There were appropriate lone working procedures in place. Staff moved acute patients to the rehabilitation wards when acute beds could not be located. We found a high number of concerns not addressed from the previous inspections. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). Staff were described as putting people who used services first and being person-centred. Staff treated patients with kindness, dignity, and respect. On Phoenix ward patients were not allowed access to the garden. Supervision and appraisal compliance of three teams fell below 75%. o We do what we say we are going to do. 78% of staff had completed their annual appraisal. As part of each inspection, we look at the way health services provide care and treatment to people. Inspectors from the Care Quality Commission (CQC) visited five services run by Leicestershire Partnership NHS Trust (LPT) in November and December last year. We saw evidence of multidisciplinary working, with staff, teams and services at this trust and external organisations working in partnership to deliver effective care and treatment. There was an unstructured, non-mandatory approach to formal end of life training for community hospital staff. The lack of psychology was an issue highlighted at our 2018 inspection. Managers used a tool to identify and review staff numbers in accordance with need. Managers had a recruitment plan in place to increase the number of substantive staff for the service. Patients were supported to meet their religious and cultural needs. This area of our site lists our partner organisations. Some key outcomes for children, young people and families using the service were regularly below expectations. There was an on-call rota system for access to a psychiatrist 24 hours a day. This did not demonstrate a consistent temperature, had been maintained to assure the safety and efficacy of the medicines. 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. We did not inspect the whole core service. Carers told us they had regular contact with the CRHT team and they were kept involved with their loved ones care. Safeguarding was a high priority with regular safeguarding reviews within each area of speciality and established systems for supporting staff dealing with distressing situations. At least one standard in this area was not being met when we inspected the service and Wards provided safe environments where patients felt secure. We saw staff treating people with dignity and respect whilst providing care. Apply. Following the appointment of a new chief executive a new trust board was formed. Staff were given feedback after incidents had been reported. The summary of this service appears in the overall summary of this report. Patients were happy with the care they received and were very complimentary about the staff who cared for them. Urgent and emergency care services across England have been and continue to be under sustained pressure. Published The trust had not ensured all staff had received training in immediate life support. We did not inspect the following areas of this core service: We did not rate this service at this inspection. We work in partnership with a range of NHS organisations, local government and other bodies and are ultimately accountable to the secretary of state for health. Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so patients were safe. Watch our short film to find out more: We Are LPT Share From a National Health Service (NHS) organisation Watch on Our strategy 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. In the dormitories, observation mirrors were situated so that staff could observe patients without having to disturb them. It was clear to see the difference the investment and improvements had made since our last visit. A childrens adolescent mental health crisis service had been developed and commenced in April 2017. Staff expressed pride in their ability to work as a team and managers told us they were proud of achievements. The service was not effective. Staff knew how to report any incidents on the trusts electronic reporting system and could raise concerns for the trust risk registers. There were inconsistent practice around conducting searches onpatients. There was a mobile phone in the ward office that patients could use for private calls, for example to a solicitor. The service did not have a system in place to monitor the number of lighters each ward held. This had been identified during the last Care Quality Commission inspection in 2015. The paperwork was difficult to find and not consistent. Staff usually met patients in their homes or in the community. Bed occupancy rates were above 85% for community health inpatient wards. For example, issues found in risk assessments, care plans and environmental concerns had been addressed in some services, but not all since our last inspection. We saw that Advanced Nurse Practitioners were completing Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) forms having completed their training to do so; however we saw that these forms were not countersigned by a doctor or consultant. The trust reported a 10% increase in the number of referrals received into the CAMHS service. Other professionals within the trust could not access this system. Staff completed care plans for patients. Through effective workforce planning we will nurture and support our staff to progress and flourish, offer them opportunities to deliver care through new models and in new roles. The acute mental health wards had two and four bedded dormitories which did not promote privacy and dignity. Staff in four of the five services we inspected did not document patient involvement in their care. One patient on Watermead ward told us that a staff member had ignored them when they had asked them for a sandwich. Save job - Click to add the job to your shortlist. Staff described various ways in which they received information from the board and other governance meetings. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. 87 of the total patients had been waiting over a year to begin treatment. There was evidence of leadership at local and senior level. Staff received supervisions and appraisal. There was good physical health care and good therapeutic treatment and activities. Some seclusion rooms had environmental concerns at Belvoir and Griffinunits, and Watermead wards. Mobility and healthcare equipment took up space in The Gillivers and 3Rubicon Close. At our last inspection we raised concerns that an insufficient number of nursing staff in community health services for adults had received appropriate statutory and mandatory training. Restraint was used only as a last resort. In addition to this, risk assessments were comprehensive and reviewed as per the trust policy, six monthly or after risk incidents. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. Jan 4. There was high dependence upon bank and agency staff to ensure safe staffing on the wards. The trust had significantlyreduced waiting times and the total numbersof children and young people waiting for assessments. Governance structures were in place and risks registers were reviewed regularly. It's a mission driven by our core values, and one that we try to achieve as a local provider, funder, and advocate. Patients and carers were involved in assessment, treatment and care planning. However, delay in paperwork completion was also responsible for a large proportion of delayed discharges. There were clear responsibilities, roles and systems of accountability to support good governance and management. 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. For services we haven't rated we use ticks and crosses to show whether we've asked them to take further action or taken enforcement action against them. The service was not well led. We had serious concerns about the trusts oversight of ward environments and safety of patients within those areas. Staff were caring and committed to providing high quality care and showed a person-centred approach. Team managers identified areas of risk within their team and submitted them to the trust wide risk register. Records were stored securely and well managed by staff to ensure that sensitive information about patients was protected. Interpreters were used when working with people who did not have English as a first language. Staff received Mental Capacity Act 2005 and Deprivation of Liberty Safeguards Some staff did not demonstrate a good understanding of the Mental Capacity Act. Improvements were needed to make them safer, including reducing ligatures, improving lines of sight and ensuring the safety and dignity of patients. ALT. Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. Click on the coloured text links below to visit any of the listed organisations' websites: People felt they had benefited from the service and told us how caring staff were. ", Daxa Mangia, Mental Health Nurse, The Willows, "I really enjoy my job, helping people to recover - I cannot imagine doing anything else.". The needs of people who used the service were assessed and care was delivered in line with their individual care plans. Curtains were missing from bed spaces and staff did not wait for an answer from patients before entering rooms on acute wards. We heard many examples of interesting innovation projects and work that staff groups had done which impacted on and improved patient care. Multi-disciplinary team meetings took place on a regular basis. 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. Patients were offered smoking cessation treatments, nicotine replacement therapy (NRT), or free vapes. Your information helps us decide when, where and what to inspect. We're always looking for the best. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. Two external governance reviews had been commissioned and undertaken. Patients families and carers were positive about the care provided. Staff documented seclusion well in most services, compared to our last inspection. We use cookies to improve your experience on our website. On Kirby ward there was no evidence of Section 132 rights read on detention in 54% of records reviewed. Since the last inspection the service now had a Section 136 suite that met the standards set out in the Royal College Standards. The trust confirmed community hospital staff were expected to undertake four clinical supervision sessions across the year. There were insufficient systems in place to monitor prescriptions. The most common reason for delayed discharges was due to family choices which were beyond the control of the trust. Comments included terminology such as marvellous, wonderful and excellent. We saw patients were treated with kindness and compassion. Staff were suitably trained with the relevant knowledge and skills to carry out their work, had regular appraisals and had access to the information they needed to perform their duties. As one of the largest registered investment advisors in the U.S., we offer a broad range of services to institutional clients, including corporate and higher-education retirement plans, foundations and endowments, and religious organizations. Staff told us they enjoyed working at the trust and thought they all worked well as a team. The waiting times in community based mental health services for adults of working age were long and breached targets. This meant patients had been placed outside of the trusts area. Staff were up to date with mandatory training and had regular supervision and appraisals. The medical and senior leadership provision within the looked after children service did not meet the professional requirements outlined in the intercollegiate document for this provision. We saw numerous interactions between staff and patients with very complex needs and staff managed extremely challenging situations with knowledge and compassion. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. Staff were passionate about their roles and enjoyed working with the client group. On Ashby ward, the shower rooms did not have curtains fitted. Staff morale in some teams was low, with high levels of stress. Clinical supervision rates were low. Staff did not consistently promote dignity and respect as expected in all services. Leicestershire Partnership NHS Trust Location Leicester Salary 27,055 to 32,934 a year Closing date 2 Feb 2023. We did not rate this inspection. This was a focused inspection. Staff felt respected, supported and valued and we heard how well the trust supported staff during the COVID-19 pandemic. Following the national withdrawal of the Liverpool Care Pathway the trust has developed an alternative care plan; however this has not yet been implemented. The needs and preferences of patients and their relatives were central to the planning and delivery of care with most people achieving their preferred place of care. Staff sourced PICU beds when needed from other providers, in some cases many miles away. At times, there were insufficient qualified nurses on shift. Care plans did not always reflect a person centred approach and people who used services and their carers were not routinely involved in CPA reviews. We are looking at different ways to indicate the outcomes of our monitoring in the future. There were no pharmacy services within the community mental health teams or crisis team. 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 minimal evidence of patient involvement in care plans. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. Care plans and risk assessments did not show staff how to support patients. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. The trust provided newsletters, quarterly serious incidence bulletins, regular emails from matrons about incidences and lesson learnt. Make a difference with a career at LPT. Staff we spoke with demonstrated their dedication to providing high quality patient care. NG3 6AA, In They showed a good understanding of peoples individual needs. 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 service is performing exceptionally well. We listen to our patients and to our colleagues, we always treat them with dignity and we respect their views and opinions, We are always polite, honest and friendly, We are here to help and we make sure that our patients and colleagues feel valued, When we talk to patients and their relatives we are clear about what is happening. We found serious concerns with medication disposal, storage, labelling and management of controlled drugs. Two patients and a carer gave feedback indicating the systems were not always robust. For example relating to assessment of ligature points at Westcotes. Multi-disciplinary teams and inter agency working were effective in supporting patients. Apply. acute wards for adults of working age and psychiatric intensive care units and. The room used to administer medication on Arran ward at Stewart House was not appropriate; the room was a bedroom and still had a toilet in. There was highly visible, approachable and supportive leadership. Support workers were being trained in phlebotomy to improve timely blood testing. Effective multi-disciplinary team working and joint working did not always take place across services. Some care plans had not been updated and physical healthcare checks were not routinely documented in young peoples notes. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. Staff empathised where a person had a negative experience and offered support where necessary. The trust had made improvements to the clinical environments since the last CQC inspection. By: Miraj Vaghadia | Tags: A project to improve patient care by making best use of capacity across Leicestershire Partnership NHS Trust (LPT) District Nursing teams has been shortlisted for the prestigious Nursing Times Awards. There was evidence of actions taken to improve the quality of the service. There were issues within the trust of a bullying culture despite evidence that staff knew the trust values. The HBPoS did not have designated staff provided by the trust. Medication management across four of the five services we inspected was poor, despite reported trust oversight and audit. Staff showed caring attitudes towards their patients. However, Griffin did not. We rated the caring domain for the community health families, young people and children service as outstanding due to staff approaches to family and patient care utilising or creating tools to assist children to understand their condition or prepare for treatment. Across the teams, we found up to date ligature audits in place. Records about the use of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) were inconsistent. Capacity assessments were not decision specific. Staff did not always have time to attend clinical supervision sessions and patient information systems were inconsistently utilised and did not always enable effective working. Bed occupancy for the last two quarters of 2013/14 was around 89%. Assessments and care planning took place for patients needs. However three staff said that information from incidents and learning points was not always fully shared. Staff felt supported by their immediate managers but felt disaffected with trust senior management. Leicestershire Partnership NHS Trust (LPT) provides a range of community health, mental health and learning disability services for people of all ages. Some risk assessments had not been reviewed regularly at The Grange. The trust had made some improvements in response to the previous CQC inspection undertaken in March 2015.This included removing some ligature anchor points in the acute mental health wards. The trust had a limited approach to patient involvement. Staff had received specialist child safeguarding training and were able to make referrals when appropriate. Staff were not aware of how this might affect the safety and rights of the patients. They did not have alarms or vision panels in the door. We had concerns about how environmental risks at CAMHS community sites were being assessed and managed. When we talk to colleagues we are clear about what is expected. This was: We also assessed if the organisation is well-led and looked at areas of governance, culture, leadership capability and improvement. Staff were confused about Deprivation of Liberty standards and paperwork was incomplete. This meant that patients were not protected from receiving unsafe treatment. The trust had reviewed existing systems and processes identified improvements and implemented changes. We carry out joint inspections with Ofsted. Six staff expressed concerns about the proposed move and some said the trust had not communicated information to staff effectively. We looked at how the adult liaison psychiatry service affected patient flow, admissions to hospital and discharges from the Leicester Royal Infirmary hospital as part of the system wide healthcare. the service is performing well and meeting our expectations. 