Improvements to mental health services across Leicestershire - but there is still work to do, says new report

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An NHS trust which provides mental health services across Leicester and Leicestershire has made improvements following a critical inspection report last year – but still has work to do – according to the latest assessment of its work.

The Care Quality Commission (CQC) carried out a follow-up inspection of Leicestershire Partnership NHS Trust after having previously recorded concerns over some patients’ ability to call for help as well as members of staff walking in on patients who were changing.

Officials returned unannounced in January this year to inspect the trust’s acute wards for adults and its psychiatric intensive care units. Their latest assessment saw the trust’s rating for this service remain as “requires improvement”.

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The report did note that improvements had been made, and when the score was broken down into categories, the trust’s rating for the service’s effectiveness, responsiveness and how caring it is improved to “good”. It remained “requires improvement” for safety and leadership.

The Care Quality Commission (CQC) carried out a follow-up inspection of Leicestershire Partnership NHS TrustThe Care Quality Commission (CQC) carried out a follow-up inspection of Leicestershire Partnership NHS Trust
The Care Quality Commission (CQC) carried out a follow-up inspection of Leicestershire Partnership NHS Trust

Patients also told the team most staff were “kind and treated people with dignity and respect”. On one ward, inspectors said there was a patient with a terminal illness and staff had “taken the time to get to know his wishes” and when the team was on the ward they saw them “going the extra mile for this patient by arranging a meaningful and fulfilling activity with his family”.

But some claimed night staff and temporary staff could be “uncaring, rude and dismissive”.

There was also a high vacancy rate across the service with an average rate of 39 per cent across all looked at areas. Conversely, there was a low staff turnover rate at the service which “had access to a full range of specialists to meet the needs of the patients”, the CQC said.

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Inspectors said the trust was actively recruiting at the time of the visit and managers used bank and agency staff to fill the gaps. It was found there were enough nursing and medical staff who knew the patients, to keep people safe from avoidable harm.

Managers were described as being “friendly and approachable” and as having “an open-door policy”. They were also quick to address risk issues, although the CQC said it was “concerned” processes had not “enabled staff to identify or act on these concerns prior to the inspection”.

The CQC also visited a second area of the service in January: community health services for adults which mostly saw care delivered in patients’ homes. This had previously been rated “requires improvement” but improved to “good” after this inspection.

Inspectors praised the service saying staff in this part of the trust kept “up to date with their mandatory training”, “understood safeguarding systems and process and how to protect patients from abuse” and “could give examples of how to protect patients from harassment and discrimination”. They also “knew how to identify adults and children at risk”.

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Staffing levels were again identified as a concern with inspectors saying the service “did not have enough permanent nursing and support staff to meet patients’ needs”. In December 2023, there were 144 vacancies in this area of the trust – a rate of 22 per cent.

Gaps in staffing were filled by bank and agency staff in this area as well. Managers used agency staff “from agreed providers whenever possible”, but this did not always meet all shift needs, the report continued.

Where staff were used outside of the agreed upon providers, support was provided by a permanent member of staff. Yet, they could not always immediately access electronic health records, the CQC said.

Staff followed systems and processes for prescribing and administering medicine to patients “safely”, inspectors found. They also reviewed each patient’s medicines regularly and advised them and carers on their healthcare.

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Ultimately, the CQC said “outcomes for patients were positive, consistent, and met expectations” within the community health services and leaders “had the skills and abilities to run the service”.

Angela Hillery, chief executive of Leicestershire Partnership NHS Trust, said: “Quality and safety remain our number one priority and we are aware we still have more to do. I am encouraged that our ongoing improvements have been recognised and it is pleasing that both inspections evidenced improvements. These are significant achievements and I want to thank all staff involved.

“However, the inspection team assessed that acute mental health ward environments were ‘not always safe, clean, well maintained and fit for purpose’. We took immediate action in response to the concerns raised and have put in place a robust plan to monitor these.

“Mandatory training rates have also improved significantly since the inspection and are now at over 85 per cent across nearly all areas.”

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Anne Scott, chief nurse at LPT, said: “I am so proud that our staff have been recognised as caring and compassionate by the CQC inspectors. In both reports there are numerous examples of good practice involving patients and carers, of our commitment to the delivery of quality care and continuous quality improvement, career progression and equality, diversity and inclusion, and of how supported staff feel in raising any concerns they may have. This reflects the significant improvements we have made in our culture and leadership, which we will continue to build upon.

“The CQC noted the acute mental health service’s high vacancy rates for registered nurses and that staff compliance against mandatory training was variable. Although nursing shortages are a national issue, we have undertaken a significant recruitment campaign since the inspection and have 37 new nurses who have already started or ready to start.

“I am also really pleased that the reports reflect our active role with partner organisations to improve the health and wellbeing of people in Leicester, Leicestershire and Rutland.”