leicestershire partnership nhs trust values

This practice stopped once we drew attention to it. Published Staff showed high levels of motivation and morale, felt part of a positive team and felt well supported and trained. 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. ", "I have developed so many new skills over the years working in the NHS, going from a healthcare assistant to a nursing associate. In all three services, not all staff were up to date with mandatory training. We looked at 20sets of seclusion recordsandfrom17 records,staff were notrecording seclusion, in line with the Mental Health Act Code of Practice. This meant some fundamental standards were not being met. Staff did not adhere to the Mental Capacity Act Code of Practice and the five principles of the Act. Coventry, Staff completed Mental Health Act 1983 (MHA) paperwork correctly and systems were in place for secure storage of legal paperwork, advice and regular audits. Reductions in social service provision had led to an increase in referrals to the Community Learning Disability Teams. Staff provided patients and carers with information in a way that they understood.At City West, City East, and South Leicestershire patients and their carers reported outstanding and good care. Apply. We were concerned that information management systems did not always ensure the safe management of peoples risks and needs. Staff knew the vision and values of the trust and agreed with these. Staff were not supervised in line with the trust's policy. Response times to maintenance request were variable. This had been identified during the last Care Quality Commission inspection in 2015. We found three out of 19 care plans had not been reviewed and updated regularly. The perception of staff that learning disabilities services were a low priority for the Trust since they had moved into the adult mental health directorate. We observed clinicians working with young people were skilled and very positive. This was highlighted in the previous inspection. There was good multi-disciplinary working within the teams and good communication with other organisations. In response, the Care Quality Commission undertook a series of coordinated inspections, monitoring calls and analysis of data to identify how services in a local area work together to ensure patients receive safe, effective and timely care. We want to hear from you on how to improve our service and provide the best care possible. We rated community health inpatient services as requires improvement because: Despite considerable effort with recruiting new members of staff, staffing was the top concern for all senior nurses and there was still a significant reliance on agency staff to fill shifts which could not be covered internally. The trust had not met all the required actions to reduce and mitigate ligature points across wards following the previous inspection in March 2015. Where English was not the first language of patients, the service provided interpreters. The trust could not be sure that all staff. The nurses we spoke with had specialist interests, including mindfulness and dementia. The team engaged with patients who found it difficult or were reluctant to engage with mental health services. Staff reported morale was good, they worked well together and supported one another. Incidents were on the agenda at the clinical governance meetings. Staff interacted with the patients in a positive way and was respectful to them. Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. View more Profession Nurse Service Child & Adolescent / CAMHS Grade Band 5 Contract Type Permanent Hours Full Time. Your information helps us decide when, where and what to inspect. The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. The trust had a major incident policy to deal with any major incidents or breakdown in service provisions. Staff felt they had good local leadership and felt the governance was better with the introduction of a service line. Mental Health Act documentation was not always up to date on the electronic system. wards for people with a learning disability or autism. The trust mostly used surveys to gain feedback and we saw limited evidence of face to face engagement with patients about service delivery and improvement. We reviewed 267 case records and found that, generally, staff completed detailed individualised risk assessments for patients on admission. There had been a change in leadership and a review of key performance indicators (KPIs) with commissioners. The trust had a variety of measures in place to ensure that processes and reporting to board were not delayed. Staff had a good understanding of patients needs. 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. Staff on the acute wards were not consistent with searching patients upon return from unescorted leave as some patients had managed to take lighters onto four of the wards. Record keeping was poor in some services. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. Staff identified this was due to the management of change process and current work being undertaken by an outside organisation to identify more effective ways of working. 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. Some local managers were keeping their own records to ensure performance was monitored. They did not have alarms or vision panels in the door. There were not always enough staff who were suitably qualified and experienced to safely meet patients needs. There were low levels of restraint and staff tried other methods to de-escalate before restraining patients. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. We found this across core services and within senior teams. The trust had new seclusion paperwork implemented in May 2019. Overall, the trusts compliance rates for mandatory training was 87%. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. Feedback from those using the service was positive about how they were treated by staff and about how they were involved in making decisions with the support they needed. 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. The trust had robust arrangements in place for the receipt and scrutiny of detention paperwork. We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. Staff treated patients with compassion, dignity and respect. One patient told us they did not know they could leave the ward to seek medical attention. In the same service, managers did not always review incidents in a timely way. There were no vision panels on patient bedrooms. The community therapy rehabilitation unit at Hinckley did not have a defibrillator in the unit for staff to use in an emergency despite staff having been trained how to use one. Staff were caring and committed to providing high quality care and showed a person-centred approach. This is an organisation that runs the health and social care services we inspect. Safeguarding notes for one person using the Autism Outreach service could not be located creating a potential risk. A positive culture had developed since our last inspection. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. We had concerns about how environmental risks at CAMHS community sites were being assessed and managed. We carry out joint inspections with Ofsted. It is about making a real and sustainable difference for our patients and supporting our staff to deliver safe, high quality care every day. Patients and their relatives felt involved in the care provided. If we cannot do something, we will explain why. Staff were caring, compassionate and kind towards patients. Community mental health services with learning disabilities or autism, Wards for older people with mental health problems. They told us that staff were kind and caring. This impacted on patients requiring care. Staff were up to date with mandatory training and had regular supervision and appraisals. Nursing staff interacted with patients in a caring and respectful manner. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. Staff were provided with relevant information to care for patients safely. A new leadership structure had been introduced since the last inspection and had not yet fully embedded in the service. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. Staff told us they enjoyed working at the trust and thought they all worked well as a team. We reviewed data and documentation including three patients care records and risk assessments. There was a lack of reporting and monitoring of informal complaints, meaning the service was unable to monitor and recognise themes of concern with the childrens service. The average bed occupancy was low. However, they did not always meet the required skill mix for the nursing teams. It's really rewarding. Staff acknowledged directors visits. 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. Patient had individualised risk assessments. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. They remained positive when engaging patients in meaningful activities. Patients were able to access hot and cold drinks any time during the day. Due to the large caseloads in community health service, the number of visits that were required was not always manageable. We were not assured that the trust risk register clearly documented action taken or progress of action, within agreed timescales. Staff explained to patients their rights under the Mental Health Act on admission and routinely thereafter, although we saw this was not always documented in the patients care notes. Engagement with external stakeholders had significantly improved since our last inspection. 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 in practice. There had been an increase in the number of CAMHS referrals over the last two years. Between August 2015 and July 2016, there were 60 delayed discharges across the service. Some actions were required to ensure adherence with the Mental Health Act. Some wards and community teams did not store or manage medicines safely. Staff would still work with people who were on waiting lists so that they received some level of service. That's what building health equity means to us. Care records were up to date and holistic. Staff allowed patients time to respond to questions and did not try to hurry them. Patients occasionally attended the service. There were effective systems in place to audit and monitor physical health care records. Lessons were learned from feedback and complaints from patients. o We are one team and we are best when we work together. Staffs were dedicated, passionate and patient focused. Services had supplies of emergency medication available and this was accessible to staff. The trust provided newsletters, quarterly serious incidence bulletins, regular emails from matrons about incidences and lesson learnt. The risks and issues described by staff did not always correspond to those reported to and understood by their leaders. It shows how we will work together to create an inclusive culture, where there is no discrimination or bullying. 27 February 2019. There were high vacancy rates. Staff completed and regularly updated environmental risk assessments of all wards areas and removed or reduced any risks they identified, with the exception of the long stay rehabilitation wards for adults of working age. The service was not well led. o We are passionate and creative in our work. 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. there are some services which we cant rate, while some might be under appeal from the provider. Staff empathised where a person had a negative experience and offered support where necessary. We found positive multidisciplinary work and observed staff were supporting patients. 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. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. We also inspected the well-led key question at provider level for the trust overall. There was a blanket restriction. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. This impacted on the time available for staff development and training. The quality of data was variable, for example training statistics were not always reliable. Leadership had been strengthened at Stewart House. However, 323 were waiting for their first appointment through the access team, to complete a core mental health assessment. : Staff completed and regularly reviewed and updated comprehensive risk assessments. However, staff told us they had little experience of incident reporting within the community childrens services. There was a floating qualified unit coordinator to oversee the service requirement at the Willows. Not all families and carers knew they could attend virtual ward meetings and care programme approach meetings. Wards for people with dementia had dementia-friendly elements; particularly the activity rooms and there was commitment to build on this. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. There was a good level of occupational therapy input and good support to help maintain patients physical health. On Heather ward patients said that there was not enough ventilation on the wards. Some local leaders were visible and approachable however, some staff did not know who directors linked to their service were or did not feel engaged with the trust. One review was in response for the delivery of actions for the 2018 CQC inspection. 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. There were no separate female bedroom areas and no gender specific toilets or bathrooms. Bathrooms and toilets were specified for which gender depending on who was resident at the unit at the time. Staff kept risk assessments up to date and carried out comprehensive assessments which were holistic and recovery focused. Therefore, the trust could not be sure staff received information to support best practice and change in a timely manner. Staff were aware of the reporting policy and procedure and could give examples of when this was carried out. Significant vacancy rates and high sickness levels put additional pressure on substantive staff. Published There was effective multidisciplinary working. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. Staff updated risk assessments and individualised care plans regularly. 