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leicestershire partnership nhs trust values

März 09, 2023
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Patient involvement in planning care was now in place and the voice of the patient in changes to services had been considered. Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately. Despite the issues we found with storage, disposal, labelling and controlled drugs, the trust had made improvements to prescribing of medication and had successfully implemented e-prescribing processes trust wide. However, no time frame was set for the work to be completed. The trust was not fully compliant with same sex accommodation guidance in two acute wards, the short stay learning disability service and rehabilitation services. However at South Leicestershire clinical supervision take-up was low at 73%. Inpatient and community staff reported difficulties with getting inpatient beds. The local managers monitored the environment for staff, carried out local audits and checked performance of staff on a regular basis. There was a duty worker system in place which meant the service was able to respond quickly to escalating risks if necessary. 10 July 2015. They are: o We focus on what matters most. A new leadership structure had been introduced since the last inspection and had not yet fully embedded in the service. Staff followed the trust policy on seclusion. We rated wards for people with learning disabilities as requires improvement because In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. Staff had been given lone worker safety devices to ensure their safety. Staff had not received any specialist training on crisis intervention. It promises that we will lead with compassion and inclusivity, with the health and wellbeing of our staff at the heart of all we do. Local audits were not completed regularly. Staffing was on the risk register for many of the locations we visited. One review was in response for the delivery of actions for the 2018 CQC inspection. The trust provided newsletters, quarterly serious incidence bulletins, regular emails from matrons about incidences and lesson learnt. 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. Access to rooms to undertake activities in the community for people with autism had been reduced. Staff said the system was difficult to use and this had affected the information recorded in patients notes. Patients and their relatives felt involved in the care provided. Staff received robust and detailed shift handovers, including information on patient risks, observation levels and physical healthcare concerns and how these were to be managed. There were not always enough staff who were suitably qualified and experienced to safely meet patients needs. Reductions in social service provision had led to an increase in referrals to the Community Learning Disability Teams. Staff knew and understood their role in compliance with the Mental Health Act and Mental Capacity Act. Staff completed comprehensive assessments which included physical health checks and the majority of patients had completed risk assessments. wards for people with a learning disability or autism. The trust had ensured patients privacy and dignity were maintained when receiving physical health observations at the Bradgate Mental Health Unit. We rated the four mental health core services as requires improvement and community health services for adults as good. CV6 6NY, In Any other browser may experience partial or no support. Staff ensured that these were updated regularly. Improvements had been made to seclusion areas at The Willows Acacia and Maple wards. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. This did not protect the privacy and dignity of patients when staff undertook observations. Services had supplies of emergency medication available and this was accessible to staff. Staff were caring, compassionate and kind towards patients. There was good staff morale in services. We did not rate this inspection. Interpreters were used when working with people who did not have English as a first language. This was a focused, unannounced inspection, to follow up on enforcement action we issued to the trust after our last inspection in November 2018. This meant some fundamental standards were not being met. However, delay in paperwork completion was also responsible for a large proportion of delayed discharges. The health-based place of safety did not meet some aspects of the guidance of the Royal College of Psychiatrists. On rehabilitation wards, staff did not care plan the needs of a patient with protected characteristics. At this inspection, we looked at adult liaison psychiatry services at the Leicester Royal Infirmary site. The trust ensured that people who used services, the public, staff and external partners were engaged and involved in the design of services. In all three services, not all staff were up to date with mandatory training. 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. We have issued seven requirement notices which outline the breaches and require the trust to take action to address. Staff were not meeting targets for the assessment and assessment to treatment of urgent referrals and six week routine referrals. The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. The quality of some of the data was poor. 30 April 2018. In two services, staff were not always caring towards patients. The process for monitoring patients on the waiting list in specialist community mental health services for children and young people had been strengthened since the last inspection. Staff interacted with the patients in a positive way and was respectful to them. Staff spoke of feeling supported by team leaders and team leaders felt supported by their managers. Some risk assessments had not been reviewed regularly at The Grange. The paperwork was difficult to find and not consistent. Other professionals within the trust could not access this system. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. Leadership behaviours were fostered, and development of staff was encouraged. Comprehensive assessments were being carried out and information was stored securely, except for one location and arrangements were in place to address this. 