There was a strong, person-centred culture. Some patients had to be admitted to adult wards in the last year. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. Patients needs were assessed and monitored individually. We are proud of our 5,400 staff and together we aim to . Leicestershire Partnership NHS Trust Is this your company? Staff did not routinely complete detailed, person centred, individualised or holistic care plans about or with patients. There had been several serious incidents (SI) within this service in the last year and it was not clear that learning from investigations and actions consistently took place to prevent recurrence. Our judgement is based on a combination of what we found when we inspected, information from our Intelligent Monitoring system, and information given to us from people who use services, the public and other organisations. Published . There were different recording systems in place, for example paper records and electronic records, different professional kept separate files. The trust also collected feedback from patients in a variety of ways, including surveys, iPads, community forum meetings and the Friends and Family Test. The senior occupational therapist was trying to recruit to vacant occupational therapy posts. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. Nursing staff had large caseloads. Thy are entitled to receive a remuneration of 13,000 per annum each and have . The service did not exclude patients who would have benefitted from care. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Despite the issues we found with storage, disposal, labelling and controlled drugs, the trust had made improvements to prescribing of medication and had successfully implemented e-prescribing processes trust wide. They did not have alarms or vision panels in the door. Wards did not have a list of stock items. However, 323 were waiting for their first appointment through the access team, to complete a core mental health assessment. Derby, We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. Staff completed Mental Health Act 1983 (MHA) paperwork correctly and systems were in place for secure storage of legal paperwork, advice and regular audits. Managers did not successfully cascade information down to all ward staff in acute mental health services. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. Care records were up to date and holistic. Ligature risks had been identified in bedrooms, bathrooms and toilets but there was no clear action to address all of the identifed risks, The seclusion rooms had known blind spots but no action had been taken to reduce them. 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. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. The trust had systems for promoting, monitoring and responding to complaints. There were problems with access to the electronic system owing to ongoing building works. We had concerns about the environment but noted the service was due to move locations within two weeks. Staffing numbers were met but not always the right skill mix. That's what building health equity means to us. At this inspection the well-led provider rating improved from inadequate to requires improvement. Plans were shared with family and carers. The trust confirmed community hospital staff were expected to undertake four clinical supervision sessions across the year. This was a breach of the patients privacy and dignity to patients as staff might be required to enter the shower rooms to check patients were safe. Risks to people who used the service and staff were assessed and managed. The trust had begun the process of replacing some beds with more suitable options for the patient group. Three patients told us of times when staff had been rude, threatening and disrespectful towards them. The dignity and privacy of patients across three services we visited was compromised. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. Specialist community mental health services for children and young people. This was a focused inspection. Some actions were required to ensure adherence with the Mental Health Act. The health-based place of safety did not meet some aspects of the guidance of the Royal College of Psychiatrists. Staff morale appeared low. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. Inpatient and community staff reported difficulties with getting inpatient beds. Staff were not always recording their supervision on the electronic system so we could not be assured they were receiving it regularly. There was access to interpreters and staff were aware of how to access them. We rated all three mental health services inspected as requires improvement overall. Staff managed their caseloads effectively; they discussed their caseloads during multi-disciplinary team meetings as well as in supervision. Staff followed infection control practices and maintained equipment through regular servicing. Where patients did not access multimedia, families and carers said there was less communication with the service. Waiting times and lists remained of concern, and this had been identified in the previous inspection. Staff mostly felt positive about their managers and said that the services provided were well-led. Patients and carers knew how to complain and complaints were investigated and lessons identified. We are proud of our 5,400 staff and together we aim to . 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. 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 The nurses we spoke with had specialist interests, including mindfulness and dementia. Patients we spoke with knew how to complain. We don't rate every type of service. All wards had developed their own systems to improve medicines management in their areas. Staff felt supported by their managers and received regular supervision and annual appraisals. Staff received feedback on the outcomes on investigation of complaints via their managers. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. When we talk to colleagues we are clear about what is expected. 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. Staff did not always feel actively engaged or empowered. Staff sourced PICU beds when needed from other providers, in some cases many miles away. The service did not have a system in place to monitor the number of lighters each ward held. