England's Chief Inspector of Hospitals has told Leeds and York Partnership NHS Foundation Trust that it must make improvements following an inspection by the Care Quality Commission in July 2016.
Overall, CQC has rated Leeds and York Partnership NHS Foundation Trust as Requires Improvement. It rated the trust as Good for providing services that are caring and responsive and Requires Improvement for providing services that are safe, effective and well-led.
Full reports including ratings can be found on this website.
Leeds and York Partnership NHS Foundation Trust has 10 active locations registered with the CQC, serving mental health and learning disability needs. In addition the trust also provides supported living services, eating disorder services, perinatal services, gender identity services and psychology and psychotherapy services. The trust delivers holistic care for people with complex medically unexplained symptoms and physical - psychological comorbidities at its Yorkshire Centre for Psychological Medicine. It also provides substance misuse services as part of the consortium Forward Leeds.
Inspectors could see that staff were respectful, caring and compassionate towards patients, relatives and carers. They also observed examples, on the wards and during home visits, where staff maintained patients’ dignity, privacy and confidentiality. The trust scored higher than the England average on the patient led assessment of the care environment for privacy, dignity and well-being
Some of the key findings from the inspection included:
CQC rated the community services that supported deaf and hearing impaired children and young people, as well as children and young people with mental health problems whose family had hearing impairments, as Outstanding.
Inspectors had concerns about the management of medicines in some settings. Medicines across the trust were not being stored at the correct temperatures to remain effective.
The trust did not ensure that staff received appropriate training, supervision and appraisal. The trust had not met its target of 90% compliance for appraisals and some services had low compliance. Compliance for clinical supervision was low across the trust except for the mental health services for children and young people.
Inspectors raised concerns in relation to the trust’s management of mixed sex environments and maintaining the patients’ dignity and privacy at three of the inpatient services visited including the Yorkshire Centre for Psychological Medicine, Two Woodland Square and the crisis assessment unit.
Dr Paul Lelliott, the Deputy Chief Inspector of Hospitals (and CQC lead for mental health), said:
“The quality of the services provided by Leeds and York Partnership NHS Foundation Trust varied. There was some good practice; particularly in respect of staff recruitment and reducing ligature risks. We were also impressed with the quality of the community mental health services for children and adolescents – which we rated as Outstanding
“However, there remain a number of areas where the trust still needs to take action from the 2014 inspection and additional actions we identified as result of this latest inspection.
“I compliment the trust on the arrangements it had put in place to attract more staff. It had successfully recruited newly qualified and experienced staff through its recruitment events and its work with the universities. Patient involvement was good and appeared to be embedded in the trust’s approach to shaping its services and informing care and treatment.
“I acknowledge there has been some progress, but it is limited. The trust must work to improve those services where we found problems and maintain its areas of good practice. Should they be able to do so, I am hopeful of being able to report improvement at the next inspection”
The inspection team found several areas of good practice, including:
- The Leeds autism diagnostic service completed assessments and diagnosis for some patients in additional languages. Where patients’ spoken language was not English the teams had completed assessments in the language spoken by the patient. Staff had completed assessments in Shona and Persian to accommodate the needs of patients as an alternative to using interpreter services.
- Staff were able to access a personal health budget to manage the health of the inpatients on the rehabilitation and long stay wards for people with mental health problems. This is a pilot and involvement is agreed as part of the multidisciplinary team. As an example, a patient with self-esteem issues due to their appearance was able to access this money to get some dentistry work done to their teeth.
The inspection team also identified areas where the trust must improve, including:
- The trust must ensure all its services comply with the Department of Health guidance on same sex accommodation and the code of practice. CQC did not accept that the Yorkshire Centre for Psychological Medicine met the requirements of the Department of Health guidance on same sex accommodation.
- The provider must ensure that incidents are identified and reported in teams and services across the trust and that the systems are in place to enable them to do so. In addition the trust must ensure that they respond to requests for information from the Care Quality Commission and report all incidents to the national reporting and monitoring systems, in a timely way.
The Care Quality Commission will present its findings to a local quality summit, including NHS commissioners, providers, regulators and other public bodies. The purpose of the quality summit is to develop a plan of action and recommendations based on the inspection team's findings.
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