leicestershire partnership nhs trust values

Senior leaders in core services we inspected, had not maintained oversight of improvement across all wards of their services. Following the appointment of a new chief executive a new trust board was formed. They were able to talk about the effectiveness of Listening in Action events which aimed to improve the quality of services. We identified medicines management issues, including out of date medication in the acute mental health wards and fridge temperatures were not monitored in community based mental health services for adults. Staff explained to patients their rights under the Mental Health Act on admission and routinely thereafter, although we saw this was not always documented in the patients care notes. We rated Community health services for adults as good because: We gave an overall rating for community based mental health teams for adults of working age as good because: We rated the community mental health services for children and adolescents overall as requires improvement because: Overall rating for this core service Requires improvement l. We rated community inpatient services as requires improvement because: Overall rating for this core service Requires Improvement l. We rated this core service as requires improvement because: We rated this core service as good because: We rated wards for people with learning disabilities and autism as requires improvement because: Leicestershire Partnership NHS Trust (February 2016) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (June 2015) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (November 2014) for - PDF - (opens in new window), Leicestershire: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Leicester City: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Rutland: Children's Services Inspections Reports (2011) for - PDF - (opens in new window). We rated it as requires improvement because: When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. Patients needs were assessed and monitored individually. Young people and their carers spoke positively about the CAMHS service. Staff were trained appropriately within their speciality and new staff were supported to gain experience and skills. The service was not meeting its performance targets. Our patients are at the heart of all we do and we believe that 'Caring at its Best' is not just about the . Staff knew the vision and values of the trust and agreed with these. The clinic rooms across sites had all the equipment calibrated. Staff were passionate about their roles and enjoyed working with the client group. Across the teams, we found up to date ligature audits in place. Staff demonstrated poor understanding of some aspects of the Mental Capacity Act. A childrens adolescent mental health crisis service had been developed and commenced in April 2017. Apply. 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 was a range of large therapeutic areas and rooms for art therapy plus other interventions. Two external governance reviews had been commissioned and undertaken. 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. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. Staff in some services completed care plans with detailed information on allergies, and risks around medication. Clinical supervision was not taking place regularly across the service. The trust was not meeting its target rate of 85% for clinical supervision. PIER staff reported having good links with universities and colleges regarding students needing early intervention services. The trust had made improvements to the clinical environments since the last CQC inspection. The local managers monitored the environment for staff, carried out local audits and checked performance of staff on a regular basis. Apply. there are some services which we cant rate, while some might be under appeal from the provider. Patients had opportunities to continue their education. There some gaps in staff receiving regular supervision. the service is performing well and meeting our expectations. In two of the core services inspected, the environment had not been well maintained. There was limited time available for staff to attend specialist courses to enhance their knowledge. Adult liaison psychiatry services are delivered by the mental health trust across three acute hospital sites at Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital. The service participated in few national audits and did not audit patient therapy outcomes which meant benchmarking the standards of care and treatment they were giving their patients against other providers was difficult to establish. Two patients we interviewed on Ashby and Heather wards told us that staff did not always knock on their bedroom doors before entering. We had concerns about how environmental risks at CAMHS community sites were being assessed and managed. Patients were able to access hot and cold drinks any time during the day. 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. 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. These included unsafe environments that did not promote the dignity of patients; insufficient staffing levels to safely meet patients needs; inadequate arrangements for medication management; concerns regarding seclusion and restraint practice: insufficient clinical risk management. Multi-disciplinary teams and inter agency working were effective in supporting patients. The Trust should ensure that the transition is in line with best practice in future. Therefore, the trust could not be sure staff received information to support best practice and change in a timely manner. Record keeping was poor in some services. The most common reason for delayed discharges was due to family choices which were beyond the control of the trust. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. egistered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. At the time of inspection, there were a total of 647 children and young people currently waiting to be seen in specialised treatment pathways. Managers changed practice because of this. The acute wards for adults of working age had not complied with all of the required actions following the previous inspection of September 2013. Any other browser may experience partial or no support. There had been an increase in the number of CAMHS referrals over the last two years. Some patients told us that staff were polite and respectful and willing to go the extra mile in supporting them. Feedback from those who used the families, young people and children services was consistently positive. We rated the trust as requires improvement for well led. Staff would still work with people who were on waiting lists so that they received some level of service. Staff were not meeting targets for the assessment and assessment to treatment of urgent referrals and six week routine referrals. 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. Waiting times and lists remained of concern, and this had been identified in the previous inspection. 