Priory Horizon House

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

At our last assessment we rated effective as outstanding. At this assessment the rating has changed to good. Staff assessed the physical and mental health of all patients on admission. They developed individual care plans which were reviewed regularly through multidisciplinary discussion and updated as needed. Staff provided a range of treatment and care for patients based on national guidance and best practice. The ward team included or had access to the full range of specialists required to meet the needs of patients on the ward. Staff from different disciplines worked together as a team to benefit patients. Staff understood their roles and responsibilities under the Mental Health Act 1983 (MHA) and the Mental Health Act Code of Practice and discharged these well.

However, some patients told us there was a lack of communication between doctors and day staff, particularly regarding section 17 leave. One patient also told us they had not been given key information relating to their rights under the MHA when they arrived at the ward.

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 evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We reviewed 6 care records which showed that staff completed a comprehensive mental health assessment in a timely manner at, or soon after, admission. Patients were involved in the assessment of their needs and care plans were personalised, holistic and recovery focused.

Staff assessed patients’ physical health needs and escalated any concerns appropriately.

Staff developed care plans that met the needs identified during assessment, including patients’ communication needs. Patients care needs were routinely reviewed and care plans were updated regularly.

The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well

Staff provided a range of care and treatment interventions suitable for the patient group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence (NICE) and the Royal College of Psychiatrists (RCP).

Staff ensured that patients had good access to physical healthcare, including access to specialists when needed. Medical staff told us that they had excellent working relationships with general medical colleagues and could escalate physical health concerns quickly.

Patients had access to the full range of specialists required to meet their needs. In addition to doctors, nurses, and clinical support staff, the service employed occupational therapists, and a drama therapist.

Staff participated in clinical audits and the service was also a member of the AIMS Quality Network for Inpatient Working Age Mental Health Services, which is run by the Royal College of Psychiatrists (RCP).

Mental Health Act

• The provider reported 81.3% of staff had received training and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles.
• Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.
• The provider had relevant policies and procedures that reflected the most recent guidance.
• Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.
• Patients had easy access to information about independent mental health advocacy.
• Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done it.
• Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this has been granted.
• Staff requested an opinion from a second opinion appointed doctor when necessary.
• Staff stored copies of patients' detention papers and associated records (for example, Section 17 leave forms) correctly and so that they were available to all staff that needed access to them.
• The service displayed a notice to tell informal patients that they could leave the ward freely.
• Care plans referred to identified Section 117 aftercare services to be provided for those who had been subject to section 3 or equivalent Part 3 powers authorising admission to hospital for treatment.
• Staff did regular audits to ensure that the Mental Health Act was being applied correctly and there was evidence of learning from those audits.

The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff held regular and effective multidisciplinary meetings every day. These meetings were comprehensive and covered all aspects of patients’ care.

Staff used a set template for handovers between shifts and teams to ensure all essential information about patients was shared.

Teams maintained effective working relationships with external partners such as local authorities and GPs. They supported patients in accessing relevant local services and collaborated effectively with the other services run by the provider at the same location.

However, some patients told us there was a lack of communication between doctors and day staff, particularly regarding section 17 leave and access to cigarette breaks.

The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff completed an initial physical health check for patients on admission to the unit. Staff supported patients to live healthier lives – for example, through participation in smoking cessation schemes, healthy eating advice, managing cardiovascular risks.

Staff promoted healthy lifestyles through ward activities, including sports sessions, and cooking healthy meals, for example, the service hosted a “Priory Olympics Day”, which was an inclusive event aimed at promoting physical activity and ran a healthy eating initiative “Beyond Expectations: Revolutionising Rehabilitation Through Co-Produced Cooking". The occupational therapy team offered a full schedule of activities and events to help support patients to live healthier lives, for example, they arranged yoga sessions at a local deer and wildlife park where patients could get out in the fresh air away from the hospital to exercise. Patients also had the opportunity to be supported to play golf at the local driving range and crazy golf course as well as day trips wild berry picking.

Patients told us that their care was personalised and they were encouraged to engage in healthy eating and physical activity.

The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff used recognised rating scales to assess and record severity and outcomes. These included the Global Assessment of Functioning Scale (GAF) and National Early Warning Score (NEWS 2). The data from this was used to inform care planning and make adjustments where needed.

Clinical data, such as blood tests and physical health checks, were recorded and stored by nursing staff. The specialty doctor would be sighted on these results, and they would be discussed in daily meetings and ward rounds with the patient.

The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff took practical steps to enable patients to make their own decisions. We observed staff engaging patients in conversations about their wishes for the day and what activities they wanted to do. The service followed a care model that emphasised positive decision-making. We saw enough staff were available for patients to check in and ask questions when needed.

The catering team and the occupational therapy team worked closely together to co‑produce meals with patients. They supported patients to plan meals, took them on trips to the local supermarket to buy ingredients, and helped them prepare their own food. This collaborative approach gave patients greater control and variety over their meals and helped them develop practical daily‑living skills.

Staff demonstrated a clear understanding of how consent interacts with the Mental Health Act. When patients were detained under the Act, staff continued to involve them in decisions wherever possible and applied least restrictive principles, including for medication and restrictive interventions.