England’s Chief Inspector of Hospitals has rated the services provided by Leicestershire Partnership NHS Trust as Requires Improvement following an inspection by the Care Quality Commission.
The CQC inspected the core services provided by the trust between 14 and 18 and on the 24 November 2016. The trust provides community and mental health services across Leicestershire. The services provided by the trust are used by children and adolescents, young adults, acute adults and older adults.
A team of inspectors, which included a variety of specialists and experts by experience visited hospital wards and community based mental health services.
The CQC has rated the trust as Requires Improvement overall. It was rated as Good for being caring, Requires Improvement for being safe, effective, responsive and well led.
CQC’s Deputy Chief Inspector of Hospitals (and lead for mental health), Dr Paul Lelliott, said:
“Our inspectors found the trust must make a number of improvements to bring its services overall up to a level that would earn a rating of Good overall. We gave immediate feedback to the trust following the inspection and this report presents the detail of our findings, our ratings and our recommendations.
“While progress had been made since our last inspection in 2015, the trust had not done enough to ensure it was providing services that were fully safe, effective and responsive.
“In particular, we were concerned the trust had not met all the required actions to mitigate the risks associated with ligature points or poor lines of sight. The trust was not fully compliant with guidance relating to same sex accommodation.
“Some areas lacked essential emergency equipment; for example, the health based place of safety did not have resuscitation equipment or emergency medication. We found some wards and community teams that did not store or manage medicines safely.
“We found areas where there were low staffing levels or an absence of specialist staff and the child and adolescent mental health (CAMHS) community team’s caseloads were above the nationally recommended level.
“Staff did not always maintain people’s dignity and privacy and record keeping was poor in some areas.
“However, we found some areas of good practice including the triage car which saw the trust working with the police and other healthcare professionals to help people who might have mental health problems. We were also impressed by an app which had been developed to help young people with early onset of dementia.
“The trust leadership is aware of what it needs to do to bring about improvement in the areas identified. We will continue to monitor the trust and our inspectors will return at a later date to check on what progress has been made.”
The CQC has told the trust to take action in several areas, including:
- Where appropriate, patients must be involved in their care planning and this must be recorded appropriately.
- The provision of staffing in the multidisciplinary teams, specifically in relation to psychological input, must be reviewed.
- Patient privacy and dignity must be protected.
- Staff must follow the trust’s policy, the Mental Capacity Act and associated code of practice when assessing patients’ capacity.
- Safety concerns in the health-based place of safety regarding ligature risks, blind spots and mixed sex accommodation must be addressed.
- Medication must be safely managed.
- The trust must ensure systems and processes to identify and assess risks to the health, safety and/or the welfare of people awaiting treatment are in place and that there are accurate records of decisions taken in relation to the care and treatment of patients.
- Sufficient numbers of suitably qualified, skilled, experienced and supervised staff must be available to meet the needs of patients.
The CQC inspection team also found a number of areas of good practice, including:
- The triage car - which was called to incidents where it might be appropriate to detain a person under the Mental Health Act - had improved access to assessments for people who came to the attention of the police and may have mental health needs. Staff undertook assessments in an environment that provided dignity and confidentiality.
- Within the learning disability service we saw staff had developed care plans for patients that explained their treatment in pictures as well as words
- In conjunction with the young onset dementia service, a digital app for younger people who have developed dementia. The app was highly commended in the Innovation Support Service Development category of the Care Coordination Association 2016 awards.
- The primary mental health team had a professional’s consultation line and responded to questions from children and adolescents who accessed a health app called education, health and care app. The use of social media had been developed to help engage young people, ask questions and seek help and advice about mental health issues.
- Coalville Hospital had introduced activity coordinators to inpatient wards (known as the pink ladies) which had improved patients’ experience and increased the number of activities available for them.
- Rutland Ward had taken extra care to ensure a husband and wife could stay together on the ward while both required inpatient services.
- The electronic prescribing system which was introduced in all community health hospitals supported the safe administration of medicines.
- The web-based health text service and web chat service was successful in communicating with young people and providing information.
- The flexibility and empathy demonstrated by the looked after children’s team was unyielding during challenging times.
Ends
For media enquiries contact Louise Grifferty, regional engagement manager on 07717 422917 or Helen Gildersleeve, regional engagement officer on 0191 233 3379. CQC’s press office is also available on 0207 4489401. For general enquiries, call 03000 61 61 61.