Background to this inspection
Updated
21 June 2023
Priory Hospital East Midlands is in Annesley in Nottingham and is one of the hospitals of Partnerships in Care Limited.
Priory Hospital East Midlands is registered to provide the following regulated activities:
• Assessment or medical treatment for persons detained under the Mental Health Act 1983.
• Treatment of disease, disorder, or injury.
The provider offers specialised assessment and treatment to help patients for return to either local services or alternative appropriate accommodation.
The following service and wards were visited on this inspection:
Acute wards for adults of working age and psychiatric intensive care units:
• Littlemore Ward, a female psychiatric intensive care unit with ten beds.
• Barton Ward, an acute admission ward for females with nine beds.
The most recent focused inspection of this location was on 30 August 2022. As this inspection was not rated the hospital was not rated. Therefore, the service is rated of inadequate in the safe and well led key questions following the inspection of May 2022. Due to these concerns and ratings the service was placed into special measures.
Following the inspection of August 2022, we served a warning notice under Regulation 12, safe care and treatment under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 due to finding issues of concern around medicine management.
We carried out this inspection as we were notified concerns from patients about their care and treatment.
What people who use the service say
People were unhappy that there was only one washing machine available.
People told us they did not like being woken up by staff turning lights on during the night to do their checks.
People told us that the wards can be noisy when people are in distress.
One person told us that there had been confusion regarding the whereabouts of their key to their bedroom and how this had made them feel unsafe.
People told us that on Barton ward handovers happen in the dining room which means that they cannot access drinks and snacks whilst it is going on.
People told us that they feel that the wards are not cleaned enough as there is only one cleaner.
People told us that the food is nice but due to having one meal a day at lunchtime that if they are asleep at that time, they miss it.
People told us they were not happy with the visiting area as it was small, and the coffee machine (at the time of the inspection) was broken. Visitors were traveling a distance to see them.
People told us that they feel there is enough staff on shift.
People told us staff are visible on the ward.
People told us that there are activities available.
People told us that they can go on leave and have access to the garden.
Updated
21 June 2023
The service remains in 'special measures.' This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
Priory Hospital East Midlands is in Annesley in Nottingham and is one of the hospitals of Partnership in Care Limited. It has two female wards: one specialist acute ward and one psychiatric intensive care ward. The service works with patients in achieving their goals and preparing them to move back into the community, or into other appropriate accommodation. We carried out this unannounced inspection because we received information giving us concerns about the safety and quality of the service.
Our rating of this location improved. We rated it as requires improvement because:
- The ward environments were not always and clean. There was a lack of cleaning staff to ensure that the hospital was cleaned regularly.
- Staff were not able to fully observe patients in the seclusion room due to the observation area in the bathroom section of the seclusion room being used for storage.
- Staff did not adhere to infection control procedures in relation the laundry of patients and staff clothing and bedding.
- Staff did not always assess and managed risk well in relation to manage items that are deemed to be a risk for individuals. When managing risk staff did not use the correct practice when performing restrictive interventions.
- Managers did not always ensure that these staff received training, supervision, and appraisal. Staff had not received additional specialised training to support the care and treatment of patients.
- Medical staff did not follow the providers policy when admitting patients to the service, this meant that patients physical health was not complete in a timely way and medication had not been prescribed. Whilst the service had an on-call duty doctor system in place, the doctor on call was not always contactable.
- Patients were not always discharged promptly once their condition warranted this or changed.
- Staff did not always treat patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients.
- Leadership had recently changed, and governance process and systems were still not fully embedded.
However:
- Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
- The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. The ward staff worked well together as a multidisciplinary team.
- The wards had enough nurses and doctors. They minimised the use of restrictive practices and followed good practice with respect to safeguarding.
- Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
- The service managed beds well so that a bed was always available locally to a person who would benefit from admission.
Forensic inpatient or secure wards
Updated
17 December 2021
Our rating of this service went down. We rated it as inadequate because:
The service did not provide safe care. The ward environment was not safe and clean.
Staff did not always assess and manage environmental risks well. The carpet and flooring on Harris ward was unsafe and was a risk to patients.
The service did not ensure infection control risks were minimised, the wards were not clean.
Staff told us did not get the time they required to read patients care plans or review updates to the patients risks.
However:
Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice.
The wards had enough nurses and doctors. They minimised the use of restrictive practices and followed good practice with respect to safeguarding.
The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.