The Priory Hospital Altrincham

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

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

Good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

We do not always maximise the effectiveness of people's care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

• We reviewed 6 care records during the assessment.
• We reviewed care plans for patients with known physical health diagnoses or complications and found that some had not been appropriately followed up. For example, one patient's 'Keeping Healthy' care plan did not include guidance on monitoring pre-existing health conditions or address concerns noted prior to admission.
• We identified that physical health needs indicated by National Early Warning Score (NEWS2) results were not always documented in care records, and there was no evidence that medical consultation had been sought where the NEWS2 score indicated this. Gaps in physical health monitoring records for another patient suggested that their needs were not effectively assessed or reviewed.
• Stakeholders told us that psychology services on Tatton ward were limited, due to a vacant psychologist post. The service did not have access to clinical psychology treatment, and while some psychological assessment was available, there was insufficient psychological support in place for patients.
• On Tatton Ward, care plans did not consistently include relevant areas of patient care. We noted a Keeping Connected care plan without reference to neurodiversity; a Keeping Healthy care plan without reference to relevant blood results; and a Keeping Well care plan that did not reflect the person's voice or involvement in the planning process.
• Care plans were mostly personalised, holistic, and recovery-oriented, with goals included. However, they did not always reflect the needs identified during assessment, for example, for neurodiverse patients, or those on Dunham ward whose needs differed from alcohol substance misuse. We also noted repetitive use of stock phrases in some care plans.
• Patients were involved in reviewing their health and care needs. Most told us they had participated in developing their care plans and had received copies. On Tatton ward, we observed a detailed and positive ward review that was goal-focused and engaging, with the patient actively contributing to the discussion. On Dunham ward, we observed a clinical team discussion ahead of a patient review meeting, which acknowledged the patient's declining mental health and sensitively considered both patient and carer support needs in detail.
• Psychological formulation was available for patients on Dunham ward.

We do not always plan and deliver people’s care and treatment with them, including what is important and matters to them and in line with legislation and current evidence-based good practice and standards.

• The team did not include or have access to the full range of specialists required to meet the needs of patients in the service. There was no psychologist in the team for either acute ward. As a result, no psychological interventions were delivered on Tatton Ward. Patients on Dunham ward could access privately arranged psychological assessments.
• Managers did not consistently provide appropriate inductions for new agency staff. Of the 15 agency induction checklists we reviewed, 10 were incomplete or missing, and this included agency staff working on the day of our assessment. This raised concerns about whether staff had the necessary knowledge and skills to support the patients on the ward.
• Staff did not always provide care and treatment interventions suited to the diverse needs of patient groups. For example, patients with substance misuse issues other than alcohol addiction reported that some elements of the therapy programme were not relevant to them.
• Managers provided staff with supervision (meetings to discuss case management, to reflect on and learn from practice, and for personal support and professional development) and appraisal of their work performance. We reviewed supervision records and found that staff on both wards were receiving this in line with the provider’s policy. On Dunham ward the compliance rate for staff receiving supervision in line with the provider’s policy was 100%, and on Tatton ward the compliance rate was 82%.
• Patients on Dunham ward who were receiving care for addiction followed a structured Alcohol Treatment Programme. This programme ran daily from 9:30am to 4:30pm and included a range of therapeutic activities and support sessions. In addition, patients were supported to attend evening Alcoholics Anonymous (AA) meetings, providing further opportunities for peer support and reinforcing recovery outside of core treatment hours.
• We received positive feedback about the activity provision. A varied programme of activities was offered each day. Tatton ward had a well-equipped and colourful activity room, with craft materials, musical instruments, and artwork displayed on the walls. Patients on Dunham ward had access to a pool room, lounges, and an activity room, as well as a range of therapies facilitated off the ward in another building.
• Staff participated in clinical audit, including audits of the clinic room.
• We reviewed detailed and clear team meeting notes for Dunham ward. Tatton ward team meeting minutes also included standard agenda items and action/decision points, an action owner, and a date deadline.
• The percentage of staff that had had an appraisal in the last 12 months was 100% for both wards.

We work effectively across teams and services to support people, making sure they only need to tell their story once by sharing their assessment of needs when they move between different services.

• Staff held regular and effective multidisciplinary meetings. We reviewed minutes of the last 3 meetings for both acute wards, which were mostly well attended and had detailed and clear minutes. Tatton night staff team meetings were well attended but did not have an agenda or as clear a format as day team meetings which meant that specific information would be hard to identify easily. Tatton ward had clearly identified meeting actions.
• The teams had effective working relationships, including good handovers, with other relevant teams within the organisation (for example, therapy teams).
• The teams had effective working relationships with teams outside the organisation (for example, commissioners, advocacy and chaplaincy services). Commissioners told us the ward was well led and effective. The hospital had been commissioned to provide services since 2021.

We support people to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce their future needs for care and support.

• Staff supported patients to live healthier lives. There were accessible garden spaces, with lawned areas, seating and exercise equipment. The hospital grounds were available to patients and visiting family and friends. These were spacious, with cultivated boarders, and covered walkways from the wards to the main hospital building.
• A range of ward activities promoted healthy lifestyles and well-being. Smoking cessation support was advertised on notice boards, and information about sleep hygiene. Activities advertised on the boards included yoga, mindfulness, outdoor walks, and trips to local parks. Therapy and activity rooms offered opportunities for relaxation through music, arts and crafts, while group games were occasionally organised to encourage social interaction and connection.
• Menus included healthy options such as salads and fruit.

We do not always routinely monitor people’s care and treatment to continuously improve it and to ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.

• Staff did not consistently monitor patient outcomes, and we identified several physical health monitoring records that contained inconsistencies and gaps. This lack of accurate and comprehensive recording limited the ability to track patients’ physical health conditions effectively and posed potential risks to timely identification and management of physical health needs and progress.
• Patient feedback forms were available to capture patient-reported goals, expectations, and progress for use in multidisciplinary team (MDT) ward review meetings. However, staff told us that these forms were not widely used in practice, limiting opportunities to incorporate the patient voice consistently in monitoring and improving outcomes.
• Clinical staff described using systematic approaches to monitor patient’s mental health progress, which were linked to individual risk assessments and levels of observation. These approaches supported responsive and informed adjustments to care planning, helping to ensure that changes in patient need and progress were identified and addressed in a timely and supportive manner.
• Commissioners told us the service was highly effective. They noted that patient length of stay in hospital was lower than some other providers.

We tell people about their rights around consent and respect these when we deliver person-centred care and treatment.

• Staff took practical steps to support patients in making their own decisions. For example, interpreters were used in patient review meetings to ensure inclusion for a patient whose first language was not English.
• For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. Staff gave examples of how mental capacity was assessed and best interest decisions had been made, and these were decision-specific in relation to personal hygiene and access to mobile.
• Staff told us that Mental Health Act rights reminders were recorded when due and highlighted during handover meetings.
• Posters on ward notice boards explained patient rights in relation to blanket restrictions, the availability of mental health advocacy for patients detained under sections of the Mental Health Act, and how to complain about the use of the Mental Health Act.