The Priory Hospital Market Weighton

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

At our last inspection we rated this key question requires improvement. The service was in breach of legal regulation in relation to person centred care. The service had made improvements and is no longer in breach of regulations. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. At this assessment, the rating has changed to Good.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us that they took care to communicate with patients in a way that they could understand. The service had input from a speech and language therapist who contributed to specific care plans regarding patients’ communication needs to enable effective communication.

Patients we spoke with told us the service involved them in the planning of their care and treatment. Individuals confirmed they had input from nurses, psychology, occupational therapy, physiotherapy and speech and language therapy.

Staff completed an assessment of each patient and the 9 care records we reviewed included information on the individual’s needs and preferences to ensure the care was person centred. Assessments identified physical health needs. The provider had service level agreements in place with a local GP practice and mental health trust to undertake physical health monitoring. When patients could not access the GP practice for their physical health care the GP would attend the hospital. However, we reviewed 5 patients physical health care records and evaluated that the process for reviewing physical health care needs or documents by the hospital was not always robust, for example in 2 care plans there was a lack of actions or interventions in relation to needs identified, 1 patient’s electrocardiogramresult had not been reviewed, and 1 patients diabetes care plan was incomplete.

We saw evidence that most people’s needs were met in line with current guidance. Multi-disciplinary team discussions involved the patient and their family or advocate in decision making and planning care and treatment.

The service used recognised tools in occupational therapy, psychology and for monitoring deterioration of physical health. However, we did not see any evidence of use of side-effect monitoring scales or tools. We could not be assured that patients knew how to raise concerns about side effects or how this would be identified and managed effectively.

The service had audits in place to ensure staff provided evidence-based care and treatment, including treatment under the Mental Health Act 1983. Restrictions on patients were regularly reviewed to maximise their independence.

Since the last inspection, the services occupational therapy had improved and the focus of the team was rehabilitation and recovery, making links with the community, promoting independent living and combatting institutionalisation.

Staff we spoke with also told us their development needs were identified during supervision, and they were encouraged to learn about new approaches and attend training that could improve the way care was delivered to people.

The service held monthly community meetings for patients and the service ensured people had access to activities and local community groups.

Staff told us that meetings in place were effective for sharing information internally. The service had clinical governance and team meetings, handover meetings, multi-disciplinary meetings, and review meetings for patients. The external advocacy service produced a quarterly report which we reviewed.

The service had good working relationships with external teams and organisations, however feedback we received from some external services highlighted that communication could be improved between the nursing staff and external services to improve the effectiveness of these relationships.

Case notes indicated evidence of external appointments and input from speech and language therapy, where appropriate. Discharge planning was collaborative with the patient. Feedback we received from advocacy regarding a discharge was positive, they commented that the hospital engaged well with the patient and external services to ensure the provision put in place supported a successful discharge.

Staff we spoke with understood the importance of ensuring people's needs were met, including their physical health. Patients were having regular sessions with psychology and occupational therapy as part of their holistic programme of recovery. Patients we spoke with did not raise concerns regarding their physical health care and one patient told us that they saw a physical health nurse weekly.

There were planned activities on the ward but patients we spoke with gave mixed feedback regarding this. 6 patients we spoke with told us that they do not get involved in activities either because they do not want to or because they were boring or there was not much variety. However, 1 patient we spoke with was positive about the activities and told us how the hospital had supported them to improve their computer skills and use of a smartphone. Patients attended monthly community meetings, and we saw evidence that the activity timetables were discussed during this meeting, including ideas for group outings.

The service used several methods to monitor and improve outcomes such as regular audits, meetings, surveys, and feedback. The service reviewed all of these including incidents, restrictive practice and blanket restrictions as part of clinical governance meetings and in restraint and reduction network meetings.

The staff team supported patients, and they attended meetings with a range of different professionals involved in their care to discuss their progress.

We spoke with staff and leaders of the service who told us that meetings gave them the opportunity to share good practice and discuss quality improvement. Staff felt that clear outcomes and actions from meetings were communicated to them.

Training records showed staff received training in Mental Capacity Act and the Deprivation of Liberty Safeguards and the training statistics showed 83% and 87% compliance. Staff we spoke with had a good understanding of consent including the Mental Capacity Act. Patients were supported to communicate and make decisions to enable the service to deliver person-centred care and treatment in line with people's best interests.

We looked at 9 care records which demonstrated consideration of a person’s capacity to consent. Capacity assessments were carried out as appropriate and were both time and decision specific.

Care plans evidenced that staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded they had done it.

Patients told us they were able to raise concerns and complaints, and these were acted on. Patients had access to advocacy. The independent advocate we spoke with told us that they attended on a weekly basis and were invited to attend relevant meetings.