We found a patient being nursed in the low stimulus area and their liberty was restricted. Patients said they got bored at the weekends, as there were fewer activities on offer. We found that while performance improvement tools and governance structures were in place these had not always brought about improvement to practices. We looked at 20sets of seclusion recordsandfrom17 records,staff were notrecording seclusion, in line with the Mental Health Act Code of Practice. Staff held multidisciplinary team meetings weekly and these were attended by a range of mental health professionals. 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. Specialist equipment needed to provide care and treatment to patients in their home was appropriate and fit for purpose so patients were safe. Staff empathised where a person had a negative experience and offered support where necessary. Care plans did not always consider the patient views, and were generic did and not all were recovery focussed. 42% of staff on Phoenix ward and 27% Griffin ward had received clinical supervision. Leicester, United Kingdom. Patients reported staff treated them with dignity and respect. Some risk assessments had not been reviewed regularly at The Grange. Ward matrons were looking into these alleged incidents. Managers shared the outcome of complaints with their ward teams. There were delays in staff delivering treatments to young people and young people following assessment. 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. Leadership behaviours were fostered, and development of staff was encouraged. Staff did not record consent to treatment, and capacity to consent and best interests decisions when these were needed. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. This reduced continuity of care. Staff felt supported by their immediate managers but felt disaffected with trust senior management. We did not inspect the whole core service. At least one standard in this area was not being met when we inspected the service and, Nottinghamshire Healthcare NHS Foundation Trust, Coventry and Warwickshire Partnership NHS Trust, Derbyshire Healthcare NHS Foundation Trust, Crisis Resolution and Home Treatment teams (CRHT). Fire safety was much improved, withfire drills carried out regularly. On rehabilitation wards, staff did not care plan the needs of a patient with protected characteristics. Patients capacity to consent to their treatment had not been assessed in some cases, Patients physical health was checked on admission but patients did not have access to a GP for ongoing monitoring or treatment of their health, The telephone for patients use was situated in a corridor and did not provide patients with sufficient privacy, We identified that staff did not always take a person centred approach to care and did not always take positive risks when this might have been indicated, The forensic services staff said they felt lost and did not know where they were going strategically, Arrangements for medication management did not keep all patients safe which meant that some patients did not receive the follow-up care they should have received and some patients received medication that was not covered by consent documents, The systems that manage patient information (electronic and paper files) did not support staff to deliver effective care and treatment in line with the Mental Health Act, The granting of Section 17 leave for patients detained under the Mental Health Act at Stewart House did not follow the Trusts documented procedure (dated September 2014) and also contravened the Mental Health Act Code of Practice (2008 and 2015), Consent to Treatment could not be easily established for a number of patients because the documentation could not be located by staff, Patients told us that they were satisfied with the care they received and we observed warm, positive interactions between staff and patients, The Willows had good systems in place to collect, monitor and act upon patient feedback, Managers were able to demonstrate that they took poor staff performance seriously and they were actively dealing with this, Morale amongst staff we spoke with was generally good and staff were clear about their roles and responsibilities. People knew how to make a complaint as this information was provided in welcome packs. When we talk to colleagues we are clear about what is expected. Derby, We are looking at different ways to indicate the outcomes of our monitoring in the future. Inconsistencies in record-keeping for the Autism Outreach services as some records were missing, but others were of an acceptable standard. There was no evidence of patient involvement recorded in some of the notes. Response times to maintenance request were variable. We found that there were still errors within the staffs application of the Mental Capacity Act. We want to hear from you on how to improve our service and provide the best care possible. Staffing skill mix was appropriate to need overall. The trust used key performance indicators/dashboards to gauge the performance of the team. The transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. Most patients spoke positively about their care and said they were involved. When community meetings occurred, staff did not include details of outcomes to evidence change. Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. We spoke with carers; they all stated that staff responded well when they contacted the service. Suspended ratings are being reviewed by us and will be published soon. In rating the trust, we took into account the previous ratings of the core services we did not inspect on this occasion. Record keeping at Stewart House was disorganised. On many wards, the trust had not supplied sufficient numbers of lounge and dining chairs to accommodate all patients and some wards did not have sufficient quiet rooms for care and treatment or for patients to receive visitors. Leicestershire Partnership NHS Trust Location Loughborough Salary 27,055 to 32,934 a year Closing date 13 Jan 2023. Nurses and managers from LPT who were supported . 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. Comprehensive relocation action plans were available. The trust experienced high demand for acute inpatient beds. However, we were concerned that ligature risks remained in these bedrooms. There were low levels of restraint and staff tried other methods to de-escalate before restraining patients. We observed some very positive examples of staff providing emotional support to people. Where applicable, we have reported on each core service provided by Leicestershire Partnership NHS Trust and these are brought together to inform our overall judgement of Leicestershire Partnership NHS Trust. Wards had well equipped clinic rooms with appropriate equipment which staff regularly checked. Risk management in services required improvement. Demand for neurodevelopment assessments remained high. We were not assured that the trust risk register clearly documented action taken or progress of action, within agreed timescales. The trust did not always manage the admission of patients into mixed sex environments well. A dashboard of key performance indicators was being developed. Staff were not aware of the trusts visions or values. The trust did not ensure that they meet set target times for referral to initial assessment, and assessment to treatment in the majority of teams. Children and young people felt listened to in a non-judgmental way and told us they felt respected. Care plans were not always holistic and person centred. The adult community therapy team did not meet agreed waiting time targets. Our rating of this service stayed the same. Staff were up to date with mandatory training and had regular supervision and appraisals. Supervision and appraisal compliance of three teams fell below 75%. All patients told us staff respected their privacy and dignity. the service is performing well and meeting our expectations. Waiting lists for psychological services were high and currently on the Trusts risk register. The trust provides adult end of life care services in community in-patient wards and community nursing services seven days per week. PIER staff reported having good links with universities and colleges regarding students needing early intervention services. One Community Learning Disability Team had developed an educational awareness raising event to prevent hospital admissions due to dehydration. In rating the trust overall, we took into account the current ratings of the 12 services not inspected this time. Comprehensive assessments were being carried out and information was stored securely, except for one location and arrangements were in place to address this. Staff held high caseloads in community based mental health services for adults of working age, an issue which had been recognised by the trust and placed on the risk register. On acute wards, not all informal patients knew their rights. the service isn't performing as well as it should and we have told the service how it must improve. There had been only one out of area placement over 14 months. In addition to this, risk assessments were comprehensive and reviewed as per the trust policy, six monthly or after risk incidents. The high demand for services, high levels of staff sickness and staff vacancy rates had not been managed effectively. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. Following inspection, the trust submitted an action plan to review access to call alarms. Staff monitored patients physical health regularly from the point of admission. 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