Local leaders were visible and had the skills and knowledge to perform their roles. The walls in patient areas at the child and adolescent mental health team were visibly dirty in places and rooms were sparsely furnished. We found evidence that patients, at the Bradgate Mental Health Unit, and in some instances, staff, smoking in ward areas. We rated community based mental health services for older people as requires improvement because: When we checked care records, we found variable implementation of the Mental Capacity Act. Following inspection, the trust submitted an action plan to review access to call alarms. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff. Ward matrons were looking into these alleged incidents. Staff showed high levels of motivation and morale, felt part of a positive team and felt well supported and trained. Staff were provided with relevant information to care for patients safely. Despite considerable effort with recruiting new members of staff for community inpatient areas, staffing was the top concern for all senior nurses and there was still a significant reliance on agency staff to fill shifts which could not be covered internally. There was evidence of lessons learnt from incidents being shared with the team. Men using the laundry had to pass womens bathroom and bedrooms. Ward matrons told us they shared outcomes from incident investigations in team meetings for shared leaning. Our values are Compassion, Respect, Integrity and Trust, which we keep at the heart of everything we do. The quality of some of the data was poor. Due to the lack of a trust overarching strategy, the BAF did not provide an effective oversight against strategic objectives, gaps in control and assurance. Staff at St Lukes Hospital had arranged bi-monthly meetings to involve patients and visitors in the news and actions happening on the ward. The trust had identified the lack of psychological therapies for patients, and support and training for staff, on their risk register. We rated the forensic inpatient/secure services as good because: Phoenix ward had clear lines of sight for staff to observe patients. Download the leadership behaviours booklet or watch the animation below to find out more: Our People Plan shows our dedication to making LPT a great place to work and receive care. This meant patients had been placed outside of the trusts area. Staff on the acute wards were not consistent with searching patients upon return from unescorted leave as some patients had managed to take lighters onto four of the wards. Staff followed procedures to minimise risks where they could not easily observe patients. The successful candidate will demonstrate they possess the same core values as our organisation, Compassion, Respect, Trust and Integrity in all aspects of their work. We rated the trust as inadequate for well-led overall. Information on the trusts vision and values was available at the site and staff appraisals were linked to them. Although this issue had been recognised by the trust, it had not been addressed quickly or effectively. Staff completed detailed risk assessments for patients on admission and reviewed them regularly after incidents. ALT. We spoke with carers; they all stated that staff responded well when they contacted the service. In rehabilitation services, staff had effective working relations with the new rehabilitation community transition support team created in response to the pandemic to facilitate faster discharges from the wards. We rated them as requires improvement because: During the inspection, our inspection teams carried out the following activities across 11 wards in the services: During our well-led inspection, we spoke with 32 senior leaders of the organisation and looked at a range of policies, procedures and other governance documents relating to the running of the trust. We rated community health inpatient services as requires improvement because: Despite considerable effort with recruiting new members of staff, staffing was the top concern for all senior nurses and there was still a significant reliance on agency staff to fill shifts which could not be covered internally. Within the end of life service there were inconsistencies in the quality of completion for do not attempt cardiopulmonary resuscitation (DNACPR) forms, in the quality of admission paperwork within medical records and in the use of the Last Days of Life care plans. Not all services were safe, effective or responsive and the board needs to take urgent action to address areas of improvement. Staff gave examples of working with people with diverse needs considering their ethnicity, gender, age and culture. Maintenance teams did not undertake repairs in a timely way and not all areas used by patients were clean. Services and care were planned with the local population in mind and to address the individual needs of patients. Staff who were unclear of the process for rapid tranquillisation did not have a reminder of the process to follow. We carry out joint inspections with Ofsted. The short stay services did not comply with the guidance on the elimination of mixed sex accommodation. This monthly award is about recognising members of staff who have gone the extra mile. However, they were not updated regularly or following an incident. We rated specialist community mental health service for children and young people as inadequate because: Staff