This meant board members were not able to monitor the trusts assertions that there were strong systems and processes in place for identifying and reporting serious incidents, including deaths, or monitoring whether reviews and investigations were completed fully. Computer systems were not shared across GP surgeries so information sharing did not happen effectively. However there was no evidence of clinical audits or monitoring of the service in order to improve care provided to patients and staff were unable to talk about this to inspectors. Requires improvement Published For example, furniture was light and portable and could be used as a weapon. Medicine management training sessions had been undertaken with inpatient ward sisters and charge nurses. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. The trust had improved how staff recorded patients physical healthcare, and monitored patients who had ongoing physical healthcare problems. Connect with our community. There were clear treatment pathways. Managers had introduced a specialist child and adolescent mental health traffic light system, a red, amber and green rating tool for managing risk. Care records showed that physical health examinations were completed upon admission and there was ongoing monitoring of physical health across the trust. 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. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. Staff had good knowledge of safeguarding processes and risk assessments were generally detailed, timely and specific. There were no separate female bedroom areas and no gender specific toilets or bathrooms. The trust had completed ligature risk assessments across all wards, detailing where risks were located and how these should be managed. There was good staff morale. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. Admission to the unit was agreed with commissioners. The trusts Board Assurance Framework (BAF) was lengthy, was combined with a corporate risk register and had overdue actions. 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.) The learning disability community team had not met the six week target for initial assessment on average it was six days over. Patients and their carers were not involved in care planning and care programme approach (CPA) reviews. Staff gave examples of initiatives such as the chief executives blog and the presentation of the valued star award. On one ward, female shower rooms did not contain shower curtains. 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. Suspended ratings are being reviewed by us and will be published soon. To find out more, review our cookie policy. However, we saw evidence this was not always achieved. Assessments and care planning took place for patients needs. All patients told us staff respected their privacy and dignity. 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 was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. This included environmental improvements, shared sleeping accommodation, response times to maintenance issues, care planning and access to relevant therapies in certain services. Services had complied with guidance on eliminating mixed sex accommodation. Staff reported morale was good, they worked well together and supported one another. Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), In Not all care plans reflected patients assessed needs, or were personalised, holistic and recovery oriented. 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. Staff were not meeting targets for the assessment and assessment to treatment of urgent referrals and six week routine referrals. Patients occasionally attended the service. 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. There was access to interpreters and staff were aware of how to access them. Patients waiting for their appointment in community based mental health services for adults of working age had access to a room unsupervised which held items which could cause harm. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. People knew how to make a complaint as this information was provided in welcome packs. The service is not appropriately commissioned to provide sufficient school nurses to meet the standard service recommendations of one nurse per secondary school and its associated primary schools. The trust had robust arrangements in place for the receipt and scrutiny of detention paperwork. Patients reported they were treated with dignity and respect. Caring stayed the same, rated as good. 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. Staff were dedicated and passionate about the work that they undertook. 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. This was a focused inspection. Staff said this made them feel safe whilst visiting patients at home or whilst undertaking activities with patients in the community. We did not have assurance service leads had good oversight of the risks relating to this service as staff were not always recording incidents, the service was unable to identify incidents specific to patients at the end of life and concerns relating to the out of hours GP service were not formally recorded. The 30 bed unit at Stewart House was mixed sex and there were no doors to lock between the male and female sections. the service isn't performing as well as it should and we have told the service how it must improve. Staff we spoke with demonstrated their dedication to providing high quality patient care. There was no process in place for learning from other organisations which provided similar services or to share this services best practice. There were good systems for lone-working which included a code word that staff used when they required assistance. Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately. We observed many examples of staff treating patients with care and compassion. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. University Hospitals of Leicester NHS Trust. We rated responsive and well led as requires improvement, and safe, effective and caring as good. There were effective methods for obtaining feedback from service users and carers and feedback was acted upon. Wards employed additional healthcare support workers to meet patient needs when needed. The trust had launched its "Step up to Great" approach, which identified the vision and priorities for the year. Safeguarding was a high priority with regular safeguarding reviews within each area of speciality and established systems for supporting staff dealing with distressing situations. We could not find records for seclusion or evidence of regular reviews taking place as per trust policy. Their service users and staff are extremely important to them. The adult community therapy team did not meet agreed waiting time targets. Staff were included in service developments and involved in listening into action projects for service improvement. We identified that in community mental health teams, wards and community inpatient hospitals, fridge temperatures were not recorded correctly; either single daily temperature readings were recorded rather than maximum and minimum levels or temperatures were not recorded on a daily basis. Your information helps us decide when, where and what to inspect. 