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. Apply. 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. The service employed care navigators to help families and carers negotiate their journey through the various services provided. Care and treatment was mostly planned and delivered in line with current evidence. Some wards and community teams did not store or manage medicines safely. The trust had a range of information displayed on the ward and the hospital site relating to activities, treatment, safeguarding, patients rights and complaint information. Mental health crisis services and health-based places of safety had an overall mandatory training compliance rate of 82%. 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. Staff treated patients with kindness, compassion and respect.We saw staff spend time talking to and their carers. Staff knew and understood their role in compliance with the Mental Health Act and Mental Capacity Act. Six staff expressed concerns about the proposed move and some said the trust had not communicated information to staff effectively. Trust staff working within the had remote access to electronic systems used by the trust. There had been several serious incidents (SI) within this service in the last year. Apply. They could undertake both internal and external training and were able to give feedback on service development. Managers identified the breach in these targets and had plans in place to reduce them and had highlighted this risk on the risk register. We inspected three mental health inpatient services because of the ratings from the previous inspection. People that were referred to the service were waiting for a care co-ordinator to be allocated. The service used a computer record system that differed from the rest of the trust. Wards had high numbers of hydraulic style patient beds that were a risk to patients with histories of self-harming behaviour. On rehabilitation wards, staff did not care plan the needs of a patient with protected characteristics. Staff demonstrated a respectful manner when working with patients, carers, within teams and showed kindness in their interactions. Care plans were not always holistic and person centred. Staff had not managed all risks to patients in services. Patient involvement in planning care was now in place and the voice of the patient in changes to services had been considered. Services had supplies of emergency medication available and this was accessible to staff. At this inspection we found compliance levels with this type of training were still below the trusts target. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. The waiting areas and interview rooms where patients were seen were clean and well maintained. Staff received training in safeguarding and knew how to report when needed. Services and care were planned with the local population in mind and to address the individual needs of patients. We recommend using one of the following browsers: Chrome, Firefox, Edge, Safari. Information on the trusts vision and values was available at the site and staff appraisals were linked to them. There was regular and effective multidisciplinary working. Patients and carers confirmed in most services they had not received copies of care plans. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. Clinic rooms were overstocked with medications. Staff demonstrated poor understanding of some aspects of the Mental Capacity Act. The quality of data was variable, for example training statistics were not always reliable. However, staff did not consistently record patients views in their care plan or ensure they had received a copy. the service is performing badly and we've taken enforcement action against the provider of the service. The trusts pace for implementing equality and diversity initiatives across the organisation needed improvement. There were inconsistent practice around conducting searches onpatients. They remained positive when engaging patients in meaningful activities. New systems were in place for staff to report any repairs or maintenance issues. We found concerns with the environment in all five core services we inspected. Safeguarding notes for one person using the Autism Outreach service could not be located creating a potential risk. Services had complied with guidance on eliminating mixed sex accommodation. Clinical audit was taking place and learning was shared across the service. These reports were presented in an accessible format. Patients own controlled drugs were not always managed and destroyed appropriately. Patients using the CRHT team had limited access to psychological therapies and there were no psychologists working within the CRHT team. Supervision, appraisals and training compliance did not always meet the trust standard. Bed occupancy for the last two quarters of 2013/14 was around 89%. The ward had sufficient staff to provide care and treatment to patients. We rated it as requires improvement because: Our rating of the trust stayed the same. It is about making a real and sustainable difference for our patients and supporting our staff to deliver safe, high quality care every day. On one ward, female shower rooms did not contain shower curtains. 30 April 2018. Staff completed detailed individualised risk assessments for patients on admission and updated these regularly and after incidents. Since the last inspection the service now had a Section 136 suite that met the standards set out in the Royal College Standards. This does not comply with the guidance from the Royal College of Psychiatrists. There was an effective duty system in place to provide rapid access to support. The Health Trust HIV/AIDS Services program delivers groceries to homebound seniors and adults throughout Santa Clara County. 78% of staff had completed their annual appraisal. Improvements were noted in some wards in core services but not all. There was minimal evidence of patient involvement in care plans. We noted how much time the new executive team had invested in making and implementing improvements during the COVID-19 pandemic. The trust had developed checklists to assist staff with the receipt and scrutiny process. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. 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