The trust ceased mixed sex breaches by maintaining male and female only weeks. We noted how much time the new executive team had invested in making and implementing improvements during the COVID-19 pandemic. Staff told us they felt happy and enjoyed their work. There could be risks posed by the use of different recording systems across teams as staff may not all have access to all records. Staff told us they enjoyed working at the trust and thought they all worked well as a team. 29 October 2021. The HBPoS did not have designated staff provided by the trust. Patients were involved in the writing of their care plans and their views were reflected in the plans. Patients were not always involved in the planning of their care. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. The trust had a major incident policy to deal with any major incidents or breakdown in service provisions. Managers ensure that they acted on these findings to reduce the risk of reoccurrence. 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. 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. Staff completed risk assessments that were thorough and had been reviewed following incidents. The service was not effective. The matron opened some vault windows via a remote. If this service has not had a CQC inspection since it registered with us, our judgement may be based on our assessment of declarations and evidence supplied by the service. We saw patients were treated with kindness and compassion. Curtains separated patients bed areas and the rooms were not secured to allow free access; meaning that patients could have their property removed by other patients. This reduced continuity of care. We looked at the domains of safe, effective and responsive and we did not inspect all of the key lines of enquiry. Our HIV/AIDS Services program is in need of volunteers to help deliver . For example, Ashby, Aston, Bosworth and Thornton Wards had been converted to single sex only accommodation to ensure compliance with the Department of Health and Mental Health Act 1983 guidance on mixed sex accommodation. Medication management systems were in place and followed to ensure that medicines were stored safely. We saw numerous interactions between staff and patients with very complex needs and staff managed extremely challenging situations with knowledge and compassion. The waiting times in community based mental health services for adults of working age were long and breached targets. Team meetings were not regular, or didn't take place.The sharing of lessons learnt remained inconsistent across some wards. In two services, staff were not always caring towards patients. Patients had opportunities to continue their education. Staff said the system was difficult to use and this had affected the information recorded in patients notes. 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. View more Profession Nurse Service Child & Adolescent / CAMHS Grade Band 5 Contract Type Permanent Hours Full Time. Care plans were not always holistic and person centred. Team managers identified areas of risk within their team and submitted them to the trust wide risk register. The trusts Board Assurance Framework (BAF) was lengthy, was combined with a corporate risk register and had overdue actions. Notes reflected caring and compassionate view of patients. The ward had an up to date ligature risk audit, staff mitigated the risks on the ward by observing patients. Some staff found there was insufficient time to complete their visits within the working day. Overall, patients were positive about the care they received and had access to advocacy services on all wards. There were not always enough staff who were suitably qualified and experienced to safely meet patients needs. They were supported to have training to help them to develop additional skills and expertise. We rated community based mental health services for adults of working age as requires improvement because: Access to the service was delayed due to variable caseloads and waiting times. There was no funding for staff to provide activities so patients had limited access to activities of their choice during their stay. Record keeping was poor in some services. Services have been transferred to this provider from another provider, Mental health crisis services and health-based places of safety, an inspection looking at part of the service. egistered general nurses with dedicated time to focus on individual healthcare plans at Stewart House and The Willows. We talk to patients, the public and colleagues about what matters most to them and we do not assume that we know best. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. They were reflected in the objectives of local teams. Staff showed us that they wanted to provide high quality care, despite the challenges of staffing levels and some poor ward environments. Some families carers said that the meals were unhealthy. We rated Community health services for adults as good because: We gave an overall rating for community based mental health teams for adults of working age as good because: We rated the community mental health services for children and adolescents overall as requires improvement because: Overall rating for this core service Requires improvement l. We rated community inpatient services as requires improvement because: Overall rating for this core service Requires Improvement l. We rated this core service as requires improvement because: We rated this core service as good because: We rated wards for people with learning disabilities and autism as requires improvement because: Leicestershire Partnership NHS Trust (February 2016) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (June 2015) for - PDF - (opens in new window), Leicestershire Partnership NHS Trust (November 2014) for - PDF - (opens in new window), Leicestershire: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Leicester City: Children's Services Inspections Reports (2012) for - PDF - (opens in new window), Rutland: Children's Services Inspections Reports (2011) for - PDF - (opens in new window). Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. Some records were over more than one database/system which could make locating information a problem. Detention paperwork for those detained under the Mental Health Act was detailed and followed procedures. For over 20 years we've ensured that health related grants, policies, and services exist to help give everyone the opportunity to be healthy - especially the most vulnerable. There was no performance data dashboard to gauge the performance of the service. There was an unstructured, non-mandatory approach to formal end of life training for community hospital staff. Staff kept risk assessments up to date and carried out comprehensive assessments which were holistic and recovery focused. Staff involved patients in the ward review and community meetings. Staff had set clear guidelines on where and how physical health observationswere completed on wards. Staff followed infection and prevention control practices and the community inpatient wards were visibly clean. The ratings from the inspection which took place in November 2018 remain the same. They were constantly looking at ways to improve their work and the patient experience of the service. 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. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. Patients were not always safeguarded. Leadership had been strengthened at Stewart House. Incidents were on the agenda at the clinical governance meetings. Patients were supported to meet their religious and cultural needs. Records in the HBPoS did not clearly indicate if patients had their rights explained to them. However, we saw evidence this was not always achieved. There were no records of capacity being assessed for patients consent to treatment, and no clear evidence of best interests decisions being agreed. Governance processes had improved since our last inspection and operated effectively at trust level to ensure that performance and risk were managed well. In the same service, managers did not always review incidents in a timely way. Care and treatment was mostly planned and delivered in line with current evidence. The HBPoS had poor visibility for observing patients. We did not inspect the following areas of this core service: We did not rate this service at this inspection. Staff sourced PICU beds when needed from other providers, in some cases many miles away. There had been periods of understaffing. Staff had limited opportunities to receive specialist training. The school nurses used technology to communicate with young people. Managers did not successfully cascade information down to all ward staff in acute mental health services. Some teams told us about a lack of teamwork, best practice was not shared amongst services and regular meetings did not take place in some services. Patient views on the quality of the food were variable. Suspended ratings are being reviewed by us and will be published soon. Patients occasionally attended the service. Staff reported they felt supported by their colleagues and managers. There was no evidence of patient involvement recorded in some of the notes. We will be supporting each other in the delivery of these leadership behaviours so we can all Step up to Great together. The environment in the crisis service did not ensure confidentiality as rooms were not sound proofed and conversations could be heard outside the room. At Melton, Rutland and Harborough, City East and City West CMHTs m. At City West in conjunction with the young onset dementia assessment service staff developed a digital app for younger who were developing dementia. Staff in four of the five services we inspected did not document patient involvement in their care. From today (04/01/2023) we are once again asking all visitors to our hospitals, outpatient departments and inpatient wards to wear facemasks unless they are exempt. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. This was done by sliding signs to the door as needed. Staff were open about their poor understanding around the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. Staff had access to quick guides in their clinical areas to ensure they were aware of how to manage risks. There were significant waiting times for a range of further assessments and treatments including psychology, school observations, psychiatric opinion and group work. However, they were not updated regularly or following an incident. The environmental risks in the health based place of safety identified in our previous inspection remained. When staff raised concerns or ideas for improvement, they felt they were not always taken seriously. Staff completed Mental Health Act 1983 (MHA) paperwork correctly and systems were in place for secure storage of legal paperwork, advice and regular audits. Advanced Directives had been introduced to enable patients to make decisions now about their long term care. Click on the coloured text links below to visit any of the listed organisations' websites: 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. Staff provided psychological therapies as recommended by NICE such as group work and cognitive behavioural therapy. Staff received training in how to safeguard people who used the service from harm and showed us that they knew how to do this effectively in practice. Staff and senior leaders could not articulate the trusts direction of travel and how this was co-ordinated. Some local managers were keeping their own records to ensure performance was monitored. A dual paper and electronic recording system meant that some information was not accessible to all of the staff that might need it. 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. The Health Trust HIV/AIDS Services program delivers groceries to homebound seniors and adults throughout Santa Clara County. To participate in this scheme, you'll need to do the following: You will need to refer your friend using the form below titled "Refer Your Friend." To address this deficit the trust moved patients that required an acute bed to a rehabilitation bed which was not clinically justified or met the needs of the patients. Staff did not record seclusion well. Some managers had access to key performance data and could respond to areas of improvement, but this was not consistent in all aspects of care delivery and across all services. There was good staff morale. Some improvements were seen in seclusion documentation and seclusion environments. Patients were frequently not discharged when ready due to transport problems or difficulties putting care packages in place. Patients and carers knew how to complain and complaints were investigated and lessons identified. Staffing levels were not consistent across the two sites. There was no fridge to keep medicines cool when required. We have four core values: Compassion, Respect, Integrity, Trust. As part of each inspection, we look at the way health services provide care and treatment to people. Ward teams did not hold regular team meetings. This did not protect the privacy and dignity of patients when staff undertook observations. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. The service was recovery focused and had developed pathways with other agencies to build on recovery capital for people who used the service. Staff on the acute wards were not consistent with searching patients upon return from unescorted leave as some patients had managed to take lighters onto four of the wards. However at South Leicestershire clinical supervision take-up was low at 73%. The service did however, complete local audits and produced action plans for improvement in care. 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. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. A childrens adolescent mental health crisis service had been developed and commenced in April 2017. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. In community based mental health teams for older people five of six services breached national targets from referral to assessment. We use cookies to improve your experience on our website. Some wards and patient areas had blind spots, where staff could not easily observe patients. The service did not have any out of area placements, readmissions or delayed discharges. Staff empathised where a person had a negative experience and offered support where necessary. Bed occupancy for the last two quarters of 2013/14 was around 89%. Staffing was on the risk register for many of the locations we visited. Staff interacted with patients in a responsive and respectful manner at all times and showed a good understanding of individual needs. The health-based place of safety did not meet some aspects of the guidance of the Royal College of Psychiatrists. Staff monitored the ongoing condition of any secluded patient. Staff in the community adult mental health teams did not protect patients dignity or privacy. 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 had made significant improvements to develop a strengthened vision and strategy. Staff told us they felt supported by their line managers, ward managers and matrons. We rated the trust as inadequate for well-led overall. Some seclusion rooms had environmental concerns at Belvoir and Griffinunits, and Watermead wards. The trust had maintained patients privacy and dignity at Short Breaks Services. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. 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