The teams were able to respond quickly when patients or carers telephoned with problems. Mobility and healthcare equipment took up space in The Gillivers and 3Rubicon Close. 27 February 2019. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. Patients were protected from avoidable harm by sufficient staffing and safeguarding processes. The trust had a major incident policy to deal with any major incidents or breakdown in service provisions. Facilities had been adapted to improve access and systems were in place to support the most vulnerable. Patients families and carers were positive about the care provided. However, Griffin did not. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. We inspected adult psychiatric liaison services as part of Mental Health Crisis and Health Based Places of Safety core service. Staff followed infection control practices and maintained equipment through regular servicing. Staff were not supervised in line with the trust's policy. Care and treatment was planned and delivered in line with current evidence-based guidance, standards, best practice and legislation. Some care plans had not been updated and physical healthcare checks were not routinely documented in young peoples notes. Staff usually met patients in their homes or in the community. 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. 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. We noted a box for discarded needles being left unattended in a communal area. 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. There was no fridge to keep medicines cool when required. The trust could not be sure that all staff. Patients own controlled drugs were not always managed and destroyed appropriately. Governance structures were in place and risks registers were reviewed regularly. Six staff expressed concerns about the proposed move and some said the trust had not communicated information to staff effectively. NHS England / NHS Improvement - for general enquiries contact Helen Barlow on 0300 123 2038 or by emailing helen.barlow2@nhs.net. The trust delivered programmes for staff to develop into senior roles and had a clear career development programme for nursing staff. There was an established five year strategy and vision for the families, young people and childrens (FYPC) services and staff innovation was encouraged and supported. 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. At this inspection, we looked at adult liaison psychiatry services at the Leicester Royal Infirmary site. They showed a good understanding of peoples individual needs. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. The HBPoS had poor visibility for observing patients. Staff were dedicated and passionate about the work that they undertook. there are some services which we cant rate, while some might be under appeal from the provider. . The health-based place of safety did not meet some aspects of the guidance of the Royal College of Psychiatrists. 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. There was effective multidisciplinary working. Managers did not ensure that the staff were receiving regular clinical supervision and had not met the trust target compliance rate of 85%. Nursing staff interacted with patients in a caring and respectful manner. Staff at the PIER team had not received recent Mental Health Act training. Suspended ratings are being reviewed by us and will be published soon. The trust had no auditing system to measure performance in order to improve the service. 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. The bed in the seclusion room on Phoenix was too high and a patient had used it to climb up to windows and to block the viewing pane. Waiting times and lists remained of concern, and this had been identified in the previous inspection. There could be risks posed by the use of different recording systems across teams as staff may not all have access to all records. When we talk to colleagues we are clear about what is expected. there are some services which we cant rate, while some might be under appeal from the provider. DE22 3LZ. Leicestershire patient care project shortlisted in prestigious awards. Staff were adequately supported and debriefed following incidents and could access further support if required. 56% of individual care plans were not up to date, personalised or holistic. Some staff used tools and approaches to rate patient severity and monitor their health. Patients needs were assessed and monitored individually. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. One patient on Thornton ward told us that while staff did knock, they did not wait for a response before entering, which had resulted in staff walking into their room while they were changing their clothes, compromising their privacy and dignity. Multidisciplinary team work both internal and external to the service was effective and patients were supported to make informed decisions about their care. However, staff did not consistently record patients views in their care plan or ensure they had received a copy. Staff demonstrated commitment to delivering high quality end of life care for their patients. We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. Leicestershire Partnership NHS Trust | 5,409 followers on LinkedIn. This had previously been identified on the CQC inspection in March 2015. On Bosworth ward patient privacy was compromised when staff and patients entered the clinic room during examinations because there was no privacy curtain in place. The 30 bed unit at Stewart House was mixed sex and there were no doors to lock between the male and female sections. Fire safety was much improved, withfire drills carried out regularly. There were good systems for lone-working which included a code word that staff used when they required assistance. the service is performing badly and we've taken enforcement action against the provider of the service. Patients were happy with the care they received and were very complimentary about the staff who cared for them. The overall average compliance rate for supervision of staff in the learning disability wards was 46%. The trust confirmed that these were reinstalled after the inspection had taken place. However, this was a temporary restriction due to the building works and patient safety. Staff told us there were no service information leaflets available. o We are one team and we are best when we work together. Some key outcomes for children, young people and families using the service were regularly below expectations. Cleaning products in a cupboard in the waiting area was unlocked, which posed a risk to the young people. Our overall rating of this trust stayed the same. The trust confirmed after our inspection Advanced Nurse Practitioners used a DNACPR form which had been agreed within NHS East Midlands. Staff informed us there was a safeguarding lead to refer to when guidance was needed. Recruitment was in progress for 10 new healthcare support workers. : Staff completed and regularly reviewed and updated comprehensive risk assessments. Four young people told us they felt involved in developing their care plan however, they had not received a copy. 