leicestershire partnership nhs trust values
Leicestershire Partnership NHS Trust | 4,712 followers on LinkedIn. Staff sourced PICU beds when needed from other providers, in some cases many miles away. All wards had developed their own systems to improve medicines management in their areas. We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. However, they were not updated regularly or following an incident. Managers ensured they used regular bank staff to achieve the required safer staffing levels and to promote continuity of care of patients. The trust had reviewed existing systems and processes identified improvements and implemented changes. Oct 2015 - Apr 20193 years 7 months. Care planning had improved in the crisis service. 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. Wards provided safe environments where patients felt secure. We were concerned that information management systems did not always ensure the safe management of peoples risks and needs. Staff held high caseloads in community based mental health services for adults of working age, an issue which had been recognised by the trust and placed on the risk register. There was a clear vision for the service which staff understood. Patients had their own copies of care plans and were involved in their care plan reviews. There were no recorded regular temperature checks of the medication cupboard. Staff were up to date with mandatory training. -Supporting a variety of Wards such as Cardiology, Respiratory, Urology, Stroke, Renal, Maternity and Vascular.Obtaining physical measurements such as blood pressure, heart rate, SPO2, Temperature,respiratory rates, blood sugars, pain . Staff who were unclear of the process for rapid tranquillisation did not have a reminder of the process to follow. The number of visits was not always manageable. Staff reported they felt supported by their colleagues and managers. Nursing staff interacted with patients in a caring and respectful manner. We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels: Outstanding There was limited time available for staff to attend specialist courses to enhance their knowledge. Some key outcomes for children, young people and families using the service were regularly below expectations. Another patient said on their comment card they did not see enough of the occupational therapist. The assessment and resulting care plans were personalised, holistic and recovery focussed. Leicestershire Partnership NHS Trust provides mental health, learning disability and community health services across Leicestershire, England.. Patients and their relatives felt involved in the care provided. Staff working within criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. Leicestershire Partnership NHS Trust interview details: 3 interview questions and 3 interview reviews posted anonymously by Leicestershire Partnership NHS Trust interview candidates. The trust had a culture of promoting staff learning and development and encouraged staff to share best practice and innovation. We found that there were still errors within the staffs application of the Mental Capacity Act. Many staff knew the Trust values and were aware of the Chief Executive Officer. 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. This meant board members were not able to monitor the trusts assertions that there were strong systems and processes in place for identifying and reporting serious incidents, including deaths, or monitoring whether reviews and investigations were completed fully. Patients returning from leave from the acute mental health wards were not assured of returning to their original ward. Staff were kind, caring and respectful towards patients. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the patients. There were insufficient systems in place to monitor prescriptions. There was detailed discussion and consideration of patients and carers needs. Patients families and carers were positive about the care provided. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. Staff interacted with the patients in a positive way and was respectful to them. However, we saw evidence this was not always achieved. There were effective methods for obtaining feedback from service users and carers and feedback was acted upon. There was a risk that staff did not receive adequate support or that their capability was not reviewed. Care and treatment was mostly planned and delivered in line with current evidence. These reports were presented in an accessible format. Overall, the trusts compliance rates for mandatory training was 87%. Managers had introduced a duty clinician to manage caseload sizes and reduce patients risks. Medication management systems were in place and followed to ensure that medicines were stored safely. the service is performing badly and we've taken enforcement action against the provider of the service. There had been only one out of area placement over 14 months. received 41 comment cards from patients that were available for patients to complete during the time of our inspection. We are proud of our 5,400 staff and together we aim to . Make a difference with a career at LPT. The service participated in few national audits and did not audit patient therapy outcomes which meant benchmarking the standards of care and treatment they were giving their patients against other providers was difficult to establish. Staff felt well supported and were able to raise concerns with their line manager and were listened to. 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. NHS England / NHS Improvement - for general enquiries contact Helen Barlow on 0300 123 2038 or by emailing helen.barlow2@nhs.net. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. Consent to care and treatment was obtained in line with relevant guidance and legislation. Not all patients on acute wards for adults of working age could summon help from staff if required. A carers group was available to give support. Nurses and managers from LPT who were supported . Staff demonstrated a good knowledge of the Mental Capacity Act and consent however this was not routinely documented in care records. They were supported to have training to help them to develop additional skills and expertise. There was good multi-disciplinary working within the teams and good communication with other organisations. There was highly visible, approachable and supportive leadership. Capacity assessments were unclear. Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so patients were safe. There were effective systems in place to audit and monitor physical health care records. Staff were unaware of any service specific strategic direction. We rated the trust as requires improvement overall: Whilst there had been some progress since the last inspection in 2015, the trust was not yet safe, fully effective or responsive. Some improvements to address the no smoking policy at the Bradgate Mental Health Unit wards were seen. Caring stayed the same, rated as good. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. We rated community health services for adults as requires improvement because. There were problems with access to the electronic system owing to ongoing building works. This meant staff transferred patients to wards that had seclusion rooms when needed. 56% of individual care plans were not up to date, personalised or holistic. The quality of data was variable, for example training statistics were not always reliable. There were systems for lone-working in place including a red folder process that kept workers safe. Community mental health services with learning disabilities or autism, Wards for older people with mental health problems. We spoke with carers; they all stated that staff responded well when they contacted the service. Safeguarding notes for one person using the Autism Outreach service could not be located creating a potential risk. Many of the actions listed included plans to review process, establish an approach, or to develop areas. Through this collaborative working we are also building a culture of continuous improvement and learning, supported by a robust governance framework and more sustainable and efficient use of resources. On one ward, female shower rooms did not contain shower curtains. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. Staff morale was low and they felt disempowered in some areas. The trust had developed new processes and redesigned and improved data validation. There were low levels of restraint and staff tried other methods to de-escalate before restraining patients. The previous rating of requires improvement remains. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. The school nursing service was understaffed and consequently there was an adverse impact on outcomes for children and young people and on staff morale. This had continued during the pandemic. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. The teams were able to respond quickly when patients or carers telephoned with problems. Some staff found there was insufficient time to complete their visits within the working day. At the Valentine Centre improvements had been made to the storage of cleaning materials. The overall average compliance rate for supervision of staff in the learning disability wards was 46%. Staff told us that the trust were recruiting for their vacancies and they hoped to have a full complement of staff in the coming months. This promotion is being run by Leicestershire Partnership NHS Trust. However staff did not appear to be fully aware of services provided and told us there were plans to implement a seven day service in end of life care. Staff followed infection and prevention control practices and the community inpatient wards were visibly clean. Nursing staff did not have a stock list to randomly check medication which meant they could not reconciliation check. Apply. The trust had made improvements to the clinical environments since the last CQC inspection. Managers did not ensure that the staff were receiving regular clinical supervision and had not met the trust target compliance rate of 85%. Three out of 18 staff interviewed said that supervision was irregular. Staffing levels were below the expected level. Staff were not always recording room and fridge temperatures in clinical rooms and out of date nutrional supplement drinks had not been appropriately disposed of. Ward teams did not hold regular team meetings. There were no separate female bedroom areas and no gender specific toilets or bathrooms. Staff did not effectively complete risk assessments for patients, manage a smoke free environment, or share information about incidents or share learning from incidents within teams, across services or between services in the trust. The trust was not fully compliant with same sex accommodation guidance in two acute wards, the short stay learning disability service and rehabilitation services. Managers had a system in place for tracking and learning from safeguarding incidents and other reportable events. There was poor medicines management in relation to checking expiry dates, storage and consent documentation. Managers had introduced a specialist child and adolescent mental health traffic light system, a red, amber and green rating tool for managing risk. 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. By doing this it will help us achieve our vision of creating high quality, compassionate care and wellbeing for all. At this inspection we found compliance levels with this type of training were still below the trusts target. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. The trust had a patient involvement centre, which was pleasant, well-equipped and supported involvement from friends and family. 