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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

Before people are given any examination, care, treatment or support, they should be asked if they agree to it (outcome 2)

Not met this standard

We checked that people who use this service

  • Where they are able, give valid consent to the examination, care, treatment and support they receive.
  • Understand and know how to change any decisions about examination, care, treatment and support that has been previously agreed.
  • Can be confident that their human rights are respected and taken into account.

How this check was done

Our judgement

Arrangements were in place for obtaining consent to treatment for patients and signed consent forms were found in patient medical notes. However, for one patient detained under Section 3 of the Mental Health Act 1983 a copy of the consent form required under Section 58 of the Act was found in the patients medical notes but a copy was not attached to their medication chart. Failure to attach the consent form to the medication chart contravenes the Mental Health Act 1983 Code of Practice. Chapter 24.71 of the Code of Practice states that a copy of the signed consent form should be kept with the patient’s medication chart in order to minimise the risk of the patient being given medication for which they have not given consent.

User experience

No specific comments were received.

Other evidence

A nurse on the adolescent ward explained that consent to treatment forms are kept in each young person’s file and these are signed by the parent or carer, the doctor and the young person. She said that there was always an attempt to gain the consent of the young person even if the parent or carer had already given consent.

A nurse on the adult ward explained to us the process for gaining consent from a patient detained under the Mental Health Act 1983. She gave an example of a patient transferred to the ward on a Section 2 and described how repeated attempts had been made to explain his rights under the Mental Health Act 1983 to him. The nurse demonstrated knowledge of the Mental Health Act 1983 and the process of explaining rights under the Act, the right to appeal and the need to obtain consent.

We reviewed three medication charts on the adult ward and found that the charts were signed appropriately by doctors and nurses for medication prescribed and given and if medication had been refused this was clearly marked. The medication chart of one patient detained under Section 3 of the Mental Health Act 1983 did not have the consent/capacity to consent form attached. The consent form was later located in the patent’s file after several attempts. This showed that consent had been obtained from the patient as required under Section 58 of the Mental Health Act 1983.

The Mental Health Act Administrator told us that a central register is held containing all the details of all detained patients admitted. The file was reviewed and copies of completed consent forms seen. One patient’s records in the central folder contained evidence that the patient had been read their rights and had signed to that effect, this had happened on two occasions. The consent and capacity to consent forms were in place and completed appropriately. There was a copy of a patient information sheet which we were told had been given to the patient, medical recommendations, and Approved Mental Health Practitioner reports. The Administrator also kept a detained patient chart which listed all the patients detained in the adult ward, the lead nurse and the date of the next review of detention. We saw that this was also displayed in the Ward office. The Administrator told us that she is ensuring that the hospital is compliant with the Mental Health Act and that appropriate procedures are followed.

We looked at a case file of a young person on the adolescent unit detained in hospital under Section 2 of the Mental Health Act. This included appropriate documentation including the patient’s signature showing that she had had her rights explained to her. The consent to treatment form was signed by the patient’s brother but not by the young person. Three medical records of non-detained patients were reviewed in the adult ward and these showed that patients had signed and agreed to their treatment.