The Priory Hospital Preston

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• 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

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

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

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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 and the Mental Health Act Code of Practice and discharged these well.

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.

We scored the service as 3. 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 3 patient care records during the inspection. Staff had completed a comprehensive mental health assessment of the patient in a timely manner at, or soon after, admission. Staff assessed patients’ physical health needs in a timely manner after admission.

Staff developed care plans that met the needs identified during assessment. Care plans were personalised, holistic and recovery-oriented. Care plans were individual to the patients and made reference to their specific needs. Staff had updated care plans when necessary.

We scored the service as 3. 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. These included medication and psychological therapies. The ward followed Medical Emergencies in Eating Disorders (MEED) guidance.

Staff ensured that patients had good access to physical healthcare, including access to specialists when needed. The patient records included ongoing physical healthcare and monitoring of this. Patients confirmed that they received support in relation to any physical health issues that they had.

Staff assessed and met patients’ needs for food and drink and for specialist nutrition and hydration. Patients had individualised meal plans in place and, where relevant, appropriate NG feed plans. The service had recently recruited a new dietician who had oversight of this and who ensured these were in line with MEED guidelines.

Staff participated in clinical audit, benchmarking and quality improvement initiatives. The ward manager had introduced ward specific audits to ensure that staff were delivering care and treatment appropriately and in line with expectations.

The team included or had access to the full range of specialists required to meet the needs of patients in the service. The ward had a consultant psychiatrist, speciality doctor, consultant psychologist, psychology assistant, occupational therapist, occupational therapy assistants, a dietician and some hours for an activity co-ordinator on weekends. The service had recently fully recruited to its therapy staff, which meant there were no longer any vacant posts. The service did not employ a speech and language therapist (SALT) however, they had links with an external SALT who they could make referrals to.

Staff were experienced and qualified, and had the right skills and knowledge to meet the needs of the patient group.

Managers provided new staff with appropriate induction. The hospital had an induction period that staff were required to complete before starting work on the ward.

Managers provided staff with supervision and appraisal of their work performance. Staff received both management and clinical supervision as appropriate. The average compliance rate for staff receiving clinical supervision over the 12 months prior to the inspection was 82%. The average compliance rate for staff receiving managerial supervision over the 12 months prior to the inspection was 68%. The compliance rates for both clinical and managerial supervision had improved in the 3 months prior to the inspection, increasing to 86% and 94% respectively. The percentage of staff that had had an appraisal in the last 12 months was 100%. Staff spoken with all felt supported and indicated the ward manager promoted an open culture of discussion and raising issues.

Managers held team meetings that staff could access, although meetings were not occurring as frequently as they should. Managers noted that they expected to hold monthly team meetings but there had been occasions they had not been able to do this. We requested copies of the last 3 team meetings. The provider submitted notes from meetings in December 2025 and January 2026. We were therefore not assured that team meetings were occurring regularly, although staff that we spoke with felt well supported and informed about the ward and the hospital.

Managers identified the learning needs of staff and provided them with opportunities to develop their skills and knowledge. Managers ensured that staff received the necessary specialist training for their roles.

Managers dealt with poor staff performance promptly and effectively. The ward manager explained how they had oversight of staff performance and how they would manage this if any issues were identified.

Mental Health Act

73.9% of staff had completed their training in the Mental Health Act as of the time of the inspection. 21.7% of staff had been assigned the training but not yet started it whilst 4.3% of staff were in progress of completing the training. When allocated a training course, staff were given a target completion date for them to complete the training by. Staff recorded as not started or in progress were therefore not considered non-compliant.

Staff were trained in 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 hospital had an on-site Mental Health Act administrator who provided support for staff and oversight of Mental Health Act documentation and processes.

The ward manager noted that, if the Mental Health Act administrator was absent, then the hospital had a process to access support from another of the organisation’s hospitals.

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. Information was on display for patients in the communal ward areas about advocacy services that they could access and how they could contact them.

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 had been granted.

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.

Staff did regular audits to ensure that the Mental Health Act was being applied correctly and there was evidence of learning from those audits.

We scored the service as 3. 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 team (MDT) meetings. Managers and staff reported positive relationships amongst the multidisciplinary team. Patients and staff felt involved in this process and described that they had a voice in these meetings. Patients gave positive feedback about their experiences of the multidisciplinary meetings.

Staff shared information about patients at effective handover meetings within the team. Staff felt that handovers were effective and ensured that all essential information was provided to them for each shift.

The teams had effective working relationships with other relevant teams within the organisation.

The teams had effective working relationships with teams outside the organisation. Managers reported positive relationships with external agencies and stakeholders.

We scored the service as 3. 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 supported patients to live healthier lives. Information about various health conditions was on display in the ward and leaflets were available for patients. The ward had a full therapy team including a dietician at the time of the inspection. The dietician provided information and support to patients about nutrition education and food exposure.

Ward activities helped promote a healthy lifestyle for patients. The ward had weekly activity programmes which included a variety of different activities and groups, including areas such as mindfulness, life skills and anxiety management.

We scored the service as 3. 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. This included Health of the Nation Outcome Scales (HONOS), eating disorder examination questionnaire (EDEQ), generalised anxiety disorder assessment (GAD-7) and the patient health questionnaire 9 (PHQ-9). The ward would also use additional tools for individual patients as required.

The ward manager completed checks and audits to ensure all had been completed and logged appropriately. The provider monitored outcome measures and data to consider if there were any themes and trends. The ward manager noted that no themes or trends had been identified for Bartle recently.

Managers also reviewed outcome measures as part of the dashboard that was looked at in flash meetings twice a week. The service held hospital-wide flash meetings every weekday which senior managers, along with the ward managers, attended to discuss key information and updates for each ward.

We scored the service as 3. 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 all practical steps to enable patients to make their own decisions. Patients felt that staff supported them to understand any decisions they may have to make about their care and treatment.

For patients who may have had impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions. There was evidence in patient records that staff had considered and reviewed this where required.

When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history.