The Care Quality Commission (CQC) carried out a planned unannounced inspection of Leicestershire Partnership NHS Trust (LPT), between May and July 2021. The inspectors visited three of our 15 core services: two of our mental health services previously rated as inadequate and one mental health service rated requires improvement (2019). They also inspected our Trust against the well-led domain, previously rated as inadequate.
The services visited were:
- acute wards for adults of working age and psychiatric intensive care units and
- long stay or rehabilitation wards for working age adults.
- wards for people with a learning disability or autism.
In summary, the CQC inspection report shows that LPT has: –
- Retained the overall rating of Requires Improvement at this time.
- Retained the Good rating for Caring.
- Improved core service ratings as the Trust no longer have any core service rated Inadequate overall and must continue to embed actions to build upon these improvements.
- Improved the well-led domain which has progressed from Inadequate to Requires Improvement with many Good characteristics including significant improvements in leadership, governance and oversight of performance and risk, and an improved culture and engagement with staff and people using services.
The CQC has continued to be concerned regarding aspects of our Mental Health estate and in particular our dormitory accommodation. We are equally concerned and have had a robust capital programme in place since 2019 to address this. This remains a significant priority – and whilst it was affected by the Covid pandemic, we are continuing to implement our schedule and respond to feedback provided. We are committed to eliminating dormitory and shared sleeping accommodation to give better privacy and dignity to our patients, and in the meanwhile we recognise this will affect quality and safety ratings by CQC. We have been successful in gaining national funding to eliminate dormitory accommodation; two wards have been completed over the summer (see this film https://youtu.be/j2dnrUs9GOY) and we have a rolling programme to complete the work at the remaining mental health wards.
The CQC shared that all staff they spoke with told them they felt proud to work for the trust, that their teams were valued and that they were proud to make a difference to those who used our services. We are proud of the dedication our staff have shown during the Covid-19 pandemic, and of their commitment to creating high quality, compassionate care and wellbeing for all.
Safety is our number one priority, so we are pleased that the CQC report has recognised “an improved safety culture” at LPT. “There was an improved safety culture in the organisation. Safety first was a common theme in trust board meetings and committees. Improvements had been made in screening serious incidents, ensuring lessons were learnt from incidents and action plans included embedded evidence to demonstrate learning. Safety was not compromised by finance.”
Whilst only three of our 15 core services were visited in the inspection and our overall rating as a Trust remains at ‘requires improvement’, we are proud that we no longer have any core services rated as inadequate, our staff remain rated as ‘good’ for caring – reflecting our commitment to our values of compassion, respect, integrity and trust and our well-led review has progressed from Inadequate to Requires Improvement. We will continue to build upon our improvements and are confident in our staff who have been amazing in responding to a Covid pandemic during this time too.
In relation to the well-led review, the CQC highlights a strong executive team, and “significant improvements to develop a strengthened vision and strategy”, alongside a positive and collaborative culture since the last inspection. Their report describes “a culture of inclusive, compassionate and effective leadership with plans to sustain the progress made. We are very pleased that the previous Inadequate rating for ‘well-led’ has improved to ‘Requires Improvement’, which is a testament of the immense work we have undertaken to strengthen our governance, risk management and strategy to Step up to Great whilst responding to a Covid pandemic. We are proud of this progress – a big thank you to all of our staff for embracing our step up to great strategy and for their continued support. We will continue to welcome feedback on improvements we can make and focus upon embedding these within all our core services.
We are particularly proud that our out of area placements for people requiring Mental Health beds in crisis have drastically decreased in the last 14 months, which is a huge testament to the hard work of our staff. The inspectors also recognised improvements in the way our staff manage risks and reduced ligature risks to keep our inpatients safe, an area previously highlighted for improvement. The inspectors have also outlined other significant areas of improvement since the last inspection including our elimination of mixed sex accommodation, improved seclusion environments, medicines management and patient involvement. Our staff have also worked hard to ensure our mental health patients have good access to physical healthcare and support to live healthier lives, and we are pleased the report recognises this. The inspectors have also said we practice good infection prevention control and take complaints seriously, sharing lessons learnt with staff. This is important for our continuous improvement.
Other areas for improvement included the timeliness of repairs, storage and cleanliness, which are provided through a contract with the University Hospitals of Leicester. We are taking steps to improve this, alongside our existing programme of internal quality checks and accreditations which continue to monitor standards. Since the inspection we have implemented an enhanced action plan to address the concerns raised.
We were pleased to see the CQC report acknowledge our positive culture and staff morale, our improved engagement with stakeholders and our active role with partner organisations to improve the health and wellbeing of people in Leicester, Leicestershire and Rutland. They also recognised our commitment to improving equality, diversity and inclusion, staff health and wellbeing and their career progression, and how we ensure the involvement of patients, service users, the public, staff and partners in the design of services. We were pleased the report highlights outstanding practice in patient and carer involvement and engagement with inpatients in our adult learning disabilities mental health unit.
Thank you to our group partners Northamptonshire Healthcare Foundation NHS Trust (NHFT). We are proud that this relationship has: “allowed shared learning and collaboration to continue from the foundations of the buddy scheme.” We will continue to work on transformation priorities together.
Finally, a big thank you to all of our staff for being tremendous throughout the Covid pandemic, and despite this challenging time they have demonstrated improvements and retained our Good rating for Caring. We know we have more to do, and we remain determined to build further with our staff, patients, service users and partners, towards an overall rating of Good for our Trust and our population. Thank you to all our partners for all your ongoing support.