The Care Quality Commission and Chief Inspector of Hospitals has recently published a report on the quality of care provided by the Leicestershire Partnership NHS Trust following an inspection in March 2015.
The Leicestershire Partnership NHS Trust provides community health and mental health services for Leicestershire.
In the report, the Trust was rated as “Requires Improvement” overall. It was rated as ‘Good’ for whether the services are caring, ‘Requires Improvement’ for whether services are effective and, rated ‘Inadequate’ for whether services are safe.
Some the identified concerns were:
- Inspectors had concerns regarding potential ligature risks on the Bradgate Unit, Herschel Prins Unit and the Agnes Unit. Inspectors noted that some of the wards did not facilitate the necessary observation and safety of patients and there were concerns about the design of seclusion facilities at some of the units.
- A lack of beds meant that people did not always receive the right care at the right time. This also meant that at times people would be moved, or discharged early, or managed within an inappropriate service.
- It seemed that there were inadequate staff numbers and a heavy reliance on bank staff.
- Arrangements for the safe and effective administration, management and storage of medication across the Trust were inadequate.
Despite the concerns identified, Inspectors reported that staff had shown that they wanted to provide a high quality of care, despite the challenges of staff levels and some poor ward environments. Inspectors also saw good multidisciplinary working and that people’s needs were being assessed appropriately.
The Trust is now required to take action in several areas and the Care Quality Commission has reported that the Trust has already started to make several changes to rectify the issues identified.
In particular, the Trust:
- Must ensure that medicines are stored, administered, recorded and safely disposed.
- Must ensure that the use of syringes and needles meets the Health and Safety Executive Regulations.
- Must ensure that action is taken to remove identified ligature risks and mitigate where there are poor lines of sight.
- Must ensure that national guidance be followed regarding mixed sex accommodation in order to promote safety and dignity.
- Must check emergency equipment on a regular basis.
- Must ensure that there are sufficient and appropriately qualified staff at all times to provide care to meet patients’ needs.
- Must ensure that all risk assessments and care plans are updated consistently in line with changes to patients’ needs or risks.
The Care Quality Commission’s Deputy Chief Inspector of Hospitals said:
“Our inspectors found the Trust must make some improvements to bring its services overall up to a level that would earn a rating of “Good”….In particular, we were concerned that staffing levels were not sufficient at a number of inpatient wards and communities across the Trust. Policies and procedures regarding restraint and seclusion did not comply with national guidance and we found a number of mental health wards that did not provide a safe environment. However, as well as finding some areas for improvement, we also found a number of areas of good practice across the trust. In particular, we concluded that most staff were caring and compassionate…”
“The Trust leadership knows what it needs to do to bring about improvement and our inspectors will return at a later date to check on what progress has been made.”
The Chief Executive of the Trust was reported as saying:
“We have made significant progress by improving staffing levels, changing the skill mix in nursing staff, increasing the number of therapists and investing in leaders. I am proud the CQC has recognised the commitment and care of our staff. We recognise there are a number of areas where we need to improve.”
Comment
Whilst it is positive that the Trust has demonstrated areas in which it is performing well and that a proactive approach has been taken to act on the concerns identified, it is still worrying that some of the most vulnerable of patients may have been and/or continue to be placed at risk in this way. It is vital that the Trust keep up the momentum is making the necessary changes to improve as soon as possible in order to ensure the best possible care for patients is achieved.
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