Staff involved patients in the ward review and community meetings. Therefore there were no beds available if patients returned from leave. At least one standard in this area was not being met when we inspected the service and Some actions were required to ensure adherence with the Mental Health Act. Leicester, United Kingdom. Two patients discharges were delayed at The Agnes Unit because the commissioners could not find specialist placements. Patients reported that they felt safe on the wards. Staff received regular managerial and group supervision. Staff had limited opportunities to receive specialist training. The transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. All the people who used services and the carers spoken to were happy with the service they had received and spoke positively about their interactions with staff. A programme of work was due to start in forthcoming months, for wards yet to be refurbished. Patients did not have access to regular community meetings where they would discuss ward issues and concerns. Staff held multidisciplinary team meetings weekly and these were attended by a range of mental health professionals. Staff were visible in the communal ward areas and attentive to the needs of the patients they cared for. Staff provided patients and carers with information in a way that they understood.At City West, City East, and South Leicestershire patients and their carers reported outstanding and good care. Staff were included in service developments and involved in listening into action projects for service improvement. There was an on-call rota system for access to a psychiatrist 24 hours a day. 89% of staff had attended their mandatory training; 92% of appropriate staff had received training in safeguarding adults and 90% of staff had completed safeguarding children training. Young people and their carers spoke positively about the CAMHS service. Engagement and joint planning between departments was well developed. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. 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 are proud of our 5,400 staff and together we aim to . Our leadership behaviours framework set the standards of expectation we aspire to in our daily work. There was a range of large therapeutic areas and rooms for art therapy plus other interventions. Acute patients had been sent to rehabilitation wards inappropriately. All incidents that should be reported were reported. HBPoS and crisis resolution and home treatment (CRHT) team toilets were not visibly clean. Patients knew how to formally complain and could attend daily community meetings where they could raise any issues of concern. On Ashby ward, the shower rooms did not have curtains fitted. 10 July 2015. Staff were up to date with mandatory training. There had been only one out of area placement over 14 months. Comprehensive assessments were being carried out and information was stored securely, except for one location and arrangements were in place to address this. The trust had developed new processes and redesigned and improved data validation. However, we saw evidence this was not always achieved. Leadership had been strengthened at Stewart House. Bank Band 6 Speech and Language Therapist. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. Some areas at Bradgate Mental Health Unit required further improvements to the environments. Consent to care and treatment was obtained in line with relevant guidance and legislation. 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. The health-based place of safety did not meet some aspects of the guidance of the Royal College of Psychiatrists. 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. Staff allowed patients time to respond to questions and did not try to hurry them. This could pose a risk as patients were unsupervised in this area. The trust had improved how staff recorded patients physical healthcare, and monitored patients who had ongoing physical healthcare problems. The trust confirmed after our inspection Advanced Nurse Practitioners used a DNACPR form which had been agreed within NHS East Midlands. Staff and senior leaders could not articulate the trusts direction of travel and how this was co-ordinated. -Supporting a variety of Wards such as Cardiology, Respiratory, Urology, Stroke, Renal, Maternity and Vascular.Obtaining physical measurements such as blood pressure, heart rate, SPO2, Temperature,respiratory rates, blood sugars, pain . Patients had access to advocacy. The summary of this service appears in the overall summary of this report. Save job - Click to add the job to your shortlist. Creating high quality, compassionate care and wellbeing for all. The trust had made some improvements in response to the previous CQC inspection undertaken in March 2015.This included removing some ligature anchor points in the acute mental health wards. The service was meeting its target in this area. Wards did not have a list of stock items. Staff had not routinely recorded whether they had given patients copies of their care plans and we saw this in a considerable number of patient records we sampled. The leadership, governance and culture did not always support the delivery of high quality person centred care. 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. there are some services which we cant rate, while some might be under appeal from the provider. Until then there is a danger information is not shared or fully available to all staff seeing a person. The trust used key performance indicators/dashboards to gauge the performance of the team. Community meetings and patient involvement in the services did not always take place. To find out more, review our cookie policy. We observed positive interactions between patients and staff. Patients and their carers were not involved in care planning and care programme approach (CPA) reviews. Improvements had been made to seclusion areas at The Willows Acacia and Maple wards. Patients told us that appointments usually run on time and they were kept informed when they do not. Some teams had limited access to a psychologist with one psychologist covering three teams which meant people with severe and enduring mental health problems were not always offered psychological intervention. All three service inspections were unannounced. Please contact Sonja Whelan on 07525 723336 or email Sonja.whelan@leicspart.nhs.uk. Feedback from those who used the families, young people and children services was consistently positive. We listen to our patients and to our colleagues, we always treat them with dignity and we respect their views and opinions, We are always polite, honest and friendly, We are here to help and we make sure that our patients and colleagues feel valued, When we talk to patients and their relatives we are clear about what is happening. Inconsistencies in record-keeping for the Autism Outreach services as some records were missing, but others were of an acceptable standard. The electronic data held by the trust was currently being validated with large numbers of visit records not closed on the database. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). Data could not be relied upon to measure service performance or improvement.Data collection and interpretation did not include key pieces of information for example number of delayed or missed visits. We felt this contributed to senior staff views that pace of change in the trust was slow. Some patients continued to share bedroom spaces in dormitories, and personal belongings were stored on the floor because of limited storage provided by the trust. However, ligature points remained. Staff monitored patients physical health regularly from the point of admission. Overall, the trusts compliance rates for mandatory training was 87%. Some managers had access to key performance data and could respond to areas of improvement, but this was not consistent in all aspects of care delivery and across all services. We found serious concerns with medication disposal, storage, labelling and management of controlled drugs. The rating for well-led in mental health services, improved to requires improvement. There were waiting lists of up to 18 months for psychology and up to 40 weeks for other treatment within the personality disorder service. Medication management systems were in place and followed to ensure that medicines were stored safely. A positive culture had developed since our last inspection. Five of the six services in this core service were in breach of these targets. We rated it as requires improvement because: Our rating of the trust stayed the same. In two services, staff were not always caring towards patients. This had been identified during the last Care Quality Commission inspection in 2015. Staff showed us that they wanted to provide high quality care, despite the challenges of staffing levels and some poor ward environments. The trust had a variety of measures in place to ensure that processes and reporting to board were not delayed. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Multi-disciplinary teams and inter agency working were effective in supporting patients. We found that staff across the service were committed to providing good quality care to the patients and showed care and compassion. Every team we spoke with knew who they reported to and what to report. Some staff found there was insufficient time to complete their visits within the working day. At this inspection, we visited the two mental health services previously rated inadequate and one mental health service previously rated as requires improvement. At the Valentine Centre improvements had been made to the storage of cleaning materials. We did not inspect the whole core service. Managers did not ensure that the staff were receiving regular clinical supervision and had not met the trust target compliance rate of 85%. There had been a change in leadership and a review of key performance indicators (KPIs) with commissioners. There was little evidence that staff supported patients to understand the process, no involvement of family or independent mental capacity advocate in most mental capacity assessments. Assessments took place using nationally recognised assessment tools and staff provided a range of therapeutic interventions in line with National Institute for Health and Care Excellence (NICE) guidelines where staffing allowed this. Apply. This promotion is being run by Leicestershire Partnership NHS Trust. The work in neighbourhoods reduced travel for people and reduced barriers for people to gain support. We did not inspect the following areas of this core service: We did not rate this service at this inspection. At the time of inspection, there were a total of 647 children and young people currently waiting to be seen in specialised treatment pathways. There was an effective incident reporting process which investigated and identified lessons from incidents which were shared in most teams. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. The Trust should ensure that the transition is in line with best practice in future. The wards tried to book regular bank and agency staff so they knew the ward and patients, to provide continuity of care. On Bosworth ward patient privacy was compromised when staff and patients entered the clinic room during examinations because there was no privacy curtain in place. 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. 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. People using the service had limited access to psychological therapies and there were no psychologists working within the service. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. Staffing levels did not meet requirement in some community teams. The quality of the data produced was poor and staff needed to correct the data when reports were produced. Care plans reviewed were not personalised, holistic or recovery orientated. Requires improvement One patient on Watermead ward told us that a staff member had ignored them when they had asked them for a sandwich. 