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. Leicestershire City Council are proposing to keep Leicestershire Partnership NHS Trust as the provider, as it is a high performing service, and to recommission 0-19HCP by using Section 75 of the National Health Services Act of 2006. All wards had developed their own systems to improve medicines management in their areas. The acute service contained large numbers of beds in bed bays accommodating up to four patients. Some staff did not receive regular supervision or annual appraisals. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. We found the average wait times for patients presenting with a mental health crisis or specific mental health needs were between 1.5 hours and 1.9 hours. We found damaged fixings on one ward; that posed a risk to patients. Staff were caring and committed to providing high quality care and showed a person-centred approach. On rehabilitation wards, staff did not care plan the needs of a patient with protected characteristics. Following the appointment of a new chief executive a new trust board was formed. We had concerns about the safety of some of the facilities where care was delivered. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. Staff had set clear guidelines on where and how physical health observationswere completed on wards. There was no medicines management input from pharmacy within the community based mental health services for adults of working age. Browser Support Some wards and patient areas had blind spots, where staff could not easily observe patients. 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 environmental risks in the health based place of safety identified in our previous inspection remained. Staff treated patients with kindness, dignity, and respect. The trust used key performance indicators/dashboards to gauge the performance of the team. Senior managers were aware of the bed pressures in their acute and PICU service and had raised concerns with their commissioners. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Staff were not aware of how this might affect the safety and rights of the patients. 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. The longest wait was 108 weeks for four patients to access group work or outpatients. Staff interacted with patients in a responsive and respectful manner at all times and showed a good understanding of individual needs. For example, furniture was light and portable and could be used as a weapon. Data could not be relied upon to measure service performance or improvement.Data collection and interpretation did not include key pieces of information for example number of delayed or missed visits. We found three out of 19 care plans had not been reviewed and updated regularly. Mental health crisis services and health-based places of safety had an overall mandatory training compliance rate of 82%. We will be supporting each other in the delivery of these leadership behaviours so we can all Step up to Great together. Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately. Staff felt supported by their managers and received regular supervision and annual appraisals. 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. This meant patients had been placed outside of the trusts area. 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. There was a skilled multi-disciplinary team able to offer a variety of therapies. 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. Risk assessments were completed during the initial assessment at the CRHT team. The waiting areas and interview rooms where patients were seen were clean and well maintained. If we cannot do something, we will explain why. the service is performing exceptionally well. Nursing staff did not have a stock list to randomly check medication which meant they could not reconciliation check. Engagement and joint planning between departments was well developed. We did not speak to any patients using the service at the time of the inspection. The acute wards for adults of working age had not complied with all of the required actions following the previous inspection of September 2013. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. Make a difference with a career at LPT. Clinical supervision rates were low. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the patients. The summary for this service appears in the overall summary of this report. There was detailed discussion and consideration of patients and carers needs. The quality of some of the data was poor. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. The local managers monitored the environment for staff, carried out local audits and checked performance of staff on a regular basis. Beds were not always available for people living in the trusts catchment area. Patients had access to advocacy. This practice stopped once we drew attention to it. We did not identify any significant community wide areas for improvement but did find many exemplary services provided by the trust. The NHS is founded on principles and values that bind together the diverse communities . Mental Health Act documentation was not always up to date on the electronic system. Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. Staff kept risk assessments up to date and carried out comprehensive assessments which were holistic and recovery focused. Due to this staff could not observe all parts of wards due to their lay out and the risk had not been mitigated. One patient on Watermead ward told us that a staff member had ignored them when they had asked them for a sandwich. The trust had not fully addressed the issues of poor lines of sight in wards. Where relevant we provide detail of each location or area of service visited. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. Staff ensured that these were updated regularly. Staff monitored the ongoing condition of any secluded patient. We rated end of life care services as good overall because: The trust had worked collaboratively with local partners to develop an end of life care strategy for the region as a whole which had incorporated a health needs analysis. We looked at the domains of safe, effective and responsive and we did not inspect all of the key lines of enquiry. There was an extensive wellbeing offer available to staff. Clinic rooms were overstocked with medications. The trust had systems for promoting, monitoring and responding to complaints. HBPoS and crisis resolution and home treatment (CRHT) team toilets were not visibly clean. Incidents were on the agenda at the clinical governance meetings. We rated all three mental health services inspected as requires improvement overall. We reviewed 267 case records and found that, generally, staff completed detailed individualised risk assessments for patients on admission. People that were referred to the service were waiting for a care co-ordinator to be allocated. Whilst staff were working hard to identify and manage individual risks, some ward environments were unacceptable. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). Staff told us they will move to a new electronic system in July 2015 which will be the same as other areas in the trust. This reduced continuity of care. 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