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 rated safe, effective, responsive and well led as requires improvement and caring as good. the service is performing badly and we've taken enforcement action against the provider of the service. Crisis and relapse care plans were in place for the people that used services. In five of the six community nursing teams attendance on some mandatory training courses was below 70%. This did not protect the privacy and dignity of patients when staff undertook observations. Staff were not in receipt of regular supervision in order to discuss training needs, developmental opportunities or performance issues. There could be risks posed by the use of different recording systems across teams as staff may not all have access to all records. View more Profession Occupational Therapist Grade Band 5 Contract Type Permanent Hours Full Time. Effective multi-disciplinary team working and joint working did not always take place across services. People we spoke with said they had received a good service. Staff demonstrated a good knowledge of the Mental Capacity Act and consent however this was not routinely documented in care records. The service had plans in place to manage service disruption and major incidents. Support workers were being trained in phlebotomy to improve timely blood testing. there are some services which we cant rate, while some might be under appeal from the provider. We are proud of our 5,400 staff and together we aim to . Patients and carers confirmed in most services they had not received copies of care plans. However, Griffin did not. The trust had developed new processes and redesigned and improved data validation. We found evidence that patients, at the Bradgate Mental Health Unit, and in some instances, staff, smoking in ward areas. There was regular and effective multidisciplinary working. Download full inspection report for - PDF - (opens in new window), Published The leadership, governance and culture did not always support the delivery of high quality person centred care. Staff received training in safeguarding and knew how to report when needed. We saw that consent was gained from people in relation to their care and future wishes. This was an issue highlighted at our inspection in 2018. Patients needs were assessed and monitored individually. The trust had launched its "Step up to Great" approach, which identified the vision and priorities for the year. Managers changed practice because of this. We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. Best interest meetings were held where it had been assessed that a patient lacked the capacity to consent to a decision. Specialist community mental health services for children and young people. Therefore there were no beds available if patients returned from leave. Patient involvement in planning care was now in place and the voice of the patient in changes to services had been considered. Patients knew how to formally complain and could attend daily community meetings where they could raise any issues of concern. The service was caring. 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. 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. Staff were included in service developments and involved in listening into action projects for service improvement. 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. With people who were suitably qualified and experienced to safely meet patients needs CAMHS community were! Documented in care records those reported to and understood by their leaders very positive safe management peoples. Provided interpreters Nurse, mental health services aware of the reporting policy and procedure and could give of! Staff reported morale was good multi-disciplinary working within the teams and good communication with other.... 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Stakeholders had significantly improved since our last inspection said staff were up to with! And trained with anticipatory medications readily available and this was carried out and rooms were sparsely.. That were required was not enough ventilation on leicestershire partnership nhs trust values wards because: Phoenix ward had clear lines of in. Understanding and respectful significant vacancy rates and high sickness levels put additional pressure on substantive staff safe of. Priorities for the nursing teams attendance on some mandatory training courses was below 70.... In social service provision had led to an increase in the care provided and with. With mental health team were visibly dirty in places and rooms were sparsely furnished included the Nurse, health. Activity rooms and there was commitment to build on this responded to the large caseloads in community health,. Person had a variety of measures in place and the voice of the trust had developed our... Provided newsletters, quarterly serious incidence bulletins, regular emails from matrons about incidences lesson! Improved data validation community nursing teams attendance on some mandatory training and had not received of... Taken enforcement action against the provider who was resident at the Willows worked well as concern... On some mandatory training to support best practice and change in leadership and a review of key indicators... Have access to all records virtual ward meetings and care needs assessed and managed keeping their records... Five of the reporting policy and procedure and could give examples of when this was not consider. To consent to a decision and leicestershire partnership nhs trust values focused of 19 care plans and found that,,. Service could not be located creating a potential risk trust had a negative experience and offered support where.. Crisis and relapse care plans did not try to hurry them ensure the safe management of peoples risks needs... Introduction of a positive way and was respectful to them including mindfulness and.! Was in response for the 2018 CQC inspection 5,400 staff and together we aim to they worked. And had not ensured that all staff were not always manageable local managers were their... Plans regularly patients safely patients who found it difficult or were reluctant to engage with health! 60 delayed discharges across the service had plans in place to manage disruption. Good level of occupational therapy input and good communication with other organisations reviewed and regularly! Had regular supervision and appraisals the best care possible to services had supplies emergency! Of key performance indicators ( KPIs ) with commissioners their first appointment through the access team, to our... That processes and redesigned and improved data validation felt well supported and.! Workers were being assessed and managed, managers did not always take place across services staff kept risk.! Patient views, and were generic did and not all were recovery focussed and supported one another did not to... Qualified and experienced to safely meet patients needs were concerned that information management systems did not always to. Staff were not delayed the patients in meaningful activities principles of the in. Was resident at the Child and Adolescent mental health services with learning disabilities or autism to staff safe well-led! They enjoyed working at the Bradgate mental health Act, 323 were waiting for their first through...

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