leicestershire partnership nhs trust values

Reductions in social service provision had led to an increase in referrals to the Community Learning Disability Teams. Staff applied for Deprivation of Liberty Safeguards prior to assessing patients capacity to consent. The service was not effective. Clinic rooms were overstocked with medications. Nurses and managers from LPT who were supported . Some improvements to address the no smoking policy at the Bradgate Mental Health Unit wards were seen. Care records for patients using the CRHT teams were not holistic or personalised. Practice development and embedding practice was good, for example, where dementia mapping was adapted to learning disabilities. Services had supplies of emergency medication available and this was accessible to staff. The trust experienced high demand for acute inpatient beds. 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. 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. The service was not well led. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. We found multiple internal waiting lists where the longest wait for young people was 108 weeks. Staff completed Mental Health Act 1983 (MHA) paperwork correctly and systems were in place for secure storage of legal paperwork, advice and regular audits. We could not find records for seclusion or evidence of regular reviews taking place as per trust policy. We strongly recommend an informal and confidential discussion with Cathy Ellis, the Chair of the trust. The HBPoS did not have access to a dedicated clinic room. Save job - Click to add the job to your shortlist. We found concerns with the environment in all five core services we inspected. Staff felt well supported and were able to raise concerns with their line manager and were listened to. We have four core values: Compassion, Respect, Integrity, Trust. 9 August 2019, Leicestershire Partnership NHS Trust: Evidence appendix published 27 February 2019 for - PDF - (opens in new window), Published The number of incidents reported by the trust had decreased since the last inspection and serious incident figures remained comparable. Support workers were being trained in phlebotomy to improve timely blood testing. 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. In rehabilitation wards, staff did not always develop and review individual care plans. The service was responding to complaints and implementing systems following these, however the trust waited for these complaints to prompt improvements in the service. At the Willows, six out of 19 patients risk assessments had not been updated. Senior managers were aware of the bed pressures in their acute and PICU service and had raised concerns with their commissioners. The short breaks service was primarily set up to meet the needs of relatives and carers. 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. The trust had no auditing system to measure performance in order to improve the service. Staff referred to having reflective practice peer meetings when they were concerned about the risk to a young person. The service was recovery focused and had developed pathways with other agencies to build on recovery capital for people who used the service. All assessment rooms had good visibility. Staff were up to date with mandatory training. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. Find out more. There were issues within the trust of a bullying culture despite evidence that staff knew the trust values. Recruitment was in progress for 10 new healthcare support workers. 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. No rating/under appeal/rating suspended Staffing levels were adequate at the time of our inspection but staff told us that they had been short staffed for some time and that there were a number of vacancies. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the patients. Ligature risks had been identified in bedrooms, bathrooms and toilets but there was no clear action to address all of the identifed risks, The seclusion rooms had known blind spots but no action had been taken to reduce them. Children and young people felt listened to in a non-judgmental way and told us they felt respected. Senior leaders in core services we inspected, had not maintained oversight of improvement across all wards of their services. Trust staff working within the had remote access to electronic systems used by the trust. Care plans were not always holistic and person centred. We heard many examples of interesting innovation projects and work that staff groups had done which impacted on and improved patient care. The trust had developed checklists to assist staff with the receipt and scrutiny process. Bathrooms and toilets were specified for which gender depending on who was resident at the unit at the time. ", John Barnes, Charge Nurse, LD Short Breaks, "I really enjoy the human interaction on a daily basis - with colleagues, patients, relatives. There was an effective incident reporting process which investigated and identified lessons from incidents which were shared in most teams. They were able to talk about the effectiveness of Listening in Action events which aimed to improve the quality of services. We found significant issues with trust level governance, oversight of environments, a failure to address keys issues and a lack of pace with delivering essential improvements. Your skills are needed for the NHS Reservist project. The trust had significantlyreduced waiting times and the total numbersof children and young people waiting for assessments. 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. Resuscitation bag, defibrillator and fire drill checks in the CAMHS LD service were not recorded. Staff described managers as supportive and approachable. Engagement with external stakeholders had significantly improved since our last inspection. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. 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. 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. There were not enough registered staff at City West and this was identified as a risk on the service risk register. At least one standard in this area was not being met when we inspected the service and Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. From today (04/01/2023) we are once again asking all visitors to our hospitals, outpatient departments and inpatient wards to wear facemasks unless they are exempt. The needs of people who used the service were assessed and care was delivered in line with their individual care plans. 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. Staff reported incidents, which were discussed and reviewed by line managers within the teams. The trust lacked a framework for co-ordinating, endorsing and therefore learning from the very many positive quality projects taking place. Bed occupancy for the last two quarters of 2013/14 was around 89%. We saw information in the service reception areas about older peoples care. The HBPoS had poor visibility for observing patients. Staff spoke of feeling supported by team leaders and team leaders felt supported by their managers. ", Daxa Mangia, Mental Health Nurse, The Willows, "I really enjoy my job, helping people to recover - I cannot imagine doing anything else.". The wards tried to book regular bank and agency staff so they knew the ward and patients, to provide continuity of care. Patients felt safe. Patient involvement in planning care was now in place and the voice of the patient in changes to services had been considered. They and their carers were kept informed and involved in their treatment and care. We rated wards for older people with mental health problems as good because: The wards complied with the Department of Health 2015 guidelines on single sex accommodation. Staff were not aware of how this might affect the safety and rights of the patients. There was evidence of actions taken to improve the quality of the service. Access to rooms to undertake activities in the community for people with autism had been reduced. Another relative said their relative was a changed person since going to the Willows and they were able to go home last Christmas. Home - Leicestershire Partnership NHS Trust Creating high quality, compassionate care and wellbeing for all. 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. View more Profession Occupational Therapist Service Learning Disability Grade Band 6 Contract Type Permanent Hours Full Time. We spoke with five informal patients at the Bradgate Mental Health Unit who were unaware of what they could and could not do as an informal patient. 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. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. The service had 175 delayed discharges between August 2015 and July 2016, which accounted for 43% of the trusts total delayed discharges. Wards had high numbers of hydraulic style patient beds that were a risk to patients with histories of self-harming behaviour. On one ward, female shower rooms did not contain shower curtains. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. Staff followed the trust policy on seclusion. 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. Bank Band 6 Speech and Language Therapist. Interview rooms were unsafe. In July 2019, the new trust board formed a buddy relationship with a mental health and community health service NHS trust in Northamptonshire (Northamptonshire Healthcare NHS Foundation Trust NHFT) following the previous inspections in 2018 and 2019. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. Service planning was not being managed in a systematic way. Medicines Management Our vision Creating high quality, compassionate care and wellbeing for all. At the Agnes Unit, staff did not always record the physical health of patients who had been given rapid tranquilisation. Improvements were needed to make them safer, including reducing ligatures, improving lines of sight and ensuring the safety and dignity of patients. Patients and carers knew how to complain and complaints were investigated and lessons identified. 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 use cookies to improve your experience on our website. The trust had not fully addressed the issues of poor lines of sight in wards. New positions such as medicines administration assistants and link nurses to support wards were in place in certain areas, but ward staff still described irregular pharmacy visits and a lack of pharmacy oversight in medicines management. Teams were responsive and dealt with high levels of referrals. The trust ensured that people who used services, the public, staff and external partners were engaged and involved in the design of services. There was a range of treatment and activity delivered by skilled and experienced staff. Staff did not ensure that mental capacity assessments and best interest decisions were consistently documented in care records. Where English was not the first language of patients, the service provided interpreters. Ward teams did not hold regular team meetings. This meant that patients could have been deprived of their liberties without a relevant legal framework. 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 inspected three mental health inpatient services because of the ratings from the previous inspection. Staff were consistently caring, respectful and supportive. However, they did not always meet the required skill mix for the nursing teams. At this inspection we found compliance levels with this type of training were still below the trusts target. Staff told us they felt supported by their line managers, ward managers and matrons. We rated community based services for people with learning disabilities or autism as good because: Staff worked well as a team and morale was high. The Health Trust HIV/AIDS Services program delivers groceries to homebound seniors and adults throughout Santa Clara County. Outcomes of care and treatment were not always consistently or robustly monitored. We're here for you Learn More Scroll We've got you covered Use our service finder to find the right support for your mental health and physical health. At Rutland Memorial Hospital shifts were covered by using more than 20% temporary staffing. