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

The service ensured people received effective care and treatment by carrying out thorough assessments and regularly reviewing individuals’ health, wellbeing, care and communication needs in partnership with them. Care was planned and delivered collaboratively, reflecting what mattered to people and aligned with legislation, evidence‑based practice and current standards.

Teams and services worked well together, sharing assessments so people did not have to repeat their story when moving between services. Staff supported people to maintain and improve their health and wellbeing, promoting independence, choice and control, and helping them reduce future need for care where possible.

The service monitored outcomes routinely, using this information to drive continuous improvement and ensure care remained effective, consistent and person‑centred. People were informed about their rights around consent, and staff respected these when delivering care and treatment.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 19 sets of children and young people’s core mental health assessments and care plans. Care plans were personalised, holistic and recovery‑focused, and were developed collaboratively with children, young people and their families. Care plans clearly evidenced effective transition planning for young people moving to adult mental health services.

Staff completed a comprehensive mental health assessment at, or soon after, admission to the service, ensuring needs were identified promptly. Initial assessments usually took between 60 and 90 minutes and were usually able to be completed by one practitioner. More complex multi-disciplinary assessments took longer to complete.

Staff assessed children and young people’s physical health care after admission. This included monitoring blood pressure, and body weight.

Families and carers were actively involved in children and young people’s care plans. This approach ensured the child or young person’s voice was central while also recognising the important role families play in shared decision‑making and safety planning. Care plans were reviewed regularly with the child, their family and the care team to support consistency, understanding and effective management of needs.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff provided a range of care and treatment interventions suitable for the patient group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence (NICE). Staff delivered evidence‑based, trauma‑informed care using a structured core pathway, ensuring consistent assessment, intervention and discharge. Risks, progress and outcomes were routinely reviewed to keep care plans up to date.

The multidisciplinary team were made up of experienced and qualified staff with the right skills and knowledge to meet the needs of the children and young people. Teams included or had access to the full range of specialists required including psychiatrists, psychologists, nurses, occupational therapists, other mental health practitioners, speech and language therapists, peer support workers, psychotherapists (Systemic, Cognitive Behavioural and Psychodynamic), community participation leads and youth workers.

Managers ensured that staff received the necessary specialist training for their roles. Staff said they were encouraged to attend relevant role appropriate training.

Managers ensured that staff had access to regular team meetings appropriate to their roles.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. Staff told us they felt well supported by line managers and the multidisciplinary team.

Managers provided staff with supervision meetings to discuss case management, to reflect on and learn from practice, and for personal support and professional development and appraisal of their work performance. Regular reflective practice sessions were available across sites. Staff had access to an online multidisciplinary team form, which they used to record information about the child or young person case and to request timely advice or oversight from a relevant clinician.

Staff received managerial and clinical supervision. Managers monitored the provision of supervision, to ensure that compliance with the trust’s policy was above the 85% target.

The compliance rate for management supervision was 93% and clinical supervision was 95%. Ninety percent of staff had received an appraisal in the last 12 months.

Managers dealt with poor staff performance promptly and effectively. Service managers held monthly meetings with the Human Resources team and discussed staff targets and concerns about performance.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff held regular and effective multidisciplinary meetings. We observed an Acuity Meeting attended by all strands of the community children and adolescents’ mental health services (CAMHS). Staff shared information about patient care effectively across the service.

Staff would follow the 72-hour follow up process to coordinate care for children and young people in crisis or had an inpatient admission and ensure the service worked across multi-agency teams and services to support children and young people. Care Navigators worked closely across teams to ensure children, young people and their families were signposted and able to access other services/resources within the community including other health and social care services, social activities, and education.

We spoke with 26 members of staff, most of whom spoke positively about the quality of multidisciplinary collaboration. Staff described a strong sense of professional identity. They felt well supported and understood by colleagues.

The teams had effective working relationships, including good handovers, with other relevant teams within the organisation for example, community mental health teams and the crisis team. There was clear evidence of effective multi‑agency collaboration and strong engagement across the multidisciplinary team.

The teams had effective working relationships with teams outside the organisation for example, local authority social services, schools and GPs. There was clear evidence of effective multi‑agency working.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff helped promote a healthy lifestyle for children and young people for example through participation in structured skills programmes to help young people improve sleep, reduce anxiety, manage school stress and build resilience. We observed staff discussing lifestyle factors including diet, physical activity, and screen use when clinically relevant, ensuring this was done in a sensitive, age‑appropriate way.

Staff supported children and young people to live healthier lives. Young people told us that staff helped them understand their mental health, recognise triggers, and develop strategies that supported healthier day‑to‑day routines.

The service provided information about other support services to children and young people on the waiting list. Information could be accessed through a scannable quick response (QR) code where the individual could then choose from a range of support. Information and groups available included an introducing group work session, decider skills, emotional skills, stabilisation group, sleep hygiene, sensory support and anxiety workshops.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff used recognised rating scales to assess and record severity and outcomes for example the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), Goal‑Based Outcomes (GBOs), the Experience of Service Questionnaire (ESQ), and the Outcome Rating Scale (ORS)/CORE‑YP, all of which were embedded within the electronic patient record system. Staff used these consistently at assessment, review points, and discharge to monitor changes and ensure treatment delivered positive progress for children and young people.

Staff used technology to support children and young people. For example, children, young people and families could give feedback in the service electronically through the experience of service questionnaire. This technology was used at multiple points across the care pathway, including after face‑to‑face appointments. This information was compiled into reports and shared with teams, contributing to quality improvements and reflective practice. Staff told us they valued this feedback and used it to adapt their approach and improve service experience.

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

Staff took all practical steps to enable patients to make their own decisions. Staff assessed and recorded capacity to consent clearly each time a child or young person made an important decision. The service’s electronic care plans had built in pages around capacity and consent to treatment.

For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately.

When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. They did this on a decision-specific basis with regard to significant decisions. Staff may request an assessment under the Mental Health Act.

Staff demonstrated good understanding and application of consent and capacity. For children and young people under 16, staff applied Gillick competency principles. Ninety-five per cent of eligible staff had completed safeguarding training that included elements of Gillick competence. Staff understood how to assess whether a young person under 16 had the maturity and understanding to make their own decisions. When treating older adolescents aged 16 or over, staff understood how to apply the Mental Capacity Act and documented assessments thoroughly within clinical records.

Staff supported young people to make decisions for themselves wherever possible, using age‑appropriate communication and involving parents or carers when appropriate while still respecting the young person’s autonomy.