We did not inspect the whole core service. The trust had high numbers of vacancies for registered nurses. Staff routinely referred patients to access additional support for employment, housing, benefits and independent mental health advocacy. Patients were supported to meet their religious and cultural needs. 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. We observed many examples of staff treating patients with care and compassion. Download full inspection report for - PDF - (opens in new window), Published There was no performance data dashboard to gauge the performance of the service. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. Through effective workforce planning we will nurture and support our staff to progress and flourish, offer them opportunities to deliver care through new models and in new roles. The136 suiteis a place of safety for those who have been detained under Section 136 of the Mental Health Act. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. We rated the trust overall for well-led as inadequate. While staffing numbers were usually maintained, there was a high reliance on agency and bank staff to achieve this. Six staff expressed concerns about the proposed move and some said the trust had not communicated information to staff effectively. The community nursing service could not measure its performance in relation to response times for unplanned care. Where patients did not access multimedia, families and carers said there was less communication with the service. Staff did not consistently promote dignity and respect as expected in all services. There were not always enough staff who were suitably qualified and experienced to safely meet patients needs. 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. We work in partnership with a range of NHS organisations, local government and other bodies and are ultimately accountable to the secretary of state for health. Our rating of this service improved. This has been brought. Teams were responsive and dealt with high levels of referrals. received 41 comment cards from patients that were available for patients to complete during the time of our inspection. We looked at the domains of safe, effective and responsive and we did not inspect all of the key lines of enquiry. Staff were not meeting targets for the assessment and assessment to treatment of urgent referrals and six week routine referrals. There was evidence of items being submitted to the trust risk register where appropriate. The majority of repairs and maintenance issues highlighted within the warning notice at the Bradgate Mental Health Unit had been fixed or resolved. The dignity and privacy of patients across three services we visited was compromised. Managers did not successfully cascade information down to all ward staff in acute mental health services. Most patients spoke positively about their care and said they were involved. 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. 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. We saw evidence of discharge planning in care plans written by CRHT staff. In two services, staff were not always caring towards patients. Staff held multidisciplinary team meetings weekly and these were attended by a range of mental health professionals. Patients had access to advocacy. We gave an overall rating for mental health crisis services and health-based places of safety of requires improvement because: Overall we rated this core service as requires improvement because: We do not give an overall rating for specialist services. One patient on Heather ward claimed that they had previously watched a staff member walking past a distressed patient and did not seek to reassure them or ask what was wrong. People using the service had limited access to psychological therapies and there were no psychologists working within the service. Apply. Staff interacted with people in a positive way and were person centred in their approach. Some patients had to be admitted to adult wards in the last year. Managers did not ensure that staff completed Mental Capacity assessments in line with the Act. There were improved systems and processes to manage storage, disposal and administration of medications. Managers did not ensure that the staff were receiving regular clinical supervision and had not met the trust target compliance rate of 85%. This did not protect the privacy and dignity of patients when staff undertook observations. Staff referred to having reflective practice peer meetings when they were concerned about the risk to a young person. The teams did not have waiting lists for care coordinators at the time of inspection. Staff were up to date with mandatory training and had regular supervision and appraisals. 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. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. 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. There was a high staff sickness rate reported and managers did not always follow the managing sickness policy. Due to the large caseloads in community health service, the number of visits that were required was not always manageable. Staff were caring, compassionate and kind towards patients. This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. The integrated therapy and nursing teams and the primary care coordinators in conjunction with the night service had clear focus on keeping patients safe and well in their own homes. Use our service finder to find the right support for your mental health and physical health. Patients reported staff treated them with dignity and respect. 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. CV6 6NY, In Some wards and community teams had low staffing levels, or an absence of specialist staff, and this had an impact on care.Staffing levels remained low at the Bradgate mental health unit. Delivered through over 100 settings from inpatient wards to out in the community, our 6,500 staff serves over 1 million people living in Leicester, Leicestershire and Rutland. We saw staff engaging with patients in a kind and respectful manner on all of the wards. 