The Care Quality Commission
  • Mental Health
  • Independent mental health service

Priory Hospital Enfield

Overall: Good read more about inspection ratings

15 Church Street, Edmonton, London, N9 9DY (020) 8956 1234

Provided and run by:
Partnerships in Care Limited

All Inspections

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

We carried out a comprehensive assessment of the Priory Hospital Enfield Acute ward on 22nd October 2025.

The acute ward was for female patients who were aged 18+ who required inpatient care for a wide range of mental health conditions.

Priory Hospital Enfield was last inspected by the CQC in September 2021. The hospital was rated good overall. The Acute ward was rated requires improvement for responsive. There were three requirement notices issued at the previous inspection.

At this assessment we rated the ward as good. Previous breaches have now been addressed, and the service is now compliant with regulations in these areas.

We spoke with 12 members of staff, 5 patients and 2 carers. We also reviewed the care and treatment records of 4 patients.

We identified several areas of good practice during this inspection. Staff had a good understanding of what incidents to report and the process for doing so. Staff told us they avoided using physical restraint by using de-escalation techniques. All staff were up to date with their yearly appraisals. Patients could access a range of interventions and activities in line with national guidance. Patients told us staff were kind and treated them well. All staff told us they felt respected, supported and valued by their colleagues and managers.

During an assessment of Forensic inpatient or secure wards

Priory Hospital Enfield is provided by Partnerships in Care Limited. There are three forensic mental health wards for male inpatients. Byron Ward is a low secure unit and Coleridge and Keats wards are medium secure. The forensic service was last inspected in September 2021 and received an overall rating of requires improvement.

The current inspection took place on 15 – 17 September 2025 with 30 minutes notice. We spoke with 10 patients across the wards and conducted a tour of each ward. We spoke with 26 staff members including the previous and current hospital directors, medical director, clinical director, physical health lead, ward managers, registered and non-registered nurses, a consultant psychiatrist, occupational therapists and assistants, psychologists, activities coordinator, and a social worker. We had the opportunity to attend ward rounds on 3 wards, and a referral meeting for the hospital. We reviewed 16 care records of patients on the wards. The inspection included a member of the medicine’s optimisation team visiting each ward and reviewing the medicines administration and care records for 11 people. They reviewed the use of medicines to manage anxiety and/or agitation, administration records against relevant mental health act consent to treatment document and reviewed policies and procedures. Following the inspection we spoke with 7 carers/relatives of patients on the ward.

Prior to the inspection we received several anonymous whistleblowing concerns about the hospital regarding restrictive practices, overmedication, physical health monitoring, a closed culture, discrimination in recruitment, and a punitive approach to complex behavioural issues. Overall, we did not find evidence of these concerns. However, we did note that there were some gaps in senior oversight in specific areas that required improvement. These related to clear seclusion records and medicine administration records.

Overall, we have rated the service as Good. We found several areas of good practice. There had been significant recruitment of staff within the hospital, with few vacant posts and reduced use of agency staff. Overall, we found an improvement in monitoring of rapid tranquilisation including staff training and audits. We found evidence of good patient involvement in their ward rounds.

There was effective use of the National Early Warning Scores. A physical health nurse for the hospital started in January 2025 and was creating a competency document for the nursing team. Staff described good teamwork on the wards and there were daily multi-disciplinary team meetings and structured handover records used on each ward. We found an improvement in staff ensuring patients were informed of their rights and a patient representative attended clinical governance meetings at the hospital.

We also identified some areas for improvement. We found some gaps in records of patients in seclusion including the reason for seclusion, rationale, doctors’ comments and initial seclusion care plans. There were some environmental issues with the seclusion room that did not uphold the privacy and dignity of patients as well as it could have. We found 2 mattresses appeared to be unclean on Coleridge Ward, and audits of mattress cleanliness indicated that this was an area for improvement.

Records did not always clearly show why ‘when required’ (PRN) medicines were used on the wards to manage anxiety or agitation or if they worked. Some high-risk medicines were not included in care plans or risk assessments and records did not always show that high-dose antipsychotic treatment was being reviewed.

Patients provided mixed feedback. Whilst some were very positive, others expressed concerns about the length of time between ward rounds, delays in accessing psychology, few activities at weekends, opportunities for fresh air and delays in getting leave. There was mixed evidence of patient involvement in care plans with better recording of this on Keats Ward. Observation records at night did not always have the level of detail recommended in best practice.

We found 1 breach of the regulations in relation to good governance in monitoring records of patients in seclusion, the environment within the seclusion room, and recording of the reason for use of ‘when required’ (PRN) medicines were used on the wards to manage anxiety or agitation or if they worked.

