Leicestershire Partnership NHS Trust

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

At our last inspection we rated this key question requires improvement. At this inspection the rating has changed to good.

Good: Staff assessed people’s needs holistically. The service provided evidence-based care and treatment, and staff had opportunities to stay up to date with their knowledge and training. The service had the full range of specialists needed to meet the needs of people who used services, though some of the assertive outreach team told us they felt they would benefit from having occupational therapy staff. Staff worked together and with other services effectively to deliver joined up care. People were supported to live healthier lives. Staff understood their responsibilities under the Mental Health Act 1983. The service monitored people’s outcomes.

This service scored 83 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service maximised the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

The adult community mental health service had a referral and triage process to initially assess people’s needs and plan appropriate care and treatment with them. Staff we spoke to all understood the referral and triage process and how any risk concerns should be escalated. Referral meetings were held throughout the week and attended by a multidisciplinary team, to ensure people’s needs were fully considered.

People’s needs were assessed holistically. Occupational therapy staff told us about the holistic nature of their occupational therapy assessments. The assessments looked at everything that mattered to the person and how different parts might be interconnected. For example, they told us that someone’s processing skills might be affected by hearing voices.

Community connectors had recently been introduced to CMHTs as part of a ‘front door’ pilot to contact people and helped to signpost people who used services, and carers, to support that was available in their local communities. Community connectors provided assessment support to people who were referred to the adult community mental health service. If more information was needed about a person’s referral, a community connector would contact the person. The CMHT standard operating procedure stated community connectors would contact people whose referrals were accepted by the service within 72 hours and offer an appointment. Community connectors would contact people whose referrals were not accepted by the service and signpost them to other, more suitable services. They provided support to help people contact other services if needed. One community connector told us that they had signposted several people to the trust’s recovery college, which provided a range of courses to help people understand and manage their health and wellbeing.

Staff ensured that they met people’s communication needs and preferences. This supported them to fully assess people’s needs and enhanced the effectiveness of their care and treatment. Consultants told us that they regularly used interpreters and considered cultural factors in prescribing decisions.

In 2023, the trust signed up to the Carers Trust Triangle of Care programme. The Triangle of Care is a therapeutic alliance between carers, people who use services and health professionals. It aims to promote safety and recovery and to sustain mental wellbeing by including and supporting carers. A self-assessment process helps trust achieve accreditation once they have demonstrated they have met specific standards for carer inclusion and support. The trust had a carers promise and provided carers packs that contained information to help ensure carers’ needs were met.

Most staff in the adult community mental health service told us they were aware of the importance of meeting the needs of carers as well as those they supported. They informed carers of their rights to a carer’s assessment and, with agreement from carers, made referrals for these. They told us they sent carers information about support available to them.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They worked in line with legislation and current evidence-based good practice and standards and presented internationally on the delivery of intensive models of care. Staff had opportunities to be kept informed of best practice.

The adult community mental health service offered a range of treatment options suitable for people who used their services. The team included or had access to a range of specialists to meet the needs of people who used services by using substantive, agency and bank staff. In addition to doctors, nurses, occupational therapists and psychologists, people also had access to peer support workers, mental health support workers, mental health practitioners, community connectors, mental health wellbeing practitioners, and support, time and recovery workers. The service also had non-medical Responsible Clinicians who could oversee the care and of people under the Mental Health Act 1983.

The trust told us that the assertive outreach team had produced a number of publications about their care and treatment model and outcomes of the team. One of the team’s consultants had presented the service’s model of assertive outreach at local, national and international conferences and had contributed to the national review of assertive outreach provision in England.

Standard operating procedures stated that anyone under the care of a CMHT could be considered for psychology input, regardless of diagnosis. All psychologists were trained to deliver eye movement desensitization and reprocessing (EMDR) therapy. Some of the psychology team had received further training in different therapies, which enabled the adult community mental health service to provide a range of NHS 'Psychological Therapies for Severe Mental Health Problems'. Psychologists were able to access specialist supervision with a psychologist trained in a particular therapy to support their work if needed.

Staff received training in the Mental Health Act in line with the responsibilities of their role. The service had high rates of compliance for Mental Health Act training, with most teams at 100% compliance, which averaged to 97% compliance across all teams.

