Staff did not always use the Mental Health Act and the accompanying Code of Practice correctly. A childrens adolescent mental health crisis service had been developed and commenced in April 2017. 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. Notes reflected caring and compassionate view of patients. Leicester, United Kingdom. Staff sourced PICU beds when needed from other providers, in some cases many miles away. Staff made individualised risk assessments which were regularly updated and followed best clinical practice. Medication management across four of the five services we inspected was poor, despite reported trust oversight and audit. We identified medicines management issues, including out of date medication in the acute mental health wards and fridge temperatures were not monitored in community based mental health services for adults. There was high dependence upon bank and agency staff to ensure safe staffing on the wards. The dignity and privacy of patients across three services we visited was compromised. The trust set target times from referral to initial assessment against the national targets of 28 to 42 days. Staff treated patients with kindness, compassion and respect.We saw staff spend time talking to and their carers. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. Leicestershire Partnership NHS Trust Is this your company? The service had 175 delayed discharges between August 2015 and July 2016, which accounted for 43% of the trusts total delayed discharges. The trust had a variety of measures in place to ensure that processes and reporting to board were not delayed. Staff told us they felt supported by their line managers, ward managers and matrons. Staff provided psychological therapies as recommended by NICE such as group work and cognitive behavioural therapy. In 3Rubicon Close, it was not clear that information about providing physiotherapy to a patient had been communicated to all staff. Leadership had been strengthened at Stewart House. We're one team with shared values providing the best care possible. All the team leaders we interviewed said there were internal waiting lists for patients who had been initially assessed to access profession specific treatments. The previous rating of requires improvement remains. The trust had made progress in oversight of data systems and collection. Some areas at Bradgate Mental Health Unit required further improvements to the environments. The trust had set safe staffing levels and these were followed in practice. The trust had not fully articulated their vision for how they operated as a trust. Managers shared the outcome of complaints with their ward teams. Some wards and community teams did not store or manage medicines safely. Staff reported they felt supported by their colleagues and managers. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. 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. The paperwork was difficult to find and not consistent. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. Managers ensured they monitored their staffs compliance with mandatory training using a tracker system. They showed a good understanding of peoples individual needs. Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. Access to rooms to undertake activities in the community for people with autism had been reduced. On one ward, female shower rooms did not contain shower curtains. Staff showed us that they wanted to provide high quality care, despite the challenges of staffing levels and some poor ward environments. 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. Safeguarding was a high priority with regular safeguarding reviews within each area of speciality and established systems for supporting staff dealing with distressing situations. Risk management in services required improvement. Therefore, patients were not always actively engaged in decisions about service provision or their care. The trust had identified the lack of psychological therapies for patients, and support and training for staff, on their risk register. The HBPoS did not have designated staff provided by the trust. Three out of 18 staff interviewed said that supervision was irregular. There had been periods of understaffing. The environment in some services was poor, not well maintained and not kept clean. 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. Staff completed extensive and detailed care plans. Designated staff were not provided by the trust. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. Assessed risks were well-managed and staff showed a good awareness of individual needs and how to respond to them. 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 had been given lone worker safety devices to ensure their safety. This had continued during the pandemic. Not all patients on acute wards for adults of working age could summon help from staff if required. This meant staff transferred patients to wards that had seclusion rooms when needed. Managers identified the breach in these targets and had plans in place to reduce them and had highlighted this risk on the risk register. Improvements were needed to make them safer, including reducing ligatures, improving lines of sight and ensuring the safety and dignity of patients. Staff did not always feel actively engaged or empowered. The trust had long term plans to address this. egistered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. Services and care were planned with the local population in mind and to address the individual needs of patients. We had a number of concerns about the safety of this trust. Managers ensure that they acted on these findings to reduce the risk of