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Was a high priority with regular safeguarding reviews within each area of service visited within team! The service employed care navigators to help families and carers negotiate their journey through the various services provided. Care plans and risk assessments did not show staff how to support patients. In 3Rubicon Close, it was not clear that information about providing physiotherapy to a patient had been communicated to all staff. Supervision, appraisals and training compliance did not always meet the trust standard. Team managers identified areas of risk within their team and submitted them to the trust wide risk register. Some staff had not received their mandatory training, supervision or appraisal. Staff monitored patients physical health regularly from the point of admission. Despite considerable effort with recruiting new members of staff for community inpatient areas, 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. 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. Best interest meetings were held where it had been assessed that a patient lacked the capacity to consent to a decision. Reductions in social service provision had led to an increase in referrals to the Community Learning Disability Teams. Risk management in services required improvement. The trust told us patients across mental health inpatient wards had commented positively about their experience of care. Let's make care better together. There had been a change in leadership and a review of key performance indicators (KPIs) with commissioners. The trust had systems for promoting, monitoring and responding to complaints. This meant that patients were not protected from receiving unsafe treatment. 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. The service did not have any out of area placements, readmissions or delayed discharges. Where patients took medicines home with them, staff ensured that they understood their use and storage. Recruitment was in progress for 10 new healthcare support workers. A full audit was scheduled for the end of June 2019. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. Most patients spoke positively about their care and said they were involved. The trust had systems for staff to raise any concerns confidentially. In two of the core services inspected, the environment had not been well maintained. I.T. Managers used a tool to identify and review staff numbers in accordance with need. 10 July 2015. Our rating of this service improved. Community mental health services with learning disabilities or autism, Wards for older people with mental health problems. Where relevant we provide detail of each location or area of service visited. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. Staff would still work with people who were on waiting lists so that they received some level of service. The needs of people who used the service were assessed and care was delivered in line with their individual care plans. We would expect patient involvement to be embedded at all levels of the trust, across as many departments as possible, in planning, review, evaluation and delivery. The clinic rooms across sites had all the equipment calibrated. Derby, This does not comply with the guidance from the Royal College of Psychiatrists. They showed a good understanding of peoples individual needs. On four wards in acute wards for adults of working age, there were shared sleeping arrangements for patients. Staff said this made them feel safe whilst visiting patients at home or whilst undertaking activities with patients in the community. 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. Staff usually met patients in their homes or in the community. At the last inspection, we issued enforcement action because the trust did not have systems and processes across services to ensure thatthe risk to patients were assessed, monitored, mitigated and the quality of healthcare improved in relation to: The trust was required to make significant improvements in the following core services where we found concerns in the areas listed above: Acute wards for adults of working age and psychiatric intensive care units, Wards for people with a learning disability or autism, Long stay or rehabilitation mental health wards for working age adults. Managers ensured they used regular bank staff to achieve the required safer staffing levels and to promote continuity of care of patients. WebLeicestershire Partnership NHS Trust provides high quality integrated mental health, learning disability and community health services.The Trust was created in 2002 to Patients were not always involved in the planning of their care. The trusts Board Assurance Framework (BAF) was lengthy, was combined with a corporate risk register and had overdue actions. Five out of 25 care records showed that patient involvement had not been recorded. wards for people with a learning disability or autism. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. 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. Published Improvements had been made to the seclusion facilities, and further improvements were planned across the service to improve patient experience and promote privacy and dignity. The trust admitted male patients to female areas of the mixed wards when male beds were unavailable. Some wards did not meet the Department of Health and Mental Health Act Code of Practice requirements in relation to the arrangements for mixed sex accommodation.

Staff told us they felt supported by their line managers, ward managers and matrons. Staff were described as putting people who used services first and being person-centred. This is an organisation that runs the health and social care services we inspect. Staff treated patients with respect and maintained dignity. At times, there were insufficient qualified nurses on shift. This has been brought together using feedback from staff, service users and stakeholders to evolve our work so far into a clearer trust-wide strategy for all areas: Step Up to Great.Through Step Up to Great we have identified key priority areas to focus on together. Webtypes of interview in journalism pdf; . Staff did not always use the Mental Health Act and the accompanying Code of Practice correctly. 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. Ward matrons told us they shared outcomes from incident investigations in team meetings for shared leaning. Plans were shared with family and carers. Staff completed extensive and detailed care plans. clients to achieve their objectives and desired patient outcomes through 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. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Our overall rating of this trust stayed the same. We rated the trust overall for well-led as inadequate. 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. Fire safety was much improved, withfire drills carried out regularly. The teams we spoke with, felt the trust board did not set clear timescales or direction on how to move their projects forward. Staff were positive about the support they received from their local leaders and managers but were less connected with senior leadership and management teams in the children, young people and families services. Safeguarding was a high priority with regular safeguarding reviews within each area of speciality and established systems for supporting staff dealing with distressing situations. The duty system enabled urgent referrals to be seen quickly. Ward matrons were looking into these alleged incidents. There were low levels of restraint and staff tried other methods to de-escalate before restraining patients. 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). There were not enough registered staff at City West and this was identified as a risk on the service risk register. The acute mental health wards had two and four bedded dormitories which did not promote privacy and dignity. The trust confirmed the service line was contracted to provide bed occupancy at 93%. The trust had made progress in oversight of data systems and collection. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. The wards tried to book regular bank and agency staff so they knew the ward and patients, to provide continuity of care. All jobs will require permission to work in the UK. 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. 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. experience of dealing with fraud, bribery and corruption issues, as well as Staff described various ways in which they received information from the board and other governance meetings. the service is performing badly and we've taken enforcement action against the provider of the service. Staff felt supported by their immediate managers but felt disaffected with trust senior management. The service was not meeting its performance targets. Full-time, Mandatory training that fell below 75% included adult immediate life support, adult basic life support, safeguarding children level 3 and fire safety awareness. Every team we spoke with knew who they reported to and what to report. This had improved since the last inspection in March 2015. Staff morale was low and they felt disempowered in some areas. Patients told us that staff listened and empathised with them. WebHere at LPT, our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. Patient records across community inpatient services were not always completed fully. Caring stayed the same, rated as good. Staff had the right qualifications, skills, knowledge and experience to do their job.