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. Regular team meetings took place and staff told us that they felt supported by colleagues. Interpreters were available. This impacted on the time available for staff development and training. Waiting times and lists remained of concern, and this had been identified in the previous inspection. Some staff did not receive regular supervision or annual appraisals. Within the end of life service there were inconsistencies in the quality of completion for do not attempt cardiopulmonary resuscitation (DNACPR) forms, in the quality of admission paperwork within medical records and in the use of the Last Days of Life care plans. The trust lacked an overarching strategy which everyone within the trust knew. The trust had a limited approach to patient involvement. Staff said morale was good and they felt supported by their managers. There were key performance indicators set for time from referral to assessment and where these were not being addressed action had been taken. 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. There was no performance data dashboard to gauge the performance of the service. Patients had access to advocacy. They told us that staff were kind and caring. Staff used "my care plan" documents to obtain patients views on their care. Staff allowed patients time to respond to questions and did not try to hurry them. : Staff completed and regularly reviewed and updated comprehensive risk assessments. Watch our short film to find out more: We Are LPT Share From a National Health Service (NHS) organisation Watch on Our strategy We rated child and adolescent mental health wards as good because: The ward had clear lines of sight in the main areas of the ward. Staff in some services completed care plans with detailed information on allergies, and risks around medication. Staff treated patients with respect and maintained dignity. The service had seven vacancies for qualified nurses andthree for non-registered nurses. Staff gave examples of working with people with diverse needs considering their ethnicity, gender, age and culture. Staff did not ensure that mental capacity assessments and best interest decisions were consistently documented in care records. Staff showed caring attitudes towards their patients. Staff we spoke with were proud to work within the adult psychiatric liaison team and proud to show us the work they did and the service they provided. Staff had limited opportunities to receive specialist training. The trust had significantlyreduced waiting times and the total numbersof children and young people waiting for assessments. There was a good level of occupational therapy input and good support to help maintain patients physical health. The trust had well-developed audits in place to monitor the quality of the service. One patient on Watermead ward told us that a staff member had ignored them when they had asked them for a sandwich. The longest wait was 108 weeks for four patients to access group work or outpatients. Bank Band 6 Speech and Language Therapist. The trust had ensured patients privacy and dignity were maintained when receiving physical health observations at the Bradgate Mental Health Unit. 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. The service did not have any out of area placements, readmissions or delayed discharges. 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. We inspected all key lines of enquiry in all domains (safe, effective, caring, responsive and well-led) in two services. The trust had robust systems in place which allowed staff to effectively report incidents. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. Record keeping at Stewart House was disorganised. The majority of repairs and maintenance issues highlighted within the warning notice at the Bradgate Mental Health Unit had been fixed or resolved. Interview rooms were unsafe. There was a floating qualified unit coordinator to oversee the service requirement at the Willows. That's what building health equity means to us. Managers shared the outcome of complaints with their ward teams. The trust confirmed after our inspection Advanced Nurse Practitioners used a DNACPR form which had been agreed within NHS East Midlands. Beds were not always available for people living in the trusts catchment area. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. With the exception of the liaison psychiatry service and the mental health triage car, managers were not supervising or appraising staff within the trusts supervision policy. Staff told us patients were concealing lighters and cigarettes and bringing them onto wards. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. Due to this staff could not observe all parts of wards due to their lay out and the risk had not been mitigated. In CAMHS community teams waiting times from referral to initial assessment was less than 13 weeks. 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. Lone working policies and procedures were in place for staff to follow to ensure patient and staff safety. There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS Trust (LPT). This does not comply with the guidance from the Royal College of Psychiatrists. Staff were inconsistent in updating the Historical Clinical Risk Management (HCR-20) assessments. The acute mental health wards had broken facilities which had not been repaired in a timely manner and we found dirt in some areas on one ward. 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 were not assured that the trust risk register clearly documented action taken or progress of action, within agreed timescales. These included the Older Peoples Unit at Loughborough Hospital, the Hand Injury Service, the splitting of planned and unscheduled community nursing services with a single point of access, podiatry and the specialist management of long term conditions. Staff held multidisciplinary team meetings weekly and these were attended by a range of mental health professionals. There were not always enough staff who were suitably qualified and experienced to safely meet patients needs. Patients reported they were treated with dignity and respect. Patient Advice and Liaison Service (PALS). 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