The Priory Hospital Altrincham

Updated 28 August 2025

Requires Improvement

We rated the service as Requires Improvement. In the acute wards for adults of working age and psychiatric intensive care units, we found 4 breaches of regulations in relation to: reasonable adjustments for patients with protected characteristics, physical health monitoring, assessment and mitigation of environmental risks, oversight and implementation of policies and procedures and ensuring staff receive an induction into the ward they are working on.

In the child and adolescent mental health ward we found 3 breaches of the regulations in relation to lack of psychology and individual formulation and reasonable adjustments for young people, inconsistencies in handovers and record keeping, oversight and implementation of policies and procedures and ensuring staff receive an induction into the ward they are working on.

We have asked the provider for an action plan in response to the concerns found at this assessment.

Updated 13 March 2025

We rated the acute wards for adults of working age and psychiatric intensive care unit as Requires Improvement due to several concerns regarding the delivery of safe and person-centred care on Tatton and Dunham wards. Physical health observations were not consistently completed in accordance with patient care plans or the provider's Standard Operating Procedure. Care plans sometimes failed to reflect individual needs, particularly for patients with physical health conditions, neurodiverse diagnoses, or specific accessibility requirements, and did not consistently include the patient voice or evidence of their involvement in the planning process.

On both wards, the arrangements for medicine dispensing did not protect patient confidentiality. In addition, staff were not consistently adhering to key hospital policies, including those relating to dress code, smoking, and cleaning audits, and managers did not ensure these policies were fully implemented. Induction records for agency staff working on both wards were also incomplete, limiting assurance around the preparedness and safety of temporary staff.

We saw some positive and respectful interactions between staff and patients on both Tatton and Dunham Wards. Staff were supportive and responded to patients in a kind and sensitive manner.

The service provided a good range of activities, and had pleasant, accessible grounds that benefited patients and families visiting the hospital.

Mental Health Act and Mental Capacity Act Compliance

Mental Health Act

• 96% of staff on Dunham ward had received training in the Mental Health Act.
  87%of staff on Tatton ward had received training in the Mental Health Act.
• Staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles.
• Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were, and staff told us that the administrator made regular contact via email with updates and any Mental Health Act actions required.
• The provider had relevant policies and procedures that reflected the most recent guidance. However, not all polices were updated in accordance with policy review due dates. For example, Section 2 Admissions - Receipt & Scrutiny of Detention Papers, Section 3 Admissions - Receipt & Scrutiny of Detention Papers, Section 4 Emergency Admissions - Receipt & Scrutiny of Detention Papers, had review dates of 4 November 2024; Section 5(2) Registered Medical Practitioner or Approved Clinician Holding Power - Receipt & Scrutiny of Detention Papers, had a review date of 27 October 2024; Nurse's Holding Power Section 5(4), had a review date of 28 October 2024; and Explanation of Rights under Sections 132 and 130D, had a review date of 12 January 2025.
• Patients had easy access to information about independent mental health advocacy, and we saw advocates visiting the wards.
• Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done so.
• Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this had been granted.
• Staff requested an opinion from a Second Opinion Appointed Doctor when necessary.
• Staff did regular Mental Health Act legislation audits, and these were reported as a standing item in the Clinical Governance Committee meetings.

Mental Capacity Act

• 96% of staff on Dunham ward had training in the Mental Capacity Act.
  83% of staff on Tatton ward had received training in the Mental Capacity Act.
• The provider had a policy on the Mental Capacity Act. Staff were aware of the policy and had access to it.
• Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles.
• Staff knew where to get advice from within the provider regarding the Mental Capacity Act.
• Staff took all practical steps to enable patients to make their own decisions.
• For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions. Examples included assistance with personal care and the need for antibiotics.
• When patients lacked capacity, staff made decisions in their best interests. Staff told us about best interest decisions made in relation to vulnerable patients' access to social media and use of mobile phones on the ward.

Updated 13 March 2025

We rated the ward for children and adolescents as requires improvement because parents, young people and stakeholders told us that there was a lack of psychological interventions on the ward and there was no psychologist in the team, and there had been significant staff turnover with consultant psychiatrists, the ward manager and hospital managers leaving. There was a lack of consistency with staffing, with bank, agency and staff from other wards working on the ward which meant young people did not have consistency of support and found it difficult to follow their agreed plans with staff they were not familiar with.

Agency staff were not always supported on the ward, they did not always have an induction into the ward or given clear guidance on how best to support the young people.

Care records did not always reflect the needs of the young people. Handovers did not always include an accurate summary of events. Handover and daily allocation records were not always completed fully.

Staff were not following the dress code policy and managers did not ensure this was fully implemented.

However, staff received regular supervision and training.

We saw examples of staff communicating positively and compassionately with young people.

Mental Health Act and Mental Capacity Act Compliance

Mental Health Act

• 94% of staff had received training in the Mental Health Act.
• Staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles.
• Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.
• The provider had relevant policies and procedures that reflected the most recent guidance. However, there were several Mental Health Act policies and procedures that were not updated in accordance with policy review dates.
• Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.
• Patients had easy access to information about independent mental health advocacy. We saw information on display on the ward, including details of the advocates and a “you said, we did” display.
• Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done it.
• Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this has been granted.
• Staff requested an opinion from a second opinion appointed doctor when necessary.

Mental Capacity Act

• 94% of staff had had training in the Mental Capacity Act.
• Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles.
• The provider had a policy on the Mental Capacity Act. Staff were aware of the policy and had access to it.
• Staff knew where to get advice from within the provider regarding the Mental Capacity Act.
• Staff took all practical steps to enable patients to make their own decisions.
• The provider had a Gillick competency policy for consent in healthcare settings (a test in medical law to decide whether a child of 16 years or younger is competent to consent to medical examination or treatment without the need for parental consent or knowledge).