The trust had not responded in a timely way to eliminate shared sleeping arrangements (dormitories). We actively implement equal opportunities in employment and service delivery and seek people who share our commitment. One patient at Stewart House told us other patients made comments around their protected characteristics and staff had not care planned the needs of the patient. 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. A further review was an examination of processes and procedures within the trust for reporting investigations and learning from serious incidents requiring investigation. The waiting list had increased for those children and young people waitingfor thestart of treatment, following assessment. Patients felt safe. We also inspected the well-led key question at provider level for the trust overall. Browser Support This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. The learning disability community team had not met the six week target for initial assessment on average it was six days over. We rated Leicestershire Partnership NHS trust as requires improvement because: Environmental risks in the Health Based Place of Safety (HBPoS) identified in our previous inspection remained. The successful candidate will deliver specialist fraud People that were referred to the service were waiting for a care co-ordinator to be allocated. One family member told us their relative could be challenging but they felt they were well cared for. we have taken enforcement action. We saw that consent was gained from people in relation to their care and future wishes. Some staff used tools and approaches to rate patient severity and monitor their health. Staff treated patients with kindness, dignity, and respect. Outcomes of care and treatment were not always consistently or robustly monitored. The trust did not provide data to demonstrate medical staff appraisal compliance. Patients and carers knew how to complain. There were waiting lists of up to 18 months for psychology and up to 40 weeks for other treatment within the personality disorder service. We rated acute wards for adults of working age and psychiatric intensive care units as requires improvement because: The trust had made improvements to the clinical environments but had not met all the required actions following the previous inspection of March 2015. 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.

Your information helps us decide when, where and what to inspect. Managers had a system in place for tracking and learning from safeguarding incidents and other reportable events. Patients reported they were treated with dignity and respect. Flexible approach to work to meet service needs. We were aware the local commissioning groups had not set targets for wait times. Staff were open about their poor understanding around the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. The short stay services did not comply with the guidance on the elimination of mixed sex accommodation. Response times to maintenance request were variable. Staff carried out physical health checks on admission.Ongoing physical healthcare was provided by a local GP who visited two days a week and was available in case of an emergency. One patient on Thornton ward told us that while staff did knock, they did not wait for a response before entering, which had resulted in staff walking into their room while they were changing their clothes, compromising their privacy and dignity. produce high quality reports and visual presentation of information, so One patient told us there wasnt enough to do at the Willows. Leicestershire Partnership Trust) delivering high quality counter fraud, internal 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. 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. There was good multi-disciplinary working within the teams. Staffing skill mix was appropriate to need overall. Resuscitation bag, defibrillator and fire drill checks in the CAMHS LD service were not recorded. For example relating to assessment of ligature points at Westcotes. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. Managers shared the outcome of complaints with their ward teams. frank nobilo ex wife; kompa dance

Staff had received specialist child safeguarding training and were able to make referrals when appropriate. We aim to develop a workforce that reflects our community. Staff did not record seclusion well. When staff raised concerns or ideas for improvement, they felt they were not always taken seriously. Therefore, patients were not always actively engaged in decisions about service provision or their care. Practice development and embedding practice was good, for example, where dementia mapping was adapted to learning disabilities. Inadequate At this inspection, two of the three mental health services we inspected improved overall. The work in neighbourhoods reduced travel for people and reduced barriers for people to gain support. Staff did not routinely complete detailed, person centred, individualised or holistic care plans about or with patients. We noted a box for discarded needles being left unattended in a communal area. Staff were not meeting targets for the assessment and assessment to treatment of urgent referrals and six week routine referrals. Staffs were dedicated, passionate and patient focused. It was clear to see the difference the investment and improvements had made since our last visit. The trust could not ensure continuity of care for these patients. We saw staff engaging with patients in a kind and respectful manner on all of the wards. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator. criminal case files. Able to work both within a team and be self- motivated. At the Willows, six out of 19 patients risk assessments had not been updated.