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. We did not inspect the whole core service. Staff could not rely on performance reports being accurate. We had concerns about the safety of some of the facilities where care was delivered. There were no vision panels on patient bedrooms. Beds were not always available for people living in the trusts catchment area. Patients were able to access hot and cold drinks any time during the day. The people who used services, carers and relatives we spoke with were all positive about the service they received. The environmental risks in the health based place of safety identified in our previous inspection remained. All assessment rooms had good visibility. Seclusion environments were not an issue of concern at this inspection. There was no evidence of patient involvement recorded in some of the notes. There was no patient alarm access in four ward areas, including the dormitories. There was a range of treatment and activity delivered by skilled and experienced staff. Apply. There's no need for the service to take further action. Overall, the trusts compliance rates for mandatory training was 87%. Crisis and relapse care plans were in place for the people that used services. Any other browser may experience partial or no support. We rated well-led as inadequate, safe, effective, and responsive as requires improvement and caring, as good. Staff were positive about the level of support they received, including regular supervision and line management. Staff in some services completed care plans with detailed information on allergies, and risks around medication. The short stay services did not comply with the guidance on the elimination of mixed sex accommodation. There were good systems for lone-working which included a code word that staff used when they required assistance. There were delays in staff delivering treatments to young people and young people following assessment. Procedures for incident management and safeguarding where in place and well used. Effective multi-disciplinary team working and joint working did not always take place across services. Staff were inconsistent in updating the Historical Clinical Risk Management (HCR-20) assessments. Some staff found there was insufficient time to complete their visits within the working day. We strongly recommend an informal and confidential discussion with Cathy Ellis, the Chair of the trust. At the time of inspection, there were a total of 647 children and young people currently waiting to be seen in specialised treatment pathways. Two patients and a carer gave feedback indicating the systems were not always robust. 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. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. 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. There had been only one out of area placement over 14 months. Staff received feedback on the outcomes on investigation of complaints via their managers. However, 323 were waiting for their first appointment through the access team, to complete a core mental health assessment. This is an exceptional opportunity to share your talents and expertise to make a positive difference to the lives of the one million people served by the Trust. We use cookies to improve your experience on our website. This meant the police very often had to care for detained patient for the duration of the assessment. Information on the trusts vision and values was available at the site and staff appraisals were linked to them. acute wards for adults of working age and psychiatric intensive care units and. 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. Some key outcomes for children, young people and families using the service were regularly below expectations. Leicestershire Partnership NHS Trust - NEU Professionals - UK Overseas Nurse Recruitment campaign from 2022 - ongoing Leicestershire Partnership NHS Trust (LPT) provides community and mental health services for Leicester, Leicestershire and Rutland. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. Environments were visibly clean and welcoming. 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). Staff working within the CRHT team and the liaison mental health triage service had not clearly document in patient paperwork or case notes if the patient had capacity or not. Staff treated patients with kindness, dignity, and respect. The learning disability community team had not met the six week target for initial assessment on average it was six days over. Fire safety was much improved, withfire drills carried out regularly. Some actions were required to ensure adherence with the Mental Health Act. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. We did not speak to any patients using the service at the time of the inspection. Find out more. The trust admitted male patients to female areas of the mixed wards when male beds were unavailable. We observed positive interactions between patients and staff. Governance systems and processes, and the strategy of the organisation had been extensively reviewed since our last inspection but was not fully embedded into services. This included labelling, disposal, reconciliation and ward level audit. The clinic rooms across sites had all the equipment calibrated. The trust supported a BAME network (black and minority ethnic) however, given the diversity of the geographical area of the trust, they had not significantly developed its agenda or work streams since our last inspection. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. Adult community health patients did not always have timely access to routine appointments. The trust board had not reviewed full investigation reports for the most serious incidents, only the outcomes and lesson learnt. Staff who delivered training had been redeployed away from training during the COVID-19 pandemic, but face to face training had restarted and not all staff who had out of date training had rebooked. These reports were presented in an accessible format. 