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. Staff interacted with patients in a responsive and respectful manner at all times and showed a good understanding of individual needs. At the Agnes Unit, staff did not always record the physical health of patients who had been given rapid tranquilisation. 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. We found that staff across the service were committed to providing good quality care to the patients and showed care and compassion. Advanced Directives had been introduced to enable patients to make decisions now about their long term care. One patient told us they did not know they could leave the ward to seek medical attention. 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. Services have been transferred to this provider from another provider, Mental health crisis services and health-based places of safety, an inspection looking at part of the service. In rating the trust, we took into account the previous ratings of the core services we did not inspect on this occasion. Patients in four services across the trust reported that they had not been involved in the planning of their care and had not received copies of care plans. Other professionals within the trust could not access this system. 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. The trust did not provide data to demonstrate medical staff appraisal compliance. The recording of discussions and assessments with people regarding consent to treatment was not always documented. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. Families and carers said the wards were clean. Staff were passionate about their roles and enjoyed working with the client group. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. Staff at the PIER team had not received recent Mental Health Act training. The trust could not ensure continuity of care for these patients. 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. There was no fridge to keep medicines cool when required. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. The trust confirmed the service line was contracted to provide bed occupancy at 93%. Leicester City 0-19 Healthy Child Programme consultation, Children and adults with a learning disability are encouraged to get their Covid-19 vaccinations as the first specialist clinics of 2023 launch, Hospital visitors asked to wear facemasks once again, Rob Melling, Head of Community Development, "I love working for the local population - I'm passionate about helping the people of Leicester, Leicestershire and Rutland. The trust ensured that people who used services, the public, staff and external partners were engaged and involved in the design of services. Risk assessments were completed and care plans implemented to keep patients safe and promote wellbeing. There was an effective incident reporting process which investigated and identified lessons from incidents which were shared in most teams. The trust had ensured patients privacy and dignity were maintained when receiving physical health observations at the Bradgate Mental Health Unit. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Curtains were missing from bed spaces and staff did not wait for an answer from patients before entering rooms on acute wards. Patients were supported to meet their religious and cultural needs. Staff and senior leaders could not articulate the trusts direction of travel and how this was co-ordinated. This was: We also assessed if the organisation is well-led and looked at areas of governance, culture, leadership capability and improvement. Multi-disciplinary teams and inter-agency working were effective in supporting people who used the service. We had concerns about how environmental risks at CAMHS community sites were being assessed and managed. There were waiting lists of up to 18 months for psychology and up to 40 weeks for other treatment within the personality disorder service. Staff used a mixture of paper and electronic records which were not easy to follow. 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. A report on the inspection was . Concerns about high bed occupancy, record keeping and delayed discharges were identified in the March 2015 inspection and had not been sufficiently addressed. The trust experienced high demand for acute inpatient beds. Two external governance reviews had been commissioned and undertaken. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the patients. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. Equality diversity and inclusion matters had been a focus of the new trust leadership team. Staff felt that they had opportunities to develop and were supported to undertake further study. 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. On acute wards, not all informal patients knew their rights. Staff described various ways in which they received information from the board and other governance meetings. The trust had not fully addressed the issues of poor lines of sight in wards. This was particularly relevant to protected characteristics. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. We rated all three mental health services inspected as requires improvement overall. Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. Not all of the patients felt involved in their care planning and not all had a copy of their care plans. Staff had limited opportunities to receive specialist training. Teams were responsive and dealt with high levels of referrals. Staff knew the vision and values of the trust and agreed with these. Community meetings and patient involvement in the services did not always take place. Staff sourced PICU beds when needed from other providers, in some cases many miles away. When we talk to colleagues we are clear about what is expected. We heard positive reports of senior staff feeling able to approach the executive team and the board. The teams did not have waiting lists for care coordinators at the time of inspection. Therefore, staff could ensure accurate measures of blood pressure were being recorded. At this inspection we found compliance levels with this type of training were still below the trusts target. 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