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

We carried out a comprehensive assessment of the Priory Hospital Enfield Acute ward on 22nd October 2025.

The acute ward was for female patients who were aged 18+ who required inpatient care for a wide range of mental health conditions.

Priory Hospital Enfield was last inspected by the CQC in September 2021. The hospital was rated good overall. The Acute ward was rated requires improvement for responsive. There were three requirement notices issued at the previous inspection.

At this assessment we rated the ward as good. Previous breaches have now been addressed, and the service is now compliant with regulations in these areas.

We spoke with 12 members of staff, 5 patients and 2 carers. We also reviewed the care and treatment records of 4 patients.

We identified several areas of good practice during this inspection. Staff had a good understanding of what incidents to report and the process for doing so. Staff told us they avoided using physical restraint by using de-escalation techniques. All staff were up to date with their yearly appraisals. Patients could access a range of interventions and activities in line with national guidance. Patients told us staff were kind and treated them well. All staff told us they felt respected, supported and valued by their colleagues and managers.

During an assessment of Forensic inpatient or secure wards

Priory Hospital Enfield is provided by Partnerships in Care Limited. There are three forensic mental health wards for male inpatients. Byron Ward is a low secure unit and Coleridge and Keats wards are medium secure. The forensic service was last inspected in September 2021 and received an overall rating of requires improvement.

The current inspection took place on 15 – 17 September 2025 with 30 minutes notice. We spoke with 10 patients across the wards and conducted a tour of each ward. We spoke with 26 staff members including the previous and current hospital directors, medical director, clinical director, physical health lead, ward managers, registered and non-registered nurses, a consultant psychiatrist, occupational therapists and assistants, psychologists, activities coordinator, and a social worker. We had the opportunity to attend ward rounds on 3 wards, and a referral meeting for the hospital. We reviewed 16 care records of patients on the wards. The inspection included a member of the medicine’s optimisation team visiting each ward and reviewing the medicines administration and care records for 11 people. They reviewed the use of medicines to manage anxiety and/or agitation, administration records against relevant mental health act consent to treatment document and reviewed policies and procedures. Following the inspection we spoke with 7 carers/relatives of patients on the ward.

Prior to the inspection we received several anonymous whistleblowing concerns about the hospital regarding restrictive practices, overmedication, physical health monitoring, a closed culture, discrimination in recruitment, and a punitive approach to complex behavioural issues. Overall, we did not find evidence of these concerns. However, we did note that there were some gaps in senior oversight in specific areas that required improvement. These related to clear seclusion records and medicine administration records.

Overall, we have rated the service as Good. We found several areas of good practice. There had been significant recruitment of staff within the hospital, with few vacant posts and reduced use of agency staff. Overall, we found an improvement in monitoring of rapid tranquilisation including staff training and audits. We found evidence of good patient involvement in their ward rounds.

There was effective use of the National Early Warning Scores. A physical health nurse for the hospital started in January 2025 and was creating a competency document for the nursing team. Staff described good teamwork on the wards and there were daily multi-disciplinary team meetings and structured handover records used on each ward. We found an improvement in staff ensuring patients were informed of their rights and a patient representative attended clinical governance meetings at the hospital.

We also identified some areas for improvement. We found some gaps in records of patients in seclusion including the reason for seclusion, rationale, doctors’ comments and initial seclusion care plans. There were some environmental issues with the seclusion room that did not uphold the privacy and dignity of patients as well as it could have. We found 2 mattresses appeared to be unclean on Coleridge Ward, and audits of mattress cleanliness indicated that this was an area for improvement.

Records did not always clearly show why ‘when required’ (PRN) medicines were used on the wards to manage anxiety or agitation or if they worked. Some high-risk medicines were not included in care plans or risk assessments and records did not always show that high-dose antipsychotic treatment was being reviewed.

Patients provided mixed feedback. Whilst some were very positive, others expressed concerns about the length of time between ward rounds, delays in accessing psychology, few activities at weekends, opportunities for fresh air and delays in getting leave. There was mixed evidence of patient involvement in care plans with better recording of this on Keats Ward. Observation records at night did not always have the level of detail recommended in best practice.

We found 1 breach of the regulations in relation to good governance in monitoring records of patients in seclusion, the environment within the seclusion room, and recording of the reason for use of ‘when required’ (PRN) medicines were used on the wards to manage anxiety or agitation or if they worked.

