Most patients spoke positively about their care and said they were involved. 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. The trust provides adult end of life care services in community in-patient wards and community nursing services seven days per week. Interview rooms were unsafe. The service was meeting the target for initial assessment within 13 weeks of referral with a compliance of 99%. No rating/under appeal/rating suspended We had concerns about the environment but noted the service was due to move locations within two weeks. Click on the coloured text links below to visit any of the listed organisations' websites: The trust needs to take steps to improve the quality of their services and we found that they were in breach of seven regulations. 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. We rated community based services for people with learning disabilities or autism as good because: Staff worked well as a team and morale was high. Adult liaison psychiatry services are provided by Leicestershire Partnerships NHS Trust (LPT), the mental health trust in the Leicester, Leicestershire and Rutland Integrated Care System. Patients did not have access to regular community meetings where they would discuss ward issues and concerns. Patients were offered smoking cessation treatments, nicotine replacement therapy (NRT), or free vapes. The trust had completed ligature risk assessments across all wards, detailing where risks were located and how these should be managed. Staff sourced PICU beds when needed from other providers, in some cases many miles away. Some families carers said that the meals were unhealthy. Staff were suitably trained with the relevant knowledge and skills to carry out their work, had regular appraisals and had access to the information they needed to perform their duties. We will be working with them to agree an action plan to improve the standards of care and treatment. In two of the core services inspected, the environment had not been well maintained. One review was in response for the delivery of actions for the 2018 CQC inspection. There were clear responsibilities, roles and systems of accountability to support good governance and management. We talk to patients, the public and colleagues about what matters most to them and we do not assume that we know best. Significant vacancy rates and high sickness levels put additional pressure on substantive staff. There were no vision panels on patient bedrooms. We did not rate this inspection. Apply. This meant staff transferred patients to wards that had seclusion rooms when needed. 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. We saw evidence of good team working during our inspection. Staff were provided with relevant information to care for patients safely. 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. 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 Therefore, the trust could not be sure staff received information to support best practice and change in a timely manner. Staff did not always record or update comprehensive risk assessments. The community adult team caseloads varied. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. This reduced continuity of care. The trust had made progress in oversight of data systems and collection. 87 of the total patients had been waiting over a year to begin treatment. Mental health crisis services and health-based places of safety had an overall mandatory training compliance rate of 82%. 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. Staff were unable to show us evidence of clinical audits or the basis of evidence based practice in end of life services. There was no fridge to keep medicines cool when required. Every team we spoke with knew who they reported to and what to report. They are: o We focus on what matters most. Some families and carers told us that the service was not responsive, telephone calls to the service were not returned. There were significant waiting times for a range of further assessments and treatments including psychology, school observations, psychiatric opinion and group work. Improvements to the inpatient wards included updating seclusion rooms, removing some ligature anchor points and replacing garden fencing. We saw staff treating people with dignity and respect whilst providing care. The governance processes had not picked up the issues around repairs, medicines and cleanliness. A dashboard of key performance indicators was being developed. Some care plans had not been updated and physical healthcare checks were not routinely documented in young peoples notes. The trust had set safe staffing levels and these were followed in practice. There were effective systems in place to audit and monitor physical health care records. The trust had not fully addressed the issues of poor lines of sight in wards. Overall we saw good multidisciplinary working and generally peoples needs, including physical health needs, were assessed and care and treatment was planned to meet them. There were appropriate lone working procedures in place. In all instances police transported the patient to the HBPoS. We are proud of our 5,400 staff and together we aim to . Comprehensive assessments were being carried out and information was stored securely, except for one location and arrangements were in place to address this. At the last inspection, we issued enforcement action because the trust did not have systems and processes across services to ensure thatthe risk to patients were assessed, monitored, mitigated and the quality of healthcare improved in relation to: The trust was required to make significant improvements in the following core services where we found concerns in the areas listed above: Acute wards for adults of working age and psychiatric intensive care units, Wards for people with a learning disability or autism, Long stay or rehabilitation mental health wards for working age adults. Download full inspection report for - PDF - (opens