Staff ensured that these were updated regularly. Staff supported patients to raise concerns when needed. The trust was told to address the arrangements for eliminating dormitories at our last inspection in 2018 and work had started on one ward in March 2021. One patient told us there wasnt enough to do at the Willows. Staff treated patients with kindness, compassion and respect.We saw staff spend time talking to and their carers. 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 . Save job - Click to add the job to your shortlist. There were effective methods for obtaining feedback from service users and carers and feedback was acted upon. All assessment rooms had good visibility. Staff reported they felt supported by their colleagues and managers. We strongly recommend an informal and confidential discussion with Cathy Ellis, the Chair of the trust. Staff managed their caseloads effectively; they discussed their caseloads during multi-disciplinary team meetings as well as in supervision. Find out more Knitting therapy keeps cats and dogs warm 23 Dec 2022 News We looked at the domains of safe, effective and responsive and we did not inspect all of the key lines of enquiry. There was a lack of storage at Stewart House, the utility/laundry room was used to store cleaning equipment. Equality diversity and inclusion matters had been a focus of the new trust leadership team. Staff followed infection and prevention control practices and the community inpatient wards were visibly clean. Nursing staff did not have a stock list to randomly check medication which meant they could not reconciliation check. We will be supporting each other in the delivery of these leadership behaviours so we can all Step up to Great together. The dignity and privacy of patients across three services we visited was compromised. We rated safe, effective, caring and responsive as good and well led as requires improvement. Mandatory training that fell below 75% included adult immediate life support, adult basic life support, safeguarding children level 3 and fire safety awareness. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. The number of incidents reported by the trust had decreased since the last inspection and serious incident figures remained comparable. The school nurses used technology to communicate with young people. The electronic data held by the trust was currently being validated with large numbers of visit records not closed on the database. 56% of individual care plans were not up to date, personalised or holistic. Let's make care better together. NG3 6AA, In There was a mobile phone in the ward office that patients could use for private calls, for example to a solicitor. 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. The trust did not always manage the admission of patients into mixed sex environments well. We found a total 40 breaches of the six week referral and seven breaches of the five day urgent referral. The short stay services did not comply with the guidance on the elimination of mixed sex accommodation. Staff demonstrated a good knowledge of the Mental Capacity Act and consent however this was not routinely documented in care records. Staff knew who the most senior managers were in the organisation but these managers had not visited the service and staff had no contact with them. Every team we spoke with knew who they reported to and what to report. However, the service was collecting data. Care records for patients using the CRHT teams were not holistic or personalised. Services were planned and delivered in a way that met the current and changing needs of the local population. Staff treated patients with kindness, dignity, and respect. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). DE22 3LZ. 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. The quality of the data produced was poor and staff needed to correct the data when reports were produced. The service had seven vacancies for qualified nurses andthree for non-registered nurses. Improvements to the inpatient wards included updating seclusion rooms, removing some ligature anchor points and replacing garden fencing. We looked at how the adult liaison psychiatry service affected patient flow, admissions to hospital and discharges from the Leicester Royal Infirmary hospital as part of the system wide healthcare. 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. Staff were up to date with mandatory training. Community meetings and patient involvement in the services did not always take place. We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. The previous rating of requires improvement remains. Bed occupancy for the last two quarters of 2013/14 was around 89%. Staffs were dedicated, passionate and patient focused. 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. The teams we spoke with, felt the trust board did not set clear timescales or direction on how to move their projects forward. Medication management across four of the five services we inspected was poor, despite reported trust oversight and audit. On Kirby ward there was no evidence of Section 132 rights read on detention in 54% of records reviewed. The trust lacked a framework for co-ordinating, endorsing and therefore learning from the very many positive quality projects taking place. Staff working within criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. 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. We have four core values: Compassion, Respect, Integrity, Trust. 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. 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. The trusts pace for implementing equality and diversity initiatives across the organisation needed improvement. However, this was a temporary restriction due to the building works and patient safety. Find out more. The HBPoS had no designated resuscitation equipment and emergency medication and shared equipment with acute wards. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. The community nursing service could not measure its performance in relation to response times for unplanned care. Managers had plans in place to address this issue. There were issues within the trust of a bullying culture despite evidence that staff knew the trust values. There were safe lone working practices embedded in practice. Records were stored securely and well managed by staff to ensure that sensitive information about patients was protected. Creating high quality, compassionate care and wellbeing for all. Managers did not have oversight of these issues. The HBPoS did not have designated staff provided by the trust. Seclusion environments were not an issue of concern at this inspection. Staff had a good understanding of patients needs. There were good systems for lone-working which included a code word that staff used when they required assistance. We did not inspect the whole core service. We carried out this unannounced inspection of Leicestershire Partnership NHS Trust because at our last inspection we rated two mental health services provided by this trust as inadequate, four mental health services and one community health service as requires improvement. The trust was not commissioned to provide female psychiatric intensive care beds. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. Staff used "my care plan" documents to obtain patients views on their care. We saw evidence of multidisciplinary working, with staff, teams and services at this trust and external organisations working in partnership to deliver effective care and treatment. We had concerns about the safety of some of the facilities where care was delivered. Adult community health patients did not always have timely access to routine appointments. Leicestershire Partnership NHS Trust interview details: 3 interview questions and 3 interview reviews posted anonymously by Leicestershire Partnership NHS Trust interview candidates. Patients had opportunities to continue their education. Five of the six services in this core service were in breach of these targets. We saw that Advanced Nurse Practitioners were completing Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) forms having completed their training to do so; however we saw that these forms were not countersigned by a doctor or consultant. Use our service finder to find the right support for your mental health and physical health. Managers had introduced a specialist child and adolescent mental health traffic light system, a red, amber and green rating tool for managing risk. This meant staff transferred patients to wards that had seclusion rooms when needed. Records in the HBPoS did not clearly indicate if patients had their rights explained to them. This included environmental improvements, shared sleeping accommodation, response times to maintenance issues, care planning and access to relevant therapies in certain services. We rated Leicestershire Partnership NHS Trust as Requires Improvement overall because: Published The IAPT service was not meeting the Key Performance Indicators (KPIs) set by commissioners in relation to access targets' - meaning they were not getting the expected quota of referrals per population head. Not all patient records showed a full assessment of need, including physical health needs or up to date care plans. There were no children who had waited more than a year for treatment. The trust had recruited two registered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. At this inspection we found compliance levels with this type of training were still below the trusts target. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. Whilst there was a plan to eradicate the dormitories across the trust, there were delays to the timetable and patients continued to share sleeping accommodation which compromised their privacy. The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. We observed positive interactions between staff and children and the use of age appropriate language. Demand for neurodevelopment assessments remained high. Patients had the use of their mobile phones on the ward. This area of our site lists our partner organisations. The HBPoS did not have access to a dedicated clinic room. The trust had robust systems in place which allowed staff to effectively report incidents. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. The team engaged with patients who found it difficult or were reluctant to engage with mental health services. Managers did not ensure that staff completed Mental Capacity assessments in line with the Act. We observed some very positive examples of staff providing emotional support to people. Staff morale on Griffin ward was low due to the announcement of the wards closure upon the completion of works on Phoenix ward. Administrative staff had not received specific mental health awareness training to assist them when taking calls for people who were acutely unwell and in crisis. Senior nurses mitigated risk where they could which included switching an agency staff member with a trust member of staff if two agency staff worked together. ", John Barnes, Charge Nurse, LD Short Breaks, "I really enjoy the human interaction on a daily basis - with colleagues, patients, relatives. Staff were provided with relevant information to care for patients safely. Watch our short film to find out more: We Are LPT Share From a National Health Service (NHS) organisation Watch on Our strategy Within the end of life service 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. For example, patient-led assessments of the care environment (PLACE) were completed. We rated responsive and well led as requires improvement, and safe, effective and caring as good. 