During an assessment of the hospital overall

Priory Hospital Enfield is provided by Partnerships in Care Limited. The service provides acute and forensic mental health inpatient care. The service is a 53 bedded unit, with 41 forensic beds across 3 wards and 1 acute ward with 12 beds. Byron Ward is a low secure unit and Coleridge Ward and Keats Ward are medium secure. Blake Ward is an acute mental health ward for women.

Priory Hospital Enfield was last inspected by the CQC in September 2021. The hospital was rated Good overall. The acute ward was rated Requires Improvement for Responsive. The forensic service received an overall rating of requires improvement.

Following this inspection, the overall rating for the hospital location remains Good.

Acute wards have been rated Good in all domains. The forensic wards were rated Good in Safe, Effective, Caring and Response and rated Requires Improvement in Well-Led.

We found several areas of good practice. There had been significant recruitment of staff within the hospital, with reduced use of agency staff. Overall, we found an improvement in monitoring of rapid tranquilisation including staff training and audits. We found evidence of good patient involvement in their ward rounds. Staff described good teamwork on the wards and there were structured and recorded meetings on the wards. Patients told us staff were kind and treated them well. We found an improvement in staff ensuring patients were informed of their rights and a patient representative attended clinical governance meetings at the hospital. Patients could access a range of interventions and activities in line with national guidance.

Prior to the inspection we received several anonymous whistleblowing concerns about the hospital regarding restrictive practices, overmedication, physical health monitoring, a closed culture, discrimination in recruitment, and a punitive approach to complex behavioural issues. Overall, we did not find evidence of these concerns.

We did identify some areas for improvement across the wards. In the forensic wards, although leaders understood what the local risks were and had quality assurance measures in place, at the time of the inspection, oversight was not sufficient to find and address errors in staff documentation of seclusion, medicines administration, and rapid tranquilisation. Observation records at night did not always have the level of detail recommended in best practice. Across the service it was identified that areas of improvement were care plans and documentation and the provider was in the process of training staff in these areas.

14, 15, 16, 17, 21 & 24 September 2021

During a routine inspection

Our overall rating for the service stayed the same. We rated it as Requires Improvement because:

There were lots of staff vacancies and the services relied on temporary staff to ensure the wards were safely staffed. This affected the continuity of care for patients, who reported that they were not always familiar with the staff who cared for them.

Staff on the forensic wards did not always make the necessary physical health checks when patients had received medicines by intramuscular rapid tranquilisation. This meant that potentially harmful physical health deterioration may not be identified and acted on by staff.

Staff had not taken any action to escalate problems with emergency alarms not working in two bedrooms on Coleridge ward a forensic service. This meant that staff or patients requiring assistance in an emergency in these rooms would not be able to call for assistance.

Patients on Blake ward, the acute ward for adults of working age, reported that there were not enough therapeutic activities to keep them occupied and they did not have access to support from an occupational therapist. Patients on the forensic wards reported that there were not enough activities to keep them occupied during evenings and at weekends.

The forensic mental health ward environments were not therapeutic in nature and the provider had made very limited progress in improving the ward environments since the last inspection.

The service had not yet made much progress with its approach to reducing restrictive interventions, like restraint and seclusion. The reducing restrictive interventions project group was newly formed and was not systematically reviewing themes and trends from data about the use of restrictive interventions.

Some concerns identified during the inspection had not been identified by the provider through their internal governance assurance processes.

However;

The ward environments were clean. Blake ward had recently opened as a new acute mental health ward. The provider had completed a robust programme of environmental works to ensure the ward was fit for its intended use.

Patients told us they had good therapeutic relationships with the regular staff who worked on the wards.

Patients were encouraged to give feedback on their experience and the quality of the service. They also contributed to discussions about their care and treatment and were given treatment options where appropriate.

A positive staff culture meant that staff felt well supported in their roles and could access support from colleagues. Leaders were committed to delivering a high-quality service and supporting staff. They managed to provide enough support to staff and oversight of wards despite some ward manager posts not being filled at the time of the inspection.

Improvements had been made since the last inspection. These included learning from incidents, patients knowing how to access IMHA, and access to personal emergency alarms.

Different members of the multi-disciplinary staff team were dedicated to supporting patients in their recovery. They explained how they tailored their approach to individual patients and supported patients to re-integrate to the community and boost their skills and experience where appropriate.

Staff held close professional links with colleagues in other agencies and teams which helped them plan for effective patient discharge.

17-19 April 2018

During a routine inspection

We rated The North London Clinic as requires improvement because:

  • The senior leadership team of the hospital had been unstable since the hospital’s merger with another provider in December 2016, which meant there had been inconsistent leadership. Although there was a governance framework in place, new systems and processes had not yet been fully embedded since the merger, and staff could not always find key information to help them deliver their role effectively.

