Woodbourne Priory Hospital

On this page

• 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 inspection we rated caring as requires improvement. At this inspection and assessment the rating has remained the same. Not all staff treated patients with kindness, empathy and compassion. The service did not always treat patients as individuals or make sure patient’s care, support and treatment met their needs and preferences. The service did not always promote people’s independence in relation to accessing activities.

However, patients were supported to maintain relationships and networks that were important to them. The service cared about and promoted the wellbeing of their staff.

The service was in breach of regulation 9 for person centred care.

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 2. The evidence showed some shortfalls. The service did not always treat people with kindness, empathy and compassion.

Not all patients felt they were treated with kindness, compassion and dignity in their day-to-day care and support. We asked 9 patients if staff were kind to them and respected their dignity. Four patients said some staff were kind and respected their dignity, but other staff were moody and didn’t care. One patient told us staff entered their bedroom without knocking. During our evening visit we observed the handover between the incoming and outgoing shifts. The staff member handing over described a patient as ‘having a tantrum’. We escalated this to the hospital director and were assured by the immediate action taken, which included speaking with the staff member and making it clear this was not appropriate language. Otherwise, we observed positive interactions between staff and patients during our site visit. A ward manager shared feedback received from a coroner following the death of a patient, they described the team as providing compassionate care. The ward manager told us they kept in touch with the patient’s mum to make sure they were ok. We spoke with 3 carers, 2 said the staff treated their relatives with kindness but 1 told us that although some staff demonstrated compassion, others were rude and lacked compassion and engaged in mocking behaviour towards their loved one.

We scored the service as 1. We scored the service as 1. The evidence showed significant shortfalls. The service did not treat patients as individuals or make sure patient’s care, support and treatment met their needs and preferences.

The provider did not always ensure staff met patient needs and preferences. Not all patient’s individual needs and preferences were understood and reflected in their care, treatment and support. Staff were not always upholding the rights of informal patients. On Maple ward, 1 patient told us they were aware of their rights as an informal patient, but staff weren’t and had stopped them from going out on their own. We observed staff advising this patient that should they choose to leave the ward they would have to consider sectioning them under the Mental Health Act. We reviewed care records of 2 patients on Maple ward. Both patients were informal, but staff had recorded that they read 132 rights to one of the patients. 132 rights apply to detained patients. The provider advised that the staff had recorded both patient’s status as ‘informal’ and recorded that they explained their rights to them as 132 rights as there was no specific field in the electronic records system for staff to record this. Maple ward did not have a specific notice for informal patients advising of their right to leave the ward displayed. CQC Mental Health Act reviewers issued action points for 3 wards in the previous 18 months relating to staff not upholding informal patients’ rights. We reviewed an incident on Acer ward which related to staff placing an informal patient on 1 to 1 observations, with the reason recorded as the patient required extra support. Staff had not recorded any risk behaviours or details of who decided to place the patient on 121 observations. There was no evidence of less restrictive options being tried first.

We asked 3 patients if staff knew their cultural, social and religious needs, preferences and wishes. One patient said yes, another said there was not enough choice of Halal food and the third said they were able to pray but had not seen an Imam. We spoke to a carer who told staff did not treat their relative as an individual and disregarded their preferences in relation to sensory needs which caused distress to their loved one. We found limited evidence in care records reviewed of staff treating patients as individuals. However, we reviewed 1 care record where staff recorded a patient’s preference to be supported by female staff and another that highlighted the patient required a Halal diet. Patients had access to multi faith rooms and staff described supporting patients to attend church.

We scored the service as 2. The evidence showed some shortfalls. The service did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

Patients were supported to maintain relationships and networks that were important to them. We asked 8 patients if they were able to keep in contact with their family and friends. Seven said they were, 1 patient said it was difficult as their family lived a long distance away. The service had visiting facilities, including for children.

Patients did not always have access to activities and the local community to promote and support their independence, health and wellbeing. We spoke with 10 patients across the 4 acute and PICU wards. Five told us there were not many activities and expressed boredom. Two carers told us there didn’t seem to be many activities on the wards. During our 2 days on site we observed 1 activity taking place with 1 patient on the 4 acute and PICU wards visited. We were concerned that ward staff expected the OT team to carry out activities with patients. The occupational therapy team told us they had done some work on raising awareness of what OT's do and that they were not activity coordinators and explained how HCA's can support them to engage patients. OT's said the ward staff have allotted time to do activities, but they see that these activities don't always happen. We reviewed the ‘you said, we did’ display on Acer ward. Patients requested more activities, the ‘we did’ response was to ask OT’s to facilitate. We reviewed the ‘you said, we did display on Elm ward. Patients said “we want new board games” and staff “asked the OT to sort”. We observed a community meeting on Acer ward, staff asked patients if there were any activities they would like to do and patients said no. There was no attempt by staff to make suggestions or try and encourage any further discussion about activities. Staff told us they found it difficult to engage some patients in activities. However, we saw staff on Maple ward arranged a St Patricks day event for all patients across the service and the service was preparing for a Halloween event after our site visit. Not all patients were able to make their own hot drinks on the acute wards. Patients on Elm ward had to ask staff to make them a hot drink as they did not have access to a kettle.

We scored the service as 3. The evidence showed a good standard. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff quickly recognised when patients needed urgent help or support. We asked 8 patients if staff responded when they needed urgent help or support. All said yes. On Elm ward we observed staff responding immediately when a patient knocked on the office door for help. Staff spoken with were able to describe how they would respond to a patient in distress, for example, by taking them to the quiet room to talk or implementing emergency procedures for an urgent health need.

However, some patients felt that their needs, views, wishes and comfort were not always a priority for staff. We asked 5 patients if their needs and wishes were a priority for staff. Four said no, with 1 describing staff as just being there to “take their pay”.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff.

Patients received safe and effective care as the provider recognised and met the wellbeing needs of staff. These included the necessary resource and facilities for safe working, such as regular breaks and rest areas. Staff spoken with told us they were able to take their breaks, and we observed suitable rest areas were available. The head of facilities told us they were refurbishing staff rest areas, and they issued a questionnaire to gain feedback from staff on what they would like in this facility.

Patients benefited from staff who had regular opportunities to provide feedback, raise concerns and suggest ways to improve the service or staff experiences. Staff spoken to had access to regular team meetings and said they were able to raise concerns and make suggestions for improvements.

Patients were supported by staff who felt valued by their leaders and their colleagues. Staff spoken with told us they were well supported by their managers and senior leaders at the hospital. Staff morale was mostly positive, despite recent contractual changes impacting on the service.

The provider recognised staff success and staff length of service was celebrated. Leaders published a monthly magazine for the hospital which celebrated staff success. Local awards included employee of the month, linked to the provider’s values. National awards included celebrating individuals and teams for exceptional contributions. The provider also held team celebration and wellbeing events.