior leadership leads the organisation and the provider level well-led rating is separate from the ratings of the services we inspected. 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. Leicestershire Partnership NHS Trust | 4,712 followers on LinkedIn. Some wards and patient areas had blind spots, where staff could not easily observe patients. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. There were improved systems and processes to manage storage, disposal and administration of medications. The trust had made progress in oversight of data systems and collection. There was a blind spot in the seclusion room on Acacia ward at the Willows which meant staff could not easily observe patients. We found serious concerns with medication disposal, storage, labelling and management of controlled drugs. Patients who accessed the CRHT team told us that they felt their wishes and needs were taken in to consideration, staff could be accessed quickly and they felt safe when visiting the Bradgate Mental Health unit. Some facilities lacked essential emergency equipment. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. We rated the trust as inadequate for well-led overall. Staff told us their managers were supportive and senior managers were visible within the service. Staff had the right qualifications, skills, knowledge and experience to do their job. 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. We looked at 20sets of seclusion recordsandfrom17 records,staff were notrecording seclusion, in line with the Mental Health Act Code of Practice. 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. They were reflected in the objectives of local teams. Therefore, patients were not always actively engaged in decisions about service provision or their care. This environment was pleasant and well equipped. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. People that were referred to the service were waiting for a care co-ordinator to be allocated. The local managers monitored the environment for staff, carried out local audits and checked performance of staff on a regular basis. The environment in the crisis service did not ensure confidentiality as rooms were not sound proofed and conversations could be heard outside the room. However staff did not appear to be fully aware of services provided and told us there were plans to implement a seven day service in end of life care. The services did not have a strategy and there were no service plans. Patients were protected from avoidable harm by sufficient staffing and safeguarding processes. For example relating to assessment of ligature points at Westcotes. Since the last inspection the service now had a Section 136 suite that met the standards set out in the Royal College Standards. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. Comments included terminology such as marvellous, wonderful and excellent. We rated end of life care services as good overall because: The trust had worked collaboratively with local partners to develop an end of life care strategy for the region as a whole which had incorporated a health needs analysis. 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 in practice. The trust had a variety of measures in place to ensure that processes and reporting to board were not delayed. NG3 6AA, In A new chief executive was appointed as a shared role between the two trusts. The risks and issues described by staff did not always correspond to those reported to and understood by their leaders. 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. Therefore there were no beds available if patients returned from leave. 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 trust lacked a framework for co-ordinating, endorsing and therefore learning from the very many positive quality projects taking place. There was a clear vision for the service which staff understood. We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels: Outstanding Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. Engagement with external stakeholders had significantly improved since our last inspection. Patients told us they did not have access to a copy of their care plan. Young people and their carers spoke positively about the CAMHS service. Discharge planning was considered as part of board rounds although discharge planning paperwork was not used consistently. 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. There was a range of large therapeutic areas and rooms for art therapy plus other interventions. Staffing skill mix was appropriate to need overall. We rated the trust as requires improvement for well led. The service was responding to complaints and implementing systems following these, however the trust waited for these complaints to prompt improvements in the service. View more Profession Nurse Service Child & Adolescent / CAMHS Grade Band 5 Contract Type Permanent Hours Full Time. Staff gave examples of working with people with diverse needs considering their ethnicity, gender, age and culture. The community nursing service could not measure its performance in relation to response times for unplanned care. Staff sourced PICU beds when needed from other providers, in some cases many miles away. Access to rooms to undertake activities in the community for people with autism had been reduced. 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. 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