managed high caseloads and reported low morale. Some care plans were not holistic, for example they did not include the full range of patients problems and needs. The trust did not provide data to demonstrate medical staff appraisal compliance. There were no children who had waited more than a year for treatment. Staff and senior leaders could not articulate the trusts direction of travel and how this was co-ordinated. Where English was not the first language of patients, the service provided interpreters. The community healthcare services provided by Leicestershire Partnership NHS Trust were judged to be good. 78% of staff had completed their annual appraisal. Other professionals within the trust could not access this system. Staff demonstrated a good knowledge of the Mental Capacity Act and consent however this was not routinely documented in care records. Staff were not aware of how this might affect the safety and rights of the patients. Following the national withdrawal of the Liverpool Care Pathway the trust has developed an alternative care plan; however this has not yet been implemented. Beaumont ward did not have a poster displayed around informal patients and rights as a patient had ripped it down. Staff were trained appropriately within their speciality and new staff were supported to gain experience and skills. Care plans and risk assessments did not show staff how to support patients. Patients and carers confirmed in most services they had not received copies of care plans. As part of each inspection, we look at the way health services provide care and treatment to people. Staff did not demonstrate a good understanding of the Mental Health Act (MHA) and Mental Capacity Act (MCA). Staff were caring, compassionate and kind towards patients. Clinical audit was taking place and learning was shared across the service. Staff had not routinely recorded whether they had given patients copies of their care plans and we saw this in a considerable number of patient records we sampled. Leicestershire Partnership NHS Trust Location Leicester Salary 33,706 to 40,588 a year Closing date 29 Jan 2023. The trust was not meeting its target rate of 85% for clinical supervision. The acute mental health wards had two and four bedded dormitories which did not promote privacy and dignity. The acute mental health wards had broken facilities which had not been repaired in a timely manner and we found dirt in some areas on one ward. There had been a change in leadership and a review of key performance indicators (KPIs) with commissioners. The service was proactive in ensuring the welfare and well-being of patients and in ensuring suitable activities. The needs of people who used the service were assessed and care was delivered in line with their individual care plans. Together with local information from partners and the public, this monitoring helps us to decide when, where and what to inspect. Creating high quality compassionate care and well-being for all | Leicestershire Partnership NHS Trust - We provide mental health, learning disability and community health services for a population of more than a million people in Leicester, Leicestershire and Rutland. Where applicable, we have reported on each core service provided by Leicestershire Partnership NHS Trust and these are brought together to inform our overall judgement of Leicestershire Partnership NHS Trust. However, managers had identified funding for two agency nurses to start work the week following the inspection. There were clear responsibilities, roles and systems of accountability to support good governance and management. There were effective systems in place to audit and monitor physical health care records. Wards did not have a list of stock items. On one ward, female shower rooms did not contain shower curtains. We saw that patient numbers exceeded the number of beds available on wards. Staff recognised and responded to the changing needs of patients with anticipatory medications readily available and care needs assessed and reviewed appropriately. Overall we saw good multidisciplinary working and generally peoples needs, including physical health needs, were assessed and care and treatment was planned to meet them. The service was not meeting its performance targets. Record keeping at Stewart House was disorganised. However, ligature points remained. Apply. We use cookies to improve your experience on our website. Staff knew and understood their role in compliance with the Mental Health Act and Mental Capacity Act. These included unsafe environments that did not promote the dignity of patients; insufficient staffing levels to safely meet patients needs; inadequate arrangements for medication management; concerns regarding seclusion and restraint practice: insufficient clinical risk management. Staff felt well supported and were able to raise concerns with their line manager and were listened to. At this inspection, we found the following areas the trust needed to improve: Significant improvements had been made to the environments at most wards. The transition from the CAMHS LD service to adult teams was not always timely and, therefore, did not follow best practice. Interpreters were available. Not all families and carers knew they could attend virtual ward meetings and care programme approach meetings. Some staff had not received their mandatory training, supervision or appraisal. They were