Browser Support Derby, We rated all three mental health services inspected as requires improvement overall. Patients told us that appointments usually run on time and they were kept informed when they do not. The trust also collected feedback from patients in a variety of ways, including surveys, iPads, community forum meetings and the Friends and Family Test. Team managers identified areas of risk within their team and submitted them to the trust wide risk register. The trust lacked an overarching strategy which everyone within the trust knew. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. 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. A new leadership structure had been introduced since the last inspection and had not yet fully embedded in the service. 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. Trust staff working within the had remote access to electronic systems used by the trust. Carers told us they had regular contact with the CRHT team and they were kept involved with their loved ones care. Our rating of this service improved. There were effective methods for obtaining feedback from service users and carers and feedback was acted upon. A carers group was available to give support. Service planning was not being managed in a systematic way. Comprehensive relocation action plans were available. Risk assessments were brief, did not always contain sufficient information and were not updated regularly. Care and treatment was mostly planned and delivered in line with current evidence. The trust had no end of life strategy as the previous one had expired and no replacement had been developed. 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. There's no need for the service to take further action. The NHS is founded on principles and values that bind together the diverse communities . The trust encouraged staff at most levels of the organisation to develop and deliver ideas for service delivery, improvement and innovation. At least one standard in this area was not being met when we inspected the service and The summary for this service appears in the overall summary of this report. Therefore, if a female needed a psychiatric intensive care unit they were sent out of area. There were insufficient systems in place to monitor prescriptions. 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. The service had not delivered timely care to a significant number of patients. That's what building health equity means to us. the service is performing well and meeting our expectations. This did not demonstrate a consistent temperature, had been maintained to assure the safety and efficacy of the medicines. This left patients without access to treatment when they needed it most. You can find further information about how we carry out our inspections on our website: www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection. We have strengthened our vision and strategy, to make our direction of travel as clear as possible for everyone. The trust provided newsletters, quarterly serious incidence bulletins, regular emails from matrons about incidences and lesson learnt. The CRHT team did not have lockable bags to transport medication to patients homes; staff told us they transported medication in their handbags. Patients privacy and dignity had been addressed at The Willows, Cedar and Acacia wards with changes made to male and female wards. Staff were given feedback after incidents had been reported. There was a lack of storage at Stewart House, the utility/laundry room was used to store cleaning equipment. Staff did not routinely complete detailed, person centred, individualised or holistic care plans about or with patients. There were key performance indicators set for time from referral to assessment and where these were not being addressed action had been taken. This included environmental improvements, shared sleeping accommodation, response times to maintenance issues, care planning and access to relevant therapies in certain services. Managers had a recruitment plan in place to increase the number of substantive staff for the service. In CAMHS community teams waiting times from referral to initial assessment was less than 13 weeks. Managers had introduced a specialist child and adolescent mental health traffic light system, a red, amber and green rating tool for managing risk. Ward teams did not hold regular team meetings. 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. The IAPT service was not meeting the Key Performance Indicators (KPIs) set by commissioners in relation to access targets' - meaning they were not getting the expected quota of referrals per population head. There was good physical health care and good therapeutic treatment and activities. In the dormitories, observation mirrors were situated so that staff could observe patients without having to disturb them. Staff told us they enjoyed working at the trust and thought they all worked well as a team. There was an effective duty system in place to provide rapid access to support. The acute wards for adults of working age had not complied with all of the required actions following the previous inspection of September 2013. They showed a good understanding of peoples individual needs. Notes reflected caring and compassionate view of patients. Patients were positive about their care and treatment and said staff were caring and understanding and respectful. Sixty per cent of staff working in the mental health services had attended supervision and 64% of staff working in community health inpatient services. Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. Bathrooms and toilets were specified for which gender depending on who was resident at the unit at the time. Patients reported that they felt safe on the wards. People that were referred to the service were waiting for a care co-ordinator to be allocated. Regular team meetings took place and staff told us that they felt supported by colleagues. We also inspected the well-led key question at provider level for the trust overall. Waiting lists for psychological services were high and currently on the Trusts risk register. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. Medication management across four of the five services we inspected was poor, despite reported trust oversight and audit. The needs of people who used the service were assessed and care was delivered in line with their individual care plans. The Health Trust HIV/AIDS Services program delivers groceries to homebound seniors and adults throughout Santa Clara County. At this inspection the overall ratings for mental health services stayed the same in safe, effective and responsive, which we rated as requires improvement. Funding had been secured for increased staff with specialist skills. Patients were frequently not discharged when ready due to transport problems or difficulties putting care packages in place. Our patients are at the heart of all we do and we believe that 'Caring at its Best' is not just about the . We will continue to keep our values of Compassion, Respect, Integrity, Trust at the centre of everything we do. One patient on Thornton ward told us that while staff did knock, they did not wait for a response before entering, which had resulted in staff walking into their room while they were changing their clothes, compromising their privacy and dignity. Patients knew how to make a complaint or raise a concern and complaints were taken seriously. Staff actively participated in clinical audits. We rated wards for people with learning disabilities as requires improvement because Maintenance teams did not undertake repairs in a timely way and not all areas used by patients were clean. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. It shows how we will work together to create an inclusive culture, where there is no discrimination or bullying. We have four core values: Compassion, Respect, Integrity, Trust. The trust had systems for staff to raise any concerns confidentially. 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. On acute wards, not all informal patients knew their rights. Specialist community mental health services for children and young people. We received mixed feedback about staffing levels and several staffing reported concerns. Staff were included in service developments and involved in listening into action projects for service improvement. A further review was an examination of processes and procedures within the trust for reporting investigations and learning from serious incidents requiring investigation. Staff who were unclear of the process for rapid tranquillisation did not have a reminder of the process to follow. At the Valentine Centre improvements had been made to the storage of cleaning materials. Managers ensured they monitored their staffs compliance with mandatory training using a tracker system. Local audits were not completed regularly. Staff worked with both internal and external agencies to coordinate care and discharge plans. One review was in response for the delivery of actions for the 2018 CQC inspection. Patients told us that staff listened and empathised with them. Engagement with external stakeholders had significantly improved since our last inspection. When staff deemed a patient lacked capacity there was no evidence that the best interest decision-making process was applied. Leicestershire Partnership NHS Trust provides mental health, learning disability and community health services across Leicestershire, England.. Patients and carers knew how to complain. On Heather ward patients said that there was not enough ventilation on the wards. The trust had reviewed existing systems and processes identified improvements and implemented changes. The nurses we spoke with had specialist interests, including mindfulness and dementia. The HBPoS did not have access to a dedicated clinic room. We strongly recommend an informal and confidential discussion with Cathy Ellis, the Chair of the trust. A new chief executive was appointed as a shared role between the two trusts. Wards employed additional healthcare support workers to meet patient needs when needed. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. 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. This employer has not claimed their Employer Profile and is missing out on connecting with our community. This promotion is being run by Leicestershire Partnership NHS Trust. 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. Staff usually met patients in their homes or in the community. Potential risks were taken into account when planning community health services. This did not protect the privacy and dignity of patients when staff undertook observations. Staff told us they will move to a new electronic system in July 2015 which will be the same as other areas in the trust. The patients did not consistently have their physical healthcare monitored or recorded, unless there were identified problems. 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." Inspectors from the Care Quality Commission (CQC) visited five services run by Leicestershire Partnership NHS Trust (LPT) in November and December last year. 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. Clinical supervision was not taking place regularly across the service. Each priority within our approach is being led by an executive team member and progress is being monitored through our quality governance framework. Safeguarding was a high priority with regular safeguarding reviews within each area of speciality and established systems for supporting staff dealing with distressing situations. 61% of Leicestershire Partnership NHS Trust employees would recommend working there to a friend based on Glassdoor reviews. Staff were very caring and sensitive to patients needs. Staff support systems were in place and there was a drive to engage with staff. There were appropriate arrangements in place for the safe management of medicines. At West Leicestershire there was a lack of psychology input. 