• Mental Health
  • Independent mental health service

Archived: The Priory Hospital Potters Bar

Overall: Good read more about inspection ratings

190 Barnet Road, Potters Bar, Hertfordshire, EN6 2SE (01707) 858585

Provided and run by:
Priory Rehabilitation Services Limited

Important: The provider of this service changed. See new profile

All Inspections

15 September 2016

During an inspection looking at part of the service

We carried out an unannounced inspection of The Priory Hospital Potters Bar, and focused on the areas of safe and effective in relation to staffing levels, care plans, risk assessments and observations levels. We did not rate the provider on this inspection. We did not look at the whole domains of safe and effective and focused only on specific issues.

We found:

  • Physical health monitoring was being completed but not consistently recorded. Staff did not evidence how concerns about patients blood pressure or physical health was being managed effectively.
  • Where physical health checks identified a physical health concern for example diabetes and high blood pressure, care plans were not in place.
  • Patients had pre-leave risk assessments forms in place however these were not completed with the time due in or actual time back in.
  • There were discrepancies in patients risk levels from the patient information board to those indicated in the patients risk assessment. However, risk levels and patients risk behaviours had been identified.
  • Sleep charts and observation record sheets were not fully completed in line with the hospitals’ policies. The observation sheets did not describe the patients mental state which is required as part of the observation and engagement policy.
  • There was a high use of qualified agency nurses on both Crystal and Ruby ward on a daily basis.
  • Care plans were not holistic or in the patient voice and not comprehensive.
  • Care plans did not reflect the risks that had been identified in the risk assessments. Some care plans were in place and had been written for risks that had not been identified.

However:

  • All patients were assessed by a qualified nurse and doctor within 24 hours of admission and were physically examined.
  • The hospital had a staffing matrix in place and the staffing rotas we saw met the numbers required. There was a clear handover of patient information between shifts..
  • Staff had policies in place that gave guidance on the Care Programme Approach, risk assessments, observations and engagement and the monitoring of physical health of inpatients. The provider had completed an audit on both wards that identified care plans that were due to be reviewed.

18 – 20 November 2015

During a routine inspection

We rated The Priory Hospital, Potters Bar overall as good because:

  • Each ward was purpose built and designed for safe and effective staff observation of patients. Patients told us they felt safe and well supported by staff.
  • Staff had mandatory training in those areas identified by their provider, including de-escalation and diversionary techniques. This is where staff learnt to calm and manage difficult patient behaviour through talking.
  • Patient care and treatment plans were comprehensive and completed in a timely manner. The occupational therapist and their team provided a good range of daily programmes and activities. A wide range of staff from different specialties took part in every ward round and involved the patient wherever possible.
  • Staff had received training in, and had a good understanding of, the Mental Health Act 1983, the Code of Practice and the Mental Capacity Act 2005. Staff had assessed and documented patients’ mental capacity and ability to consent to their treatment and care.
  • Patients told us that they had effective and supportive meetings with their named nurse and the clinical notes supported this. Individual care and treatment records were up-to-date and relevant. Patients had access to independent advocacy services and the provider displayed information about these services across the wards.
  • The hospital received patients from all over the UK, when NHS hospitals did not have enough beds available. This sometimes resulted in short-term admissions. The provider reported good joint working with NHS trusts around arrangements for transferring patients in and out of the service.
  • The hospital had a robust patient complaints process.
  • The hospital had a ‘lessons learnt’ group, which provided information and guidance to senior managers and each ward. Staff told us that senior managers visited their area and were accessible if they had any concerns. Frontline staff took part in clinical audits and used the findings to improve services for patients. Frontline staff spoke of having good morale on all wards. There was a low level of staff sickness.

However:

  • Seven patients out of 36 said that staff had not given them a copy of their care plan and had not involved them in developing it.
  • Nursing staff expressed frustration over the amount of paperwork they needed to complete, which they felt did not give them enough time with patients to deliver care and treatment.

5 August 2014

During an inspection looking at part of the service

We inspected this service in 24 July 2013 and identified areas where the provider needed to take action. The provider sent us a report detailing the actions they had taken. We carried out this inspection to check on the actions taken and because we were alerted to serious concerns from other agencies commissioning care of people.

Some previous compliance actions related to the Aspen Unit. However this unit was in the process of closing therefore this inspection focussed on the service being provided at the Hadley Unit. There were eight people at the Aspen Unit and 16 people at the Hadley Unit during our visit.

The service was safe. We found the provider had policies and procedures in place to protect people from abuse or harm.