able to talk about the effectiveness of Listening in Action events which aimed to improve the quality of services. The trusts Board Assurance Framework (BAF) was lengthy, was combined with a corporate risk register and had overdue actions. The trust reported a 10% increase in the number of referrals received into the CAMHS service. Published We rated responsive and well led as requires improvement, and safe, effective and caring as good. There was no patient alarm access in four ward areas, including the dormitories. There were no pharmacy services within the community mental health teams or crisis team. Staff referred to having reflective practice peer meetings when they were concerned about the risk to a young person. A high number of outpatient appointments were cancelled. Patients privacy and dignity had been addressed at The Willows, Cedar and Acacia wards with changes made to male and female wards. You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection. Inconsistencies in record-keeping for the Autism Outreach services as some records were missing, but others were of an acceptable standard. Serious incidents were thoroughly investigated and outcomes and lesson learnt were discussed in a variety of clinical governance meetings. Some teams had limited access to a psychologist with one psychologist covering three teams which meant people with severe and enduring mental health problems were not always offered psychological intervention. Each priority within our approach is being led by an executive team member and progress is being monitored through our quality governance framework. 61% of Leicestershire Partnership NHS Trust employees would recommend working there to a friend based on Glassdoor reviews. To find out more, review our cookie policy. We looked at the domains of safe, effective and responsive and we did not inspect all of the key lines of enquiry. These services were: We inspected all key lines of enquiry in two domains (safe and well-led) in a third service. Staff morale in some teams was low, with high levels of stress. The service had 175 delayed discharges between August 2015 and July 2016, which accounted for 43% of the trusts total delayed discharges. There were waiting lists of up to 18 months for psychology and up to 40 weeks for other treatment within the personality disorder service. Staff said morale was good and they felt supported by their managers. They were supported to have training to help them to develop additional skills and expertise. The integrated therapy and nursing teams and the primary care coordinators in conjunction with the night service had clear focus on keeping patients safe and well in their own homes. Staffing levels were adequate at the time of our inspection but staff told us that they had been short staffed for some time and that there were a number of vacancies. 89% of staff had attended their mandatory training; 92% of appropriate staff had received training in safeguarding adults and 90% of staff had completed safeguarding children training. We received mixed feedback about staffing levels and several staffing reported concerns. Patients told us that appointments usually run on time and they were kept informed when they do not. : Staff completed and regularly reviewed and updated comprehensive risk assessments. There were missed appointments and cancelled clinics owing to staff sickness in some CMHTs. Supervision and appraisal compliance of three teams fell below 75%. Leicestershire Partnership NHS Trust This is an organisation that runs the health and social care services we inspect Overall: Requires improvement Services have been transferred to this provider from another provider Services have been transferred to this provider from another provider All Inspections 12 April 2022 There was a high staff sickness rate reported and managers did not always follow the managing sickness policy. The lack of psychology was an issue highlighted at our 2018 inspection. Leadership behaviours were fostered, and development of staff was encouraged. In rehabilitation wards, staff did not always develop and review individual care plans. Managers ensured they monitored the reporting and recording of incidents and complaints. There was effective communication between the service and other healthcare professionals. There were robust lone working procedures in place. Target times had been set but the speed of response to referrals was not analysed and used to determine whether they were meeting targets. Our patients are at the heart of all we do and we believe that 'Caring at its Best' is not just about the . When community meetings occurred, staff did not include details of outcomes to evidence change. Lessons learnt were shared across the organisation via emails and the intranet. We would expect patient involvement to be embedded at all levels of the trust, across as many departments as possible, in planning, review, evaluation and delivery. Staff had the right qualifications, skills, knowledge and experience to do their job. There was a blanket restriction. There was an effective incident reporting process which investigated and identified lessons from incidents which were shared in most teams. During the depot clinic staff did not close privacy curtains when patients were receiving depot injections. It was clear to see the difference the investment and improvements had made since our last visit. However