The Priory Hospital Preston

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

Good: This meant people were supported and treated with dignity and respect; and involved as partners in their care.

At our last assessment we rated caring as good. At this assessment the rating has remained good. Staff treated patients with compassion and kindness. They respected patients’ privacy and dignity. Staff mostly involved patients in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately. However, staff did not always understand the individual needs of patients.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Staff attitudes and behaviours when interacting with patients showed that they were discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it. We carried out 2 short observational framework inspections (SOFIs) and found that staff engaged well with patients. For example, on Elswick ward staff were engaged in a craft session with patients and we observed staff empowering patients and treating them with warmth and kindness.

Patients said staff treated them well and behaved appropriately towards them. Almost all patients shared positive feedback about staff. Patients said staff were ‘brilliant’, ‘kind’, ‘friendly’ and ‘empathetic’.

Staff supported patients to understand and manage their care, treatment or condition. Staff discussed patient’s treatment with them during multidisciplinary team meetings and provided patients with leaflets about their care and medicines.

Staff directed patients to other services when appropriate and, if required, supported them to access those services. For example, staff supported patients to access housing support.

Staff mostly understood the individual needs of patients, including their personal, cultural, social and religious needs. For example, staff understood that some patients required cultural or religious based dietary requirements and ensured this was provided by the kitchen staff. However, they were not always aware of the needs of neurodiverse patients.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences.

Staff maintained the confidentiality of information about patients. Staff added alerts to care records where patients refused consent to speak with specific people.

We scored the service as 2. The evidence showed some shortfalls. The service did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made some adjustments for disabled patients. There were downstairs rooms on wards and wards had lifts. Staff had accessed adaptions such as shower chairs where patients needed them.

However, staff had not always met patients’ specific communication needs. For example, 1 patient had been assessed as having communication needs but no plan was in place to help them communicate. Staff had completed an easy read care plan for the patient, but this did not support them with day to day communication. Staff were not always clear which patients had an autistic spectrum disorder, and clear plans were not always in place to support them to meet these needs.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. Staff made information leaflets available in languages spoken by patients and managers ensured that staff and patients had easy access to interpreters and/or signers.

Staff ensured that patients had access to appropriate spiritual support. For example, staff supported patients to go to the local church and the service had links with Imams. The service also had a multi- faith room.

3. We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff held weekly patient forums to gain patient feedback on the running of the ward. Staff completed ‘you said we did’ actions showing changes made in response to patient feedback. This included offering smoking cessation sessions, increasing cookery sessions and providing patients with keys to their rooms.

Staff had not always recorded patients’ views when developing their care plans, however staff recorded patients’ views during multidisciplinary meetings (MDTs).

Staff explained patients’ rights to them in a way they could understand in accordance with requirements. Patients had access to advocacy where required. The service employed a lived experience partner to attend patient meetings and support and advocate for patients. A lived experience partner was a member of staff who has had experience of being a patient.

We scored the service as 2. The evidence showed some shortfalls. The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Staff were not always aware of specific risk issues, and care plans were not always in place to manage these issues. For example, we identified 1 patient who had a significant physical health problem. This was identified in the GP summary but was not present in the patient’s physical health care plan and therefore there was no plans in place at the time of our inspection for managing the patient’s physical health condition. We raised this following our inspection, and the patient’s care plan was amended to include this.

Staff did not always identify and respond to changing risks to, or posed by, patients. For example, we identified risks of violence towards staff which had been identified at assessment but were not recorded in patients’ care plans or risk assessment.

Staff used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened. Patients and staff shared examples of staff de-escalating and supporting patients when they were distressed.

We have acted on these concerns in other areas of this report.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Most staff felt respected, supported and valued. Staff told us they felt valued and supported by their managers. Staff felt positive and proud about working for the provider and their team. The staff survey showed that 91% of staff said they were proud to work for the Priory and staff told us they felt supported and they enjoyed their work.

Staff had access to support for their own physical and emotional health needs through an occupational health service.

The provider recognised staff success within the service – for example, through staff awards, employee of the month, events for staff and small gifts for staff such as selection boxes at Christmas.

Staff appraisals included conversations about career development and how it could be supported.