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The Priory Hospital Middleton St George Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 29 November 2018

We rated The Priory Hospital Middleton St George as outstanding because:

  • Leaders at all levels demonstrated the high levels of experience, capacity and capability needed to deliver excellent and sustainable care. Staff felt respected and supported through all management levels. Staff of all grades and professions told us they felt part of a team, their opinion was valued and treated with equal respect. The company recognised the value of their staff and annual awards were given to staff members in recognition of their service and contribution.
  • There was a demonstrated commitment to best practice performance and risk management systems and processes. The organisation reviewed how they functioned and ensured that staff at all levels had the skills and knowledge to use those systems and processes effectively. Problems were identified and addressed quickly and openly. Staff were proud of the organisation as a place to work and spoke highly of the culture. Staff at all levels were actively encouraged to speak up and raise concerns, and all policies and procedures positively supported this process. Plans were consistently implemented, and had a positive impact on quality and sustainability of services.

  • The long stay/rehabilitation wards had a bright and homely feel with a calming and relaxing environment. Patients and carers told us that staff treated them well and were invested in the welfare of the patients.

  • Staff and patients were kept safe and were able to get help when it was needed. Clinic rooms throughout the hospital were clean and tidy with all the necessary equipment. Equipment was well maintained and calibrated. Staffing levels throughout the hospitals were appropriate to the needs of the patients. Managers were able to increase the numbers of staff on the wards if needed. There was a good range of disciplines, knowledge and skills to care for the patients.
  • Patient risks were identified on admission and updated as needed. Management of risks was dealt with in a way that was individual and least restrictive. Incidents were reported quickly and clearly and were discussed in both the daily multi-disciplinary and hospital operational meetings.
  • There were a range of care and treatment interventions that were suitable for the patient groups. Multi-disciplinary working was planned and well structured with a clear and collaborative approach to patient care.
  • Staff completed mandatory training in both the Mental Health Act and Mental Capacity Act. The on-site Mental Health Act administrator demonstrated a clear knowledge of the Act and of patients who were detained under the Mental Health Act. Both the Mental Health Act administrator and other staff working in the hospital reported close working relationships.
  • Staff supported patients to understand and manage their care, spending time talking to them about their individual needs. Cultural, religious and social needs were discussed on admission and documented in care records. Patients were encouraged to download an application for their mobile telephones which could help them deal with situations they might find challenging. Staff involved patients in their care. Patients were able to attend meetings about their care and if they were not able to attend, could submit questions for staff to respond to. Patients were involved in the formulation of care plans and staff noted records to show which patients had accepted or refused copies of care plans. Staff donated items to ensure patients on the acute ward were provided with a bag of essential personal items on admission.
  • In the last 12 months, there had been no delayed discharges from the services. Staff planned for patient discharges and established relationships with external stakeholders to ensure patients were appropriately supported. Discharge planning throughout the service helped to ensure patients had a positive experience when leaving the hospital.
  • Patients were given information on how to make a complaint. There was information on display throughout the hospital on how to make a complaint and how to contact the Care Quality Commission. Staff and patients received feedback on complaints and investigations. Lessons learned were feedback and action points developed which were acted on as a result of these.
  • The provider had an online career pathway which provided staff with information on career progression and the knowledge and experience required to attain the role. Advertised posts were open to all staff with the right level of knowledge and experience. The provider had ring-fenced upcoming roles within the service to allow existing staff progression opportunities.
  • There was a clear framework of what was to be discussed during meetings. The hospital director was aware of all the meetings that took place in the hospital and reviewed the minutes of all meetings. Information was shared to teams in the hospital and where appropriate nationally throughout the organisation.
  • Staff used quality improvement methods and knew how to apply them. The service identified a number of innovative practices to drive quality improvement. This included defensible documentation training which gave staff the knowledge and tools to write clear and concise care notes, using the most appropriate language in line with professional standards, completion of the reducing restrictive practice self-assessment tool and implementation of the local steering group.
Inspection areas

Safe

Good

Updated 29 November 2018

We rated safe as good because:

  • Staff and patients had access to alarm systems and were able to summon help in an emergency. Furnishings throughout the hospital were homely and welcoming, giving a sense of security.
  • Clinic rooms throughout the hospital were clean and tidy with all the necessary equipment. Equipment was well maintained and regularly calibrated.
  • Staffing levels throughout the hospital were appropriate to the needs of the patients. Managers were able to increase the numbers of staff on wards based on patient acuity. There was a good range of disciplines, knowledge and skills to care for the patients.
  • Patient risks were identified on admission and updated as needed. Staff discussed patient risks daily during multi-disciplinary meetings. Management of risks was dealt with in a way that was individual and least restrictive.
  • Medicines management was good with regular audits carried out both internally and externally. Prescribing was in line with national guidance.
  • Incidents were reported quickly and clearly. Incidents were discussed in both the daily multi-disciplinary and hospital operational meetings and changes to patients’ care and treatment were made if required.