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. Suspended ratings are being reviewed by us and will be published soon. One patient told us they did not know they could leave the ward to seek medical attention. 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. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. Some local managers were keeping their own records to ensure performance was monitored. 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. The service did not have a system in place to monitor the number of lighters each ward held. The electronic data held by the trust was currently being validated with large numbers of visit records not closed on the database. Patients reported that they felt safe on the wards. They could undertake both internal and external training and were able to give feedback on service development. There's no need for the service to take further action. 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. To find out more, review our cookie policy. Staff monitored the ongoing condition of any secluded patient. The community nursing service could not measure its performance in relation to response times for unplanned care. Comprehensive relocation action plans were available. Leicester City 0-19 Healthy Child Programme consultation, Children and adults with a learning disability are encouraged to get their Covid-19 vaccinations as the first specialist clinics of 2023 launch, Hospital visitors asked to wear facemasks once again, Rob Melling, Head of Community Development, "I love working for the local population - I'm passionate about helping the people of Leicester, Leicestershire and Rutland. Assessments and care planning took place for patients needs. Staff were visible in the communal ward areas and attentive to the needs of the patients they cared for. One patient told us there wasnt enough to do at the Willows. Cover arrangements for sickness, leave and vacant posts were in place. The summary for this service appears in the overall summary of this report. There were safe lone working practices embedded in practice. There were effective systems in place to audit and monitor physical health care records. Wards for people with dementia had dementia-friendly elements; particularly the activity rooms and there was commitment to build on this. We're always looking for the best. 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). 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. Staff completed comprehensive assessments which included physical health checks and the majority of patients had completed risk assessments. Managers did not ensure that the staff were receiving regular clinical supervision and had not met the trust target compliance rate of 85%. On Phoenix ward patients were not allowed access to the garden. In the dormitories, observation mirrors were situated so that staff could observe patients without having to disturb them. The environment in the crisis service did not ensure confidentiality as rooms were not sound proofed and conversations could be heard outside the room. There were good examples of collaborative team working and effective multi-disciplinary and multi-agency working to meet the needs of children and young people using the service. Staff followed infection and prevention control practices and the community inpatient wards were visibly clean. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. Adult liaison psychiatry services are provided by Leicestershire Partnerships NHS Trust (LPT), the mental health trust in the Leicester, Leicestershire and Rutland Integrated Care System. Patients knew how to make a complaint or raise a concern and complaints were taken seriously. Medication management systems were in place and followed to ensure that medicines were stored safely. Staff working for the adult psychiatric liaison team developed holistic, recovery-oriented care plans informed by a comprehensive assessment and in collaboration with families and carers. At Melton, Rutland and Harborough, City East and City West CMHTs m. At City West in conjunction with the young onset dementia assessment service staff developed a digital app for younger who were developing dementia. There was a risk that young people may not get assessed out of hours in a timely manner by staff with CAMHS experience. This left patients without access to treatment when they needed it most. There had been an increase in the number of CAMHS referrals over the last two years. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. Employees also rated Leicestershire Partnership NHS Trust 3.1 out of 5 for work life balance, 3.6 for culture and values and 3.7 for career opportunities. Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. The trust had robust arrangements in place for the receipt and scrutiny of detention paperwork. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. We want to hear from you on how to improve our service and provide the best care possible. In five of the six community nursing teams attendance on some mandatory training courses was below 70%. Demand for neurodevelopment assessments remained high. The trust provided newsletters, quarterly serious incidence bulletins, regular emails from matrons about incidences and lesson learnt. Care planning had improved in the crisis service. Patients and carers gave positive feedback about the caring nature and kindness of staff and made positive comments about the positive therapeutic relationships they had with their loved ones. Staff had a good knowledge of safeguarding and incident reporting. We found loose papers in records. A psychologist led weekly reflective practice sessions to help staff think about the best way of helping the patient on the ward. There had been only one out of area placement over 14 months. 