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. Therefore, patients were not always actively engaged in decisions about service provision or their care. The trust had improved how staff recorded patients physical healthcare, and monitored patients who had ongoing physical healthcare problems. The trust had maintained patients privacy and dignity at Short Breaks Services. The summary for this service appears in the overall summary of this report. Staff support systems were in place and there was a drive to engage with staff. A positive culture had developed since our last inspection. The senior occupational therapist was trying to recruit to vacant occupational therapy posts. The trust had not responded in a timely way to eliminate shared sleeping arrangements (dormitories). Staff at the PIER team had not received recent Mental Health Act training. There had been several serious incidents (SI) within this service in the last year and it was not clear that learning from investigations and actions consistently took place to prevent recurrence. Risks to people who used the service and staff were assessed and managed. Patients were happy with the care they received and were very complimentary about the staff who cared for them. The ward had sufficient staff to provide care and treatment to patients. We rated community health inpatient services as requires improvement because: Despite considerable effort with recruiting new members of staff, staffing was the top concern for all senior nurses and there was still a significant reliance on agency staff to fill shifts which could not be covered internally. Curtains separated patients bed areas and the rooms were not secured to allow free access; meaning that patients could have their property removed by other patients. Staff morale in some teams was low, with high levels of stress. To find out more, review our cookie policy. Staffing levels did not meet requirement in some community teams. People using the service had limited access to psychological therapies and there were no psychologists working within the service. Staff told us they involved patients carers but there was little evidence of this in care records. Staff we spoke with were proud to work within the adult psychiatric liaison team and proud to show us the work they did and the service they provided. All the team leaders we interviewed said there were internal waiting lists for patients who had been initially assessed to access profession specific treatments. The HBPoS had no designated resuscitation equipment and emergency medication and shared equipment with acute wards. All three service inspections were unannounced. Men using the laundry had to pass womens bathroom and bedrooms. Staff had good knowledge of safeguarding processes and risk assessments were generally detailed, timely and specific. Some medication was out of date and there was no clear record of medication being logged in or out. The vacancy rate for the service was 12.9% and for band 5 and 6 nurses was 18.9%. 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. Beds were not always available for people living in the trusts catchment area. o We do what we say we are going to do. We rated wards for people with learning disabilities as requires improvement because 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 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. Care plans and risk assessments did not show staff how to support patients. The trust also collected feedback from patients in a variety of ways, including surveys, iPads, community forum meetings and the Friends and Family Test. Staff routinely referred patients to access additional support for employment, housing, benefits and independent mental health advocacy. 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. In CAMHS community teams waiting times from referral to initial assessment was less than 13 weeks. Regular team meetings took place and staff told us that they felt supported by colleagues. The services did not have a strategy and there were no service plans. A psychologist led weekly reflective practice sessions to help staff think about the best way of helping the patient on the ward. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. Service planning was not being managed in a systematic way. The trust had systems for promoting, monitoring and responding to complaints. There was an effective duty system in place to provide rapid access to support. The trust was not commissioned to provide female psychiatric intensive care beds. The trust could not ensure continuity of care for these patients. There were good systems for lone-working which included a code word that staff used when they required assistance. Staff received regular supervision and most had received an appraisal in the last 12 months. 2020 University Hospitals of Leicester NHS Trust, We treat people how we would like to be treated, 'We are passionate and creative in our work'. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. Demand for neurodevelopment assessments remained high. Staff were up to date with mandatory training and had regular supervision and appraisals. Effective multi-disciplinary team working and joint working did not always take place across services. The trust had several strategies, a vision and corporate objectives, but they did not underpin all policies and practices. 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. Bed occupancy for the last two quarters of 2013/14 was around 89%. We found that while performance improvement tools and governance structures were in place these had not always brought about improvement to practices. Therefore, if a female needed a psychiatric intensive care unit they were sent out of area. Improvements to the inpatient wards included updating seclusion rooms, removing some ligature anchor points and replacing garden fencing. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. Staff were inconsistent in updating the Historical Clinical Risk Management (HCR-20) assessments. Our rating of this service stayed the same. 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. Staff ensured that these were updated regularly. Care and treatment was mostly planned and delivered in line with current evidence. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. Every team we spoke with knew who they reported to and what to report. Watch our short film to find out more: We Are LPT Share From a National Health Service (NHS) organisation Watch on Our strategy Staff working for the adult psychiatric liaison team developed holistic, recovery-oriented care plans informed by a comprehensive assessment and in collaboration with families and carers. There was a high vacancy rate of 12.9% for band 5 and 6 nurses in community based mental health services for adults of working age, 18.9% for band 5 and 6 nurses in crisis service and 17.3% across community health services for adults. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service. Morale was found to be poor in some areas and some staff told us that they did not feel engaged by the trust. The trust ceased mixed sex breaches by maintaining male and female only weeks. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). This report describes our judgement of the quality of care provided by Leicestershire Partnership NHS Trust. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. 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 was a risk that staff did not receive adequate support or that their capability was not reviewed. Staff told us they worked as a team and enjoyed their jobs. Services had supplies of emergency medication available and this was accessible to staff. The community healthcare services provided by Leicestershire Partnership NHS Trust were judged to be good. Managers completed ligature audits which highlighted what mitigation was in place to reduce the risk for patients. There was effective communication between the service and other healthcare professionals. 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. Staff we spoke with were unaware of incidents and learning on other wards across acute wards for adults of working age; this was highlighted as an issue at our inspection in 2018. Save job - Click to add the job to your shortlist. We found that staff across the service were committed to providing good quality care to the patients and showed care and compassion. Staff followed the trust policy on seclusion. We reviewed 267 case records and found that, generally, staff completed detailed individualised risk assessments for patients on admission. The trust lacked an overarching strategy which everyone within the trust knew. DE22 3LZ. Following the national withdrawal of the Liverpool Care Pathway the trust has developed an alternative care plan; however this has not yet been implemented. A further review was an examination of processes and procedures within the trust for reporting investigations and learning from serious incidents requiring investigation. Staff did not document physical health checks for patients detained under section 136 in the HBPoS. One family member told us their relative could be challenging but they felt they were well cared for. For services we haven't rated we use ticks and crosses to show whether we've asked them to take further action or taken enforcement action against them.