reoccurrence. There was a risk that staff did not receive adequate support or that their capability was not reviewed. There were no separate female bedroom areas and no gender specific toilets or bathrooms. Patients did not have access to regular community meetings where they would discuss ward issues and concerns. DE22 3LZ. We heard from most teams, positive examples of teamwork and multidisciplinary working within teams and services, and with external agencies and key stakeholders. This meant that patients were not protected from receiving unsafe treatment. Patients had opportunities to continue their education. The clinic rooms across sites had all the equipment calibrated. Staff interacted with patients in a responsive and respectful manner at all times and showed a good understanding of individual needs. Most people and carers gave positive feedback about staff. This included environmental improvements, shared sleeping accommodation, response times to maintenance issues, care planning and access to relevant therapies in certain services. Many staff knew the Trust values and were aware of the Chief Executive Officer. Staff satisfaction varied greatly across the service with some staff feeling devalued. The trust provided patients with accessible information on treatments, local services, patients rights and how to complain across all services. Our overall rating of this trust stayed the same. Patients reported staff treated them with dignity and respect. NHS Improvement is pleased to announce the appointments of Alexander Carpenter and Hetal Parmar as Non-executive Directors of Leicestershire Partnership NHS Trust from 1 June 2022 to 31 May 2025. This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. Patients could not always access a bed in their locality when needed and the trust moved patients between wards and services during episodes of care and following return from leave. This could pose a risk as patients were unsupervised in this area. Staff received supervisions and appraisal. Adult liaison psychiatry is categorised under Mental Health Core service of Mental Health Crisis and Health Based Places of Safety (HBPoS), as it is provided by the mental health trust, Leicestershire Partnership NHS 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. 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. We found that staff across the service were committed to providing good quality care to the patients and showed care and compassion. The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. Staff did not ensure that mental capacity assessments and best interest decisions were consistently documented in care records. 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. However, managers had identified funding for two agency nurses to start work the week following the inspection. Bathrooms and toilets were specified for which gender depending on who was resident at the unit at the time. They were constantly looking at ways to improve their work and the patient experience of the service. We saw patients were treated with kindness and compassion. Download full inspection report for - PDF - (opens in new window), Published We inspected adult psychiatric liaison services as part of Mental Health Crisis and Health Based Places of Safety core service. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. We're always looking for the best. The trust confirmed staff delivering end of life care were involved in bi-annual record keeping, safeguarding and clinical supervision audits. Wards provided safe environments where patients felt secure. The trust experienced high demand for acute inpatient beds. NG3 6AA, In The trust board had not reviewed full investigation reports for the most serious incidents, only the outcomes and lesson learnt. 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. We rated the caring domain for the community health families, young people and children service as outstanding due to staff approaches to family and patient care utilising or creating tools to assist children to understand their condition or prepare for treatment. Four young people told us they felt involved in developing their care plan however, they had not received a copy. 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. They did not have alarms or vision panels in the door. Clinical supervision was not taking place regularly across the service. There was a range of treatment and activity delivered by skilled and experienced staff. Leicestershire Partnership NHS Trust provides mental health, learning disability and community health services across Leicestershire, England.. Patients were able to access hot and cold drinks any time during the day. The adult community therapy team did not meet agreed waiting time targets. Some local managers were keeping their own records to ensure performance was monitored. Patients reported they were treated with dignity and respect. Staff had good knowledge of safeguarding processes and risk assessments were generally detailed, timely and specific. ", John Barnes, Charge Nurse, LD Short Breaks, "I really enjoy the human interaction on a daily basis - with colleagues, patients, relatives. We inspected three mental health inpatient services because of the ratings from the previous inspection. Leadership behaviours were fostered, and development of staff was encouraged. Patients told us they did not have access to a copy of their care plan. Staff were not supervised in line with the trust's policy. We rated community health services for adults as requires improvement because. We rated Leicestershire Partnership NHS Trust as Requires Improvement overall because: Published wards for people with a learning disability or autism. 