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The Priory Hospital Market Weighton Outstanding


Inspection carried out on 13 February 2018

During a routine inspection

  • We rated The Priory Hospital Market Weighton as outstanding because:

  • There was positive feedback from patients, carers and the advocacy services. All felt that staff went that extra mile to provide recovery focused, person centred care. Staff were continually respectful and positive in their approach to patients and there was evidence of strong caring and supportive relationships between staff and patients.
  • Patients were actively involved their care and were involved in decisions about the service. Patients were involved in interviewing all new staff and attended meetings regarding changes about the service at every level. Feedback from advocacy services about the service was positive reporting that they received appropriate referrals and patients give positive feedback to them about the hospital and its staff. All patients we spoke with were clear that they knew how to complain should they feel they wanted to.
  • Patients were encouraged in their interests and hobbies and supported to do voluntary work in the local community.
  • All patients made positive comments about the food. The chef had an excellent knowledge of the patients and was able to talk us through each patient and their nutritional needs on the day of our inspection. Whilst no-one required a special diet the chef and other staff were clear if one was needed it would be provided.
  • The Priory Hospital Market Weighton was providing holistic and person centred care to every patient. Staff had a clear vision of recovery and used outcome measures to monitor and assess recovery, whilst engaging patients in the process. The assessment process enabled patients and staff to get to know each other in order to ensure the placement was the correct place for everyone involved. Staff encouraged daily living skills.
  • Patients had access to psychological therapies as recommended by the national institute of health and care excellence. Every patient’s physical health was checked on admission and throughout their time in the service and were registered with a local GP surgery for this support.
  • The hospital was clean, tidy and well maintained. Staff managed blind spots , such as corridors that were not in sight of the nursing office, by use of observations, individualised risk assessments and the good knowledge of the patients by the staff. The clinic room was fully equipped and there were medication audits every two weeks by the local pharmacist.
  • The hospital was staffed sufficiently in order to ensure the safety of patients. There was no evidence of restrictive practice and patient risks were managed on an individual basis using a recognised risk assessment tool. Staff had a good understanding of safeguarding procedures at all levels and the hospital had good links with the local safeguarding team. All staff were aware of how and when to report incidents and the process for learning from incidents.
  • Staff were encouraged and supported to undertake specialist training for their role. Staff received supervision every four weeks and 100% of staff had an appraisal in the 12 months leading up to our inspection.
  • There was a good understanding at all levels of the Mental Health Act and its code of practice. Likewise the staff had a good understanding of the Mental Capacity Act and Deprivation of Liberty Safeguards. Staff assessed mental capacity when there were concerns and best interest meetings were held for patients that this affected.
  • The morale in the team was high and staff had a sense of pride in their work. The staff were committed to providing good quality, recovery focused care to all patients. The provider had a range of quality assurance and governance meetings set up across their organisation in order to monitor and improve performance.

Inspection carried out on 10 and 11 June 2015

During a routine inspection

Inspection carried out on 11 December 2013

During a routine inspection

There were nine patients at the hospital at the time of our visit.

Where patients were able to consent to care or treatment their views and wishes were respected. The provider worked in accordance with relevant legislation where patients were not in a position to consent to their care or treatment.

Patients told us they were satisfied with their care and treatment. One patient told us �I like boundaries. I like to know where I am�. Patients we spoke with confirmed they were involved in their care planning and reviews. We found care plans were detailed and reviewed regularly.

Although we found medicines were given to patients as prescribed we found that a lack of effective auditing made it difficult for the provider to minimise the risks associated with medicines. Protocols for supporting people with medication administered on an �as and when required� basis were robust.

We found there were sufficient staff to meet patient�s needs. Staff and patients who we spoke with confirmed this.

Although there quality monitoring took place we found that actions were not always recorded on completion to provide a thorough audit trail. Patients were involved in governance meetings and were able to effect change.

Inspection carried out on 25 January 2013

During a routine inspection

Patients were supported to be involved in decision making about their care through a care planning process. This included that health needs were identified and patients had access to health professionals.

People told us nurses involved them in their care plan and that they contributed to their monthly reviews. They also said that staff treated them with respect and they were satisfied with thier care.

Clear systems were in place for the reporting of and supporting of people with any safeguarding issues and staff were knowledgeable on these systems.

Effective recruitment processes and quality assurance systems were in place to help manage potential risks.

Inspection carried out on 17, 18 November 2011

During a themed inspection looking at Learning Disability Services

At the time of the inspection visit, there were 11 patients present. Nine patients were living in the main unit. No 27a, which is for semi-independent and the high dependency unit make up part of the main building. One patient was in the high dependency unit and two patients were living at No 27a. Two patients were living at No 27b, which is detached from the main building and offers more independence. We met and introduced ourselves to all 11 patients and spoke with six patients in more depth to get their views of the service. All of the patients were men.

Overall, patients and their relatives told us they were satisfied with the care and treatment at Holme Road. Things that patients said they liked included: the staff, the food, and gardening, going out for walks and doing activities, like arts and crafts. One patient showed us the allotment, which they were very enthusiastic about. Another told us they did lots of things, including further education. They explained that daily living tasks were organised so everyone took turns to be involved. Patients told us the staff supported them to be involved in putting their care plans together and going to review meetings. Relatives confirmed they were involved in this process. One patient said that staff had read their care plan to them and that they would like a copy of their own, for it to be more accessible with pictures and less writing.

Two patients mentioned that they had advocates. That is someone from outside of Holme Road who came in and spoke up for them. All of the patients we spoke with said they usually got on with other patients. However, two patients did say that one particular patient sometimes hit out at people. They said that they didn�t like this and it upset them.

The expert by experience who was part of our inspection team said that they thought that generally, people appeared relaxed and reasonably happy in the home.

There was one patient in the unit who we were not able to talk with to gain their views because we were not familiar with their way of communicating. We used the SOFI tool to observe how this patient, and two other patients, were spending their time. This was very helpful and showed that there was very positive interaction between the staff and the patients.

Reports under our old system of regulation (including those from before CQC was created)

Mental Health Act Commissioner reports

Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff.

Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. We are looking at different ways to indicate the outcomes of our monitoring in the future.