Risk assessments were completed during the initial assessment at the CRHT team. Patients were able to access hot and cold drinks any time during the day. The feedback from patients and relatives was mainly positive about the staff providing care for them. The medical and senior leadership provision within the looked after children service did not meet the professional requirements outlined in the intercollegiate document for this provision. The matron opened some vault windows via a remote. Staff in some services completed care plans with detailed information on allergies, and risks around medication. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. Local audits were not completed regularly. There were appropriate arrangements in place for the safe management of medicines. Practice development and embedding practice was good, for example, where dementia mapping was adapted to learning disabilities. Team meetings were not regular, or didn't take place.The sharing of lessons learnt remained inconsistent across some wards. However, ligature points remained. There some gaps in staff receiving regular supervision. At this inspection the overall ratings for mental health services stayed the same in safe, effective and responsive, which we rated as requires improvement. 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. Staff received Mental Capacity Act 2005 and Deprivation of Liberty Safeguards Some staff did not demonstrate a good understanding of the Mental Capacity Act. Staff completed detailed risk assessments for patients on admission and reviewed them regularly after incidents. We rated community based mental health services for adults of working age as requires improvement because: Access to the service was delayed due to variable caseloads and waiting times. The trust had no auditing system to measure performance in order to improve the service. Managers had a recruitment plan in place to increase the number of substantive staff for the service. Staff were up to date with mandatory training and had regular supervision and appraisals. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. Capacity assessments were unclear. Some areas at Bradgate Mental Health Unit required further improvements to the environments. Staff used strategies to maintain patients safety which had an adverse effect on their dignity and privacy. Apply. Patients were supported, treated with dignity and respect and involved as partners in their care. Staff did not record seclusion well. The trust had completed ligature risk assessments across all wards, detailing where risks were located and how these should be managed. It was clear to see the difference the investment and improvements had made since our last visit. Staff consistently demonstrated good morale. This meant that patients could have been deprived of their liberties without a relevant legal framework. Whilst staff were working hard to identify and manage individual risks, some ward environments were unacceptable. 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. Environments were visibly clean and welcoming. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. There were safe lone working practices embedded in practice. Leicester; 33,706 to 40,588 a year (pro rata) Leicestershire Partnership NHS Trust; We are looking for a Bank Band 6 Speech and Language Therapist to join our innovative, friendly and well supported team working with children and y. 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. The overall average compliance rate for supervision of staff in the learning disability wards was 46%. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. Urgent and emergency care services across England have been and continue to be under sustained pressure. Patients were protected from avoidable harm and abuse, systems were in place to investigate incidents and concerns and staff received suitable training in safety systems. 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. We saw evidence of good team working during our inspection. We did not identify any significant community wide areas for improvement but did find many exemplary services provided by the trust. To find out more, review our cookie policy. However, the service was collecting data. 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. The number of visits was not always manageable. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. Consent to care and treatment was obtained in line with relevant guidance and legislation. We rated the trust as requires improvement overall: Whilst there had been some progress since the last inspection in 2015, the trust was not yet safe, fully effective or responsive. Download the leadership behaviours booklet or watch the animation below to find out more: Our People Plan shows our dedication to making LPT a great place to work and receive care. A carers group was available to give support. Make a difference with a career at LPT. This had previously been identified on the CQC inspection in March 2015. The trust had set safe staffing levels and these were followed in practice. The CRHT team did not have lockable bags to transport medication to patients homes; staff told us they transported medication in their handbags. The health-based place of safety did not meet some aspects of the guidance of the Royal College of Psychiatrists. Risk management in services required improvement. The trust had developed checklists to assist staff with the receipt and scrutiny process. There were long waiting times from initial referral to being seen in some clinics and services although these had improved in some areas since the last inspection. For example, Ashby, Aston, Bosworth and Thornton Wards had been converted to single sex only accommodation to ensure compliance with the Department of Health and Mental Health Act 1983 guidance on mixed sex accommodation. ", "I have developed so many new skills over the years working in the NHS, going from a healthcare assistant to a nursing associate. 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. The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. 