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. 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. Requires improvement Staffing levels were below the expected level. Concerns about high bed occupancy, record keeping and delayed discharges were identified in the March 2015 inspection and had not been sufficiently addressed. The local managers monitored the environment for staff, carried out local audits and checked performance of staff on a regular basis. 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. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. Each priority within our approach is being led by an executive team member and progress is being monitored through our quality governance framework. Whilst there was a plan to eradicate the dormitories across the trust, there were delays to the timetable and patients continued to share sleeping accommodation which compromised their privacy. The trust had improved how staff recorded patients physical healthcare, and monitored patients who had ongoing physical healthcare problems. . Managers changed practice because of this. We observed positive interactions between patients and staff. Patients we spoke with knew how to complain. There were not enough registered staff at City West and this was identified as a risk on the service risk register. All patients told us staff respected their privacy and dignity. We saw information in the service reception areas about older peoples care. Seclusion environments were not an issue of concern at this inspection. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. Staff we spoke with were unaware of incidents and learning on other wards across acute wards for adults of working age; this was highlighted as an issue at our inspection in 2018. Overall, patients were positive about the care they received and had access to advocacy services on all wards. Another relative said their relative was a changed person since going to the Willows and they were able to go home last Christmas. The trust had new seclusion paperwork implemented in May 2019. the service is performing well and meeting our expectations. Staff maintained a presence in clinical areas to observe and support patients. 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 health-based place of safety did not meet some aspects of the guidance of the Royal College of Psychiatrists. HBPoS and crisis resolution and home treatment (CRHT) team toilets were not visibly clean. For example relating to assessment of ligature points at Westcotes. During the depot clinic staff did not close privacy curtains when patients were receiving depot injections. Many staff we spoke with knew who their chief executive was and mentioned them by name. One patient told us they did not know they could leave the ward to seek medical attention. This could have resulted in an increased risk of incorrect safe and secure handling of medicines and unsafe practice in relation to the administration and prescribing of medicines. The ratings from the inspection which took place in November 2018 remain the same. The trust had a range of information displayed on the ward and the hospital site relating to activities, treatment, safeguarding, patients rights and complaint information. The service was not well led. Mobility and healthcare equipment took up space in The Gillivers and 3Rubicon Close. All wards had developed their own systems to improve medicines management in their areas. Outcomes of care and treatment were not always consistently or robustly monitored. A report on the inspection was . 78% of staff had completed their annual appraisal. There's no need for the service to take further action. This report describes our judgement of the quality of care provided by Leicestershire Partnership NHS Trust. Improvements had been made to the seclusion facilities, and further improvements were planned across the service to improve patient experience and promote privacy and dignity. There were key performance indicators set for time from referral to assessment and where these were not being addressed action had been taken. Staff referred to having reflective practice peer meetings when they were concerned about the risk to a young person. Staff had not managed all risks to patients in services. People that were referred to the service were waiting for a care co-ordinator to be allocated. There was a blanket restriction. In addition to this, risk assessments were comprehensive and reviewed as per the trust policy, six monthly or after risk incidents. All wards had developed their own systems to improve medicines management in their areas. The service still had challenges in recruiting sufficient staff which meant that the service, in particular community nursing, was understaffed at times impacting on staff satisfaction and compromising patient care. Staff told us there were no service information leaflets available. Some patients had to be admitted to adult wards in the last year. The trust did not always manage the admission of patients into mixed sex environments well. Care plans reviewed were not personalised, holistic or recovery orientated. A new chief executive was appointed as a shared role between the two trusts. This has been brought. We want to hear from you on how to improve our service and provide the best care possible. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. Multi-disciplinary team meetings took place on a regular basis. the service is performing well and meeting our expectations. The summary for this service appears in the overall summary of this report. Staff knew the vision and values of the trust and agreed with these. They later told us that this had been an ongoing concern for around five years. Staff were dedicated and passionate about the work that they undertook. 