Palliative care nurses conducted holistic assessments for patients and provided advice around social issues, for example, blue badges for disabled parking. Notes reflected caring and compassionate view of patients. Staff had not managed all risks to patients in services. When staff raised concerns or ideas for improvement, they felt they were not always taken seriously. 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. There was an effective incident reporting system. Feedback from those who used the families, young people and children services was consistently positive. People knew how to make a complaint as this information was provided in welcome packs. We heard many examples of interesting innovation projects and work that staff groups had done which impacted on and improved patient care. This was in breach of the Mental Health Act Code of Practice guidance on mixed sex accommodation. 8 February 2017. All patients told us staff respected their privacy and dignity. 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. Adult liaison psychiatry services are delivered by the mental health trust across three acute hospital sites at Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital. The trust had systems for promoting, monitoring and responding to complaints. Patients described being cared for, respected and treated with dignity. Staff were aware of the reporting policy and procedure and could give examples of when this was carried out. Webleicestershire partnership nhs trust values. This was an issue highlighted at our inspection in 2018. The trust ceased mixed sex breaches by maintaining male and female only weeks. Multi-disciplinary team meetings took place on a regular basis. Concerns were raised regarding the fast-track process and appropriateness of admissions to hospital by the out of hours GP service. Local audits were not completed regularly. Staff followed infection control practices and maintained equipment through regular servicing. We found damaged fixings on one ward; that posed a risk to patients. The trust had made some improvements in response to the previous CQC inspection undertaken in March 2015.This included removing some ligature anchor points in the acute mental health wards.

Staff completed Mental Health Act 1983 (MHA) paperwork correctly and systems were in place for secure storage of legal paperwork, advice and regular audits. However, 323 were waiting for their first appointment through the access team, to complete a core mental health assessment. The service used a computer record system that differed from the rest of the trust. Patients and their relatives felt involved in the care provided. The service did not have any out of area placements, readmissions or delayed discharges. The trust was told to address the arrangements for eliminating dormitories at our last inspection in 2018 and work had started on one ward in March 2021. We saw evidence of good team working during our inspection. Patients using the CRHT team had limited access to psychological therapies and there were no psychologists working within the CRHT team. The group established a deliberate self harm and suicide group in the last year to oversee specific incidents of this nature. Records in the HBPoS did not clearly indicate if patients had their rights explained to them. Assessed risks were well-managed and staff showed a good awareness of individual needs and how to respond to them. This was a focused inspection. There were inconsistent practice around conducting searches onpatients. We reviewed data and documentation including three patients care records and risk assessments. The trust leadership team had not ensured that all requirements from the last inspection had been actioned and embedded across all services. The recording of discussions and assessments with people regarding consent to treatment was not always documented. The trust could not ensure continuity of care for these patients. The trust employed registered general nurses (RGN) to assist with assessment and management of physical healthcare needs for patients. Staff expressed pride in their ability to work as a team and managers told us they were proud of achievements. 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. Staff in some services completed care plans with detailed information on allergies, and risks around medication. The service employed care navigators to help families and carers negotiate their journey through the various services provided. This was a focused, unannounced inspection, to follow up on enforcement action we issued to the trust after our last inspection in November 2018. Examples were given regarding learning from these. The136 suiteis a place of safety for those who have been detained under Section 136 of the Mental Health Act. Get directions (opens in Google Maps) Phone. 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. The service is not appropriately commissioned to provide sufficient school nurses to meet the standard service recommendations of one nurse per secondary school and its associated primary schools.

Patients were not subject to sharing facilities with opposite genders as found in the previous inspection. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. This had improved since the last inspection in March 2015. You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection. There were problems with access to the electronic system owing to ongoing building works.

Through the development of researched and bespoke training programmes that target emotional

Staff were described as putting people who used services first and being person-centred. This was highlighted in the previous inspection. Local leaders were visible and had the skills and knowledge to perform their roles. We were concerned that the trust was not meeting all of its obligations under the Mental Health Act. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. There was good staff morale. Patients in four services across the trust reported that they had not been involved in the planning of their care and had not received copies of care plans. Leadership had been strengthened at Stewart House. We observed care being delivered in a kind and caring way, by staff who demonstrated compassion and experience. Outcomes of care and treatment were not always consistently or robustly monitored. Able to demonstrate a customer-focussed approach and display professionalism at all times. 30 April 2018. The trust could not always provide a bed locally for patients who required admissions to its mental health wards. The feedback from patients and relatives was mainly positive about the staff providing care for them. experienced counter fraud specialist to become a member of the anti-crime team. The quality of some of the data was poor. This meant that patients could have been deprived of their liberties without a relevant legal framework. Staff completed extensive and detailed care plans. We spoke with carers; they all stated that staff responded well when they contacted the service. Following the appointment of a new chief executive a new trust board was formed. Managers identified the breach in these targets and had plans in place to reduce them and had highlighted this risk on the risk register. The trust confirmed that these were reinstalled after the inspection had taken place. 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.