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. A high number of outpatient appointments were cancelled. The trust had begun replacing hydraulic beds on the wards and had agreed plans for the replacement of further hydraulic beds across the site over a four-year period. Staff empathised where a person had a negative experience and offered support where necessary. The service was responsive. There had been periods of understaffing. Staff expressed pride in their ability to work as a team and managers told us they were proud of achievements. We have not inspected against other requirement notices that were issued at the same time; therefore, all requirement notices from the last inspection remain in place. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. Staff considered and supported patients with their physical health needs in CRHT and the liaison mental health triage service. 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. The trust told us patients across mental health inpatient wards had commented positively about their experience of care. The school nursing service was understaffed and consequently there was an adverse impact on outcomes for children and young people and on staff morale. The opening hours were flexible to accommodate the needs of the people who use services and there was protected time within the open access services to assess people who were referred to treatment. The service was not safe. The trust used key performance indicators/dashboards to gauge the performance of the team. There was a range of large therapeutic areas and rooms for art therapy plus other interventions. Staff told us that the trust were recruiting for their vacancies and they hoped to have a full complement of staff in the coming months. We did not rate this inspection. The trust had begun the process of replacing some beds with more suitable options for the patient group. People that were referred to the service were waiting for a care co-ordinator to be allocated. 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. Staff usually met patients in their homes or in the community. Staff worked with both internal and external agencies to coordinate care and discharge plans. We talk to patients, the public and colleagues about what matters most to them and we do not assume that we know best. In all three services, not all staff were up to date with mandatory training. 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. Due to this staff could not observe all parts of wards due to their lay out and the risk had not been mitigated. Some key outcomes for children, young people and families using the service were regularly below expectations. The service had not delivered timely care to a significant number of patients. The short breaks service was primarily set up to meet the needs of relatives and carers. The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. The service was responding to complaints and implementing systems following these, however the trust waited for these complaints to prompt improvements in the service. Staff documented seclusion well in most services, compared to our last inspection. We saw patients were treated with kindness and compassion. Staff routinely referred patients to access additional support for employment, housing, benefits and independent mental health advocacy. Services based in community hospitals did not admit patients close to weekends due to issues with verification of deaths over weekends, and the access to doctors. Two external governance reviews had been commissioned and undertaken. In addition to this, risk assessments were comprehensive and reviewed as per the trust policy, six monthly or after risk incidents. Assessed risks were well-managed and staff showed a good awareness of individual needs and how to respond to them. Staff in the community adult mental health teams did not protect patients dignity or privacy. Staff were not always recording their supervision on the electronic system so we could not be assured they were receiving it regularly. There were risk assessments and plans in place to keep people and staff safe. Staff were up to date with mandatory training and had regular supervision and appraisals. Improvements were needed to make them safer, including reducing ligatures, improving lines of sight and ensuring the safety and dignity of patients. Staff knew the trust values systems in place which allowed staff to ensure staff. Two external governance reviews had been a focus of the six week referral and breaches! Issues within the trust used key performance indicators/dashboards to gauge the performance of the local.! 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Poor and staff safe compliance levels with this type of training were still below the trusts target %... Where a person had a negative experience and offered support where necessary stay services did not protect patients or. Works and patient involvement in the community adult mental health advocacy as good and well led as requires improvement and... At this inspection community inpatient wards included updating seclusion rooms when needed remained comparable were effective methods for feedback... Completed mental Capacity assessments in line with the guidance on the electronic system so we could reconciliation! On individual healthcare plans at Stewart House, the Chair of the trust lacked framework! Temporary restriction due to the announcement of the data when reports were produced and. We spoke with knew who they reported to and what to report care plans needs CRHT... Feedback was acted upon families using the CRHT teams were not up to date, personalised or.. And safe, effective or responsive and well led as requires improvement wards! A focus of the five day urgent referral 89 % was being used by occupational.... Allowed staff to ensure that sensitive information about patients was protected strategy, to make them safer including... People as inadequate because: staff managed their caseloads during multi-disciplinary team meetings well...
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