CQC rate improvements in community and mental health services

Posted by: Jamie Sharp - Posted on:

The Care Quality Commission (CQC) has published two reports on services run by Leicestershire Partnership NHS Trust, following inspections of two of our 15 core services in January 2024.

Both inspections were unannounced; one was focused on community health services for adults and the other was on acute mental health wards for working age adults and psychiatric intensive care units. Both core services saw improvements from previous inspections.

We are pleased to share that, following this inspection, community health services for adults have been re-rated good overall. This inspection covered the Safe, Effective and Well-led domains. The Well-led domain has improved from requires improvement to good and Safe and Effective remained good. Responsive and caring were not included in this inspection and remain rated as good.

The rating for our acute mental health wards for working age adults and psychiatric intensive care units has again been rated as requires improvement overall. All domains were inspected with Responsive re-rated as good, and both Effective and Caring have improved from requires improvement to good.

The overall rating for Leicestershire Partnership NHS Trust remains as requires improvement because other core services would need to be inspected to change this rating.

Angela Hillery, chief executive of Leicestershire Partnership NHS Trust, said: “I am encouraged that our ongoing improvements have been recognised and it is pleasing that both inspections evidenced improvements. Our community nursing services for adults has retained their overall ‘Good’ rating, and three of the five domains rating our acute mental health wards for working age adults and psychiatric intensive care units are now rated ‘Good’. These are significant achievements and I want to thank all staff involved.

“Quality and safety remain our number one priority and we are aware we still have more to do.

In community health services for adults, inspectors found:

  • Staff treated people with compassion and kindness, respected their privacy and dignity, and understood the individual needs of people.
  • Staff provided good care and treatment to patients. They worked well together for the benefit of people, advised how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
  • Staff understood how and when to assess whether a person had the capacity to make decisions about their care.
  • Patients underwent a thorough assessment of need, and care plans were based on best practice and recovery oriented. Assessments were completed in collaboration with patients and carers.
  • Safeguarding processes were in place which reflected national guidance and were understood by all staff. There was a clear structure of reporting and responsibility for safeguarding.
  • Staff were up to date with mandatory training and had regular supervision and appraisals.

However, not all temporary staff had access to the electronic health records of people they were caring for and we are addressing this.

In acute mental health wards for adults of working age and psychiatric intensive care units, inspectors found:

  • Staff treated people with compassion and kindness and understood the individual needs of people. They actively involved patients and families and carers in care decisions.
  • Staff minimised the use of restrictive practices and followed good practice with respect to safeguarding.
  • The ward teams included, or had access to, the full range of specialists required to meet the needs of people on the wards.
  • Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
  • Staff received regular supervision and appraisal. Ward staff worked well together with other staff and roles inside and outside their ward and for providing aftercare.
  • The Trust had developed a collaborative approach to engaging with people who used services, and those close to them, to make improvements to the service.

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.

The CQC also 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 ready to start or have already started. Mandatory training rates have improved significantly since the inspection, affected by increased demands on mental health services since Covid, and these are now at over 85% across nearly all areas.

Anne Scott, chief nurse for 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.

“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.”

Both reports are available on the CQC website. See links below: