leicestershire partnership nhs trust valueslynn borden cause of death

This could pose a risk to patients and staff. Regular team meetings took place and staff told us that they felt supported by colleagues. The teams were able to respond quickly when patients or carers telephoned with problems. The number of visits was not always manageable. In most services, we were concerned with the lack of evidence in care plans which showed patients and carers had been consulted and involved in their care. There was limited time available for staff to attend specialist courses to enhance their knowledge. All three service inspections were unannounced. The HBPoS had poor visibility for observing patients. Nursing staff did not have a stock list to randomly check medication which meant they could not reconciliation check. 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. View more Profession Occupational Therapist Grade Band 5 Contract Type Permanent Hours Full Time. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. Staff described various ways in which they received information from the board and other governance meetings. Leicester, United Kingdom. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. Managers shared the outcome of complaints with their ward teams. Staff reported they felt supported by their colleagues and managers. The trust set target times from referral to initial assessment against the national targets of 28 to 42 days. Caring stayed the same, rated as good. A new leadership structure had been introduced since the last inspection and had not yet fully embedded in the service. The majority of community mental health teams did not meet the referral to initial assessment and assessment to treatment times. Carers told us they had regular contact with the CRHT team and they were kept involved with their loved ones care. wards for people with a learning disability or autism. 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 expressed pride in their ability to work as a team and managers told us they were proud of achievements. The trust had begun the process of replacing some beds with more suitable options for the patient group. In the health based place of safety resuscitation equipment and emergency medication were not available and staff had not calibrated equipment to monitor patients physical health. Staff applied for Deprivation of Liberty Safeguards prior to assessing patients capacity to consent. Clinical supervision was not taking place regularly across the service. Some facilities lacked essential emergency equipment. We found this across core services and within senior teams. Staff treated patients with kindness, dignity, and respect. The wards tried to book regular bank and agency staff so they knew the ward and patients, to provide continuity of care. Staff had the right qualifications, skills, knowledge and experience to do their job. The trust board, heads of departments and senior leaders had access to the information they needed to manage risk, issues and performance across the trust. Staff told us they worked as a team and enjoyed their jobs. There was an on-call rota system for access to a psychiatrist 24 hours a day. The introduction of activities co-ordinators at Coalville Hospital had improved the patients experience on the ward and increased the activities that were conducted on a day to day basis. We found that there were still errors within the staffs application of the Mental Capacity Act. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. 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." Patients returning from leave from the acute mental health wards were not assured of returning to their original ward. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. Leicestershire Partnership NHS Trust Location Leicester Salary 27,055 to 32,934 a year Closing date 2 Feb 2023. Due to the lack of a trust overarching strategy, the BAF did not provide an effective oversight against strategic objectives, gaps in control and assurance. We have not inspected against other requirement notices that were issued at the same time; therefore, all requirement notices from the last inspection remain in place. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. Managers used a tool to identify and review staff numbers in accordance with need. The NHS is founded on principles and values that bind together the diverse communities . Patients and carers gave positive feedback about the caring nature and kindness of staff and made positive comments about the positive therapeutic relationships they had with their loved ones. Some local managers were keeping their own records to ensure performance was monitored. 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. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the patients. Staff had limited opportunities to receive specialist training. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. The Step up to Great strategy identified key priority areas of focus which were linked to the trusts vision. The leadership, governance and culture did not always support the delivery of high quality person centred care. A lack of availability of beds meant that people did not always receive the right care at the right time and sometimes people were moved, discharged early or managed within an inappropriate service. The Health Trust HIV/AIDS Services program delivers groceries to homebound seniors and adults throughout Santa Clara County. Therefore, if a female needed a psychiatric intensive care unit they were sent out of area. The trust had identified the lack of psychological therapies for patients, and support and training for staff, on their risk register. Staff said this made them feel safe whilst visiting patients at home or whilst undertaking activities with patients in the community. Consultations with staff and the public had been undertaken to gain feedback on the proposed move of wards. We spoke with nine patient families and carers. Staff explained to patients their rights under the Mental Health Act on admission and routinely thereafter, although we saw this was not always documented in the patients care notes. We are proud of our 5,400 staff and together we aim to . All hospitals were running at a high bed occupancy level of above 85% which national data has linked to increased risk of bed shortages as well as an increase in healthcare associated infections. Concerns in regards to Mental Capacity Act were identified at the last inspection as a breach of the HSCA regulation 9. There were insufficient systems in place to monitor prescriptions. 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. Curtains were missing from bed spaces and staff did not wait for an answer from patients before entering rooms on acute wards. The trust confirmed the service line was contracted to provide bed occupancy at 93%. Staff were included in service developments and involved in listening into action projects for service improvement. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. All wards had developed their own systems to improve medicines management in their areas. The trust could not be sure that all staff. Access to rooms to undertake activities in the community for people with autism had been reduced. Staff had a good knowledge of safeguarding. We heard from most teams, positive examples of teamwork and multidisciplinary working within teams and services, and with external agencies and key stakeholders. This meant that patients could have been deprived of their liberties without a relevant legal framework. They were reflected in the objectives of local teams. There were improvements in ligature risk assessments. We noted a box for discarded needles being left unattended in a communal area. There was highly visible, approachable and supportive leadership. Notes reflected caring and compassionate view of patients. There were appropriate arrangements in place for the safe management of medicines. There was little evidence that staff supported patients to understand the process, no involvement of family or independent mental capacity advocate in most mental capacity assessments. Use our service finder to find the right support for your mental health and physical health. Staff informed us there was a safeguarding lead to refer to when guidance was needed. The service used evidence based, best practice guidance throughout its policies and procedures and ways of working. Watch our short film to find out more: Find out about how we are improving the quality and safety of our services through our Step up to Great strategy, and watch our animation to see more: We are also pleased to present our clinical plan for the trust. Staff who were unclear of the process for rapid tranquillisation did not have a reminder of the process to follow. There were no pharmacy services within the community mental health teams or crisis team. . We did not have assurance service leads had good oversight of the risks relating to this service as staff were not always recording incidents, the service was unable to identify incidents specific to patients at the end of life and concerns relating to the out of hours GP service were not formally recorded. Nursing staff had large caseloads. Multi-disciplinary teams and inter agency working were effective in supporting patients. The trust recognised this was not an appropriate target and was working with commissioners to negotiate a more appropriate target. Patients needs were assessed and monitored individually. There was a lack of understanding in teams how their own plans, visions and objectives connected with the trusts vision. Lessons were learned from feedback and complaints from patients. Some wards and community teams had low staffing levels, or an absence of specialist staff, and this had an impact on care.Staffing levels remained low at the Bradgate mental health unit. Staff were visible in the communal ward areas and attentive to the needs of the patients they cared for. Patients were not always involved in the planning of their care. Acute patients had been sent to rehabilitation wards inappropriately. The phones on each ward were in communal areas; the phone on Griffin ward had not been moved since the last inspection, although it had a privacy hood installed. Six further patients across Beaumont, Ashby and Heather wards told us that not all staff were caring or respectful. The waiting areas and interview rooms where patients were seen were clean and well maintained. 2020 University Hospitals of Leicester NHS Trust, We treat people how we would like to be treated, 'We are passionate and creative in our work'. Staff had been given lone worker safety devices to ensure their safety. However three staff said that information from incidents and learning points was not always fully shared. Therefore there were no beds available if patients returned from leave. The teams did not have waiting lists for care coordinators at the time of inspection. Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. We found a high number of concerns not addressed from the previous inspections. 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. 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. Resuscitation bag, defibrillator and fire drill checks in the CAMHS LD service were not recorded. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. Staff acknowledged directors visits. We had a number of concerns about the safety of this trust. Improvements to the inpatient wards included updating seclusion rooms, removing some ligature anchor points and replacing garden fencing. At this inspection the well-led provider rating improved from inadequate to requires improvement. Staff were passionate about their roles and enjoyed working with the client group. 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. Patients had their own copies of care plans and were involved in their care plan reviews. The trust had high numbers of vacancies for registered nurses. Patients were offered smoking cessation treatments, nicotine replacement therapy (NRT), or free vapes. The service was recovery focused and had developed pathways with other agencies to build on recovery capital for people who used the service. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), In Often patients were admitted to hospital out of the area especially if they need a more intensive support. Data could not be relied upon to measure service performance or improvement.Data collection and interpretation did not include key pieces of information for example number of delayed or missed visits. This has been brought. At Rutland Memorial Hospital shifts were covered by using more than 20% temporary staffing. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. Staff did not demonstrate a good understanding of the Mental Health Act (MHA) and Mental Capacity Act (MCA). The old kitchen at the Willows was not fit for purpose and poorly equipped but was being used by occupational therapy. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. Staff spoke of feeling supported by team leaders and team leaders felt supported by their managers. The community healthcare services provided by Leicestershire Partnership NHS Trust were judged to be good. Staff were confused about Deprivation of Liberty standards and paperwork was incomplete. Data provided by the trust showed there were four episodes of seclusion from February 2016 to July 2016. Staff explained that the figures collected around preferred place of death were collected as these were requested by the clinical commission group (CCG), although these figures were collected for services in the community; the ward based palliative care figures were not collated. 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. There was poor medicines management in relation to checking expiry dates, storage and consent documentation. criminal justice and liaison services and triage teams had good morale and worked well with internal and external colleagues. Staff reviewed young peoples risk at every appointment and recorded this in the case notes. Record keeping was poor in some services. Due to this staff could not observe all parts of wards due to their lay out and the risk had not been mitigated. The service did not have any out of area placements, readmissions or delayed discharges. There had been an increase in the number of CAMHS referrals over the last two years. All patients told us staff respected their privacy and dignity. We were concerned that information management systems did not always ensure the safe management of peoples risks and needs. Most people and carers gave positive feedback about staff. Where relevant we provide detail of each location or area of service visited. On Ashby ward, the shower rooms did not have curtains fitted. Ward matrons were looking into these alleged incidents. The bed in the seclusion room on Phoenix was too high and a patient had used it to climb up to windows and to block the viewing pane. Men using the laundry had to pass womens bathroom and bedrooms. We did not identify any significant community wide areas for improvement but did find many exemplary services provided by the trust. Some records were over more than one database/system which could make locating information a problem. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. For example, furniture was light and portable and could be used as a weapon. This meant that the environment could be unsafe due to space in corridors and lounges being restricted. The trust had improved medicines management. This was because the EDU batch refer sending four or five referrals at a time rather than when they arrive. We had concerns about the safety of some of the facilities where care was delivered. There were good examples of collaborative team working and effective multi-disciplinary and multi-agency working to meet the needs of children and young people using the service. Wards provided safe environments where patients felt secure. Staff morale appeared low. In rating the trust, we took into account the previous ratings of the core services we did not inspect on this occasion. We found a patient being nursed in the low stimulus area and their liberty was restricted. 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. Let's make care better together. Inadequate Our HIV/AIDS Services program is in need of volunteers to help deliver . Cover arrangements for sickness, leave and vacant posts were in place. Staff treated people who used the service with respect, listened to them and were compassionate. Emails and the trust intranet also provided staff with this information. This was done by sliding signs to the door as needed. However, 323 were waiting for their first appointment through the access team, to complete a core mental health assessment. 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. We were aware the local commissioning groups had not set targets for wait times. Patients had opportunities to continue their education. The duty system enabled urgent referrals to be seen quickly. Lessons learnt were shared across the organisation via emails and the intranet. In response, the Care Quality Commission undertook a series of coordinated inspections, monitoring calls and analysis of data to identify how services in a local area work together to ensure patients receive safe, effective and timely care. At times, there were insufficient qualified nurses on shift. Any other browser may experience partial or no support. Leicestershire Partnership NHS Trust Add a Review About 32 Staff showed a good awareness of patient rights. New systems were in place for staff to report any repairs or maintenance issues. Staff we spoke with demonstrated their dedication to providing high quality patient care. Staff considered and supported patients with their physical health needs in CRHT and the liaison mental health triage service. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. There was a duty worker system in place which meant the service was able to respond quickly to escalating risks if necessary. Patients waiting for their appointment in community based mental health services for adults of working age had access to a room unsupervised which held items which could cause harm. Staff did not ensure that mental capacity assessments and best interest decisions were consistently documented in care records. The trust provided patients with accessible information on treatments, local services, patients rights and how to complain across all services. 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. This practice stopped once we drew attention to it. The recording of discussions and assessments with people regarding consent to treatment was not always documented. When community meetings occurred, staff did not include details of outcomes to evidence change. The trust also collected feedback from patients in a variety of ways, including surveys, iPads, community forum meetings and the Friends and Family Test. 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. Patients did not have access to psychological therapies, as required by the National Institute for Health and Care Excellence (NICE). Staff morale on Griffin ward was low due to the announcement of the wards closure upon the completion of works on Phoenix ward. This impacted on staffs ability to assess and treat young people in a timely manner. The psychiatric outpatients was responsible for 2094 of the breaches, with city east reporting the highest of these breaches at 429.2. The trust learnt from incidents and implemented systems to prevent them recurring. Patients and carers confirmed in most services they had not received copies of care plans. Staff empathised where a person had a negative experience and offered support where necessary. We rated child and adolescent mental health wards as good because: The ward had clear lines of sight in the main areas of the ward. A further review was an examination of processes and procedures within the trust for reporting investigations and learning from serious incidents requiring investigation. We inspected adult psychiatric liaison services as part of Mental Health Crisis and Health Based Places of Safety core service. there are some services which we cant rate, while some might be under appeal from the provider. Many staff we spoke with knew who their chief executive was and mentioned them by name. Managers did not ensure that staff completed Mental Capacity assessments in line with the Act. Concerns about high bed occupancy, record keeping and delayed discharges were identified in the March 2015 inspection and had not been sufficiently addressed. We rated all three mental health services inspected as requires improvement overall. 8 February 2017. Staff interacted with patients in a caring and respectful manner. This was: We also assessed if the organisation is well-led and looked at areas of governance, culture, leadership capability and improvement. They and their carers were kept informed and involved in their treatment and care. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. The service was meeting its target in this area. Between August 2015 and July 2016, there were 60 delayed discharges across the service. This had been raised as a concern in the March 2015 inspection and had not been sufficiently addressed. Patients and their relatives felt involved in the care provided. We felt this contributed to senior staff views that pace of change in the trust was slow. Staff actively participated in clinical audits. Staff were not aware of the trusts visions or values. 30 April 2018. Apply. Staff were dedicated and passionate about the work that they undertook. The trust did not always manage the admission of patients into mixed sex environments well. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. Mobility and healthcare equipment took up space in The Gillivers and 3Rubicon Close. The child and adolescent mental health (CAMHS) community teams caseloads were above the nationally recommended amount, although young people had a care co-ordinator.

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