Leeds and York Partnership NHS Foundation Trust

Ratings - Acute wards for adults of working age and psychiatric intensive care units

• Overall

  Requires improvement

• Safe

  Requires improvement

• Effective

  Requires improvement

• Caring

  Good

• Responsive

  Good

• Well-led

  Requires improvement

Our view of the service

Leeds and York Partnership Foundation Trust provide acute inpatient services for adults of working age with mental health problems. These services are for both patients admitted informally and those detained under the Mental Health Act 1983.

The purpose of the wards is to provide assessment and treatment to people aged 18-65 who require hospital admission in an acute phase of their mental health illness.

The service consists of one psychiatric intensive care unit and five acute wards, located at two main sites: The Newsam Centre and the Becklin Centre.

The wards located at the Newsam Centre are:

• Ward 1, a 12-bed mixed gender psychiatric intensive care unit, and
• Ward 4, a 21-bed male acute ward.

The wards located at the Becklin Centre are:

• Ward 1, a 22-bed female acute ward
• Ward 3, a 22-bed male acute ward
• Ward 4, a 22-bed male acute ward, and
• Ward 5, a 22-bed female acute ward.

We last inspected the acute wards for adults of working age and psychiatric intensive care units in October 2019. At that inspection, we rated the service as good across all domains, and good overall.

Our inspection took place on 3, 4 and 5 February 2025. We inspected all wards and all five key questions: safe, effective, caring, responsive, and well-led. The inspection was unannounced (staff did not know we were coming) to enable us to observe routine activity. We gathered information from people using the service, their loved ones, staff and other external stakeholders. We observed the care being provided and reviewed a range of documents relating to the running of the hospital.

Our rating of this service went down. We rated it as requires improvement because the service did not always ensure that care and treatment is provided in a safe way to patients. This meant that the service was in breach of Regulation 12 Safe care and treatment because:

• There were blind spots on wards at the Becklin Centre which staff had not identified or recorded on the suicide prevention environmental audits.
• There was a door within the quiet room on Ward 4 at the Newsam Centre which had ligature points that had not been identified or recorded on the suicide prevention environmental audits.
• Staff did not always follow good infection prevention and control procedures in line with organisational policy. We saw that staff across the wards were not always bare below the elbows.
• Staff did not always assess patients’ physical health in a timely manner on admission. Data provided by the trust provided showed that some patients did not receive a physical health assessment until over a month after admission.

We also found that the service did not always ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment. This meant the service were in breach of Regulation 18 because:

• There were areas of non-compliance for mandatory training including fire safety.

We also found that the service did not always ensure the care and treatment of patients is appropriate, meets their needs and reflects their preferences. This mean the service was in breach of regulation 9 because:

• Care plans were generic and lack evidence of patient involvement.

We also found that the service did not always establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. This meant the service were in breach of Regulation 17 because:

• Managers and leaders had not taken appropriate steps to address issues with mandatory training.
• Managers and leaders did not have sufficient oversight of care records and had not taken appropriate action to ensure staff completed physical health assessments in a timely manner on admission.

However:

• Staff received lessons learned from the investigation of incidents, complaints and safeguarding concerns, both internal and external to the service. Staff met to discuss lessons learned and were debriefed and received support after incidents.
• Staff understood how to protect patients from abuse and the service worked well with other agencies to do so.
• Staff we spoke with understood the patient group including individual risks, and how they needed to engage with them.
• There was evidence of effective joint working with a range of internal and external teams. Managers had regular engagement with stakeholders and external services, inviting them to regular meetings and care programme approach meetings.
• There were robust processes in place for the investigation and management of complaints.
• Staff encouraged patients to live healthy lives, and there were a range of activities available to them.
• There were quality improvement projects in place which aimed to improve the quality-of-care patients received.

We have asked the trust for an action plan in response to the concerns found at this assessment.

People's experience of this service

Throughout our assessment, we observed staff being kind, compassionate and caring towards patients on the wards. They interacted with patients well and were attentive to their needs.

We spoke with 19 patients and 6 carers. Patients largely told us staff treated them well and in a caring manner. One patient told us “I can’t speak highly enough of staff. They are really friendly”. Another patient said “Staff are great. The OT [occupational therapist] is brilliant”. However, one patient said: “Most staff don’t care”.

Patients felt supported and said they were involved in decisions about their care and treatment. They told us they could provide feedback about their medicine and said they felt listened to.

Patients felt there were enough activities on the wards. One patient told us that staff from a local university attend the wards to facilitate sports sessions. Another said there was “plenty to do”.

Some patients felt there were not enough staff on the wards; said that staff were sometimes busy and did not always have time to engage with them or respond to their needs. Other patients felt there were enough staff and said their needs were met. Some patients fed back that bank staff engaged with them less than permanent staff.

None of the patients we spoke with told us they had experienced any abuse or unfair treatment on the wards, either from staff or other patients. Some patients felt that staff did not deal with disagreements between patients with one patient telling us they did not always feel safe on the ward.

Patients told us they were supported to keep in touch with family and friends and confirmed they had access to Section 17 leave.

Feedback from carers was mixed. Carers told us they felt that patients were safe and received appropriate care and treatment to meet their needs.

Most carers felt staff treated patients with kindness, dignity, respect compassion. Some carers felt staff could spend more therapeutic time with patients.

Carers told us they received updates from doctors but felt that communication from other staff could be improved. Some carers said they had to chase the ward for information or found things out when they spoked with their loved one.

Most carers told us they were unaware of the complaints process or said they had to find this out for themselves.

Carers confirmed that visits took place regularly and that they saw their loved ones during Section 17 leave.