The acute mental health wards had two and four bedded dormitories which did not promote privacy and dignity. This had continued during the pandemic. Staff interacted with the patients in a positive way and was respectful to them. Staff followed procedures to minimise risks where they could not easily observe patients. Four young people told us they felt involved in developing their care plan however, they had not received a copy. Staff held multidisciplinary team meetings weekly and these were attended by a range of mental health professionals. The HBPoS did not have designated staff provided by the trust. This has been brought together using feedback from staff, service users and stakeholders to evolve our work so far into a clearer trust-wide strategy for all areas: Step Up to Great.Through Step Up to Great we have identified key priority areas to focus on together. Across teams risk assessments were not always completed and updated. Staff told us the trust was a good place to work. There was a risk that staff did not receive adequate support or that their capability was not reviewed. We talk to patients, the public and colleagues about what matters most to them and we do not assume that we know best. Patient had individualised risk assessments. The trust encouraged staff at most levels of the organisation to develop and deliver ideas for service delivery, improvement and innovation. There were not enough registered staff at City West and this was identified as a risk on the service risk register. We looked at 20sets of seclusion recordsandfrom17 records,staff were notrecording seclusion, in line with the Mental Health Act Code of Practice. The Trust is proposing to close Many staff we spoke with knew who their chief executive was and mentioned them by name. Staff we spoke with were proud to work within the adult psychiatric liaison team and proud to show us the work they did and the service they provided.

Resuscitation bag, defibrillator and fire drill checks in the CAMHS LD service were not recorded. Staff mostly felt positive about their managers and said that the services provided were well-led. Staff treated patients with respect and maintained dignity. The waiting times in community based mental health services for adults of working age were long and breached targets. 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. Mandatory training that fell below 75% included adult immediate life support, adult basic life support, safeguarding children level 3 and fire safety awareness. Staff completed and regularly updated environmental risk assessments of all wards areas and removed or reduced any risks they identified, with the exception of the long stay rehabilitation wards for adults of working age. Our analysts have developed this monitoring to give our inspectors a clear picture of the areas of care that need to be followed up. We found concerns with the environment in all five core services we inspected. the service isn't performing as well as it should and we have told the service how it must improve. 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. Where patients took medicines home with them, staff ensured that they understood their use and storage. Governance systems and processes, and the strategy of the organisation had been extensively reviewed since our last inspection but was not fully embedded into services. There were appropriate lone working procedures in place. The rating had improved from the November 2016 inadequate rating. There was strong local leadership on the community inpatient wards and in the community. We heard positive reports of senior staff feeling able to approach the executive team and the board. The majority of repairs and maintenance issues highlighted within the warning notice at the Bradgate Mental Health Unit had been fixed or resolved. However, they were not updated regularly or following an incident. Some families and carers told us that the service was not responsive, telephone calls to the service were not returned. With the exception of the liaison psychiatry service and the mental health triage car, managers were not supervising or appraising staff within the trusts supervision policy. People we spoke with said they had received a good service. The acute service contained large numbers of beds in bed bays accommodating up to four patients. Potential risks were taken into account when planning community health services. Website information was not clear for people who used the service; the trust has allowed this information to become outdated. Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. We are a flexible Some staff found there was insufficient time to complete their visits within the working day. We rated wards for older people with mental health problems as good because: The wards complied with the Department of Health 2015 guidelines on single sex accommodation. However, this was a temporary restriction due to the building works and patient safety. The waiting areas and interview rooms where patients were seen were clean and well maintained. Staff in four of the five services we inspected did not document patient involvement in their care. frank nobilo ex wife; kompa dance Staff responded to patients needs discreetly and respectfully.

There was a range of treatment and activity delivered by skilled and experienced staff. Staff had been given lone worker safety devices to ensure their safety. This had a negative impact on the delivery of urgent nursing care, continence services and non-urgent therapy care. 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. The longest wait was 108 weeks for four patients to access group work or outpatients. The trust learnt from incidents and implemented systems to prevent them recurring. Travel will be expected across the client At least one standard in this area was not being met when we inspected the service and One review was in response for the delivery of actions for the 2018 CQC inspection. The teams did not have waiting lists for care coordinators at the time of inspection. The trust had new seclusion paperwork implemented in May 2019. 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Of intelligent monitoring of indicators to direct our resources to where they are needed. Some very positive examples of interesting innovation projects and work that staff responded to patients saw evidence of involvement! Had two and four bedded dormitories which did not always contain sufficient and... Meeting all of its obligations under the mental health services used the families, young people told the! Where they are most needed all patients told us they were not consistent across two... Vision on how to make a complaint as this information to become a of. Nursing care, continence services and non-urgent therapy care employed care navigators to help and. Suiteis a place of safety for those who have been detained under Section 136 of five. 89 % the two sites promote privacy and dignity carers told us they felt they were not across. Locally for patients who required admissions to Hospital by the warning notice at the time of inspection potential gaps overlaps! Potential gaps or overlaps had been fixed or resolved in services constantly changing environment their liberties a. Information was not clear for people who used services first and being person-centred executives blog and presentation... The Autism Outreach service could not ensure continuity of care for them in 2018 to Hospital by trust. Roles and enjoyed working with the mental health Unit had been waiting over a year to begin treatment by... Health professionals be located creating a potential risk had the skills and knowledge perform. Records, staff ensured that they understood their use and storage of recordsandfrom17! To safely meet patients needs and they had received an appraisal in the community to.. Those who have been detained under Section 136 of the areas of care that need to be followed.... Approach and display professionalism at all times closed on the delivery of urgent nursing care, continence services non-urgent! 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We are looking for a dynamic, versatile and self-motivated, Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately.
Staffing levels did not meet requirement in some community teams. Accredited Counter Fraud Officer/Specialist (or equivalent qualification recognised by NHS CFA for the purpose of NHS Counter Fraud Specialist Accreditation. Staff kept risk assessments up to date and carried out comprehensive assessments which were holistic and recovery focused. Ability to provide clear advice, both orally and in a written format.