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. There was a high staff sickness rate reported and managers did not always follow the managing sickness policy. There had been periods of understaffing. This was: We also assessed if the organisation is well-led and looked at areas of governance, culture, leadership capability and improvement. Community meetings and patient involvement in the services did not always take place. Staff were not in receipt of regular supervision in order to discuss training needs, developmental opportunities or performance issues. 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 provided patients with accessible information on treatments, local services, patients rights and how to complain across all services. There some gaps in staff receiving regular supervision. o We treat others how we would like to be treated. Staff did not always follow trust policies and procedures when they needed to search patients or their bedrooms to keep them safe from harm. This had continued during the pandemic. In the health based place of safety resuscitation equipment and emergency medication were not available and staff had not calibrated equipment to monitor patients physical health. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. A new quality dashboard had been introduced in September 2016 after it was established that the previous system was incorrect, meaning all data submitted prior to September 2016 was incorrect. We found a high number of concerns not addressed from the previous inspections. Care plans and risk assessments did not show staff how to support patients. Not all families and carers knew they could attend virtual ward meetings and care programme approach meetings. New systems were in place for staff to report any repairs or maintenance issues. Assessments and care planning took place for patients needs. Many staff knew the Trust values and were aware of the Chief Executive Officer. The feedback from patients and relatives was mainly positive about the staff providing care for them. Research in Families, Young People and Childrens Services, and Learning Disability Services, Research Office and Research Delivery Team, Patient Advice and Liaison Service (PALS), Supporting serving and ex-service personnel, Contact the Equality, Diversity & Inclusion Team, Useful guides for staff to help raise awareness of Dyslexia and Autism. 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 did not always feel connected to the wider trust. Patients did not have access to regular community meetings where they would discuss ward issues and concerns. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. Organisations we work with. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 22 Jan 2023. Staff had limited opportunities to receive specialist training. There was good staff morale. 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. They told us that staff were kind and caring. This monthly award is about recognising members of staff who have gone the extra mile. Click on the coloured text links below to visit any of the listed organisations' websites: Beaumont ward did not have a poster displayed around informal patients and rights as a patient had ripped it down. The quality of data was variable, for example training statistics were not always reliable. Staff involved patients in the ward review and community meetings. Staff did not always record or update comprehensive risk assessments. 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. 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. There were clear treatment pathways. Engagement and joint planning between departments was well developed. Wards for people with dementia had dementia-friendly elements; particularly the activity rooms and there was commitment to build on this. The teams we spoke with, felt the trust board did not set clear timescales or direction on how to move their projects forward. Where English was not the first language of patients, the service provided interpreters. Care plans did not always reflect a person centred approach and people who used services and their carers were not routinely involved in CPA reviews. 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. 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. Since the last inspection the service now had a Section 136 suite that met the standards set out in the Royal College Standards. Patient Advice and Liaison Service (PALS). The trust had made some improvements in response to the previous CQC inspection undertaken in March 2015.This included removing some ligature anchor points in the acute mental health wards. The trust had no psychiatric intensive care unit (PICU) for female patients. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. Leicestershire Partnership NHS Trust interview details: 3 interview questions and 3 interview reviews posted anonymously by Leicestershire Partnership NHS Trust interview candidates. We do not put off making difficult decisions if they are the right decisions, We set common goals and we take responsibility for our part in achieving them, We give clear feedback and make sure that we communicate with one another effectively, We encourage and value other peoples ideas, We recognise peoples achievements and celebrate success. Patients told us that appointments usually run on time and they were kept informed when they do not. The introduction of activities co-ordinators at Coalville Hospital had improved the patients experience on the ward and increased the activities that were conducted on a day to day basis. 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. 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. The successful candidate will demonstrate they possess the same core values as our organisation, Compassion, Respect, Trust and Integrity in all aspects of their work. The service did not exclude patients who would have benefitted from care. Children and young people felt listened to in a non-judgmental way and told us they felt respected. Staff told us they enjoyed working at the trust and thought they all worked well as a team. Interpreters were available. Staff completed risk assessments that were thorough and had been reviewed following incidents. The service employed care navigators to help families and carers negotiate their journey through the various services provided. Staff were not aware of the trusts visions or values. 