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Archived: The Priory Hospital Brighton & Hove Good

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Inspection Summary


Overall summary & rating

Good

Updated 13 June 2016

We rated The Priory Hospital Brighton and Hove as good because:

  • Staff delivered care and treatment to patients in a kind, caring manner that respected their dignity.
  • Patients told us they felt safe and well cared for on the ward. Staff managed patient safety by appropriate use of observations.
  • Staff mandatory training was up to date and managers had completed appraisals of staff’s work performance.
  • Staff covered all shifts and did not have to cancel therapy sessions or escorted patient leave
  • Patient care plans showed good levels of patient involvement. Patients were involved in their care and given the opportunity to raise issues with the ward managers at a weekly community meeting.
  • Patients received an induction pack when staff admitted them to the ward
  • Nurses, doctors and other health professionals worked well together to provide safe and effective care and treatment to the patients. We observed a thorough and effective patient-focussed staff handover.
  • We saw evidence of an excellent working relationship between the ward and pharmacy services.
  • Therapy staff had received training in effective, research-proven therapeutic techniques, including cognitive behavioural therapy and eye movement desensitisation and reprocessing.
  • The hospital managers were a visible presence on the ward and made themselves known to staff and patients. Staff said managers were accessible and approachable.
  • Staff had effective working relationships with surrounding NHS trusts and local authorities.

However:

  • We observed numerous blind spots and potential ligature points (places to which patients intent on self-harm might tie something to strangle themselves) on the ward.
  • Staff did not demonstrate clear understanding of the Mental Capacity Act.
  • Staff did not demonstrate a clear understanding of Deprivation of Liberty Safeguards legislation, which could have a detrimental effect on patients’ liberty and rights.
  • Not all informal patients (those not subject to the Mental Health Act) understood that they could leave the ward at any time.
Inspection areas

Safe

Requires improvement

Updated 13 June 2016

We rated safe as requires improvement because:

  • the ward did not comply with standards on gender separation.

However

  • staff rotas show that there were enough staff to cover each shift

  • each patient had a personalised risk assessment

  • staff mitigated the risk of blind spots and potential ligature risks on the ward by use of observations and updating risk assessments regularly

  • staff recorded incidents of harm or risk of harm on the electronic system and lessons learnt were circulated to all staff

  • we saw effective medicines management

  • patients told us they felt safe on the ward.

Effective

Good

Updated 13 June 2016

We rated effective as good because:

  • staff assessed patients’ needs soon after admission, including doing a comprehensive physical examination

  • patient care plans were recovery-focussed and personalised

  • patients had good access to psychological therapies and physical health treatment when needed

  • staff had regular supervision and staff appraisals were up to date

  • we observed one staff multidisciplinary meeting that was comprehensive, patient focussed and involved nurses, doctors and therapy staff

  • staff had good working arrangements with surrounding NHS trusts and the local authority.

However:

  • not all staff demonstrated an understanding of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS) and the potential implications for patients

  • one informal patient told us they understood they were not allowed to leave the ward.

Caring

Good

Updated 13 June 2016

We rated caring as good because:

  • patients said staff treated them with kindness, dignity and respect in a caring manner

  • patients were involved in their care planning

  • patients had access to advocacy when required

  • patients could give feedback on the service and raise any issues at the weekly community meeting

  • staff provided new patients with a leaflet about the ward to help them settle in

  • staff invited patients’ families to attend ward rounds

  • we observed good staff and patient interactions during a group therapy session.

Responsive

Good

Updated 13 June 2016

We rated responsive as good because:

  • there was a full range of rooms and equipment on the ward to support patients’ needs and treatment, and patients had access to a well-equipped art room throughout the day

  • patients could make hot and cold drinks at any time in the ward kitchenette

  • the clinic room was well stocked and well maintained

  • patients were able to personalise their bedrooms

  • staff ran a full therapy programme during the week and patients were able to take part in activities at the weekend

  • patients knew how to make complaints, which the hospital responded to comprehensively in a timely manner, and staff received feedback.

Well-led

Good

Updated 13 June 2016

We rated well led as good because:

  • staff were up to date with their mandatory training and received regular managerial supervision and annual appraisals of their work performance

  • senior managers were a visible presence on the ward, staff said managers were accessible and approachable, and senior managers made themselves known to staff and patients

  • staff of a suitable skill mix covered shifts and there was always enough staff to cover therapy sessions and any escorted leave from the ward

  • staff said they felt able to challenge each other without fear of victimisation

  • staff were aware of the Duty of Candour and had an open and transparent approach when things went wrong

  • staff reported good morale within the staff team.

However:

  • some staff said opportunities for career development and continuous professional development were limited.

Checks on specific services

Acute wards for adults of working age and psychiatric intensive care units

Good

Updated 13 June 2016

The overall care provided at the hospital was good with enough staff to cover shifts and provide care.  However, the ward did not meet the standard on same sex accommodation.

Some staff showed a lack of understanding of the Mental Capacity Act and the implications this may have for patients.