in new window), Published The feedback from patients and relatives was mainly positive about the staff providing care for them. The HBPoS did not have designated staff provided by the trust. All areas were very clean, fresh smelling and fit for purpose. This was a significant improvement since our last inspection which reported 171 out of area placements lasting between two and 192 days. Between August 2015 and July 2016 the trust had a total of 372 delayed discharges. There was a good level of occupational therapy input and good support to help maintain patients physical health. Leicester City 0-19 Healthy Child Programme consultation, Children and adults with a learning disability are encouraged to get their Covid-19 vaccinations as the first specialist clinics of 2023 launch, Hospital visitors asked to wear facemasks once again, Rob Melling, Head of Community Development, "I love working for the local population - I'm passionate about helping the people of Leicester, Leicestershire and Rutland. The trust lacked an overarching strategy which everyone within the trust knew. We carry out joint inspections with Ofsted. Clinical supervision was not taking place regularly across the service. We observed clinicians working with young people were skilled and very positive. We rated Leicestershire Partnership NHS trust as requires improvement because: Environmental risks in the Health Based Place of Safety (HBPoS) identified in our previous inspection remained. Data provided by the trust showed there were four episodes of seclusion from February 2016 to July 2016. Inconsistencies in record-keeping for the Autism Outreach services as some records were missing, but others were of an acceptable standard. Through effective workforce planning we will nurture and support our staff to progress and flourish, offer them opportunities to deliver care through new models and in new roles. To ensure that safer staffing levels were met they used regular bank or agency staff to achieve the required amount number of staff for the wards to meet the needs of the patients. All wards had developed their own systems to improve medicines management in their areas. Staff maintained a presence in clinical areas to observe and support patients. 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 were described as putting people who used services first and being person-centred. We identified medicines management issues, including out of date medication in the acute mental health wards and fridge temperatures were not monitored in community based mental health services for adults. ", "I like that I'm able to help both staff and service users. Bed occupancy rates were above 85% for community health inpatient wards. Some staff had not received their mandatory training, supervision or appraisal. That's what building health equity means to us. We rated community health services for adults as requires improvement because. Patients were able to access hot and cold drinks any time during the day. In rating the trust, we took into account the previous ratings of the core services we did not inspect on this occasion. We observed many examples of staff treating patients with care and compassion. The trust was not commissioned to provide a female PICU and have identified the need with their commissioners. We identified concerns around the storage of medicines in community hospitals, with missing opened or expiry dates across all hospitals. Find out more Knitting therapy keeps cats and dogs warm 23 Dec 2022 News Staff had not routinely recorded whether they had given patients copies of their care plans and we saw this in a considerable number of patient records we sampled. For services we haven't rated we use ticks and crosses to show whether we've asked them to take further action or taken enforcement action against them. Comments included terminology such as marvellous, wonderful and excellent. Patients could approach staff at night to request them. 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. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow. Patients said they got bored at the weekends, as there were fewer activities on offer. On Phoenix ward patients were not allowed access to the garden. The service was not meeting its performance targets. Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so patients were safe. A new quality dashboard had been introduced in September 2016 after it was established that the previous system was incorrect, meaning all data submitted prior to September 2016 was incorrect. there are some services which we cant rate, while some might be under appeal from the provider. There were long waiting times from initial referral to being seen in some clinics and services although these had improved in some areas since the last inspection. In rating the trust, we took into account the previous ratings of the ten core services not inspected this time. 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. Often patients were admitted to hospital out of the area especially if they need a more intensive support. 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. 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 were not meeting targets for the assessment and assessment to treatment of urgent referrals and six week routine referrals. We reviewed data and documentation including three patients care records and risk assessments. We saw the trust had developed oversight and a vision on how to improve the nine key areas identified by the warning notice. There was use of bank and agency staff. 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. The trust supported a BAME network (black and minority ethnic) however, given the diversity of the geographical area of the trust, they had not significantly developed its agenda or work streams since our last inspection. 78% of staff had completed their annual appraisal. Staff showed caring attitudes towards their patients. 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