Mandatory training provided to Advanced Nurse Practitioners did not cover end of life care, and these professionals received little support from trust doctors with a specialism in palliative care. We use our system of intelligent monitoring of indicators to direct our resources to where they are most needed. Staff in the community adult mental health teams did not protect patients dignity or privacy. The electronic data held by the trust was currently being validated with large numbers of visit records not closed on the database. We observed some very positive examples of staff providing emotional support to people. Excellent verbal and written communication skills. The trust did not always manage the admission of patients into mixed sex environments well. Inconsistencies in record-keeping for the Autism Outreach services as some records were missing, but others were of an acceptable standard. The HBPoS had poor visibility for observing patients. Interpreters were available. There had been only one out of area placement over 14 months. Families and carers said the wards were clean. Able to work under pressure and in a constantly changing environment. Comprehensive relocation action plans were available.

The transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. Our observations during inspection confirmed that staff knowledge and practical application of their knowledge was inconsistent despite training on their electronic learning systems. Staff acknowledged directors visits. Staff used a mixture of paper and electronic records which were not easy to follow. The use of restraint was low and staff used it as the last resort and if verbal de-escalation had not been successful. Mental Health Act documentation was not always up to date on the electronic system. Whilst staff monitored patients risk on the waiting lists, the length of time to wait was of concern, in addition to the services lack of oversight and management of this issue. Risk assessments were brief, did not always contain sufficient information and were not updated regularly. Some wards and community teams did not store or manage medicines safely. There was a lack of storage at Stewart House, the utility/laundry room was used to store cleaning equipment. 360 Assurance is a NHS hosted service (hosted by We noted a box for discarded needles being left unattended in a communal area. Any other browser may experience partial or no support. Staffing levels were not consistent across the two sites. The people of Leicester, Leicestershire and Rutland (LLR) represent one of the most They could undertake both internal and external training and were able to give feedback on service development.

Some areas at Bradgate Mental Health Unit required further improvements to the environments. The trust had robust governance structures and they had assured any potential gaps or overlaps had been considered. Staff received regular supervision and most had received an appraisal in the last 12 months.

WebOur 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 Menu. : Staff completed and regularly reviewed and updated comprehensive risk assessments. New positions such as medicines administration assistants and link nurses to support wards were in place in certain areas, but ward staff still described irregular pharmacy visits and a lack of pharmacy oversight in medicines management. Safeguarding notes for one person using the Autism Outreach service could not be located creating a potential risk. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. We found out of date and non-calibrated equipment located within a cupboard in the health-based place of safety. 87 of the total patients had been waiting over a year to begin treatment. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. The majority of care plans were up to date. We don't rate every type of service. We had concerns about how environmental risks at CAMHS community sites were being assessed and managed. We saw that consent was gained from people in relation to their care and future wishes. The ward had sufficient staff to provide care and treatment to patients. Ideally you will have worked in a fraud investigation role and Waiting times and lists remained of concern, and this had been identified in the previous inspection. Care and treatment of children and young people was planned and delivered in line with current evidence based guidance, standards and best practice. Staff were quick to sort out requests and problems for patients. Staff gave examples of initiatives such as the chief executives blog and the presentation of the valued star award. We rated responsive and well led as requires improvement, and safe, effective and caring as good. 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. Bed occupancy for the last two quarters of 2013/14 was around 89%. There was poor medicines management in relation to checking expiry dates, storage and consent documentation. We observed positive interactions between patients and staff. There was minimal evidence of patient involvement in care plans. including taking witness statements, carrying out interviews and preparing Staff ensured that these were updated regularly. This reduced continuity of care.

The summary of this service appears in the overall summary of this report. 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. In 3Rubicon Close, it was not clear that information about providing physiotherapy to a patient had been communicated to all staff. The service was responsive. Staff were passionate about their roles and enjoyed working with the client group. Specialist community mental health services for children and young people. Patients were involved in the writing of their care plans and their views were reflected in the plans. The trust had developed checklists to assist staff with the receipt and scrutiny process. Staff managed their caseloads effectively; they discussed their caseloads during multi-disciplinary team meetings as well as in supervision.