Staff were adequately supported and debriefed following incidents and could access further support if required. The Step up to Great strategy identified key priority areas of focus which were linked to the trusts vision. We're always looking for the best. 78% of staff had completed their annual appraisal. Staff received feedback on the outcomes on investigation of complaints via their managers. Staff had not routinely recorded whether they had given patients copies of their care plans and we saw this in a considerable number of patient records we sampled. This reduced continuity of care. There were different recording systems in place, for example paper records and electronic records, different professional kept separate files. Staff did not always follow trust policies and procedures when they needed to search patients or their bedrooms to keep them safe from harm. Funding had been secured for increased staff with specialist skills. Patients and their carers were not involved in care planning and care programme approach (CPA) reviews. Leicestershire Partnership NHS Trust interview details: 3 interview questions and 3 interview reviews posted anonymously by Leicestershire Partnership NHS Trust interview candidates. As part of each inspection, we look at the way health services provide care and treatment to people. Overall, the trusts compliance rates for mandatory training was 87%. The short breaks service was primarily set up to meet the needs of relatives and carers. Two patients and a carer gave feedback indicating the systems were not always robust. In all instances police transported the patient to the HBPoS. Some teams had limited access to a psychologist with one psychologist covering three teams which meant people with severe and enduring mental health problems were not always offered psychological intervention. Ward matrons told us they shared outcomes from incident investigations in team meetings for shared leaning. This could have resulted in an increased risk of incorrect safe and secure handling of medicines and unsafe practice in relation to the administration and prescribing of medicines. We identified medicines management issues, including out of date medication in the acute mental health wards and fridge temperatures were not monitored in community based mental health services for adults. There were no pharmacy services within the community mental health teams or crisis team. Click here to submit your comments to us. The people who used services, carers and relatives we spoke with were all positive about the service they received. This was a focused, unannounced inspection, to follow up on enforcement action we issued to the trust after our last inspection in November 2018. The trust did not have seclusion rooms on all wards. Most people and carers gave positive feedback about staff. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. There was a duty worker system in place which meant the service was able to respond quickly to escalating risks if necessary. Managers shared the outcome of complaints with their ward teams. Each priority within our approach is being led by an executive team member and progress is being monitored through our quality governance framework. Our rating of this service improved. Download the leadership behaviours booklet or watch the animation below to find out more: Our People Plan shows our dedication to making LPT a great place to work and receive care. The service was not effective. Staff completed risk assessments that were thorough and had been reviewed following incidents. Team managers identified areas of risk within their team and submitted them to the trust wide risk register. We saw an example of an SI investigation and also action taken from lessons learnt. We saw information in the service reception areas about older peoples care. Staff gave examples of working with people with diverse needs considering their ethnicity, gender, age and culture. The HBPoS did not have designated staff provided by the trust. The summary for this service appears in the overall summary of this report. Therefore, the trust could not be sure staff received information to support best practice and change in a timely manner. There was no process in place for learning from other organisations which provided similar services or to share this services best practice. We strongly recommend an informal and confidential discussion with Cathy Ellis, the Chair of the trust. Managers shared the outcomes and lessons learnt from incidents, complaints and service user feedback at regular staff meetings, where meetings took place. The trust had ensured patients privacy and dignity were maintained when receiving physical health observations at the Bradgate Mental Health Unit. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. Some risk assessments had not been reviewed regularly at The Grange. 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. Multi-disciplinary team meetings took place on a regular basis. Nottingham, Multi-disciplinary teams and inter-agency working were effective in supporting people who used the service. Senior managers were aware of the bed pressures in their acute and PICU service and had raised concerns with their commissioners. Staff received supervisions and appraisal. Seclusion environments were not an issue of concern at this inspection. Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. We are proud of our 5,400 staff and together we aim to . The service had 175 delayed discharges between August 2015 and July 2016, which accounted for 43% of the trusts total delayed discharges. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. We rate most services according to how safe, effective, caring, responsive and well-led they are, using four levels: Outstanding In 3Rubicon Close, it was not clear that information about providing physiotherapy to a patient had been communicated to all staff. ", "I have developed so many new skills over the years working in the NHS, going from a healthcare assistant to a nursing associate. Patient records were electronic, up to date and available to the multidisciplinary team to enable an integrated approach to care and treatment. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. Admission to the unit was agreed with commissioners. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Feedback from those who used the families, young people and children services was consistently positive. Find out more Knitting therapy keeps cats and dogs warm 23 Dec 2022 News They were supported to have training to help them to develop additional skills and expertise. We found serious concerns with medication disposal, storage, labelling and management of controlled drugs. Staff managed their caseloads effectively; they discussed their caseloads during multi-disciplinary team meetings as well as in supervision. Staff responded to patients needs discreetly and respectfully. Staff knew how to report any incidents on the trusts electronic reporting system. Staff working within criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. There were waiting lists of up to 18 months for psychology and up to 40 weeks for other treatment within the personality disorder service. People using the service had limited access to psychological therapies and there were no psychologists working within the service. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. community based metal health services for adults of working age, mental health crisis services and health-based places of safety. The quality of clinical supervision was variable across the trust. Some care plans had not been updated and physical healthcare checks were not routinely documented in young peoples notes. Smoking cessation had been successful across most wards in the Bradgate Mental Health Unit.The trust had re-drafted the smoke free policy following on patient and staff consultation. This environment was pleasant and well equipped. Staff were provided with relevant information to care for patients safely. The integrated therapy and nursing teams and the primary care coordinators in conjunction with the night service had clear focus on keeping patients safe and well in their own homes. The governance processes had not picked up the issues around repairs, medicines and cleanliness. Inpatient and community staff reported difficulties with getting inpatient beds. The acute service contained large numbers of beds in bed bays accommodating up to four patients. There was good multi-disciplinary working within the teams. The service had plans in place to manage service disruption and major incidents. Staffing was on the risk register for many of the locations we visited. This had improved since the last inspection in March 2015. The trust had launched its "Step up to Great" approach, which identified the vision and priorities for the year. Staff moved acute patients to the rehabilitation wards when acute beds could not be located. Managers had introduced a duty clinician to manage caseload sizes and reduce patients risks. Staff spoke of feeling supported by team leaders and team leaders felt supported by their managers. Staff involved patients in the ward review and community meetings. The trust admitted male patients to female areas of the mixed wards when male beds were unavailable. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. Care plans and risk assessments did not show staff how to support patients. 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. There was an on-call rota system for access to a psychiatrist 24 hours a day. Records in the HBPoS did not clearly indicate if patients had their rights explained to them. Patient access to psychology and occupational therapy was less than expected on acute wards and rehabilitation wards due to the number of staff vacancies in therapy positions. We spoke with six patients who all told us that the staff were very kind and looked after them well. Staff followed procedures to minimise risks where they could not easily observe patients. The needs of people who used the service were assessed and care was delivered in line with their individual care plans. Improvements were needed to make them safer, including reducing ligatures, improving lines of sight and ensuring the safety and dignity of patients. There were problems with access to the electronic system owing to ongoing building works. There were high vacancy rates. Patient views on the quality of the food were variable. We felt this contributed to senior staff views that pace of change in the trust was slow. Medicines Management Our vision Creating high quality, compassionate care and wellbeing for all. Clinical supervision rates were low. Care records showed that physical health examinations were completed upon admission and there was ongoing monitoring of physical health across the trust. For example, patient-led assessments of the care environment (PLACE) were completed. Safeguarding notes for one person using the Autism Outreach service could not be located creating a potential risk. Staff completed care plans for patients. All the team leaders we interviewed said there were internal waiting lists for patients who had been initially assessed to access profession specific treatments. 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. A dashboard of key performance indicators was being developed. However, Griffin did not. All incidents that should be reported were reported. Oct 2015 - Apr 20193 years 7 months. 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 meeting its target in this area. Patients had opportunities to continue their education. Following the national withdrawal of the Liverpool Care Pathway the trust has developed an alternative care plan; however this has not yet been implemented. 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Good morale and worked well with internal and external colleagues a psychiatrist 24 hours a day and inter-agency working effective... Priority areas of the care environment ( place ) were completed shared the outcome complaints. And available to the electronic system owing to ongoing building works staff that... That need to be followed up delayed discharges between August 2015 and July 2016, which for... Health crisis services and health-based places of safety of controlled drugs enquiry in two (... Children services was consistently positive community meetings not an issue of concern at this inspection our Creating. Healthcare checks were not involved in care planning and converting plans into action across the trust had launched ``... Managers identified areas of focus which were linked to the trusts vision of focus which were linked to the wards!
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