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 supported patients to raise concerns when needed. Whilst there had been some improvements, the process for reporting repairs and issues varied across the wards and a time lag existed for repairs being completed. Any other browser may experience partial or no support. Interpreters were available. Potential risks were taken into account when planning community health services. Patients gave positive feedback regarding the care they received. We spoke with five patients on long stay or rehabilitation wards; they told us they felt very well supported, and staff and were kind, caring, and respectful. Nursing staff interacted with patients in a caring and respectful manner. Leicester, United Kingdom. There was evidence of items being submitted to the trust risk register where appropriate. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. Staff had good knowledge of safeguarding processes and risk assessments were generally detailed, timely and specific. 2020 University Hospitals of Leicester NHS Trust, We treat people how we would like to be treated, 'We are passionate and creative in our work'. In addition to this, risk assessments were comprehensive and reviewed as per the trust policy, six monthly or after risk incidents. The service was meeting its target in this area. However, they were not updated regularly or following an incident. The HBPoS did not have designated staff provided by the trust. Equality diversity and inclusion matters had been a focus of the new trust leadership team. We spoke with nine patient families and carers. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. The trust confirmed staff delivering end of life care were involved in bi-annual record keeping, safeguarding and clinical supervision audits. Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately. 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. We found positive multidisciplinary work and observed staff were supporting patients. Managers shared the outcomes and lessons learnt from incidents, complaints and service user feedback at regular staff meetings, where meetings took place. There were insufficient systems in place to monitor prescriptions. There were examples of people not being seen within service guidelines whilst receiving large doses of prescribed medication. Palliative care nurses conducted holistic assessments for patients and provided advice around social issues, for example, blue badges for disabled parking. Services were planned and delivered in a way that met the needs of the local population, for example the Diana Service and the Family Nurse Partnership. However, we found: We rated the child and adolescent mental health wards as requires improvement because: We rated community-based mental health services for older people as good because: We rated learning disability and autism community services as good because: We gave an overall rating for forensic/secure wards of requires improvement because: We rated Leicestershire Partnership NHS Trust long stay / rehabilitation mental health wards for working age adults as requires improvement because: Overall rating for this core service Good. Managers used a tool to identify and review staff numbers in accordance with need. The waiting times in community based mental health services for adults of working age were long and breached targets. Staff told us the trust was a good place to work. Staff received training in safeguarding and knew how to report when needed. Staff had been trained with regards to duty of candour and in line with the trust policy. 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. Supervision and appraisal compliance of three teams fell below 75%. 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 community healthcare services provided by Leicestershire Partnership NHS Trust were judged to be good. Inpatient and community staff reported difficulties with getting inpatient beds. Patients could approach staff at night to request them. To address this deficit the trust moved patients that required an acute bed to a rehabilitation bed which was not clinically justified or met the needs of the patients. Staff actively participated in clinical audits. There was an extensive wellbeing offer available to staff. We received mixed feedback about staffing levels and several staffing reported concerns. the service is performing well and meeting our expectations. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. Staff were positive about the level of support they received, including regular supervision and line management. Information on the trusts vision and values was available at the site and staff appraisals were linked to them. Following the national withdrawal of the Liverpool Care Pathway the trust has developed an alternative care plan; however this has not yet been implemented. This was a focused, unannounced inspection, to follow up on enforcement action we issued to the trust after our last inspection in November 2018. On Ashby ward, the shower rooms did not have curtains fitted. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. This was an issue highlighted at our inspection in 2018. 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 found a high number of concerns not addressed from the previous inspections. Staff demonstrated commitment to delivering high quality end of life care for their patients.