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. The trust had identified the lack of psychological therapies for patients, and support and training for staff, on their risk register. The trust had systems for staff to raise any concerns confidentially. The Trust had a number of unfilled positions being covered by long-term bank staff. Staff monitored patients physical health regularly from the point of admission. Equality diversity and inclusion matters had been a focus of the new trust leadership team. Patients were protected from avoidable harm by sufficient staffing and safeguarding processes. Click on the coloured text links below to visit any of the listed organisations' websites: Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. 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. The rating for well-led in mental health services, improved to requires improvement. The trust confirmed community hospital staff were expected to undertake four clinical supervision sessions across the year. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. 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. spoke with 15 family members or carers of patients, reviewed the mental health act detention papers of 23 patients and seclusion records of 10 patients, and. Risk assessments were brief, did not always contain sufficient information and were not updated regularly. At Melton, Rutland and Harborough, City East and City West CMHTs m. At City West in conjunction with the young onset dementia assessment service staff developed a digital app for younger who were developing dementia. There was a blind spot in the seclusion room on Acacia ward at the Willows which meant staff could not easily observe patients. -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 . There was access to interpreters and staff were aware of how to access them. We heard from most teams, positive examples of teamwork and multidisciplinary working within teams and services, and with external agencies and key stakeholders. The rating had improved from the November 2016 inadequate rating. Patients were frequently not discharged when ready due to transport problems or difficulties putting care packages in place. 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. There were good examples of collaborative team working and effective multi-disciplinary and multi-agency working to meet the needs of children and young people using the service. Staff were not always recording room and fridge temperatures in clinical rooms and out of date nutrional supplement drinks had not been appropriately disposed of. The trust had maintained patients privacy and dignity at Short Breaks Services. One family member told us their relative could be challenging but they felt they were well cared for. There was good staff morale. This has been brought. Staff did not always follow trust policies and procedures when they needed to search patients or their bedrooms to keep them safe from harm. Staff identified this was due to the management of change process and current work being undertaken by an outside organisation to identify more effective ways of working. There was highly visible, approachable and supportive leadership. We have four core values: Compassion, Respect, Integrity, Trust. 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. The most common reason for delayed discharges was due to family choices which were beyond the control of the trust. Supervision and appraisal compliance of three teams fell below 75%. This was particularly relevant to protected characteristics. Staffing levels did not meet requirement in some community teams. In two services, staff were not always caring towards patients. Some improvements to address the no smoking policy at the Bradgate Mental Health Unit wards were seen. We want to hear from you on how to improve our service and provide the best care possible. Leicestershire Partnership NHS Trust interview details: 3 interview questions and 3 interview reviews posted anonymously by Leicestershire Partnership NHS Trust interview candidates. Team managers could not be assured of local performance around record keeping, care planning and patient involvement. The majority of community mental health teams did not meet the referral to initial assessment and assessment to treatment times. Managers shared the outcomes and lessons learnt from incidents, complaints and service user feedback at regular staff meetings, where meetings took place. Staff did not consistently promote dignity and respect as expected in all services. The trust admitted male patients to female areas of the mixed wards when male beds were unavailable. Services had supplies of emergency medication available and this was accessible to staff. We rated them as requires improvement because: During the inspection, our inspection teams carried out the following activities across 11 wards in the services: During our well-led inspection, we spoke with 32 senior leaders of the organisation and looked at a range of policies, procedures and other governance documents relating to the running of the trust. Medicines Management Our vision Creating high quality, compassionate care and wellbeing for all. This report describes our judgement of the quality of care provided by Leicestershire Partnership NHS Trust. There could be risks posed by the use of different recording systems across teams as staff may not all have access to all records. 78% of staff had completed their annual appraisal. 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. Jan 4. Coventry, Managers ensured they used regular bank staff to achieve the required safer staffing levels and to promote continuity of care of patients. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. New positions such as medicines administration assistants and link nurses to support wards were in place in certain areas, but ward staff still described irregular pharmacy visits and a lack of pharmacy oversight in medicines management. All assessment rooms had good visibility. The summary for this service appears in the overall summary of this report. She embraces the principles of the employee as a consumer (a person who makes the choice of where to work by considering a broadly defined value proposition, inclusive of financial, work, and social aspects of life) and agile organization (a workforce that continually evolves to meet the changing interests and needs of team members and customer.) We rated all three mental health services inspected as requires improvement overall. It promises that we will lead with compassion and inclusivity, with the health and wellbeing of our staff at the heart of all we do. We found that while performance improvement tools and governance structures were in place these had not always brought about improvement to practices. Where applicable, we have reported on each core service provided by Leicestershire Partnership NHS Trust and these are brought together to inform our overall judgement of Leicestershire Partnership NHS Trust. Where relevant we provide detail of each location or area of service visited. Bed occupancy rates were above 85% for community health inpatient wards. Patients told us that staff listened and empathised with them. The trust lacked a framework for co-ordinating, endorsing and therefore learning from the very many positive quality projects taking place. Overall community hospital occupancy rates for March 2015 were 94%, which reflected bed pressures in the local region. Patients felt safe. Engagement with external stakeholders had significantly improved since our last inspection. The duty system enabled urgent referrals to be seen quickly. In community based mental health teams for older people five of six services breached national targets from referral to assessment. This did not protect the privacy and dignity of patients when staff undertook observations. Staff explained that the figures collected around preferred place of death were collected as these were requested by the clinical commission group (CCG), although these figures were collected for services in the community; the ward based palliative care figures were not collated. 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. 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. 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. There was no patient alarm access in four ward areas, including the dormitories. Interpreters were used when working with people who did not have English as a first language. Leicestershire Partnership NHS Trust provides mental health, learning disability and community health services across Leicestershire, England.. Our HIV/AIDS Services program is in need of volunteers to help deliver . Data provided by the trust showed there were four episodes of seclusion from February 2016 to July 2016. 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. Managers changed practice because of this. Another patient said on their comment card they did not see enough of the occupational therapist. Following inspection, the trust submitted an action plan to review access to call alarms. There were appropriate lone working procedures in place. We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. Five out of 25 care records showed that patient involvement had not been recorded. Feedback from those using the service was positive about how they were treated by staff and about how they were involved in making decisions with the support they needed. Nursing staff had large caseloads. This reduced continuity of care. 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. Preventing infections Same sex accommodation Building better hospitals eHospital Programme Our values 'We treat people how we would like to be treated' 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 Multi-disciplinary team meetings took place on a regular basis. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. Men using the laundry had to pass womens bathroom and bedrooms. We inspected three mental health inpatient services because of the ratings from the previous inspection. The trusts pace for implementing equality and diversity initiatives across the organisation needed improvement. Staff were kind, caring and respectful towards patients. Staff felt supported by their immediate managers but felt disaffected with trust senior management. This was because the EDU batch refer sending four or five referrals at a time rather than when they arrive. Staff told us the trust was a good place to work. 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 service had plans in place to manage service disruption and major incidents. Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. 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. Staff reported incidents, which were discussed and reviewed by line managers within the teams. Staff did not always feel connected to the wider trust. The wards tried to book regular bank and agency staff so they knew the ward and patients, to provide continuity of care. Staff followed infection and prevention control practices and the community inpatient wards were visibly clean. Discharge planning was considered as part of board rounds although discharge planning paperwork was not used consistently. The HBPoS did not have designated staff provided by the trust. Our leadership behaviours framework set the standards of expectation we aspire to in our daily work. 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. 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. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. The trust had new seclusion paperwork implemented in May 2019. Staff were not meeting the trusts target compliance rate for annual appraisals and mandatory training. There was use of bank and agency staff. Staff were consistently caring, respectful and supportive. The service was not meeting its performance targets. Not all families and carers knew they could attend virtual ward meetings and care programme approach meetings. The trust did not provide data to demonstrate medical staff appraisal compliance. Staff knew how to report any incidents on the trusts electronic reporting system. Staff used the mental health clustering tool, which included Health of the Nation Outcome Scales (HoNOS) to assess and record severity and outcomes for all patients. There were low levels of restraint and staff tried other methods to de-escalate before restraining patients. We felt this contributed to senior staff views that pace of change in the trust was slow. 