leicestershire partnership nhs trust values

There had been an increase in the number of CAMHS referrals over the last two years. Managers shared the outcomes and lessons learnt from incidents, complaints and service user feedback at regular staff meetings, where meetings took place. The short breaks service was primarily set up to meet the needs of relatives and carers. Six staff expressed concerns about the proposed move and some said the trust had not communicated information to staff effectively. Patients who accessed the CRHT team told us that they felt their wishes and needs were taken in to consideration, staff could be accessed quickly and they felt safe when visiting the Bradgate Mental Health unit. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. 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. Staff had received specialist child safeguarding training and were able to make referrals when appropriate. 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. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. 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. Staff acknowledged directors visits. Medicines Management Our vision Creating high quality, compassionate care and wellbeing for all. The CRHT team did not have lockable bags to transport medication to patients homes; staff told us they transported medication in their handbags. The assessment and resulting care plans were personalised, holistic and recovery focussed. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Jan 4. The ward had sufficient staff to provide care and treatment to patients. Staff told us their managers were supportive and senior managers were visible within the service. Staff gave examples of working with people with diverse needs considering their ethnicity, gender, age and culture. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. Staff could not rely on performance reports being accurate. Staff had not received any specialist training on crisis intervention. We saw staff engaging with patients in a kind and respectful manner on all of the wards. NG3 6AA, In Staff had a good knowledge of safeguarding and incident reporting. This meant that patients could have been deprived of their liberties without a relevant legal framework. There were waiting lists of up to 18 months for psychology and up to 40 weeks for other treatment within the personality disorder service. For over 20 years we've ensured that health related grants, policies, and services exist to help give everyone the opportunity to be healthy - especially the most vulnerable. 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. We saw an example of an SI investigation and also action taken from lessons learnt. 100% of staff were trained in how to safeguard children from harm. the service isn't performing as well as it should and we have told the service how it must improve. Staff showed caring attitudes towards their patients. We were concerned that information management systems did not always ensure the safe management of peoples risks and needs. Another patient said on their comment card they did not see enough of the occupational therapist. The service was responding to complaints and implementing systems following these, however the trust waited for these complaints to prompt improvements in the service. the service is performing exceptionally well. Staff did not record seclusion well. 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. The trust had no auditing system to measure performance in order to improve the service. The Trust should ensure that the transition is in line with best practice in future. Patients we spoke with knew how to complain. Apply. An announcement has been made on the outcome of this appointment. Leicestershire Partnership NHS Trust Is this your company? Supervision and appraisal compliance of three teams fell below 75%. The policy for rapid tranquillisation was not in line with national guidance. 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. Following inspection, the trust submitted an action plan to review shared sleeping arrangements. 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. 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). There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. 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. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. There some gaps in staff receiving regular supervision. One patient told us there wasnt enough to do at the Willows. When community meetings occurred, staff did not include details of outcomes to evidence change. Staff received training in safeguarding and knew how to report when needed. There were not always enough staff who were suitably qualified and experienced to safely meet patients needs. The trust had launched its "Step up to Great" approach, which identified the vision and priorities for the year. Save job - Click to add the job to your shortlist. Some wards and community teams did not store or manage medicines safely. 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. The trust had improved how staff recorded patients physical healthcare, and monitored patients who had ongoing physical healthcare problems. Staff were caring, compassionate and kind towards patients. There were no children who had waited more than a year for treatment. Staff managed their caseloads effectively; they discussed their caseloads during multi-disciplinary team meetings as well as in supervision. 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. Suspended ratings are being reviewed by us and will be published soon. We're always looking for the best. Staff in the community adult mental health teams did not protect patients dignity or privacy. We found loose papers in records. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. Staff said morale was good and they felt supported by their managers. 27 February 2019. On Phoenix ward patients were not allowed access to the garden. Governance processes had improved since our last inspection and operated effectively at trust level to ensure that performance and risk were managed well. Any other browser may experience partial or no support. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. The matron opened some vault windows via a remote. Consent to care and treatment was obtained in line with relevant guidance and legislation. Care and treatment was mostly planned and delivered in line with current evidence. The recording of discussions and assessments with people regarding consent to treatment was not always documented. Staff spoke of feeling supported by team leaders and team leaders felt supported by their managers. Care records showed that physical health examinations were completed upon admission and there was ongoing monitoring of physical health across the trust. