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The Priory Hospital North London Good

All reports

Inspection report

Date of Inspection: 21 October 2010
Date of Publication: 21 December 2010
Inspection Report published 21 December 2010 PDF

People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run (outcome 1)

Not met this standard

We checked that people who use this service

  • Understand the care, treatment and support choices available to them.
  • Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support.
  • Have their privacy, dignity and independence respected.
  • Have their views and experiences taken into account in the way the service is provided and delivered.

How this check was done

Our judgement

Patients generally felt involved in their care and were treated with sensitivity and respect. They told us they were able to express their views to staff, were listened to and see changes as a result. Most patients had individualised plans of care in place. However, one young person, who had been on the ward for three weeks, did not know who their primary nurse was and said they had not seen their care plan. The hospital’s own audit of nine care plans on the adolescent ward showed that in only four instances had the young person been fully involved in the completion of the care plan and three care plans showed no involvement at all. There is a risk that by not involving patients in decisions about their care and treatment their individual needs will not be met.

User experience

We spoke to three young people on the adolescent ward and they told us that a community meeting was held every morning for staff and young people. At this meeting the ‘young people can have their say’ and their views are ‘taken on board by staff’. One member of staff later gave us an example of how the young people had complained about the ward décor and that had led to a programme of redecoration. The young people described how they had tried to negotiate a later bedtime with staff at the community meeting. They also told us that a suggestions box was available where the young people could make anonymous suggestions and that staff were receptive to these. There was also an ‘emotions’ box where one young person told us they could post a description of what they were feeling and why. This box was opened once a week and the emotions discussed in a group meeting. The young people were given a choice of outings on a Wednesday evening.

One young person said they had been in hospital for a number of weeks but did not know who their primary nurse was and had not seen their care plan. The young person also said that ‘staff could update you more on what’s happening’ with care. Another young person, who had been in the hospital for four weeks, said they had been fully informed about their care and progress and expected to be in hospital for a further four weeks. This young person described going to a care planning meeting which was attended by their key worker and consultant and they had talked about progress being made and medication.

The two patients we spoke to on the adult ward both told us that staff were respectful and sensitive in their approach towards them and said that they had weekly meetings with professionals involved in their care. One patient said that staff had taken note of his preferences regarding the treatment of a medical condition.

Other evidence

The nurse in charge of the adult ward informed us that regular reviews of patient care took place each week and a range of professionals were involved in each patient’s care and treatment. A staff member said that everyone on the adult ward had a care plan and risk assessments were reviewed everyday. She said that patients were involved in developing their care plan and given a copy. Three care records were examined in the adult ward. These contained detailed assessments, individual care plans and reviews.

We observed posters on both the adult and adolescent wards advertising the Independent Mental Health Advocacy Service provided by a local Mind organisation.

The daily programme of activities and groups was clearly displayed on the wall in the adolescent ward. A senior manager told us that the young people had become more involved in their care since a new programme of activities and groups had been started in same week as our visit.

We were shown new adolescent ward rules. These encourage the young people to respect the personal space of others and state that they should not go into other people’s bedrooms. The rules also state that no form of bullying will be tolerated and this includes ‘whispering, ignoring and teasing’. They also stress the importance of respecting other patients regardless of an individual’s race, religion, culture, class or sexual orientation.

We reviewed a number of care records on both the adult ward and adolescent ward and these showed that consent to treatment had been sought and on most occasions obtained from patients. Where patients were detained under the Mental Health Act 1983 attempts had been made to explain the patients’ rights under the Act, sometimes on repeated occasions, and these were documented in the case records.

The hospital subsequently provided us with a completed report of an audit of nine individual care plans on the adolescent ward dated 01/11/10. This audit showed that: four care plans had been completed with the involvement of the young person, three showed no involvement at all and two were rated ‘partial compliance’; five of the nine care plans had been signed by the young person; and only two care plans recorded that they had been given to the young person. Seven of the care plans were stated to be an individualised plan of care for the patient and the other two were partially compliant. An action plan was attached to the audit stating that care plans would be discussed in staff supervision, there would be weekly monitoring of care plans and work with bank and agency nurses to ensure they are familiar with hospital policies.