Staff made sure people under Community Treatment Orders (CTOs) were aware of their rights. They read people their section 132 rights and documented this in their care records. The trust’s Mental Health Act Procedural Document contained procedures for staff to follow to ensure anyone under a CTO had their rights protected under the Mental Health Act 1983. Staff had access to guidance on how to support people on CTOs and renew their rights. The service carried out CTO audits. Learning from the audits was fed back to the teams.

The service had relevant policies and procedures that reflected the most recent guidance in relation to the Mental Health Act. Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.

Staff and managers told us they could access support and guidance from the trust’s Mental Health Act Office.

The adult community mental health service participated in national and local clinical audits. In the previous 12 months, it had been involved in 1 national audit and 1 local audit that led to learning and action being taken. The psychosis intervention and early recovery (PIER) team’s involvement in the National Clinical Audit of Psychosis led to recommendations to reduce caseload sizes to 15-20 and to develop a local procedure to complement their standard operating procedure when people did not attend appointments. Both recommendations were partially complete at the time of inspection, with the PIER team having made improvements to its discharge process. The local audit looked at how the patient-rated outcome measures were used in the CMHTs. The audit led to recommendations to refresh their procedures and recruit a clinical lead to support with the consistent use of a patient-rated outcome measures tool.

The adult community mental health service ensured partners it worked with provided evidence-based care and treatment. For example, in the trust’s shared care agreement guidelines for medicines, it requested that primary care doctors ensured they reviewed up to date information on any medicine by signposting them to summaries of product characteristics (SPCs), British National Formulary (BNF), the Medicines and Healthcare Products Regulatory Agency (MHRA) and National Institute for Health and Care Excellence (NICE) websites.

The service worked effectively across teams and services to support people. They worked closely with other teams and services to ensure people’s needs were fully understood.

Teams in the adult community mental health service worked together to support people who used services. The service’s integrated neighbourhood transformation used a ‘hub and spoke’ model in which the CMHTs were the hubs for a neighbourhood locality, and specialist services and teams linked in with them in various multidisciplinary meetings.

All staff and managers spoke positively about the impact of working closely with other teams. They told us it helped them better understand the different teams and services who supported people and improved access to advice and guidance from colleagues. Some staff told us it supported more seamless transitions for people who used services when their needs changed and they moved between teams. It allowed staff to more easily monitor when people were referred to and discharged by the crisis team.

Staff in the adult community mental health service worked with primary care network staff and local authority social services. Some staff told us about work they had undertaken to support other agencies to effectively support people who used services. We were told about suicide and self-harm prevention training that the trust had jointly commissioned with the local authority, which had recently been delivered to around 250 people including staff from the district council, social prescribers, primary care networks, LPT trust staff and teachers.

Peer support workers were integrated into teams. They were staff who had lived experience of mental health challenges and used this experience to support others. Some staff told us peer support workers helped people engage more effectively with their treatment and physical health monitoring by using their own experience to support people to identify and overcome any barriers to engaging.

Some staff in the adult community mental health service told us they regularly liaised with inpatient services. They worked with inpatient wards to support people who were discharged home into the care of a community team. Between April 2024 and February 2025, 88.3% of people had a follow up appointment within 72 hours of discharge from inpatient services.

The trust provided multiple examples of how it worked with partner organisations across primary care, secondary care and the voluntary, community and social enterprise sector to provide support to people who used services. For example, the trust managed Leicester, Leicestershire and Rutland’s ‘Getting Help in Neighbourhoods’ scheme, which connected organisations with the shared aim of increasing access to mental health support in neighbourhoods and reducing health inequalities and disparities.

The service supported people to manage their health and wellbeing so they could maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. They worked with other providers to holistically support people’s healthcare needs.

People who used services had opportunities to take part in group physical activity and the adult community mental health service considered people’s support needs to maintain the greatest level of health and independence. For example, people could join occupational therapy-led walking groups and referrals to other agencies were made when people who used services would benefit from adaptations or equipment to maintain their independence.

Waiting rooms contained posters and leaflets for groups that might help people. All waiting rooms we saw during our inspection had information about drug and alcohol services. In North West Leicestershire’s waiting room, there was information about different groups and opportunities to be more physically active locally.