  • There had been a high turnover of ward managers, which meant there was a lack of leadership and experience at ward level. Most deputy ward manager posts were vacant, which meant ward managers did not always have sufficient leadership support on the wards. Staff morale was low.

  • There was a high vacancy and turnover rate for the nursing teams across the hospital. This had led to an over reliance on bank and agency staff.

  • Physical healthcare monitoring was not being carried out consistently to meet the individual needs of patients. There was no effective oversight of physical health monitoring systems within the hospital.

  • The hospital did not have enough personal alarms for all staff and external visitors, and they were not all in working order.

  • The hospital did not ensure there were effective systems in place for all staff to hear about and learn from incidents and complaints. Team meeting minutes did not demonstrate that they happened every month as managers said they should. Care record audits were not being carried out.

  • Patients who were detained had limited access to an Independent Mental Health Advocate.

  • The wards did not always promote patient recovery. The wards were not well maintained and did not provide a therapeutic environment. The hospital did not ensure staff engaged with patients following a seclusion episode, which meant patients were not provided with a de-brief and offered any additional support they may have required.

  • Carer needs were not always being met. Carers reported that communication could be improved between carers and staff at the hospital.

We found these areas of good practice:

  • There was a proactive approach to anticipating and managing individual risks for patients. Up-to-date risk assessments and management plans were in place for all patients. There were systems in place for safeguarding patients.

  • Patients’ needs were fully assessed. Care plans were comprehensive, holistic and person centred. Patients co-produced their care and risk management plans. The hospital provided a range of psychological therapies and interventions recognised by guidance from the National Institute for Health and Care Excellence.

  • The hospital was good at involving patients in their care and treatment. There were opportunities for patients to feedback on the services they received at the hospital.

  • Patients were supported with their recovery journey. There was an extensive programme of individual and group activities that reflected patients’ individual needs and preferences.

  • The hospital’s risk register matched staff concerns and our concerns found during the inspection. Detailed plans were in place to make improvements and senior management discussed the risk register regularly. Leaders had recognised the recent hospital merger had been a challenging time for staff, and had been proactive in engaging with staff and working to improve morale.

22-24 April 2015

During a routine inspection

The North London Clinic is registered to provide the following regulated activities:

  • Assessment or medical treatment for persons detained under the Mental Health Act 1983;
  • Diagnostic and screening procedures; and
  • Treatment of disease, disorder or injury.

The hospital provides secure and rehabilitation services and has four wards:

Coleridge ward

Core service provided: forensic in-patient/secure wards

Male/female/mixed: male

Capacity: 17 beds - medium secure

Keats ward

Core service provided: forensic in-patient/secure wards

Male/female/mixed: male

Capacity: 15 beds - medium secure

Byron ward

Core service provided: forensic in-patient/secure wards

Male/female/mixed: male

Capacity: 10 beds - low secure

Tennyson House

Core service provided: long stay/rehabilitation

Male/female/mixed: male

Capacity: 19 beds

Mental Health Act responsibilities

At the time of the inspection all but one of the patients were detained under a section of the Mental Health Act 1983 (MHA).

The use of the MHA in the service was good. MHA documentation was generally compliant with the Act and Code of Practice.

Staff explained patients’ rights to them in a way they understood and repeated this often. Patients had access to an independent mental health advocate who could support them.

Mental Capacity Act and Deprivation of Liberty Safeguards

Most staff had received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). However, their understanding of the legislation and how it affected their everyday clinical practice varied. Some staff, particularly on Tennyson ward had a good understanding of the MCA and DoLS. Whereas some staff on the secure wards could not clearly explain the details of a mental capacity assessment and what a deprivation of liberty meant.

20 February 2014

During a routine inspection

At this inspection we visited Tennyson and Byron wards. We spoke with ten patients admitted to those wards on the day of our visit. Most patients were positive about the care and treatment they were receiving. For example, one patient said, 'the care is fine.' Everyone told us they took part in a range of groups and activities both inside and outside the hospital. Several patients said the groups were helpful for their recovery. Many patients on Tennyson ward prepared their own meals in shared flats within the ward. We saw staff interacting with patients in a caring and compassionate way and responding to their needs. The mental and physical health needs of patients were addressed.

Patients were provided with opportunities and support to increase their independence and become involved in the local community. For example, some patients went swimming at a local leisure centre or took up volunteering opportunities in the community as part of their rehabilitation. Some patients were supported to purchase food and prepare their own meals as they progressed towards discharge from the hospital.

Patients we spoke with understood their rights under the Mental Health Act 1983 and an informal patient was clear about their right to leave the hospital.