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 Agnes Unit, staff did not always record the physical health of patients who had been given rapid tranquilisation. Patients and their relatives felt involved in the care provided. One ward matron told us that a patient had recently alleged that a staff member had assaulted them. The trust delivered programmes for staff to develop into senior roles and had a clear career development programme for nursing staff. Managers had introduced a duty clinician to manage caseload sizes and reduce patients risks. The trust had robust systems in place which allowed staff to effectively report incidents. Managers did not ensure that the staff were receiving regular clinical supervision and had not met the trust target compliance rate of 85%. Staff followed infection control practices and maintained equipment through regular servicing. Staff interacted with patients in a caring and respectful manner. The136 suiteis a place of safety for those who have been detained under Section 136 of the Mental Health Act. The trust set target times from referral to initial assessment against the national targets of 28 to 42 days. A dual paper and electronic recording system meant that some information was not accessible to all of the staff that might need it. Staff monitored the ongoing condition of any secluded patient. Patients we spoke with knew how to complain. The trust had a culture of promoting staff learning and development and encouraged staff to share best practice and innovation. The service was not effective. On many wards, the trust had not supplied sufficient numbers of lounge and dining chairs to accommodate all patients and some wards did not have sufficient quiet rooms for care and treatment or for patients to receive visitors. Staffing numbers were met but not always the right skill mix. This impacted on patients requiring care. Leicestershire Partnership NHS Trust Location Leicester Salary 27,055 to 32,934 a year Closing date 2 Feb 2023. By: Miraj Vaghadia | Tags: A project to improve patient care by making best use of capacity across Leicestershire Partnership NHS Trust (LPT) District Nursing teams has been shortlisted for the prestigious Nursing Times Awards. Nottingham, 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. Overall, patients were positive about the care they received and had access to advocacy services on all wards. There was no evidence of patient involvement recorded in some of the notes. Some seclusion rooms had environmental concerns at Belvoir and Griffinunits, and Watermead wards. The principles will normally apply but will be balanced by inspection teams using their discretion and professional judgement in the light of all of the available evidence. the service isn't performing as well as it should and we have told the service how it must improve. The average bed occupancy was low. We rated it as good because: Leicestershire Partnership NHS Trust: Evidence appendix published 30 April 2018 for - PDF - (opens in new window), Published The waiting list had increased for those children and young people waitingfor thestart of treatment, following assessment. Since the last inspection the service now had a Section 136 suite that met the standards set out in the Royal College Standards. Staff demonstrated good knowledge of the Mental Capacity Act 2005. The school nurses used technology to communicate with young people. As part of each inspection, we look at the way health services provide care and treatment to people. Staff on the acute wards were not consistent with searching patients upon return from unescorted leave as some patients had managed to take lighters onto four of the wards. There was a full complement of staff with no vacancies. 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. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. Patients waiting for their appointment in the specialist community mental health services for children and young people used a shared waiting room with the learning disabilities adults services. Staff had a good understanding of patients needs. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. Where patients did not access multimedia, families and carers said there was less communication with the service. We reviewed data and documentation including three patients care records and risk assessments. The trust had ensured patients privacy and dignity were maintained when receiving physical health observations at the Bradgate Mental Health Unit. Patient had individualised risk assessments. Some local managers were keeping their own records to ensure performance was monitored. Improvements were noted in some wards in core services but not all. Nurses and managers from LPT who were supported . We rated safe, effective, responsive and well led as requires improvement and caring as good. We saw an example of an SI investigation and also action taken from lessons learnt. Seclusion environments were not an issue of concern at this inspection. They were reflected in the objectives of local teams. Staff could not rely on performance reports being accurate. We rated wards for people with learning disabilities as requires improvement because 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. Best interest meetings were held where it had been assessed that a patient lacked the capacity to consent to a decision. Record keeping was poor in some services. They are: o We focus on what matters most. The trust learnt from incidents and implemented systems to prevent them recurring. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. The longest wait was 108 weeks for four patients to access group work or outpatients. We were not assured that the trust risk register clearly documented action taken or progress of action, within agreed timescales. They were able to talk about the effectiveness of Listening in Action events which aimed to improve the quality of services.
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