The CMHT neighbourhood leads linked with local groups and organisations and fed back to colleagues about any new services to signpost people to. Some staff told us they participated in annual health and wellbeing events with other providers which enabled members of the public to talk directly to staff and be advised about the steps they should take to get mental health support or be signposted to other appropriate organisations. One neighbourhood lead was planning a drop-in day with a primary care network that would support people who used services to have physical health checks on the day and access smoking cessation support. Some staff told us the neighbourhood leads linked in with primary care networks to try to encourage people who used services to come forward for cancer tests.

The service had signed up to an application and website that contained details of a variety of voluntary, community, social enterprise and faith services. The trust told us this helped people find information for themselves about groups and activities they could participate in that would support their mental and physical health and wellbeing.

People who used services were supported with food parcels and referrals to local food banks if needed.

The service routinely monitored people’s care and treatment to continuously improve it, to ensure that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. The service had started to introduce standardised outcome measures across CMHTs.

We saw evidence that care plans included tailored and individualised goals that were set in discussion with people who used services. People could access the service’s individual placement and support service to receive help gaining sustainable employment, which also supported people’s long term mental health and wellbeing.

The service had introduced an Active Wellbeing Occupational Therapy group which provided support and practical activities for a range of health and wellbeing topics to people who used services. The service used 2 recognised outcome measure tools at the start and the end of the 10-week programme. These showed people either remained stable or had increased scores from attending the sessions. The biggest score increases were seen in ‘motivation for occupation’ and ‘communication and interaction skills’

The service had introduced a recognised patient-rated outcome measure tool into CMHTs. The tool required people to rate their satisfaction with different aspects of their life. Between 2022 and 2024, the service piloted the patient-rated outcome measure tool in 2 of the CMHTs, where it was then used as standard. Senior leaders told us they were rolling it out across remaining CMHTs. Audit data showed that in South Leicestershire CMHT in April 2024, 37.5% of people completed an outcome measure tool questionnaire and 33.3% of people had the questionnaire discussed at clinical contact. In April 2025, this had increased to 57.1% and 75% respectively.

The trust held their own regular inspections across the adult community mental health service. Some managers told us the inspections helped them and senior leaders identify where improvements were needed to ensure people received safe and effective treatment in line with regulations. We saw the April 2025 inspection report of one CMHT, which used regulatory guidance to identify areas of good practice and areas for improvement.

The service told people about their rights around consent and respected these when they delivered person-centred care and treatment.

The need for staff to gain consent before delivering any care, treatment or intervention was highlighted in many of the trust’s policies. They also stated the need to ensure people who used services understood what they consented to and had capacity to make the decision. Staff at all levels had a good understanding of consent. We observed staff asking people who used services about consent to share information with loved ones. Staff ensured they had people’s consent before the inspection team observed any care. In most of our observations we saw that people were explicitly asked for their consent.

Staff received training in the Mental Capacity Act in line with the responsibilities of their role. The service had 97% compliance across all teams and most teams had 100% compliance.

Staff had a good understanding of the Mental Capacity Act, and capacity was clearly documented in people’s care records.

All staff we spoke to were aware of a person’s right to decide about their own care. For example, some staff told us about individuals’ capacity to make their own decisions about the medication they took.

The adult community mental health service now recorded when people under Community Treatment Orders (CTO) had their rights renewed. The trust’s Mental Health Act Procedural Document had guidance and procedures for staff to follow to ensure people under CTOs had their rights read to them at the mid-point of their CTO, or at least every 6 months, and when it was renewed. Further guidance for staff was available in the trust’s Supervised Community Treatment Orders Guidance.

The service carried out monthly CTO audits to ensure people who used services were kept informed of their rights under the Mental Health Act 1983 and had their plans updated. Audit data from April 2024 to April 2025 showed that across all CMHTs, assertive outreach and PIER, 95.3% of records evidenced that people had their mid-point rights read to them. Between April 2024 and April 2025, across all teams, 93.3% of records showed that people had their rights read to them at the point of extending their CTO.

People who used services could access advocacy support. We saw advocacy posters with contact details in waiting areas. People who received care and treatment under the Mental Health Act 1983, such as people on CTOs, could access statutory advocacy services. For others who used services, the service signposted people to a local voluntary sector advocacy service.