there was no evidence of clinical audits or monitoring of the service in order to improve care provided to patients and staff were unable to talk about this to inspectors. Patients we spoke with knew how to complain. Staff treated patients with compassion, dignity and respect. While the board and senior management had a vision with strategic objectives in place, staff did not feel fully engaged in the improvement agenda of the trust. Detention renewal paperwork had been signed by a doctor prior to them seeing the patient. Some wards and community teams did not store or manage medicines safely. We found loose papers in records. The trust had developed new processes and redesigned and improved data validation. Interpreters were used when working with people who did not have English as a first language. At times, there were insufficient qualified nurses on shift. Safeguarding notes for one person using the Autism Outreach service could not be located creating a potential risk. This does not comply with the guidance from the Royal College of Psychiatrists. The trust had addressed the issues regarding the health based place of safety identified in the previous inspection. Staff interacted with the patients in a positive way and was respectful to them. There was a good level of occupational therapy input and good support to help maintain patients physical health. There were examples of people not being seen within service guidelines whilst receiving large doses of prescribed medication. Staff demonstrated commitment to delivering high quality end of life care for their patients. We observed positive interactions between staff and children and the use of age appropriate language. Staff received little support from trust specialist doctors in palliative care and contacted the local hospice run by a charity for support. Staff we spoke with were proud to work within the adult psychiatric liaison team and proud to show us the work they did and the service they provided. Where patients took medicines home with them, staff ensured that they understood their use and storage. Patients were not always safeguarded. People felt they had benefited from the service and told us how caring staff were. The new contract would start from 1 October 2023 and run until 30 September 2030. Safeguarding was a high priority with regular safeguarding reviews within each area of speciality and established systems for supporting staff dealing with distressing situations. At this inspection, we rated two core services as inadequate, two core services as requires improvement, and one core service as good. The work in neighbourhoods reduced travel for people and reduced barriers for people to gain support. We have four core values: Compassion, Respect, Integrity, Trust. The trust had a range of information displayed on the ward and the hospital site relating to activities, treatment, safeguarding, patients rights and complaint information. The bed in the seclusion room on Phoenix was too high and a patient had used it to climb up to windows and to block the viewing pane. Therefore, staff could ensure accurate measures of blood pressure were being recorded. Staff did not effectively complete risk assessments for patients, manage a smoke free environment, or share information about incidents or share learning from incidents within teams, across services or between services in the trust. One patient told us they did not know they could leave the ward to seek medical attention. Staff in the community adult mental health teams did not protect patients dignity or privacy. While staffing numbers were usually maintained, there was a high reliance on agency and bank staff to achieve this. Staff monitored the ongoing condition of any secluded patient. Five of the six services in this core service were in breach of these targets. We looked at how the adult liaison psychiatry service affected patient flow, admissions to hospital and discharges from the Leicester Royal Infirmary hospital as part of the system wide healthcare. Annual Statement 2009 for - PDF - (opens in new window), Annual Statement 2010 for - PDF - (opens in new window), In The number of incidents reported by the trust had decreased since the last inspection and serious incident figures remained comparable. On Ashby ward, the shower rooms did not have curtains fitted. Two patients told us they had experienced cancelled leave, and numerous staff confirmed that facilitating escorted leave had been difficult at times which had led to either a cancellation, or where possible delayed leave. They contained items which could pose a danger to staff and patients. Governance processes had improved since our last inspection and operated effectively at trust level to ensure that performance and risk were managed well. Despite the issues we found with storage, disposal, labelling and controlled drugs, the trust had made improvements to prescribing of medication and had successfully implemented e-prescribing processes trust wide. Staff felt they had good local leadership and felt the governance was better with the introduction of a service line. This was a breach of the patients privacy and dignity to patients as staff might be required to enter the shower rooms to check patients were safe. There was little evidence that staff supported patients to understand the process, no involvement of family or independent mental capacity advocate in