There were systems in place to ensure the hospital was clean and to reduce the risk of infection. These were mostly effective.

8 April 2013

During an inspection looking at part of the service

We carried out this unannounced inspection to check whether the provider had complied with two warning notices served after the last inspection of the service in February 2013. At the last inspection we had found that emergency resuscitation and first aid equipment was not properly maintained and not suitable for its purpose. The system in place to identify, assess and manage risks did not protect patients against the risks of inappropriate or unsafe care in an emergency.

During this inspection we found that improvements had been made. We checked all of the emergency equipment and found it was suitable for its purpose and being properly maintained. A system of regular checks had been implemented. Senior managers regularly monitored the implementation of checks to ensure they were taking place. Systems in place reflected guidance from expert bodies and were effective in managing risks to patients and others in an emergency.

We spoke with six patients detained under the Mental Health Act 1983. Patients confirmed they were able to raise their concerns with the manager, although they did not think these were always promptly addressed. Patients had mixed views about the quality of care and treatment they had received during their admission. For example, one patient said, 'the staff are like family to me' and another told us 'staff are fine, most are polite.' However, two others were less positive and considered they received little help from staff.

8 February 2013

During an inspection in response to concerns

We carried out this inspection to see whether the provider had made improvements to the systems in place to medically review patients held in seclusion and to follow up on concerns arising from recent incidents that had occurred at the hospital.

There were 49 patients admitted to the hospital at time of our inspection. We spoke with four patients on Coleridge and Tennyson wards. They told us they were satisfied with the care and treatment provided by the service. Staff received appropriate training to enable them to provide the care and treatment that patients needed.

However, emergency resuscitation and first aid equipment was not properly maintained and not suitable for its purpose. As a result the provider had not made suitable arrangements to protect patients and others from the risk of using unsafe equipment in emergency situations.

Although the provider had a system in place to assess and monitor the care and treatment provided to patients and to identify, assess and manage risks relating to their health, welfare and safety, this was not effective. The system in place did not protect patients against the risks of inappropriate or unsafe care in an emergency. We have taken action to address these concerns.

31 August 2012

During a routine inspection

We carried out a joint visit to the service with a mental health act commissioner who reviewed the provider's arrangements for the seclusion of patients.

There were 41 patients admitted to the hospital on the day of our visit. We spoke with four patients on Keats Ward and Byron Ward. Patients confirmed that therapeutic groups and activities usually took place as outlined on their individual timetables. Most had found their admission to the service helpful. For example one patient told us 'it is helping being here' and another said, 'I've come a long way'.

Patients described most staff as 'good' or 'very good'. A typical comment we received was 'staff are helpful'. Some patients told us they wanted to have more time to speak with the consultant psychiatrist in the monthly ward round. One patient told us that five minutes of discussion with their consultant was 'not enough'.

There were generally enough staff on duty and staff had undergone a range of training to help them meet the needs of patients. Patients knew how to make a complaint and one patient told us their complaint had been resolved satisfactorily. However, the provider did not have an effective system in place to regularly assess and monitor the care and treatment of patients in seclusion and protect them against the risks of inappropriate or unsafe care.

27 October 2011

During an inspection looking at part of the service

The patients we spoke to during our visit to the hospital told us that they were generally happy with the care provided to them. Patients told us they met regularly with their primary nurse and one person said, 'we have good therapeutic input, it has made such a difference to my life'. Patients were able to receive visits from family and friends and increased facilities had been made available for this. There were usually enough staff on duty to ensure that patients could go out on escorted leave when this was agreed as part of their care plan. Patients told us they took part in a range of activities and were able to go outside in the secure compound several times during the day.

25 January 2011

During a routine inspection

Patients told us that they were happy with the care and treatment they received at The North London Clinic. They were involved in planning their care and could raise collective issues of concern through the patients' representatives meetings. Typical comments we received included: 'I've got involved in my care plan. I see my primary nurse regularly and talk through my care plan'; and 'there is a planning meeting every day to discuss what there is to do. Staff involve us in this and give you a choice of activities'. Everyone told us they were treated well by staff and their dignity was respected. One patient commented that 'you can approach staff if you are unhappy about anything'. Patients were concerned about the limited space available for seeing visitors and the impact on other patients who were unable to access activity rooms during visits. They were also concerned about the cost of telephone calls and some types of postal costs. There were mixed views expressed on the food provided with most patients describing it as acceptable. Everyone said they were given a choice of meal and individual needs and preferences were catered for.

Mental Health Act Commissioner reports

Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff.

Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. We are looking at different ways to indicate the outcomes of our monitoring in the future.