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. Adult community health patients did not always have timely access to routine appointments. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. Engagement and joint planning between departments was well developed. Each priority within our approach is being led by an executive team member and progress is being monitored through our quality governance framework. 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. Not all patients on acute wards for adults of working age could summon help from staff if required. The trust had developed checklists to assist staff with the receipt and scrutiny process. If we cannot do something, we will explain why. However, managers had identified funding for two agency nurses to start work the week following the inspection. The trust had a patient involvement centre, which was pleasant, well-equipped and supported involvement from friends and family. Leicestershire Partnership NHS Trust This is an organisation that runs the health and social care services we inspect Overall: Requires improvement Services have been transferred to this provider from another provider Services have been transferred to this provider from another provider All Inspections 12 April 2022 Staff told us they worked as a team and enjoyed their jobs. People we spoke with said they had received a good service. Cover arrangements for sickness, leave and vacant posts were in place. Patients could approach staff at night to request them. We observed some very positive examples of staff providing emotional support to people. Staff had a good knowledge of safeguarding and incident reporting. Staff felt they had good local leadership and felt the governance was better with the introduction of a service line. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. The trust used key performance indicators/dashboards to gauge the performance of the team. Ward teams did not hold regular team meetings. Senior leaders in core services we inspected, had not maintained oversight of improvement across all wards of their services. 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. The trust had not fully addressed the issues of poor lines of sight in wards. Staff had been trained with regards to duty of candour and in line with the trust policy. We inspected three mental health inpatient services because of the ratings from the previous inspection. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. Care and treatment was mostly planned and delivered in line with current evidence. The Step up to Great strategy identified key priority areas of focus which were linked to the trusts vision. Patients were full of praise for staff and the care and support they offered. Research in Families, Young People and Childrens Services, and Learning Disability Services, Research Office and Research Delivery Team, Patient Advice and Liaison Service (PALS), Supporting serving and ex-service personnel, Contact the Equality, Diversity & Inclusion Team, Useful guides for staff to help raise awareness of Dyslexia and Autism. The adult psychiatric liaison service provides assessment and treatment for adults between the ages of 16 to 65, who experience mental health problems in the context of physical illness. At the Valentine Centre improvements had been made to the storage of cleaning materials. 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. There is a vacancy for a Non-executive Director at Leicestershire Partnership NHS Trust (LPT). The trust had well-developed audits in place to monitor the quality of the service. The acute wards for adults of working age had not complied with all of the required actions following the previous inspection of September 2013. Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. The offer is for 250 to be paid through payroll and subject to tax and National Insurance and is non pensionable. Staff were visible in the communal ward areas and attentive to the needs of the patients they cared for. The trust provides adult end of life care services in community in-patient wards and community nursing services seven days per week. We want to hear from you on how to improve our service and provide the best care possible. The trust had launched its "Step up to Great" approach, which identified the vision and priorities for the year. Staff told us the trust was a good place to work. Leicester; 33,706 to 40,588 a year (pro rata) Leicestershire Partnership NHS Trust; We are looking for a Bank Band 6 Speech and Language Therapist to join our innovative, friendly and well supported team working with children and y. Capacity assessments were unclear. When staff raised concerns or ideas for improvement, they felt they were not always taken seriously. Patients reported they were treated with dignity and respect. The service employed care navigators to help families and carers negotiate their journey through the various services provided. Managers ensured they monitored the reporting and recording of incidents and complaints. Oct 2015 - Apr 20193 years 7 months. The service did not have any out of area placements, readmissions or delayed discharges. We saw an example of an SI investigation and also action taken from lessons learnt. 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 updated risk assessments and individualised care plans regularly. The service is not appropriately commissioned to provide sufficient school nurses to meet the standard service recommendations of one nurse per secondary school and its associated primary schools. We did not identify any significant community wide areas for improvement but did find many exemplary services provided by the trust. The nurses we spoke with had specialist interests, including mindfulness and dementia. The dignity and privacy of patients across three services we visited was compromised. 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.
Mike Ness House Santa Ana Address,
Equestrian Yard To Rent Nottinghamshire,
City Sauna Rota Maria,
Articles L
leicestershire partnership nhs trust values