Improvements were needed to ensure the service was effective. The provider had systems in place for ensuring secure storage of records. We found that improvements were needed to ensure that robust assessment and care planning were in place for each person using the service.

The service was caring. Most people gave us positive feedback about staff and the service given. However the provider might like to note that not all people were aware of their care plan.

The service was responsive. We saw that staff gave support to people to ensure individual choice and that people who used this service had enough to eat and drink.

The provider had systems to ensure the service was well led. The current manager was not a registered manager with the CQC but was submitting an application for this. The provider had taken steps to address the areas of previous non-compliance.

24 July 2013

During a routine inspection

Most of the people had complex needs and were therefore unable to speak with us. However, a visiting relative said, 'The place has gone down in the last two weeks; you sometimes have to wait hours to get things done.' They also told us 'Some carers get very angry and take it out on the residents.' One person who used the service also told us that ' Staff members can be very argumentative and shout above me when they are talking to me. However, generally, it's good here.'

We noted that everyone we saw appeared to be clean and tidy and the home smelt clean. We found the provider did not have appropriate processes in place ensure people were not receiving inappropriate or unsafe care. Nor did they always have effective procedures to protect people from abuse or harm.

We noted that there were not always robust systems in pace to prevent unauthorised access of the file of both staff and people who used the service. We saw that at lunch time people were not always appropriately supported with their meals.

Since the last inspection the provider had positively modified their processes in relation to the administration of morning mediation so that people were not woken early in order to take a medication which could be administered later in the day. We also noted that people's continence needs were attended to effectively and in a timely fashion.

15 April 2013

During an inspection in response to concerns

Due to the time of our inspection most people who used the service were asleep. People we spoke with said they were mostly happy with the care they received from the provider. However, some people were not happy with the how the provider supported them with their care needs.

There were systems in place to manage and administer medicines so that people received their medication as prescribed.

The provider had procedures in place to ensure there were sufficient suitably qualified staff to care for people who used the service. We found that the provider did not always treat people with consideration and respect when providing their care.

13, 14 November 2012

During a routine inspection

People who had received a service told us that they were able to make choices regarding how they organised their daily lives and had been involved in decisions about their care and treatment. One person said "I am very happy with my surroundings and this makes me happy despite my disability'.

People confirmed that their individual needs had been catered for. A female service user said, 'I choose to have my personal care done by a female carer in the privacy of my own room and this has continued and I have been living here for over two years'. Another person said, 'I am asked the day before what meal I would like from the menu and I do get what I requested and I must add the meals are very good'. One individual said, 'I do get meals that I like from my culture'

We noted that there was an enthusiastic team of activity organisers and therapists who had enabled people to take part in activities out in the community as well as exercise sessions, support groups, entertainment and social activities within the service.

People told us that they felt safe. One resident remarked, 'I am well looked after, my experiences are all pleasant,' Another said, 'I enjoy living here'. One person said that, 'I am treated with the highest respect, as staff always ask for my opinion about matters concerning my day to day care'

We noted there were robust systems in place that ensured suitable staff had been employed and that the quality of the service provided was monitored effectively.

17 October 2012

During an inspection in response to concerns

During our visit to the service on 17 October 2012 we had contact with ten people who received a service at The Priory Grange Potters Bar, two relatives and six staff.

The people who used the service told us that they got on well with staff and could discuss any issues they had with the staff on the unit or more senior staff. People said that there had been improvements in the activities available and several people were out on the day of our visit. One person told us about a trip to Lakeside. We were told a group of people had recently been on holiday to Blackpool and another person told us about the wheelchair disco held on site.

We identified that each unit was appropriately staffed on the day of our visit with permanent members of staff who had received training related to the needs of the people they were supporting. The staff confirmed they regularly worked on the same unit, which provided people with continuity and enabled staff to develop and maintain their skills in specialist areas. All the staff we spoke with confirmed they could raise concerns with their immediate manager or more senior managers if needed. Information about raising concerns and speaking out to keep people safe was displayed in various places around the building.

3 July 2012

During an inspection in response to concerns

The main focus of this review was in relation to people using the service who have mental health problems. This was because concerns had been raised with us regarding staff responses to changes in people's health and their ability to raise concerns with senior staff.

The people we spoke with during our visit, on 03 July 2012, indicated that they were satisfied with the service provided and got on well with the staff who support them. One person particularly named two members staff they got on well with and would go to if they had a problem. Not everyone was able to communicate directly with us but we observed positive interaction with staff throughout the day as people moved about the building and attended the various activities provided. We noted people were also provided with opportunities to go out using the two buses available or walked to the local shops with staff. The people we spoke with confirmed they felt safe.

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.