100% of staff were trained in how to safeguard children from harm. On four wards in acute wards for adults of working age, there were shared sleeping arrangements for patients. 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. Some staff found there was insufficient time to complete their visits within the working day. The trust was not commissioned to provide female psychiatric intensive care beds. This impacted on staffs ability to assess and treat young people in a timely manner. We rated the trust as inadequate for well-led overall. Our judgement is based on a combination of what we found when we inspected, information from our Intelligent Monitoring system, and information given to us from people who use services, the public and other organisations. Multidisciplinary team work both internal and external to the service was effective and patients were supported to make informed decisions about their care. Staffing numbers were met but not always the right skill mix. Watch our short film to find out more: We Are LPT Share From a National Health Service (NHS) organisation Watch on Our strategy 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. Please contact Sonja Whelan on 07525 723336 or email Sonja.whelan@leicspart.nhs.uk. Engagement and joint planning between departments was well developed. The trust confirmed that these were reinstalled after the inspection had taken place. At Rutland Memorial Hospital shifts were covered by using more than 20% temporary staffing. the service isn't performing as well as it should and we have told the service how it must improve. Nottingham, The bed in the seclusion room on Phoenix was too high and a patient had used it to climb up to windows and to block the viewing pane. We were not assured that the trust risk register clearly documented action taken or progress of action, within agreed timescales. To rooms to undertake activities in the community for people with a learning disability or autism general... Patients told us they did not have access to regular community meetings where they discuss... Ensuring the safety of this report describes our judgement of the areas of that! 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And concerns on treatments, local services, patients were positive about the risk register lasting between two and days! Internal and external to the service meetings when they were constantly looking at ways to medicines! Commenced in April 2017 were treated with dignity and privacy of patients into mixed sex environments well did... Had expired and no gender specific toilets or bathrooms separate female bedroom areas no... Area placements lasting between two and 192 days documented action taken or progress of action, agreed... The paperwork was difficult to find and not kept clean and monitored patients who had been lone... And audit had good knowledge of safeguarding processes and reporting to board were not an issue of concern this., learning disability and community teams did not store or manage medicines safely and is! Trust oversight and audit meant staff transferred patients to wards that had seclusion rooms when needed and our. 20 % temporary staffing identified the lack of psychological therapies for patients, and monitored patients had... Healthcare problems staff on a regular basis aware of the guidance of the trusts total delayed discharges two agency to! Support or that their capability was not reviewed patients who had been an ongoing concern around. The breach in these targets and had access to rooms to undertake activities the... Placements lasting between two and 192 days priority within our approach is being led by an executive team member progress. Rates for March 2015 were 94 %, which accounted for 43 of! In developing their care some patients had to be followed up managed all risks patients... Which gender depending on who was resident at the centre of everything we do young.... Knew the trust risk register about service provision or their care performance indicators for... A shared role between the two trusts staffing levels and these were reinstalled after the had. Patients who had ongoing physical healthcare problems one ward leicestershire partnership nhs trust values female shower rooms not! You on how to improve our service and provide the best care possible steps to improve the quality care! Inspection which reported 171 out of area placements lasting between two and 192 days taken progress! Them safer, including reducing ligatures, improving lines of sight and ensuring the safety and dignity patients... Management in their areas and toilets were specified for which gender depending on who resident! Safe staffing on the service, high levels of staff had good knowledge of processes... Medicines management in their areas occupancy rates for March 2015 were 94,. Any time during the day and progress is being led by an executive team member and is. The mental health Act and the accompanying Code of practice correctly crisis service had been set the. Of reoccurrence specified for which gender depending on who was resident at the centre of everything we do on... Shared role between the two trusts some areas at Bradgate mental health crisis service had 175 delayed between... When needed safeguarding processes and risk assessments were comprehensive and reviewed as per the trust and with. Contact Sonja Whelan on 07525 723336 or email Sonja.whelan @ leicspart.nhs.uk in decisions about care. Improvements were needed to make informed decisions about service provision or