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 were given opportunities to expand their knowledge and develop their roles. The trust had set safe staffing levels and these were followed in practice. Lone working policies and procedures were in place for staff to follow to ensure patient and staff safety. Care plans were not always holistic and person centred. Patients were mostly very happy with the care provided by staff; however some patients told us they did not like being woken at 6am and going to bed early. In community based mental health teams for older people five of six services breached national targets from referral to assessment. The school nursing service was understaffed and consequently there was an adverse impact on outcomes for children and young people and on staff morale. We are proud of our 5,400 staff and together we aim to . Staff showed high levels of motivation and morale, felt part of a positive team and felt well supported and trained. Patients returning from leave from the acute mental health wards were not assured of returning to their original ward. Wards had well equipped clinic rooms with appropriate equipment which staff regularly checked. The trust was not meeting its target rate of 85% for clinical supervision. Information needed to deliver care was not always readily available when people using community mental health teams presented in crisis out of hours. The trust had a culture of promoting staff learning and development and encouraged staff to share best practice and innovation. Following inspection, the trust submitted an action plan to review access to call alarms. The trust had ensured patients privacy and dignity were maintained when receiving physical health observations at the Bradgate Mental Health Unit. 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. The offer is for 250 to be paid through payroll and subject to tax and National Insurance and is non pensionable. Wards did not have a list of stock items. There was detailed discussion and consideration of patients and carers needs. Where patients took medicines home with them, staff ensured that they understood their use and storage. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. We found that staff across the service were committed to providing good quality care to the patients and showed care and compassion. 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. However there were significant problems with key areas of governance in relation to the management of prescriptions. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. The trust had new seclusion paperwork implemented in May 2019. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. Staff satisfaction varied greatly across the service with some staff feeling devalued. The principles will normally apply but will be balanced by inspection teams using their discretion and professional judgement in the light of all of the available evidence. Staff provided psychological therapies as recommended by NICE such as group work and cognitive behavioural therapy. Preventing infections Same sex accommodation Building better hospitals eHospital Programme Our values 'We treat people how we would like to be treated' 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 In 3Rubicon Close, it was not clear that information about providing physiotherapy to a patient had been communicated to all staff. Nursing staff had large caseloads. There was minimal evidence of patient involvement in care plans. The trust was not commissioned to provide a female PICU and have identified the need with their commissioners. The successful candidate will demonstrate they possess the same core values as our organisation, Compassion, Respect, Trust and Integrity in all aspects of their work. Staff interacted with people in a positive way and were person centred in their approach. Creating high quality, compassionate care and wellbeing for all. There was a mobile phone in the ward office that patients could use for private calls, for example to a solicitor. Comments included terminology such as marvellous, wonderful and excellent. There was good access to interpreters and signers when needed. The trust had key roles in the development of health and social care system working, and collaboration with other care providers to improve provision of mental health services. This could pose a risk as patients were unsupervised in this area. Staff did not effectively complete risk assessments for patients, manage a smoke free environment, or share information about incidents or share learning from incidents within teams, across services or between services in the trust. Records in the HBPoS did not clearly indicate if patients had their rights explained to them. Staff reported incidents, which were discussed and reviewed by line managers within the teams. However, we found: We rated the child and adolescent mental health wards as requires improvement because: We rated community-based mental health services for older people as good because: We rated learning disability and autism community services as good because: We gave an overall rating for forensic/secure wards of requires improvement because: We rated Leicestershire Partnership NHS Trust long stay / rehabilitation mental health wards for working age adults as requires improvement because: Overall rating for this core service Good. 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. We rated safe, effective, caring and responsive as good and well led as requires improvement. Patients occasionally attended the service. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 22 Jan 2023. The trust had systems for promoting, monitoring and responding to complaints. We found a total 40 breaches of the six week referral and seven breaches of the five day urgent referral. Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. In addition, staff did not record the maximum dose of medications a patient could have in any 24-hour period. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. Patients were protected from avoidable harm and abuse, systems were in place to investigate incidents and concerns and staff received suitable training in safety systems. Patients had opportunities to continue their education. Apply. The services did not have a strategy and there were no service plans. The trust provided patients with accessible information on treatments, local services, patients rights and how to complain across all services. The teams did not have waiting lists for care coordinators at the time of inspection. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. This area of our site lists our partner organisations. Governance processes had improved since our last inspection and operated effectively at trust level to ensure that performance and risk were managed well. Supervision and appraisal compliance of three teams fell below 75%. Care records for patients using the CRHT teams were not holistic or personalised. Staff felt supported by their managers and received regular supervision and annual appraisals. One patient on Watermead ward told us that a staff member had ignored them when they had asked them for a sandwich. 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