Inspectors said services provided by Leicestershire Partnership NHS Trust were still in need of improvement, following their latest visit.
The Care Quality Commission inspected the trust in November, rating it “requires improvement” overall and also for being safe, effective, responsive and well led. But it was rated “good” for being caring.
“We found areas where there were low staffing levels”
The CQC told the trust to take action in several areas, including that sufficient numbers of “suitably qualified, skilled, experienced and supervised staff must be available to meet the needs of patients”.
In addition, the regulator said the provision of staffing in multi-disciplinary teams, specifically in relation to psychological input, must be reviewed.
Dr Paul Lelliott, CQC deputy chief hospital inspector and mental health lead, said: “We found areas where there were low staffing levels or an absence of specialist staff and the child and adolescent mental health community team’s caseloads were above the nationally recommended level.”
The trust was also told it must ensure systems were in place to identify and assess risks to patient health, safety and welfare, and that accurate records were kept of treatment decisions taken.
“Despite our challenges, I am confident about the journey we are on”
Where appropriate, patients must be involved in their care planning and that it be recorded, added the CQC in its report, which also warned that “patient privacy and dignity must be protected”.
Meanwhile, the trust was told to address safety concerns regarding ligature risks, blind spots and mixed sex accommodation, and to ensure that medication was safely managed.
Dr Lelliot said: “While progress had been made since our last inspection in 2015, the trust had not done enough to ensure it was providing services that were fully safe, effective and responsive.
Dr Paul Lelliott
“In particular, we were concerned the trust had not met all the required actions to mitigate the risks associated with ligature points or poor lines of sight,” he said.
He added: “Some areas lacked essential emergency equipment. For example, the health based place of safety did not have resuscitation equipment or emergency medication. We found some wards and community teams that did not store or manage medicines safely.”
However, the inspectors also noted some areas of good practice, including a “triage car”, which was called to incidents where it might be appropriate to detain someone under the Mental Health Act.
Within the learning disability service “we saw staff had developed care plans for patients that explained their treatment in pictures as well as words”, said the CQC inspectors.
The trust was also praised for its use of technology, especially for younger patients.
For example, the CQC noted a web-based health text and web chat service had been successful in informing and communicating with young people, and the primary mental health team also responded to questions from children and adolescents via its “education, health and care app”.
Staff shortages highlighted at Leicestershire mental health trust
Similarly, a digital app had been introduced for younger people who had developed dementia.
Meanwhile, it was highlighted that the Coalville Hospital had introduced activity co-ordinators to inpatient wards – known as the pink ladies – which had improved patients’ experience.
In addition, Rutland Ward had taken extra care to ensure a husband and wife could stay together on the ward while both required inpatient services.
The trust provides community and mental health services across Leicestershire, which are used by children and adolescents, young adults, acute adults and older adults.
Trust chief executive Dr Peter Miller said: “The CQC inspection is a point in time along our improvement journey.
“Many of our changes will take much longer to embed than 18 months; though we are pleased that our progress to date has been recognised,” he said.
Dr Miller noted that the CQC had not highlighted anything “we are not already actively addressing or have not planned to address”.
“Despite our challenges, I am confident about the journey we are on, proud of our achievements so far, and committed to providing the best services for patients and their families,” he said.
He added: “Thank you to our staff for their continued commitment, incredible compassion and hard work, which has helped to move forward at a time when our services are getting busier and we don’t have as many permanent staff as we would want.”