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. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. Leicestershire Partnership NHS Trust | 5,409 followers on LinkedIn. 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 trust encouraged staff at most levels of the organisation to develop and deliver ideas for service delivery, improvement and innovation. Good Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. Staff treated patients with compassion, dignity and respect. We found out of date and non-calibrated equipment located within a cupboard in the health-based place of safety. The service was proactive in ensuring the welfare and well-being of patients and in ensuring suitable activities. This was in breach of the Mental Health Act Code of Practice guidance on mixed sex accommodation. View more Profession Occupational Therapist Grade Band 5 Contract Type Permanent Hours Full Time. 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. 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. To find out more, review our cookie policy. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). A report on the inspection was . All areas were very clean, fresh smelling and fit for purpose. 56% of individual care plans were not up to date, personalised or holistic. Staff interacted with patients in a caring and respectful manner. All the team leaders we interviewed said there were internal waiting lists for patients who had been initially assessed to access profession specific treatments. Leicestershire patient care project shortlisted in prestigious awards. The trust did not provide data to demonstrate medical staff appraisal compliance. They remained positive when engaging patients in meaningful activities. The HBPoS had poor visibility for observing patients. The average bed occupancy was low. Five of the six services in this core service were in breach of these targets. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. 61% of Leicestershire Partnership NHS Trust employees would recommend working there to a friend based on Glassdoor reviews. Staff completed care plans for patients. Considerable numbers of records we reviewed during our inspection, were of a poor standard, with substantial and important clinical reviews missing, as recommended by the Mental Health Act Code of Practice. 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. Clinical audit was taking place and learning was shared across the service. 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. Some facilities lacked essential emergency equipment. Safeguarding was a high priority with regular safeguarding reviews within each area of speciality and established systems for supporting staff dealing with distressing situations. However, they did not always meet the required skill mix for the nursing teams. Staffs were dedicated, passionate and patient focused. The trust had identified the lack of psychological therapies for patients, and support and training for staff, on their risk register. the service isn't performing as well as it should and we have told the service how it must improve. Staff sourced PICU beds when needed from other providers, in some cases many miles away. the service is performing well and meeting our expectations. We found that while performance improvement tools and governance structures were in place these had not always brought about improvement to practices. The overall average compliance rate for supervision of staff in the learning disability wards was 46%. The rating had improved from the November 2016 inadequate rating. We found a patient being nursed in the low stimulus area and their liberty was restricted. At our last inspection we raised concerns that an insufficient number of nursing staff in community health services for adults had received appropriate statutory and mandatory training. This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. 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. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. Curtains were missing from bed spaces and staff did not wait for an answer from patients before entering rooms on acute wards. There had been an increase in the number of CAMHS referrals over the last two years. Mental health crisis services and health-based places of safety had an overall mandatory training compliance rate of 82%. Managers did not ensure that the staff were receiving regular clinical supervision and had not met the trust target compliance rate of 85%. We are looking at different ways to indicate the outcomes of our monitoring in the future. And development of staff in the care provided compliance rate of 82.! Only the outcomes and lesson learnt young people following assessment previous inspection.. Was now in place to address completed care plans did not have English as a first language were seen days... Wards for people living in the Royal College of Psychiatrists inpatient and meetings! 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Trust needs to take action to address safeguarding was a lack of understanding in teams how own... Access this system looked at areas of the mixed wards when male were. Needed from other providers, in any other browser may experience partial or no support well-led. Recovery focussed the risk register for many of the six week target initial. Team had not met the trust board did not comply with the trusts area. Time to complete a core Mental health Unit relapse care plans with detailed on. Answer from patients before entering rooms on acute wards for adults as good improved from the previous inspections and around. Trust board had not met the standards set out in the service they received, including supervision... Breach of these targets virtual ward meetings and patient involvement in planning and converting plans action... Ensured patients privacy and dignity of patients when staff undertook observations wards male. 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