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. We found: However, we noted one issue that could be improved: We spoke with six members of staff including matrons, team leaders and mental health practitioners and reviewed all the assessment areas the adult psychiatric liaison team uses. Staff communicated with patients in a calm, professional way and showed an understanding of patients needs. Information needed to deliver care was not always readily available when people using community mental health teams presented in crisis out of hours. Due to this staff could not observe all parts of wards due to their lay out and the risk had not been mitigated. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. As one of the largest registered investment advisors in the U.S., we offer a broad range of services to institutional clients, including corporate and higher-education retirement plans, foundations and endowments, and religious organizations. Carers told us they had regular contact with the CRHT team and they were kept involved with their loved ones care. Patients described being cared for, respected and treated with dignity. People knew how to make a complaint as this information was provided in welcome packs. Wards had high numbers of hydraulic style patient beds that were a risk to patients with histories of self-harming behaviour. We found damaged fixings on one ward; that posed a risk to patients. The trust used key performance indicators/dashboards to gauge the performance of the team. For example, furniture was light and portable and could be used as a weapon. A report on the inspection was . At this inspection we found compliance levels with this type of training were still below the trusts target. For example relating to assessment of ligature points at Westcotes. Staff completed detailed risk assessments for patients on admission and reviewed them regularly after incidents. 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. 8 February 2017. Plans were shared with family and carers. An escape plan was developed with patients (PEEP)who may not be able to reach an ultimate place of safety unaided, or within a satisfactory period of time in the event of any emergency. The service was meeting its target in this area. This was highlighted in the previous inspection. Staffs were dedicated, passionate and patient focused. There was no fridge to keep medicines cool when required. Any other browser may experience partial or no support. Some care plans had not been updated and physical healthcare checks were not routinely documented in young peoples notes. Our inspection approach allows us to make a judgement on how the trusts senior leadership leads the organisation and the provider level well-led rating is separate from the ratings of the services we inspected. The trust had set safe staffing levels and these were followed in practice. 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. 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. We rated it as good because: Leicestershire Partnership NHS Trust: Evidence appendix published 30 April 2018 for - PDF - (opens in new window), Published The trust had addressed the issues previously identified with the health based place of safety. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. Some wards did not meet the Department of Health and Mental Health Act Code of Practice requirements in relation to the arrangements for mixed sex accommodation. Some local managers were keeping their own records to ensure performance was monitored. Three patients told us of times when staff had been rude, threatening and disrespectful towards them. Staff were provided with relevant information to care for patients safely. We use cookies to improve your experience on our website. Some wards and patient areas had blind spots, where staff could not easily observe patients. Staffing levels were not consistent across the two sites. If we cannot do something, we will explain why. Many staff we spoke with knew who their chief executive was and mentioned them by name. We carried out this unannounced focused inspection of adult liaison psychiatry services as part of a system wide inspection of Urgent and Emergency Care provision in the Leicester, Leicestershire and Rutland Integrated Care System. It shows how we will work together to create an inclusive culture, where there is no discrimination or bullying. Bathrooms and toilets were specified for which gender depending on who was resident at the unit at the time. Our HIV/AIDS Services program is in need of volunteers to help deliver . There were improved systems and processes to manage storage, disposal and administration of medications. There was good staff morale. We want to hear from you on how to improve our service and provide the best care possible. They later told us that this had been an ongoing concern for around five years. We did not inspect the following core services previously rated as requires improvement: We did not inspect the following core services previously rated as good: We are monitoring the progress of improvements to services and will re-inspect them as appropriate. This was in breach of the Mental Health Act Code of Practice guidance on mixed sex accommodation. Inpatient and community staff reported difficulties with getting inpatient beds. Patients did not have access to regular community meetings where they would discuss ward issues and concerns. View more Profession Occupational Therapist Grade Band 5 Contract Type Permanent Hours Full Time. However staff did not appear to be fully aware of services provided and told us there were plans to implement a seven day service in end of life care. Some medication was out of date and there was no clear record of medication being logged in or out. Two core services did not promote patient centred care in all aspects of care delivery. Patients social, emotional and religious needs were met and relatives valued the emotional support they received. Some staff used tools and approaches to rate patient severity and monitor their health. However, they did not always meet the required skill mix for the nursing teams. Care plans and risk assessments did not show staff how to support patients. They provided feedback to staff via monthly ward meetings, MDT meetings supervision and handovers. Patients reported staff treated them with dignity and respect. Therefore, patients were not always actively engaged in decisions about service provision or their care. Staff were dedicated and passionate about the work that they undertook. Therefore, staff could ensure accurate measures of blood pressure were being recorded. The trust employed registered general nurses (RGN) to assist with assessment and management of physical healthcare needs for patients. This reduced continuity of care. Practice development and embedding practice was good, for example, where dementia mapping was adapted to learning disabilities. Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. This area of our site lists our partner organisations. Feedback from those who used the families, young people and children services was consistently positive. The trust had made improvements to the clinical environments since the last CQC inspection. Thy are entitled to receive a remuneration of 13,000 per annum each and have . The single point of access made contacting the service easy for both patients and health professionals and enabled referrals into the service to be triaged and assigned from one central point. Staff showed us that they wanted to provide high quality care, despite the challenges of staffing levels and some poor ward environments. Some facilities lacked essential emergency equipment. Waiting lists for psychological services were high and currently on the Trusts risk register. Staffing was on the risk register for many of the locations we visited. 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. They told us that staff were kind and caring. Patients told us that staff listened and empathised with them. 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. Patients were involved in the writing of their care plans and their views were reflected in the plans. Managers had a recruitment plan in place to increase the number of substantive staff for the service. Multi-disciplinary teams and inter-agency working were effective in supporting people who used the service. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. Staff completed extensive and detailed care plans. There were key performance indicators set for time from referral to assessment and where these were not being addressed action had been taken. The trust provides adult end of life care services in community in-patient wards and community nursing services seven days per week. 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. In two services, staff were not always caring towards patients. o We are one team and we are best when we work together. There were effective methods for obtaining feedback from service users and carers and feedback was acted upon. At the last inspection, we issued enforcement action because the trust did not have systems and processes across services to ensure thatthe risk to patients were assessed, monitored, mitigated and the quality of healthcare improved in relation to: The trust was required to make significant improvements in the following core services where we found concerns in the areas listed above: Acute wards for adults of working age and psychiatric intensive care units, Wards for people with a learning disability or autism, Long stay or rehabilitation mental health wards for working age adults. The provider supplied lockers on the wards; however, these were not large enough to contain all possessions and patients did not hold keys. This could pose a risk to patients and staff. In the dormitories, observation mirrors were situated so that staff could observe patients without having to disturb them. There were delays in staff delivering treatments to young people and young people following assessment. Some seclusion rooms had environmental concerns at Belvoir and Griffinunits, and Watermead wards. There had been periods of understaffing. Inadequate Interview rooms were unsafe. This has been brought. The quality of the data produced was poor and staff needed to correct the data when reports were produced. The ovens were old and the dials were not visible and cupboards were broken. Two patients and a carer gave feedback indicating the systems were not always robust. 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. Information on the trusts vision and values was available at the site and staff appraisals were linked to them. In rehabilitation services, staff had effective working relations with the new rehabilitation community transition support team created in response to the pandemic to facilitate faster discharges from the wards. Lessons learnt were shared across the organisation via emails and the intranet. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. All hospitals were running at a high bed occupancy level of above 85% which national data has linked to increased risk of bed shortages as well as an increase in healthcare associated infections. Some staff found there was insufficient time to complete their visits within the working day. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. Staff received feedback on the outcomes on investigation of complaints via their managers. Staff did not document physical health checks for patients detained under section 136 in the HBPoS. 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. Watch our short film to find out more: Find out about how we are improving the quality and safety of our services through our Step up to Great strategy, and watch our animation to see more: We are also pleased to present our clinical plan for the trust. All assessment rooms had good visibility. The waiting list had increased for those children and young people waitingfor thestart of treatment, following assessment. Patient involvement in planning care was now in place and the voice of the patient in changes to services had been considered. We had a number of concerns about the safety of this trust. The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. The feedback from patients and relatives was mainly positive about the staff providing care for them. Detention renewal paperwork had been signed by a doctor prior to them seeing the patient. 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. The room used to administer medication on Arran ward at Stewart House was not appropriate; the room was a bedroom and still had a toilet in. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. Patient outcomes for people using trust services were very good and the trust was able to demonstrate that their services had a positive impact through good data collection and review mechanisms. One patient on Watermead ward told us that a staff member had ignored them when they had asked them for a sandwich. 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. This was a breach of the patients privacy and dignity to patients as staff might be required to enter the shower rooms to check patients were safe. : Staff completed and regularly reviewed and updated comprehensive risk assessments. 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. The acute mental health wards had broken facilities which had not been repaired in a timely manner and we found dirt in some areas on one ward. Teams how their own plans, visions and objectives connected with the CRHT team did not details! Low morale 6AA, in staff delivering treatments to young people waitingfor thestart of treatment, assessment. 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