The Priory Hospital Middleton St George

Updated 28 July 2021

The Priory Hospital Middleton St George is a 101-bed hospital that provides 24-hour support seven days a week for people aged 18 years and over with mental health problems, personality disorders or both.

Patient accommodation comprises:

• Birch ward – psychiatric intensive care unit for men (12 beds)
• Chester ward – psychiatric intensive care unit for women (12 beds)
• Oak ward – acute admission ward for women (15 beds)
• Thoburn ward – acute admission ward for both women and men (22 beds)
• Dalton ward – locked rehabilitation ward for women (13 beds)
• Hazelwood ward – locked rehabilitation/personality disorders ward for women (13 beds)
• Linden ward – locked rehabilitation ward for men (15 beds).

The hospital director is the registered manager and has been in post since February 2020.

The hospital is registered with the Care Quality Commission to provide the following regulated activities:

• assessment or medical treatment for people detained under the Mental Health Act 1983
• treatment of disease, disorder or injury.

There have been 12 inspections carried out at the Priory Hospital Middleton St George in the last nine years.

The most recent inspection took place in September 2020. This was a focused responsive inspection of Hazelwood, Oak, Thoburn, Birch and Chester wards following concerns raised by whistle blowers and notifications from the provider relating to patients being able to self-harm and ligature whilst on enhanced observations. We looked at specific key lines of enquiry issues under the safe and well led key questions.

This resulted in this location being rated as inadequate overall and placed into special measures because we identified serious concerns. These included concerns about:

• low staffing numbers
• the competency and training of agency staff
• the poor quality of documentation on the wards
• staff undertaking patient observations for excessive hours
• staff being unable to take breaks during 12-hour shifts
• a lack of management oversight.

We also took enforcement action against the provider and required the management team to provide fortnightly updates on how it was addressing the issues we had identified. We issued requirement notices in relation to the issues we found within the acute and psychiatric intensive care unit service.

What people who use the service say

We spoke with 46 patients and the overwhelming majority felt staff gave patients help, emotional support and advice when they needed it. However, on Oak ward we observed staff did not respond to two patients who had made frequent requests for help.

Patients said staff supported them to understand and manage their own care, treatment or condition.

Most patients we spoke with said staff treated them well and behaved kindly. However, four patients on Oak ward said some staff members could be abrupt towards them at times.

Staff involved patients and, in most cases, gave them access to their care planning and risk assessments. However, four out of the 46 patients who spoke with us within the hospital said they had never seen their care plan.

We spoke with two carers within the long stay rehabilitation service. The first carer said that staff had informed them about the change to their loved one’s medicine. A second carer told us that they had concerns their loved one’s medicine was ineffective and had been told they would have to wait until the following week to see a doctor about it. We raised this with the provider and the patient was seen by a doctor later that day, had their medicine changed and was told they would be discharged the following week.

We saw a summary of the results of feedback provided on discharge over the previous 12 months. The results showed 92 per cent of patients who completed the survey agreed staff respected their privacy and dignity, were caring and supportive and communicated well with them. Eighty-five per cent of patients agreed they felt supported to stay in contact with the important people in their lives. Eighty-five per cent of patients would recommend the service to family or friends and felt staff were caring and supportive. The results also showed 85 per cent of patients agreed the skills they had learnt would help them manage their life as they move on from treatment.

Updated 28 July 2021

Our rating of this service improved. We rated it as good because:

• The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Most patients felt staff treated them with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They involved patients and families and carers in care decisions.
• The service was well led and the governance processes ensured that ward procedures ran smoothly.

However, we found the following issues that the provider needed to improve:

• We found a blanket restriction within the hospital during our inspection. Patients on Chester ward were being made to use plastic cutlery. However, we were informed shortly afterwards that metal cutlery had been ordered so the provider had addressed this.
• Managers did not always ensure staff received regular supervision. An action plan was in place for low compliance with supervision on Birch ward.

Updated 28 July 2021

Please see the overall summary for this location above for further information.

Updated 28 July 2021

Please see the overall summary for this location above for further information.