Lincolnshire Partnership NHS Foundation Trust

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Systems were in place to manage safeguarding incidents and staff were trained in safeguarding people from abuse. Staff felt confident action would be taken when concerns were raised. Staff described the action they would take. Records reviewed showed staff reported safeguarding incidents appropriately. Comprehensive care records including patients voice were in place. Risk assessments that had been updated regularly were in place to reduce people's risk of harm. Staff rotas reviewed showed that safe staffing numbers were not always reached, however, where this was the case clinical and ward managers worked on the wards. Staff we spoke to felt there was sufficient staffing on the wards. Patients felt the staffing had improved over the last few weeks. Staff received regular supervisions and training. Patients received their medicines safely and in a timely manner. Medicines were stored securely and managed well.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Patients felt safe on the ward. Patients said they felt happy, safe, and supported. They felt the staff knew them well which meant that staff were able to effectively support them to manage any risks. Staff were able to take the time to listen to them and were genuinely interested in whatever they had to say.

We spoke with 8 clinical staff; they were able to define safeguarding concerns and described the necessary actions required to report safeguarding incidents. We looked at 6 care records and saw evidence of safeguarding incidents being reported appropriately by staff.

The ward had a dedicated safeguarding noticeboard. This contained information on what might constitute a safeguarding concern, how to report it and informed staff of the characteristics that are protected by the Equality Act 2010. Details of the trust safeguarding team and how to contact them were also displayed.

The trust responded to safeguarding incidents well. They investigated concerns and where lessons learnt were identified appropriate actions were put into place. The trust safeguarding policy was reviewed annually and gave staff clear guidance on types of abuse and how to report concerns. Staff safeguarding training compliance was at 100% for safeguarding adults training and 96% for safeguarding children’s training.

Care records reviewed, all included the patient voice and showed patients had been offered a copy of their plan. We saw that each patient had an up to date risk assessment in place, that had been updated as required. Patients were supported by staff to be as physically, mentally and emotionally well as they could be. Patients said they were always invited to contribute and attend their ward round meeting and staff were supportive and helpful.

We observed 1 power, threat, meaning meeting which was attended by professionals. The meeting went well and allowed all attending to contribute to the discussions. This was a multi-disciplinary meeting which focused on the identification of patterns of emotional distress, unusual experiences and troubled or troubling behaviour for the patient. The aim was to help patients to create more hopeful narratives or stories about their lives and the difficulties they have faced or are still facing, instead of seeing themselves as blameworthy, weak, deficient or 'mentally ill'. We spoke with the clinical lead for the service who said the impact on both patients and staff had been overwhelmingly positive and had led to a better understanding of emotional distress.

The trust had a detailed policy on completing and reviewing care plans and risk assessments. This included the involvement of people using the service, commissioners a full multi-disciplinary team and family members (where the patient had consented). The policy guided staff to provide care and treatment in the least restrictive way possible, enabling patients to maintain the maximum possible level of independence, choice and control. There was a detailed process in place to update care and treatment plans.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Patients told us the ward had been understaffed but things had been improving over recent weeks. They told us they felt safe on the ward and there were enough staff to ensure they were able to have section 17 leave. One patient told us they had been recently supported by staff to attend a hairdressing appointment in the hospital vehicle.

Staff confirmed the ward had recently been short staffed due to an increase of clinical activity and acuity. They told us they had introduced additional staff to undertake a twilight shift and that this would remain in place until at least the end of March, when it will be reviewed. Staff we spoke with confirmed this was the case and that it had made a positive impact on the ward.

We observed 1 activity session where 4 patients and 4 members of staff participated in a baking and music session. We spoke with 2 patients attending the session who told us staff were lovely and always had a smile on their face.

We reviewed staffing rotas for February 2024. This showed out of 87 shifts the service did not meet safe staffing levels on 30 shifts as they were 1 staff member short in February. Managers told us during the day the ward would be supported by the ward manager and clinical lead and at night the ward had access to the on-call support to ensure the ward had sufficient staff support. Staff were appropriately trained with mandatory training compliance at 97%. Staff received regularly appraisals and clinical supervisions. However, managerial supervision compliance had dropped to 78% February but was at 97% in January 2024. These supervisions had been planned to be completed.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

Patients received their medicines safely and in a timely manner. Decision making processes were in place to ensure people’s behaviour was not controlled by excessive and inappropriate use of medicines. Care plans for patients reflected their individual needs and how to help them when they became distressed. Staff ensured that when rapid tranquilisation was utilised, the appropriate physical health monitoring was carried out in line with national guidance, to ensure patients remained safe. Staff provided specific advice to patients and carers about their medicines. Pharmacy staff provided specific counselling to patients when they were discharged with new medicines to ensure that they understood how to take them.

Staff completed mandatory medicines management training and annual assessments were completed to ensure they remained competent. Staff followed national practice to check patients had the correct medicines when they were admitted into the service. There were robust processes in place to investigate when incidents occurred, and lessons learnt were cascaded to staff.

Medicines including controlled drugs were stored securely and safely. We observed that medicines were given to patients in a person-centered and caring way. Ward rounds were multidisciplinary, and patients were involved when making decisions about their treatment where appropriate.

The service had an electronic prescribing and administration system in place. We reviewed electronic prescribing and administration system records for five patients and found that all had allergies documented, and venous thromboembolism assessments had been completed. Staff ensured that medicines were prescribed and administered according to the appropriate mental health act certificates. When patients were administered long-acting depot medicines, staff documented the site of administration to ensure that this was rotated as per manufacturers guidance. Medicines audits were completed regularly, actions identified were communicated with the ward and followed up by pharmacy staff.