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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 get safe and coordinated care when they move between different services (outcome 6)

Meeting this standard

We checked that people who use this service

  • Receive safe and coordinated care, treatment and support where more than one provider is involved, or they are moved between services.

How this check was done

Our judgement

One community consultant reported not receiving the majority of patient discharge summaries in the past but said that this had improved very recently. Generally, patient care planning involved community mental health teams and information was shared with other services and mental health professionals. It is important that this improvement is maintained and discharge summaries are sent to services receiving patients at the time of discharge or transfer so that patients continue to receive the care and treatment that they need.

User experience

The young people we spoke to on the adolescent ward told us that they had attended their own care planning meetings and had taken part in discussions about their care and treatment, although one young person said that the purpose of the meeting had not been properly explained to them.

Other evidence

The Medical Director explained that currently all young people admitted on the adolescent ward are NHS patients. They mostly come from three London boroughs with which they have contracts or from other areas when adolescent mental health beds are temporarily unavailable. Staff told us that individual care planning meetings regularly took place on the adolescent ward and health professionals from the Child and Adolescent Mental Health Services (CAMHS) were routinely invited and attended. One therapist we spoke to said that communication with the community teams was good and that they knew many of the community psychiatric nurses and social workers as the same ones come to the care planning meetings on a regular basis.

One case file belonging to a young person who was admitted to the adolescent ward for two months in 2010 was reviewed. A discharge summary was present in the file along with a copy of a discharge letter to the CAMHS team. There was also evidence of fortnightly feedback sent to the care co-ordinator and an invitation to a Care Programme Approach (CPA) meeting addressed to the CAMHS team. A second case file of a young person currently admitted to the adolescent ward contained a letter to the referring CAMHS from the hospital Medical Director regarding the young person. The file notes that a CPA meeting took place but the CAMHS representative was unable to attend, however the family of the young person did attend. There was also a copy of a letter to social services regarding the young person’s family issues along with an invitation to a CPA meeting.

The staff communications book kept in the office on the adolescent ward showed a number of messages recorded from social workers and family members.

We saw an email showing that arrangements had been made for a young person to attend an appointment with her CAMHS psychiatrist the day after her discharge from the adolescent ward.

We later spoke on the telephone to a consultant psychiatrist from a local Child and Adolescent Mental Health Service who confirmed that invitations to care planning meetings were received by the CAMHS teams and minutes of the meetings were sent to them afterwards. The consultant also said that 'very recently' they had started receiving discharge summaries for the young people transferred back to their care but in the past they had not received discharge summaries in the 'majority of cases'.

The hospital provided us with a completed audit of nine individual care plans on the adolescent ward dated 01/11/10 which showed that discharge care plans had not been completed. A senior manager told us that current practice is to start compiling the discharge care plan when the young person’s clinical presentation improved, diagnosis made and future plan of care developed. Therefore it would not be unusual to see an audit where discharge plans had not been started. He explained that admissions to the adolescent ward were often crisis admissions and that it can take some time to draw up a long term plan of care.