The Priory Hospital North London

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

Our overall rating of effective at The Priory Hospital North London Acute is Good.

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.

The service maximised the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 7 care and treatment records across the wards during our inspection.

The service assessed patients before admission to ensure they were suitable for the ward. Staff completed a comprehensive mental health assessment on admission or shortly afterwards.

Patients had their physical health assessed soon after admission and this was regularly reviewed throughout their stay. Staff supported patients with their physical health needs and worked collaboratively with specialists when required. Ward doctors assessed and monitored patients’ physical health and liaised with GPs and other specialists when necessary. Staff carried out routine electrocardiograms (ECGs) for all patients, including prior to the commencement of antipsychotic medication.

Staff developed comprehensive care plans that addressed each patient’s mental and physical health needs. Care plans were updated weekly in line with hospital protocol and whenever patients’ needs changed. The service completed weekly audits of care plans and risk assessments and took action to address any shortfalls.

The service planned and delivered people’s care and treatment with them, taking account of what was important to them and in line with legislation, current evidence‑based practice and national standards.

The service had access to a range of specialists to meet the needs of patients on the wards. All wards were staffed with registered nurses and had input from ward doctors, consultant psychiatrists, therapists, clinical psychologists, assistant psychologists and a pharmacist. The service was awaiting the start of an occupational therapist and 2 occupational therapy assistants, who would join the occupational therapist currently working across both wards.

Staff delivered a range of care and treatment interventions suitable for the patient group. Interventions were recommended by, and delivered in line with, National Institute for Health and Care Excellence (NICE) guidance. These included medicines, psychological therapies, structured activities and community access. Occupational therapy staff facilitated daily groups and activities on Lower Court ward, such as yoga, meditation, group therapy, music therapy and drama therapy. However, patients told us there could be a wider range of activities available on Oak Ward.

Managers provided each new member of staff with a full induction before they started work. Recently appointed staff told us they had received a comprehensive induction and felt well supported.

Managers supported staff through regular, constructive clinical supervision. Compliance with clinical supervision was over 97% across the wards at the time of inspection. Managerial supervision rates varied between 50% and 100% across the previous 12 months. Staff told us they had regular supervision, which they used to reflect on practice, discuss patient care, review incidents and support their professional development.

Managers ensured staff attended regular team meetings or received information from meetings they could not attend. Meeting minutes were available for all staff.

Managers recognised and addressed poor performance through supervision and performance management processes. Both ward managers told us they operated an open‑door policy and aimed to spend as much time as possible physically present on the wards. They had also adjusted their working hours so they could attend morning handovers, meet with night staff and discuss patients’ presentation over the previous 12 hours.

Staff participated in clinical audits, benchmarking and quality improvement initiatives. Managers used audit results to drive improvements and monitored progress through action plans. For example, we saw improvements in care plans and physical health checks since the last inspection.

Staff ensured patient safety by sharing key information, risks and plans for the week ahead during handovers. Handovers took place at the beginning of each nursing shift, as well as during weekday morning multidisciplinary meetings. We observed a multidisciplinary handover meeting, which included detailed, patient‑led discussions about new risks since the previous meeting and any information staff needed to be aware of.

The service had effective working relationships with teams outside the organisation. We observed two ward round meetings where person‑centred discussions took place regarding patients’ care, discharge planning and Mental Health Act status. Staff invited care coordinators to ward rounds and other meetings about patients, although they did not always attend.

The service supported people to manage their health and wellbeing so they could maximise their independence, choice and control, live healthier lives and, where possible, reduce their future need for care and support.

Staff helped patients live healthier lives by supporting them to take part in health‑promoting programmes and offering advice, including guidance on healthy eating and support with issues related to substance misuse.

Staff identified and recorded patients’ physical health needs in their care plans. Staff checked patients’ pulse, temperature, weight, height and blood pressure frequently. Staff recorded notes on each shift detailing patients’ medication, food and fluid intake, hygiene and sleep.

Staff ensured patients had access to physical healthcare, including specialist input when required. Patients were seen promptly by a doctor if they felt physically unwell.

The service routinely monitored people’s care and treatment to support continuous improvement and to ensure outcomes were positive and consistent.
Staff monitored patients’ health, mental state and their well-being. At handover meetings, staff noted details of patients’ sleep, food and fluid intake, personal hygiene, compliance with medication and engagement in activities. Any changes in a patient’s presentation were discussed at the daily multidisciplinary team meeting.
Staff used recognised rating scales to assess and record the severity of patients’ conditions and to measure treatment outcomes. Patients’ progress and the effectiveness of interventions were reviewed at each ward round, during clinical improvement meetings and against individual recovery goals. Outcome measures used included the Health of the Nation Outcome Scales (HoNOS), PHQ‑9 (Patient Health Questionnaire‑9), GAD‑7 (Generalised Anxiety Disorder Assessment), which were completed regularly to monitor patients’ progress, symptoms and wellbeing.

The service told people about their rights around consent and respected these when delivering person‑centred care and treatment.

Staff assessed each patient’s capacity to consent to admission and treatment on admission. Capacity was monitored and recorded at multidisciplinary team meetings.

Staff gave patients all possible support to make specific decisions for themselves before determining that a patient lacked capacity. When patients were assessed as not having capacity, staff made decisions in their best interests and took account of their wishes, feelings, culture and history. When a patient lacked capacity for a specific decision, the multidisciplinary team would discuss the issue with input from the patient wherever possible and agree a best‑interest decision that reflected the patient’s preferences.

Staff told us they respected patients’ choices when offering care and support. Patients confirmed this and said they felt consulted and well informed.