Effective

Good

Updated 29 November 2018

We rated effective as good because:

  • There were a range of care and treatment interventions that were suitable for the patient groups. This included access to mindfulness on long stay and rehabilitation wards and dialectical behaviour therapy.
  • Patients on the long stay and rehabilitation wards were able to download an application for smart phones which was linked to the mindfulness skills they had obtained and could help them deal with stressful or worrying situations while outside the hospital.
  • Multi-disciplinary working was planned and well structured. There was a clear collaborative approach to patients care and treatment with excellent peer support.
  • Staff completed mandatory training in both Mental Health Act and Mental Capacity Act which was reviewed annually. Staff demonstrated a good working knowledge of both. The on-site Mental Health Act administrator demonstrated very clear knowledge of patients who were detained under the Mental Health Act and had a close working relationship with staff.

Caring

Outstanding

Updated 29 November 2018

We rated caring as outstanding because:

  • Staff on all wards made an effort to get to know the patients. Cultural, religious and social needs were discussed. Individual needs were discussed and staff helped patients understand how to prevent their condition from impacting their daily activities. Staff on the acute ward provided essential personal items.
  • Patient records included sharing information with others. Staff were aware of patient preferences and followed these where possible.
  • Patients were fully involved in care planning and treatment. Patients were invited to meetings and if they were unable to attend they were able to record their views and any questions they had for staff. There was clear evidence of patient involvement and also notes to show which patients had accepted and declined copies of care plans.
  • Patients were fully involved in choices about the service. Tasting sessions were carried out to allow patients to sample food and drinks and there was evidence of patient involvement in the recruitment of staff.

Responsive

Good

Updated 29 November 2018

We rated responsive as good because:

  • The hospital had no delayed discharges in the 12 months prior to our inspection. Staff completed discharge plans and worked with patients to ensure their discharge went smoothly. Staff worked closely with external services to ensure relationships had been formed between patients and support staff and patients had appropriate levels of support in place.
  • Staff and patients had access to a full range of rooms and equipment to support treatment and care. All wards had a sensory room and patients were also able to access the hospital gym to help with their physical health. Patients were able to access kitchens and make hot drinks and snacks throughout the day and night.
  • There was information displayed throughout the hospital on how patients could make complaints and how to contact the Care Quality Commission. Staff and patients received feedback on the outcome of complaints and investigations. Lessons learned were feedback and action points were developed as a result of these.

Well-led

Outstanding

Updated 29 November 2018

We rated well-led as outstanding because:

  • There was a demonstrated commitment to best practice performance and risk management systems and processes. The organisation reviewed how they functioned and ensured that staff at all levels had the skills and knowledge to use those systems and processes effectively. Problems were identified and addressed quickly and openly.
  • Staff were proud of the organisation as a place to work and spoke highly of the culture. Staff at all levels were actively encouraged to speak up and raise concerns, and all policies and procedures positively supported this process. Plans were consistently implemented, and had a positive impact on quality and sustainability of services.
  • There was a clear framework of what was to be discussed during meetings. The hospital director was aware of all the meetings that took place in the hospital and reviewed the minutes of all meetings. Information was shared to teams in the hospital and where appropriate nationally throughout the organisation.
  • Staff felt respected and supported through all management levels. Staff of all grades and professions told us they felt part of a team, their opinion was valued and treated with equal respect. The company recognised the value of their staff and annual awards were given to staff members in recognition of their service and contribution.
  • The provider had an online career pathway which provided staff with information on career progression and the knowledge and experience required to attain the role. Advertised posts were open to all staff with the right level of knowledge and experience. The provider had ring-fenced upcoming roles within the service to allow existing staff progression opportunities.
  • Ward managers had a good understanding of the service they managed and a clear focus on providing high quality care. All members of the senior management team visited the wards regularly and senior managers carried out regular quality walk rounds. Staff spoke highly of the management team and about how they were approachable to staff and patients.
Checks on specific services

Long stay or rehabilitation mental health wards for working age adults

Outstanding

Updated 29 November 2018

Acute wards for adults of working age and psychiatric intensive care units

Good

Updated 29 November 2018