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. Please contact Sonja Whelan on 07525 723336 or email Sonja.whelan@leicspart.nhs.uk. Whilst staff monitored patients risk on the waiting lists, the length of time to wait was of concern, in addition to the services lack of oversight and management of this issue. We found out of date and non-calibrated equipment located within a cupboard in the health-based place of safety. Coventry, Patients were involved in the writing of their care plans and their views were reflected in the plans. Clinical supervision rates were low. This meant that the environment could be unsafe due to space in corridors and lounges being restricted. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. Save job - Click to add the job to your shortlist. People using the service may not be able to get the speed of telephone response they needed in a crisis. People we spoke with said they had received a good service. We want to hear from you on how to improve our service and provide the best care possible. We spoke with five patients on long stay or rehabilitation wards; they told us they felt very well supported, and staff and were kind, caring, and respectful. A psychologist led weekly reflective practice sessions to help staff think about the best way of helping the patient on the ward. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. CAPTRUST for Institutions. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. 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. There were low levels of restraint and staff tried other methods to de-escalate before restraining patients. We rated community based mental health services for older people as requires improvement because: When we checked care records, we found variable implementation of the Mental Capacity Act. Services and care were planned with the local population in mind and to address the individual needs of patients. The policy for rapid tranquillisation was not in line with national guidance. Staff told us they felt supported by their line managers, ward managers and matrons. Interview rooms were unsafe. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. One ward matron told us that a patient had recently alleged that a staff member had assaulted them. Not all of the patients felt involved in their care planning and not all had a copy of their care plans. The trust had completed ligature risk assessments across all wards, detailing where risks were located and how these should be managed. There were safe lone working practices embedded in practice. The service had not delivered timely care to a significant number of patients. the service is performing badly and we've taken enforcement action against the provider of the service. In most services, we were concerned with the lack of evidence in care plans which showed patients and carers had been consulted and involved in their care. At this inspection, we visited the two mental health services previously rated inadequate and one mental health service previously rated as requires improvement. Patient access to psychology and occupational therapy was less than expected on acute wards and rehabilitation wards due to the number of staff vacancies in therapy positions. 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 lack of psychology was an issue highlighted at our 2018 inspection. Staff completed extensive and detailed care plans. Seclusion environments were not an issue of concern at this inspection. Data provided by the trust showed there were four episodes of seclusion from February 2016 to July 2016. We rated responsive and well led as requires improvement, and safe, effective and caring as good. The trust had maintained patients privacy and dignity at Short Breaks Services. The short breaks service was primarily set up to meet the needs of relatives and carers. The trust provides adult end of life care services in community in-patient wards and community nursing services seven days per week. Curtains were missing from bed spaces and staff did not wait for an answer from patients before entering rooms on acute wards. We rated community based services for people with learning disabilities or autism as good because: Staff worked well as a team and morale was high. Patients families and carers were positive about the care provided. Facilities had been adapted to improve access and systems were in place to support the most vulnerable. Staff considered and supported patients with their physical health needs in CRHT and the liaison mental health triage service. Nursing staff interacted with patients in a caring and respectful manner. There was detailed discussion and consideration of patients and carers needs. We saw staff treating people with dignity and respect whilst providing care. 56% of individual care plans were not up to date, personalised or holistic. Staff had the right qualifications, skills, knowledge and experience to do their job. Lessons were learned from feedback and complaints from patients. Consent to care and treatment was obtained in line with relevant guidance and legislation. Employees also rated Leicestershire Partnership NHS Trust 3.1 out of 5 for work life balance, 3.6 for culture and values and 3.7 for career opportunities. Patients experiencing mental health crisis and distress did not have access to a fully private area in these environments. This was done by sliding signs to the door as needed. 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. Leicestershire Partnership NHS Trust | 5,409 followers on LinkedIn. Four young people told us they felt involved in developing their care plan however, they had not received a copy. The trust had not made sufficient progress in addressing the concerns raised at the previous inspection in March 2015. We are proud of our 5,400 staff and together we aim to . The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. On Phoenix ward patients were not allowed access to the garden. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. Medicine management training sessions had been undertaken with inpatient ward sisters and charge nurses. Local leaders were visible and had the skills and knowledge to perform their roles. The environmental risks in the health based place of safety identified in our previous inspection remained. The trust had key roles in the development of health and social care system working, and collaboration with other care providers to improve provision of mental health services. 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 quality of the data produced was poor and staff needed to correct the data when reports were produced. This was particularly relevant to protected characteristics. There was an extensive wellbeing offer available to staff. Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. Staff did not adhere to the Mental Capacity Act Code of Practice and the five principles of the Act. Our overall rating of this trust stayed the same. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. Staff undertook comprehensive assessments and developed high quality care plans. The trust told us patients across mental health inpatient wards had commented positively about their experience of care. The risks and issues described by staff did not always correspond to those reported to and understood by their leaders. People knew how to make a complaint as this information was provided in welcome packs. There was effective multidisciplinary working. We found concerning evidence of long waiting times for assessment in specialist community mental health services for children and young people. Services had supplies of emergency medication available and this was accessible to staff. This is an organisation that runs the health and social care services we inspect. We strongly recommend an informal and confidential discussion with Cathy Ellis, the Chair of the trust. Staff completed comprehensive assessments which included physical health checks and the majority of patients had completed risk assessments. The waiting areas and interview rooms where patients were seen were clean and well maintained. Staff had set clear guidelines on where and how physical health observationswere completed on wards. The trust confirmed contracts for patient transport and local authority care packages were monitored and work was ongoing with partner organisations to improve services for patients. Staff demonstrated poor understanding of some aspects of the Mental Capacity Act. Patients and carers confirmed in most services they had not received copies of care plans. 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 carried out this unannounced focused inspection of adult liaison psychiatry services as part of a system wide inspection of Urgent and Emergency Care provision in the Leicester, Leicestershire and Rutland Integrated Care System. There were key performance indicators set for time from referral to assessment and where these were not being addressed action had been taken. Staff were consistently caring, respectful and supportive. Concerns were raised regarding the fast-track process and appropriateness of admissions to hospital by the out of hours GP service. Ward teams did not hold regular team meetings. There were effective methods for obtaining feedback from service users and carers and feedback was acted upon. Access to rooms to undertake activities in the community for people with autism had been reduced. We found this across core services and within senior teams. Staff reported they felt supported by their colleagues and managers. Mandatory training provided to Advanced Nurse Practitioners did not cover end of life care, and these professionals received little support from trust doctors with a specialism in palliative care. The summary of this service appears in the overall summary of this report. Staff were not in receipt of regular supervision in order to discuss training needs, developmental opportunities or performance issues. The introduction of activities co-ordinators at Coalville Hospital had improved the patients experience on the ward and increased the activities that were conducted on a day to day basis. Staff did not always follow trust policies and procedures when they needed to search patients or their bedrooms to keep them safe from harm. There was a lack of storage at Stewart House, the utility/laundry room was used to store cleaning equipment. Staff said morale was good and they felt supported by their managers. On Heather ward patients said that there was not enough ventilation on the wards. Following inspection, the trust submitted an action plan to review access to call alarms. On Kirby ward there was no evidence of Section 132 rights read on detention in 54% of records reviewed. There was highly visible, approachable and supportive leadership. Wards had high numbers of hydraulic style patient beds that were a risk to patients with histories of self-harming behaviour. There was limited time available for staff to attend specialist courses to enhance their knowledge. Leicestershire Partnership NHS Trust 2.5K subscribers We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. Medication management systems were in place and followed to ensure that medicines were stored safely. Staff had a good understanding of patients needs. Bed occupancy for the last two quarters of 2013/14 was around 89%. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. 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. Meeting these standards and developing the capability to exceed them, will not only ensure that we continue to improve and respond flexibly to changing needs as an organisation, but will also help our staff to fulfil their potential, both in terms of personal achievement and career advancement. There was effective communication between the service and other healthcare professionals. Restraint was used only as a last resort. The trust experienced high demand for acute inpatient beds. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. Funding had been secured for increased staff with specialist skills. The duty system enabled urgent referrals to be seen quickly. Good 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. 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