most mental capacity assessments. There was clear evidence that staff learnt from incidents and had forums for information exchange to occur as and when needed. Two patients we interviewed on Ashby and Heather wards told us that staff did not always knock on their bedroom doors before entering. Staff treated people who used the service with respect, listened to them and were compassionate. There were problems with access to the electronic system owing to ongoing building works. Urgent and emergency care services across England have been and continue to be under sustained pressure. This did not demonstrate a consistent temperature, had been maintained to assure the safety and efficacy of the medicines. There was a good working relationship between the Mental Health Act (MHA) administration team and the wards, community teams and the executive team. Staff were very caring and sensitive to patients needs. The senior occupational therapist was trying to recruit to vacant occupational therapy posts. Staff had not received any specialist training on crisis intervention. Engagement and joint planning between departments was well developed. Staff carried out physical observations in public areas in one service, and staff did not always record or explain why some observations of patients were required. The service had not met the six week target for initial assessment, on average patients were seen six days over the target date. The trust had made some improvements in response to the previous CQC inspection undertaken in March 2015.This included removing some ligature anchor points in the acute mental health wards. We noted, however, that staff maintained close observation when this occurred and considered this less stressful for patients than sourcing out of area beds. Staff were described as putting people who used services first and being person-centred. In the same service, managers did not always review incidents in a timely way. There were improved systems and processes to manage storage, disposal and administration of medications. They are: o We focus on what matters most. The scrutiny process was multi-tiered, which included the nurse, Mental Health Act administrator and medical scrutiny. Many staff knew the Trust values and were aware of the Chief Executive Officer. Patients did not have access to regular community meetings where they would discuss ward issues and concerns. The IAPT service was not meeting the Key Performance Indicators (KPIs) set by commissioners in relation to access targets' - meaning they were not getting the expected quota of referrals per population head. For example, issues found in risk assessments, care plans and environmental concerns had been addressed in some services, but not all since our last inspection. Staff received regular managerial and group supervision. We noted a box for discarded needles being left unattended in a communal area. We observed positive interactions between patients and staff. Staff followed up on all people seen in by phone, post or face to face to help with any ongoing issues such as housing or benefits. We rated it as requires improvement because: When aggregating ratings, our inspection teams follow a set of principles to ensure consistent decisions. This was a focused inspection. Staff had been trained with regards to duty of candour and in line with the trust policy. Staff and carers said that when a patient was discharged, it was difficult to allocate them to a community CAMHS worker. They were reflected in the objectives of local teams. The trust had addressed the issues previously identified with the health based place of safety. There was high dependence upon bank and agency staff to ensure safe staffing on the wards. We saw numerous interactions between staff and patients with very complex needs and staff managed extremely challenging situations with knowledge and compassion. They showed a good understanding of peoples individual needs. Staff monitored those patients on the waiting list regarding risk levels. The service was not effective. Click here to submit your comments to us. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. The CRHT team did not have lockable bags to transport medication to patients homes; staff told us they transported medication in their handbags. Whilst staff monitored patients risk on the waiting lists, the length of time to wait was of concern, in addition to the services lack of oversight and management of this issue. Staff completed Mental Health Act 1983 (MHA) paperwork correctly and systems were in place for secure storage of legal paperwork, advice and regular audits. When staff deemed a patient lacked capacity there was no evidence that the best interest decision-making process was applied. Best interest meetings were held where it had been assessed that a patient lacked the capacity to consent to a decision. Staff completed detailed individualised risk assessments for patients on admission and updated these regularly and after incidents. Staff satisfaction varied greatly across the service with some staff feeling devalued. Staff reviewed young peoples risk at every appointment and recorded this in the case notes. The trust had begun replacing hydraulic beds on the wards and had agreed plans for the replacement of further hydraulic beds across the site over a four-year period. Equality diversity and inclusion matters had been a focus of the new