England's Chief Inspector of Hospitals has rated Leicestershire Partnership NHS Trust as Requires Improvement following a CQC inspection.
A team of CQC inspectors visited the trust in November and December 2018 and identified a number of improvements that the trust needs to make to ensure services meet the standards people should be able to expect.
The trust is rated as Requires Improvement overall as well as for whether its services are safe, effective and responsive. It is rated as Good for whether its services are caring, and Inadequate for whether its services are well-led.
Deputy Chief Inspector for Hospitals (lead for mental health), Paul Lelliott, said:
“When we inspected the services provided by Leicestershire Partnership NHS Trust, we found that the trust had not addressed a number of the concerns we had raised following previous inspections.
“The trust lacked an overarching strategy and staff working in clinical teams did not understand how their own plans and objectives connected with the trust’s overall vision for the service. We found significant deficiencies in governance at the trust-level and the trust risk register did not clearly document action taken to address the risks that had been identified. Overall, the pace of change in planning and converting plans into action across the trust was disappointingly slow.
“The trust must improve its oversight of ward environments and of the safety of patients cared for in these settings. Despite CQC having raised concerns in 2017, the trust has still not taken the action necessary to ensure that these wards are safe, clean well equipped, well maintained and fit for purpose. We found concerns with the environment in all five core services that we inspected.
“However, staff showed caring attitudes towards their patients. We observed many positive interactions between staff and patients and saw staff managing challenging situations with knowledge and compassion. Most patients and carers that we spoke with gave positive feedback and made positive comments about the therapeutic relationships with staff. These findings resulted in us rating the trust as Good overall for whether its services are caring.
“As a result of our findings we issued the trust with a warning notice, which requires them to make immediate improvements to a number of areas. We will continue to monitor the trust and we will return to check on its progress with improvements. This will include further inspections.”
CQC has told the trust it must make a number of improvements including:
- The trust must ensure all environmental risks are identified and mitigated against on its acute wards for adults of working age and psychiatric intensive care units. This includes ensuring ligature risk assessments contain plans to update, replace or remove ligature risks.
- The trust must ensure the safe management of medicines and that medical equipment used by staff is regularly and accurately checked.
- Staff must consistently apply and record appropriate elements of the seclusion policy in line with the Mental Health Act Code of Practice.
- Lessons from incidents and complaints must be shared with staff.
- The trust must ensure all staff are aware of the Department of Health’s guidance on eliminating mixed sex accommodation and that it reviews arrangements of dormitory accommodation with a view to eliminating this in line with national guidance.
- Staff must involve patients in their care planning and ensure their views are recorded appropriately.
- The privacy and dignity of patients must be protected, sufficient facilities must be available to meet the needs of all patients and environments must be regularly maintained and updated to ensure they provide a safe environment for patient care.
- On wards for people with a learning disability or autism the trust must ensure that staff adhere to infection control principles and that items such as hairbrushes are not used for different patients.
- The trust must review their service provision for patients with attention deficit hyperactivity and autism spectrum disorders and reduce service waiting times in the Child and Adolescent Mental Health services in the community.
- The trust must ensure there is effective leadership of Child and Adolescent Mental Health services in the community.
- The trust must ensure they have accessible and comprehensive data/systems for Child and Adolescent Mental Health services in the community to measure their performance and risks.
- The trust must review their recruitment processes and ensure there is adequate staff available to reduce the patient waiting lists for assessment and treatment in Child and Adolescent Mental Health services in the community.
The trust provides mental health, learning disability and community health services across Leicester, Leicestershire and Rutland.
Full details of the ratings, including a ratings grid, are given in the report published online at www.cqc.org.uk/provider/RT5.
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