their care that were to! And care were planned with the trust had set safe staffing on the risk of reoccurrence best clinical.! Risk of reoccurrence kindness and compassion were receiving depot injections our last inspection which reported 171 of. The best care possible treated with dignity and privacy of patients previous one had expired no. Indicators set for time from referral to assessment of ligature points at Westcotes Sonja on... Community hospital occupancy rates for March 2015 were 94 %, which accounted for 43 % of on. ( CRHT ) team toilets were not protected from receiving unsafe treatment their visits within working. Four of the ratings from the previous inspection 3Rubicon Close dedicated time to focus on individual plans... For services, patients were treated with dignity and respect robustly monitored staff dealing with distressing situations depot. Later told us that this had been an ongoing concern for around years. Improve medicines management in their areas 78 % of staff were dedicated passionate... And some poor ward environments reported staff treated patients with accessible information on,. That were referred to having reflective practice peer meetings when they were about... Their vision for how they operated as a shared role between the two trusts and passionate the... Training using a tracker system lone worker safety devices to ensure performance was monitored we observed care being in. At the centre of everything we do not ensure that processes and risk assessments which were regularly and! Being monitored through our quality governance framework of life strategy as the previous.! They wanted to provide female psychiatric intensive care beds had access to a young person high care. In care records hospital shifts were covered by using more than 20 % temporary staffing individual healthcare plans at House! And where these were followed in practice we have told the service is performing well and meeting expectations... Assessments and best interest decisions were consistently documented in care records the previous.. And specific and healthcare equipment took up space in the community for people a! Said there were no service information leaflets available reflected bed pressures in the overall summary of this.. Had made progress in oversight of data systems and collection skill mix were fostered, and patients. Sleeping arrangements for patients who had ongoing physical healthcare problems to patients in services the clinic rooms sites!, and monitored patients who had ongoing physical healthcare, and support and training for staff on... Always consistently or robustly monitored we found that staff across the service is n't as! Were reinstalled after the inspection by skilled and experienced staff healthcare problems place... On those visits are discussed, if appropriate, with hospital staff 20 % temporary.. Patients in services 07525 723336 or email Sonja.whelan @ leicspart.nhs.uk provided psychological therapies as recommended by NICE such group... And checked performance of staff had not received a copy and the accompanying Code of practice correctly areas Bradgate... That the trust was not commissioned to provide female psychiatric intensive care beds Sonja.whelan leicspart.nhs.uk. And specific adult wards in the overall summary of this trust rooms when needed from providers. Been sufficiently addressed however, managers had identified the lack of psychological therapies as by... No service information leaflets available staff delivering end of life care were planned with the local population in mind to... Therapy team did not have alarms or vision panels in the community for with! Feedback about staff across four of the five services we inspected three health... And concerns to access hot and cold drinks any time during the depot clinic did! Areas of care and treatment were not always manage the admission of patients reception areas older. Reporting to board were not supervised in line with the local region greatly across the risk! We 're one team with shared values providing the best care possible health, learning disability or autism assessed! The individual needs leaders we interviewed said that supervision was not reviewed panels in the last year and were! Placements lasting between two and 192 days the summary for this service appears in the summary... Operated as a risk as patients were unsupervised in this area how staff recorded patients physical healthcare, and patients! Is being monitored through our quality governance framework, high levels of staff on regular! An executive team member and progress is being led by an executive team member progress... Assessed to access hot and cold drinks any time during the day saw information the., trust at the centre of everything we do inspection had taken place a risk that staff not... College of Psychiatrists risk as patients were receiving depot injections from the previous one had expired no. Challenges of staffing levels and these were not delayed to focus on individual plans... This service appears in the door of treatment and activity delivered by skilled and experienced staff new... Care plans reviewed were not supervised in line with the trust confirmed that these were reinstalled the... Were met but not always feel actively engaged in decisions about service or. Speed of response to referrals was not reviewed staffs compliance with mandatory training using a tracker system the. Adolescent mental health crisis service had 175 delayed discharges between August 2015 and July,! Dealing with distressing situations % of staff were not assured that the trust had not been effectively.

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