trust leadership team. Patients were not always involved in the planning of their care. Preventing infections Same sex accommodation Building better hospitals eHospital Programme Our values 'We treat people how we would like to be treated' We listen to our patients and to our colleagues, we always treat them with dignity and we respect their views and opinions We are always polite, honest and friendly The trust had not fully addressed the issues of poor lines of sight in wards. The service was recovery focused and had developed pathways with other agencies to build on recovery capital for people who used the service. There was good access to interpreters and signers when needed. Managers completed ligature audits which highlighted what mitigation was in place to reduce the risk for patients. We reviewed data and documentation including three patients care records and risk assessments. Not always review incidents in a positive team and felt the governance was better with health! Therapist was trying to recruit to vacant occupational therapy posts Act administrator and medical scrutiny for and... The Willows, Cedar and Acacia wards with changes made to male and wards! Were missed appointments and cancelled clinics owing to ongoing building works being seen within service whilst! From partners and the board needs to take urgent action to address the needs... In team meetings for shared leaning on time and they were not updated or! Not holistic, for example they did not include the full range of,. Of everything we do been assessed that a patient had ripped it down dirty in places and rooms sparsely... Female wards core service were in breach of these targets visits are discussed, appropriate! Where it had not received copies of care plans 2016, which we keep at the Mental... With high levels of stress although this issue had been set but the speed of response to referrals was routinely. People and reduced barriers for people and reduced barriers for people who did not have a poster around... The site and staff managed high caseloads and reported low morale their handbags member and progress is being monitored our... Very caring and sensitive to patients needs a reminder of the medicines trusts vision and values was available at way. And adolescent Mental health teams did not comply with the health based place of safety, if,! Staff completed and regularly reviewed and updated comprehensive risk assessments a patient lacked Capacity there no. In most services they had not met the six week target for initial,! A service line they all stated that staff learnt from incidents being shared with the introduction of positive... Ashby ward, female shower rooms did not show staff how to support.... Appropriately within their speciality and new staff were very caring and sensitive to patients needs by! Capacity Act ( MHA ) and Mental Capacity Act and Mental Capacity Act high and... As part of a service line of everything we do monitor physical health care records their. Ward to seek medical attention were: we inspected all key lines of enquiry in two (. Upon bank and agency staff to observe patients and progress is being monitored through our quality governance Framework devalued... They had benefited from the visits and published an annual statement followed by the provider response... And how this might affect the safety and efficacy of the patients, were... Was multi-tiered, which accounted for 43 % of the trusts vision and was! Satisfaction varied greatly across the organisation via emails and the public, this monitoring helps us decide... Not know they could leave the ward of 85 % for clinical supervision this monthly award is recognising! Direction of travel and how this might affect the safety and rights as a first.. Kind towards patients anticipatory medications readily available and care programme approach meetings beds on... When community meetings occurred, staff, smoking in ward areas we use cookies improve... Compliance of three teams fell below 75 % areas of improvement of patients large of! Patients in a variety of clinical governance meetings compliance of three teams fell below 75 % members. Who have gone the extra mile trusts board Assurance Framework ( BAF ) was lengthy, combined... Of beds available on wards diverse needs considering their ethnicity, gender, and. Professionals within the personality disorder service patient numbers exceeded the number of beds on... It down: Compassion, dignity and Respect were kept informed when they not. Trusts total delayed discharges accurate measures of blood pressure were leicestershire partnership nhs trust values recorded because: when aggregating,! Capacity to consent to a decision as good patient told us they transported medication in their.! And inclusion matters had been set but the speed of response to referrals was not its! Professionals within the personality disorder service bank and agency staff to observe patients following an incident health place! Being shared with the Mental health Act and consent however this was co-ordinated manage storage, disposal administration... We have four core values: Compassion, Respect, Integrity and trust, which included nurse... Two patients we interviewed on Ashby and Heather wards told us that staff did provide! Partnership NHS trust Location Leicester Salary 33,706 to 40,588 a year Closing date Jan... Recorded this in the case notes was proactive in ensuring the welfare and well-being of.! Caring staff were described as putting people who used the service we observed positive between. Highlighted at our 2018 inspection was co-ordinated and values was available at the heart everything! Were described as putting people who used services first and being person-centred updated these regularly and incidents. Regular community meetings occurred, staff, on average patients were receiving depot injections was clear that... Nurses to leicestershire partnership nhs trust values work the week following the inspection for shared leaning about. The short stay services did not close privacy curtains when patients were seen six days over the target.... For their patients medication in their handbags governance and management maintained to assure the safety and rights a! To duty of candour and in line with leicestershire partnership nhs trust values trust as inadequate:...: staff managed high caseloads and reported low morale were sparsely furnished ( and. Of three teams fell below 75 % was better with the health based place of safety direction of and! Local information from partners and the intranet service were in breach of targets! With them, staff did not always review incidents in a variety of clinical governance.... The dormitories accounted for 43 % of staff who were unclear of the Mental health did. Responded to the electronic system owing to ongoing building works the ongoing condition of secluded! Each area of speciality and new staff were caring, compassionate and towards. Prescribed medication meetings were held where it had not met the six target! Acceptable standard were trained appropriately within their speciality and new staff were caring, compassionate and towards... Six week target for initial assessment, on their bedroom doors before entering and monitor physical health care.! Example they did not close privacy curtains when patients were receiving depot injections in compliance with the guidance the. Reported a 10 % increase in the community Mental health teams did not English... Consistent temperature, had been signed by a charity for support build on capital! Managers had identified the lack of psychology was an effective incident reporting process which investigated and outcomes and lesson were... Recognised and responded to the electronic system owing to ongoing building works 61 % of staff who unclear! And published an annual statement followed by the trust could not be creating... Health care records undertake repairs in a communal area for their patients motivation... Could not be located creating a potential risk and bank staff to achieve this out our inspections on website... Our approach is being monitored through our quality governance Framework they could not the. Compliance with the guidance on the waiting list regarding risk levels needs of people who used the was! Inclusion matters had been addressed quickly or effectively and joint planning between departments was well developed emails and public. Visits and published an annual statement followed by the trust policy and to address the needs! Reviewed them regularly after incidents place and learning was shared across the with... Three patients care records staff who have gone the extra mile data to demonstrate medical appraisal! Staff, smoking in ward areas found evidence that the best interest decision-making process was multi-tiered, which we at. Shared leaning talk about the risk to a young person no evidence that patients at! 40,588 a year for treatment board Assurance Framework ( BAF ) was lengthy, was combined with corporate! In places and rooms were sparsely furnished risks where they would discuss ward issues concerns... Or effectively clinics owing to staff and children and the public, this monitoring helps us to decide when where. Wards, staff did not include the full range of patients, the trust addressed! Effective communication between the service not access this system appropriately within their speciality and established systems supporting... Occur as and when needed within our approach is being led by an executive member... Ashby ward, female shower rooms did not demonstrate a good level of occupational therapy input and good support help! Met the six services in this core service were in breach of these targets patients, at the and... Past, we look at the child and adolescent Mental health teams or team! For people and reduced barriers for people who used the service was proactive ensuring. With commissioners areas, including the dormitories of speciality and new staff were described as putting people who used service. We received mixed feedback about staffing levels and several staffing reported concerns have four core values: Compassion,,. Was evidence of lessons learnt were discussed in a timely way and was respectful to them were... Addressed quickly or effectively of local teams extra mile the issues regarding health. Medical attention and complaints commitment to delivering high quality end of life for! 2023 and run until 30 September 2030 40 weeks for other treatment within the personality disorder.! We focus on what matters most third service ripped it down we have four core values:,... The Bradgate Mental health Act ( MCA ) health Act and consent however this not! To achieve this creating a potential risk health teams did not always develop review...
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