Staff reported incidents, which were discussed and reviewed by line managers within the teams. We saw numerous interactions between staff and patients with very complex needs and staff managed extremely challenging situations with knowledge and compassion. Comments included terminology such as marvellous, wonderful and excellent. We inspected three mental health inpatient services because of the ratings from the previous inspection. Patients and carers confirmed in most services they had not received copies of care plans. Some local leaders were visible and approachable however, some staff did not know who directors linked to their service were or did not feel engaged with the trust. This was an issue highlighted at our inspection in 2018. Suspended ratings are being reviewed by us and will be published soon. There was a high staff sickness rate reported and managers did not always follow the managing sickness policy. The CRHT team did not have lockable bags to transport medication to patients homes; staff told us they transported medication in their handbags. Your information helps us decide when, where and what to inspect. Staff were de-briefed and supported after a serious incident; we saw that incidents were a standing agenda item for team meetings and were discussed with staff. Care plans were generalised, not person centred or recovery focused. One patient at Stewart House told us other patients made comments around their protected characteristics and staff had not care planned the needs of the patient. Access to rooms to undertake activities in the community for people with autism had been reduced. At the Agnes Unit, staff did not always record the physical health of patients who had been given rapid tranquilisation. This meant the police very often had to care for detained patient for the duration of the assessment. Clinical supervision was not taking place regularly across the service. 30 April 2018. View more Profession Nurse Service Child & Adolescent / CAMHS Grade Band 5 Contract Type Permanent Hours Full Time. A carers group was available to give support. There were good systems for lone-working which included a code word that staff used when they required assistance. Care records for patients using the CRHT teams were not holistic or personalised. People we spoke with said they had received a good service. Clinical supervision rates were low. However, we found: We rated the child and adolescent mental health wards as requires improvement because: We rated community-based mental health services for older people as good because: We rated learning disability and autism community services as good because: We gave an overall rating for forensic/secure wards of requires improvement because: We rated Leicestershire Partnership NHS Trust long stay / rehabilitation mental health wards for working age adults as requires improvement because: Overall rating for this core service Good. Staff had a good knowledge of safeguarding. Flexible working arrangements allowed staff to work effectively in teams, particularly when there were not enough staff in some professional groups such as speech and language therapists, occupational therapists and psychologists. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. We felt this contributed to senior staff views that pace of change in the trust was slow. We will be working with them to agree an action plan to improve the standards of care and treatment. The learning disability community team had not met the six week target for initial assessment on average it was six days over. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. The local managers monitored the environment for staff, carried out local audits and checked performance of staff on a regular basis. Not all of the patients felt involved in their care planning and not all had a copy of their care plans. Our leadership behaviours framework set the standards of expectation we aspire to in our daily work. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. When community meetings occurred, staff did not include details of outcomes to evidence change. The trust had addressed the issues regarding the health based place of safety identified in the previous inspection. There were not enough registered staff at City West and this was identified as a risk on the service risk register. Some key outcomes for children, young people and families using the service were regularly below expectations. Staff were dedicated and passionate about the work that they undertook. The trust set target times from referral to initial assessment against the national targets of 28 to 42 days. Staff described managers as supportive and approachable. A new chief executive was appointed as a shared role between the two trusts. Some areas at Bradgate Mental Health Unit required further improvements to the environments. Patients were frequently not discharged when ready due to transport problems or difficulties putting care packages in place. The trust had not met all the required actions to reduce and mitigate ligature points across wards following the previous inspection in March 2015. Staff did not always feel actively engaged or empowered. There were delays in maintenance and repairs in some areas. Staff felt supported by their managers and received regular supervision and annual appraisals. There was good physical health care and good therapeutic treatment and activities. On Phoenix ward patients were not allowed access to the garden. We had concerns about the safety of some of the facilities where care was delivered. The trust had made improvements to the clinical environments since the last CQC inspection. However, we saw evidence this was not always achieved. The number of incidents reported by the trust had decreased since the last inspection and serious incident figures remained comparable. Bed occupancy rates were above 85% for community health inpatient wards. Creating high quality compassionate care and well-being for all | Leicestershire Partnership NHS Trust - We provide mental health, learning disability and community health services for a population of more than a million people in Leicester, Leicestershire and Rutland. The community adult team caseloads varied. Due to the large caseloads in community health service, the number of visits that were required was not always manageable. the service is performing well and meeting our expectations. There were high vacancy rates. Staff demonstrated poor understanding of some aspects of the Mental Capacity Act. Not all medicine records included allergy information. Improvements were noted in some wards in core services but not all. The team engaged with patients who found it difficult or were reluctant to engage with mental health services. Staff showed high levels of motivation and morale, felt part of a positive team and felt well supported and trained. We observed positive interactions between staff and children and the use of age appropriate language. Staff were given feedback after incidents had been reported. Download full inspection report for - PDF - (opens in new window), Published There was strong local leadership on the community inpatient wards and in the community. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. The trust was not meeting its target rate of 85% for clinical supervision. Some staff did not receive regular supervision or annual appraisals. We found concerns with the environment in all five core services we inspected. This employer has not claimed their Employer Profile and is missing out on connecting with our community. There was a risk that young people may not get assessed out of hours in a timely manner by staff with CAMHS experience. Mobility and healthcare equipment took up space in The Gillivers and 3Rubicon Close. 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. Multi-disciplinary teams and inter agency working were effective in supporting patients. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. The trust had long term plans to address this. the service isn't performing as well as it should and we have told the service how it must improve. There some gaps in staff receiving regular supervision. There was good staff morale in services. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. Managers ensured they monitored the reporting and recording of incidents and complaints. Safeguarding notes for one person using the Autism Outreach service could not be located creating a potential risk. Information on the trusts vision and values was available at the site and staff appraisals were linked to them. Mental Health Act documentation was not always up to date on the electronic system. The trust had set safe staffing levels and these were followed in practice. The lack of psychology was an issue highlighted at our 2018 inspection. 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. Staff were not aware of how this might affect the safety and rights of the patients. The trust had completed ligature risk assessments across all wards, detailing where risks were located and how these should be managed. The acute mental health wards had broken facilities which had not been repaired in a timely manner and we found dirt in some areas on one ward. The trust had new seclusion paperwork implemented in May 2019. we have taken enforcement action. However, managers had identified funding for two agency nurses to start work the week following the inspection. To address this deficit the trust moved patients that required an acute bed to a rehabilitation bed which was not clinically justified or met the needs of the patients. Staff demonstrated a good knowledge of the Mental Capacity Act and consent however this was not routinely documented in care records. Governance systems and processes, and the strategy of the organisation had been extensively reviewed since our last inspection but was not fully embedded into services. We saw that patient numbers exceeded the number of beds available on wards. The trust was not commissioned to provide female psychiatric intensive care beds. There were systems for lone-working in place including a red folder process that kept workers safe. Lone working policies and procedures were in place for staff to follow to ensure patient and staff safety. Flu and Covid-19 are currently circulating at high levels and are likely to continue to increase in coming weeks. Many staff knew the Trust values and were aware of the Chief Executive Officer. The service used a computer record system that differed from the rest of the trust. Bed occupancy for the last two quarters of 2013/14 was around 89%. Staff did not assess and record the risks posed by medicines stored in patents homes. Staff followed infection and prevention control practices and the community inpatient wards were visibly clean. When we talk to colleagues we are clear about what is expected. Staff used strategies to maintain patients safety which had an adverse effect on their dignity and privacy. Community meetings and patient involvement in the services did not always take place. Information needed to deliver care was not always readily available when people using community mental health teams presented in crisis out of hours. Staff documented seclusion well in most services, compared to our last inspection. Staff told us they involved patients carers but there was little evidence of this in care records. Save job - Click to add the job to your shortlist. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. People knew how to make a complaint as this information was provided in welcome packs. Staff did not always feel connected to the wider trust. Staff had limited opportunities to receive specialist training. 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. The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. On Ashby ward, the shower rooms did not have curtains fitted. 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. Apply. There was a range of treatment and activity delivered by skilled and experienced staff. Patient views on the quality of the food were variable. Staffing numbers were met but not always the right skill mix. Smoking cessation had been successful across most wards in the Bradgate Mental Health Unit.The trust had re-drafted the smoke free policy following on patient and staff consultation. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. Leicestershire Partnership NHS Trust - NEU Professionals - UK Overseas Nurse Recruitment campaign from 2022 - ongoing Leicestershire Partnership NHS Trust (LPT) provides community and mental health services for Leicester, Leicestershire and Rutland. 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. This could pose a risk to patients and staff. We rated community health services for adults as requires improvement because. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. Staff had received specialist child safeguarding training and were able to make referrals when appropriate. There was limited time available for staff to attend specialist courses to enhance their knowledge. 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. 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. Organisations we work with. There had been periods of understaffing. We rated it as requires improvement because: Our rating of the trust stayed the same. Across teams risk assessments were not always completed and updated. The trust could not ensure continuity of care for these patients. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. Interpreters were available. 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. 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. o We are passionate and creative in our work. Leicestershire Partnership NHS Trust This is an organisation that runs the health and social care services we inspect Overall: Requires improvement Services have been transferred to this provider from another provider Services have been transferred to this provider from another provider All Inspections 12 April 2022 We could not find records for seclusion or evidence of regular reviews taking place as per trust policy. 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. We remain concerned that a significant period had passed and the trust had not improved access to psychology for patients and staff. There was a mobile phone in the ward office that patients could use for private calls, for example to a solicitor. The services did not have a strategy and there were no service plans. Waiting times and lists remained of concern, and this had been identified in the previous inspection. Staff said the system was difficult to use and this had affected the information recorded in patients notes. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. 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 assessment and resulting care plans were personalised, holistic and recovery focussed. The service did however, complete local audits and produced action plans for improvement in care. Admission to the unit was agreed with commissioners. You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection. One review was in response for the delivery of actions for the 2018 CQC inspection. Multi-disciplinary team meetings took place on a regular basis. Waiting times for referral to initial assessment appointments were good, although patients experienced delays for community paediatric clinic follow up appointments. We spoke with six patients who all told us that the staff were very kind and looked after them well. Four young people told us they felt involved in developing their care plan however, they had not received a copy. One ward matron told us that a patient had recently alleged that a staff member had assaulted them. We observed clinicians working with young people were skilled and very positive. There was no evidence of patient involvement recorded in some of the notes. We talk to patients, the public and colleagues about what matters most to them and we do not assume that we know best. There was no patient alarm access in four ward areas, including the dormitories. There was no fridge to keep medicines cool when required. 42% of staff on Phoenix ward and 27% Griffin ward had received clinical supervision. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. 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. Not all patients on acute wards for adults of working age could summon help from staff if required. Patients reported staff treated them with dignity and respect. They provided feedback to staff via monthly ward meetings, MDT meetings supervision and handovers. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. Services had supplies of emergency medication available and this was accessible to staff. Patients were offered smoking cessation treatments, nicotine replacement therapy (NRT), or free vapes. However, no time frame was set for the work to be completed. Staff had not managed all risks to patients in services. Staff told us they felt happy and enjoyed their work. 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 spoke with five informal patients at the Bradgate Mental Health Unit who were unaware of what they could and could not do as an informal patient. We do not put off making difficult decisions if they are the right decisions, We set common goals and we take responsibility for our part in achieving them, We give clear feedback and make sure that we communicate with one another effectively, We encourage and value other peoples ideas, We recognise peoples achievements and celebrate success. There were no children who had waited more than a year for treatment. Recruitment was in progress for 10 new healthcare support workers. However, the service was collecting data. 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. 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. Urgent and emergency care services across England have been and continue to be under sustained pressure. Staff ensured that these were updated regularly. Risk management in services required improvement. This did not demonstrate a consistent temperature, had been maintained to assure the safety and efficacy of the medicines. There was a lack of storage at Stewart House, the utility/laundry room was used to store cleaning equipment. Apply. The phones on each ward were in communal areas; the phone on Griffin ward had not been moved since the last inspection, although it had a privacy hood installed. Some families and carers told us that the service was not responsive, telephone calls to the service were not returned. It must improve managers and received regular supervision and handovers our last inspection of treatment and activities and there systems. Site and staff vacancy rates had not improved access to psychology for patients using the CRHT did. 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Disability community team had not met all the required actions to reduce and mitigate points. The lack of storage at Stewart House, the number of incidents reported by trust.
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