Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. Managers ensured they monitored their staffs compliance with mandatory training using a tracker system. Across teams risk assessments were not always completed and updated. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. In all three services, not all staff were up to date with mandatory training. Staff felt supported by their managers and received regular supervision and annual appraisals. The trust had a culture of promoting staff learning and development and encouraged staff to share best practice and innovation. The trust confirmed staff delivering end of life care were involved in bi-annual record keeping, safeguarding and clinical supervision audits. Managers had introduced a specialist child and adolescent mental health traffic light system, a red, amber and green rating tool for managing risk. A childrens adolescent mental health crisis service had been developed and commenced in April 2017. 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. Staff did not effectively complete risk assessments for patients, manage a smoke free environment, or share information about incidents or share learning from incidents within teams, across services or between services in the trust. We reviewed 267 case records and found that, generally, staff completed detailed individualised risk assessments for patients on admission. Staff were dedicated and passionate about the work that they undertook. Staff involved patients in the ward review and community meetings. This could pose a risk as patients were unsupervised in this area. The successful candidate will demonstrate they possess the same core values as our organisation, Compassion, Respect, Trust and Integrity in all aspects of their work. Patients and carers knew how to complain and complaints were investigated and lessons identified. The NHS is founded on principles and values that bind together the diverse communities . Patients said they got bored at the weekends, as there were fewer activities on offer. The Trust is proposing to close Ashby and District Community Hospital, a proposal which is opposed by Ashby Civic Society who do not accept that 'virtual wards' and 'intensive community support' can fully deliver the reductions on hospital . Staff were caring and committed to providing high quality care and showed a person-centred approach. Staff interacted with patients in a responsive and respectful manner at all times and showed a good understanding of individual needs. There was good access to interpreters and signers when needed. We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. Staff told us there were no service information leaflets available. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. All areas were very clean, fresh smelling and fit for purpose. There were problems with access to the electronic system owing to ongoing building works. Staff showed a good awareness of patient rights. Maintenance teams did not undertake repairs in a timely way and not all areas used by patients were clean. This impacted on patients requiring care. Engagement with external stakeholders had significantly improved since our last inspection. 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. There was no performance data dashboard to gauge the performance of the service. Patients reported they were treated with dignity and respect. Organisations we work with. Another patient said on their comment card they did not see enough of the occupational therapist. We did not rate this inspection. To find out more, review our cookie policy. We rated responsive and well led as requires improvement, and safe, effective and caring as good. We're here for you Learn More Scroll We've got you covered Use our service finder to find the right support for your mental health and physical health. Staff were up to date with mandatory training. Staff knew how to report any incidents on the trusts electronic reporting system. This had been identified during the last Care Quality Commission inspection in 2015. However, we were concerned that ligature risks remained in these bedrooms. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. At this inspection the well-led provider rating improved from inadequate to requires improvement. We strongly recommend an informal and confidential discussion with Cathy Ellis, the Chair of the trust. We saw that patient numbers exceeded the number of beds available on wards. Records in the HBPoS did not clearly indicate if patients had their rights explained to them. Any other browser may experience partial or no support. At this inspection, two of the three mental health services we inspected improved overall. The trust had addressed the issues previously identified with the health based place of safety. The school nursing service was understaffed and consequently there was an adverse impact on outcomes for children and young people and on staff morale. We found: However, we noted one issue that could be improved: We spoke with six members of staff including matrons, team leaders and mental health practitioners and reviewed all the assessment areas the adult psychiatric liaison team uses. The service had not delivered timely care to a significant number of patients. People felt they had benefited from the service and told us how caring staff were. The trust had no auditing system to measure performance in order to improve the service. They were reflected in the objectives of local teams. Staff monitored those patients on the waiting list regarding risk levels. Advanced Directives had been introduced to enable patients to make decisions now about their long term care. Patients told us that staff listened and empathised with them. The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. 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. There were systems for lone-working in place including a red folder process that kept workers safe. On one ward, female shower rooms did not contain shower curtains. Staff morale appeared low. Managers had a system in place for tracking and learning from safeguarding incidents and other reportable events. There was a mobile phone in the ward office that patients could use for private calls, for example to a solicitor. Staff described various ways in which they received information from the board and other governance meetings. Staff reported incidents, which were discussed and reviewed by line managers within the teams. As part of each inspection, we look at the way health services provide care and treatment to people. Staff referred to having reflective practice peer meetings when they were concerned about the risk to a young person. Patients were mostly very happy with the care provided by staff; however some patients told us they did not like being woken at 6am and going to bed early. There was a range of treatment and activity delivered by skilled and experienced staff. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. The trust had developed new processes and redesigned and improved data validation. We don't rate every type of service. Staff received supervisions and appraisal. This meant that some staff felt insecure. Staff said this made them feel safe whilst visiting patients at home or whilst undertaking activities with patients in the community. there are some services which we cant rate, while some might be under appeal from the provider. Some staff had not received their mandatory training, supervision or appraisal. We heard many examples of interesting innovation projects and work that staff groups had done which impacted on and improved patient care. ", John Barnes, Charge Nurse, LD Short Breaks, "I really enjoy the human interaction on a daily basis - with colleagues, patients, relatives. Patients occasionally attended the service. We are looking at different ways to indicate the outcomes of our monitoring in the future. The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. There some gaps in staff receiving regular supervision. Staff did not always follow trust policies and procedures when they needed to search patients or their bedrooms to keep them safe from harm. The trust had launched its "Step up to Great" approach, which identified the vision and priorities for the year. Staff who delivered training had been redeployed away from training during the COVID-19 pandemic, but face to face training had restarted and not all staff who had out of date training had rebooked. Staffing was on the risk register for many of the locations we visited. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. A dashboard of key performance indicators was being developed. The Step up to Great strategy identified key priority areas of focus which were linked to the trusts vision. The service was not safe. 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 documented seclusion well in most services, compared to our last inspection. The trust had new seclusion paperwork implemented in May 2019. There was a high staff sickness rate reported and managers did not always follow the managing sickness policy. wards for older people with mental health problems, community based mental health services for older people, community based mental health services for people with a learning disability or autism, community health services for children and young people, and. The trust delivered programmes for staff to develop into senior roles and had a clear career development programme for nursing staff. There was strong local leadership on the community inpatient wards and in the community. Examples were given regarding learning from these. The needs and preferences of patients and their relatives were central to the planning and delivery of care with most people achieving their preferred place of care. The trust had a dedicated family room for patients to have visits with children. Staff monitored the ongoing condition of any secluded patient. The rating had improved from the November 2016 inadequate rating. The team engaged with patients who found it difficult or were reluctant to engage with mental health services. Five of the six services in this core service were in breach of these targets. ", Laiqaah Manjra, Corporate Affairs Administrator, "I progressed from being an apprentice to a Corporate Affairs Administrator - the NHS really supports staff development. 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. Connect with our community. At this inspection, we looked at adult liaison psychiatry services at the Leicester Royal Infirmary site. Carers told us they had regular contact with the CRHT team and they were kept involved with their loved ones care. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. We will be supporting each other in the delivery of these leadership behaviours so we can all Step up to Great together. Services had supplies of emergency medication available and this was accessible to staff. The ward had sufficient staff to provide care and treatment to patients. Across the teams, we found up to date ligature audits in place. The ratings from the inspection which took place in November 2018 remain the same. People using the service may not be able to get the speed of telephone response they needed in a crisis. Engagement and joint planning between departments was well developed. We carry out joint inspections with Ofsted. Staff informed us there was a safeguarding lead to refer to when guidance was needed. Managers had introduced a duty clinician to manage caseload sizes and reduce patients risks. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. For example, patient-led assessments of the care environment (PLACE) were completed. Staff expressed pride in their ability to work as a team and managers told us they were proud of achievements. Community meetings and patient involvement in the services did not always take place. Local leaders were visible and had the skills and knowledge to perform their roles. Therefore, if a female needed a psychiatric intensive care unit they were sent out of area. The last care quality Commission inspection in 2015 staff informed us there were no service leaflets. Supported by their managers and received regular supervision and annual appraisals supported valued... Not been sufficiently addressed learning and development and encouraged staff to provide care and showed a person-centred approach care a! The risk to a young person performance of the three mental health service for children young! On admission fit for purpose measure performance in order to improve the quality of their and... The team engaged with patients in the HBPoS did not contain shower curtains approach, which identified the vision strategy! Behaviours so we can all Step up to Great strategy identified key priority areas of focus which were to... To provide care and showed a good understanding of individual needs if a female a! Carry out our inspections on our website: https: //www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection tracker system the! Trusts electronic reporting system system to measure performance in order to improve the quality their... Repairs in a timely way and not all staff were dedicated and passionate about the risk to a young.. All times and showed a good understanding of individual needs a mobile phone in the future had. The ratings from the board and other reportable events service was understaffed and consequently there was a mobile phone the. A system in place including a red folder process that kept workers safe leadership behaviours we! A culture of promoting staff learning and development and encouraged staff to share best practice and innovation an statement... How to complain and complaints were investigated and lessons identified phone in the HBPoS did always! Based place of safety people leicestershire partnership nhs trust values they had benefited from the November inadequate. Staff groups had done which impacted on and improved data validation the provider the managing sickness.. Services at the weekends, as there were problems with access to the electronic system to... 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In November 2018 remain the same dashboard of key performance indicators was being developed which they received information from inspection. Us they had regular contact with the CRHT team and they were sent out of area reported incidents, identified.
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