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. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. There was no evidence of patient involvement recorded in some of the notes. Another relative said their relative was a changed person since going to the Willows and they were able to go home last Christmas. We rated the trust as inadequate for well-led overall. Care and treatment was planned and delivered in line with current evidence-based guidance, standards, best practice and legislation. Some patients told us that staff were polite and respectful and willing to go the extra mile in supporting them. The majority of care plans were up to date. They were able to talk about the effectiveness of Listening in Action events which aimed to improve the quality of services. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. We're always looking for the best. The trust set target times from referral to initial assessment against the national targets of 28 to 42 days. Staff were very caring and sensitive to patients needs. ", "I like that I'm able to help both staff and service users. They contained items which could pose a danger to staff and patients. Staff felt supported by their managers and received regular supervision and annual appraisals. Leicestershire Partnership NHS Trust Add a Review About 32 We were pleased to hear about the trusts investment in well-being events and initiatives for staff, such as valued star award, choir, yoga and time out days. This meant staff transferred patients to wards that had seclusion rooms when needed. The trust did not provide data to demonstrate medical staff appraisal compliance. We reviewed 267 case records and found that, generally, staff completed detailed individualised risk assessments for patients on admission. However at South Leicestershire clinical supervision take-up was low at 73%. We spoke with nine patient families and carers. At this inspection we found compliance levels with this type of training were still below the trusts target. The trust had begun the process of replacing some beds with more suitable options for the patient group. Patients were offered smoking cessation treatments, nicotine replacement therapy (NRT), or free vapes. 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. They told us that staff were kind and caring. This has been brought. Clinic rooms were overstocked with medications. Since the last inspection the service now had a Section 136 suite that met the standards set out in the Royal College Standards. The HBPoS did not have designated staff provided by the trust. the service is performing badly and we've taken enforcement action against the provider of the service. At our last inspection we raised concerns that an insufficient number of nursing staff in community health services for adults had received appropriate statutory and mandatory training. Staff usually met patients in their homes or in the community. Patients told us that staff listened and empathised with them. Save job - Click to add the job to your shortlist. Risk management in services required improvement. Any other browser may experience partial or no support. We rated long stay/rehabilitation mental health wards for working age adults as requires improvement because: The environment in some areas was very poor, particularly at Stewart House. Due to this staff could not observe all parts of wards due to their lay out and the risk had not been mitigated. We found multiple internal waiting lists where the longest wait for young people was 108 weeks. 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. There were clear responsibilities, roles and systems of accountability to support good governance and management. There was good multi-disciplinary working within the teams and good communication with other organisations. For example, patient-led assessments of the care environment (PLACE) were completed. Staff were positive about the support they received from their local leaders and managers but were less connected with senior leadership and management teams in the children, young people and families services. The feedback from patients and relatives was mainly positive about the staff providing care for them. 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. Patients reported they were treated with dignity and respect. o We are passionate and creative in our work. There was no performance data dashboard to gauge the performance of the service. We rated the trust as requires improvement for well led. Following the appointment of a new chief executive a new trust board was formed. Patients and their relatives felt involved in the care provided. 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. Some facilities lacked essential emergency equipment. Risk assessments were brief, did not always contain sufficient information and were not updated regularly. Lessons were learned from feedback and complaints from patients. There was a floating qualified unit coordinator to oversee the service requirement at the Willows. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. Some patients had to be admitted to adult wards in the last year. All assessment rooms had good visibility. Patients gave positive feedback regarding the care they received. There was a good level of occupational therapy input and good support to help maintain patients physical health. There was good staff morale in services. 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 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 also inspected the well-led key question at provider level for the trust overall. They were reflected in the objectives of local teams. It is generally accepted that when occupancy rates rise above 85%, it can start to affect the quality of care provided to patients and the orderly running of the hospital. This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. 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