Priory Hospital Enfield

On this page

• 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 the best available evidence.

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

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 looked at 4 care and treatment records for the ward.

Staff assessed each patient’s needs when they were admitted to the hospital and created care plans to support their different identified needs. We saw that care plans were not always updated with detailed information or information was not always easy to be found, for example when on site we were not able to find information to provide assurance that the RT checks had been completed. The provider had recognised areas they wanted to improve in this area and was in the process of training staff. There was a training session taking place on the day of our inspection.

Care records showed staff providing individualised care to patients.

There were no delays in patients’ physical health needs being assessed after admission. Staff used the national early warning score (NEWS) system to detect and respond to any clinical deterioration of the patients’ physical health. Patients’ records also showed evidence of regular physical health reviews.

Care plans did not consistently include patient views in their own words and appeared to be written in the voice of the staff member writing the notes.

The team included or had access to a range of specialists to meet the needs of patients in hospital. This included doctors, nurses, occupational therapists and activity co-ordinators.

There were two clinical psychologists who worked at the hospital site covering 4 wards. Although they were able to offer input into ward rounds, assessments and formulation, their limited number meant they could not offer regular interventions such as individual and group therapy. The hospital should consider weather whether increasing psychology hospitals would benefit the patient group.

Staff were aware of how often each patient needed their physical health vital signs checked and knew how to record this appropriately.

An occupational therapist and activity co-ordinator worked from 9am to 5pm each weekday, offering and supporting a range of activities to keep the patients engaged. They prepared a schedule of activities for the weekend. A music teacher attended the ward once a week.

Most patients told us they met regularly with their named nurse. The ward had an activity room and a therapy room that was equipped with soft furnishings and calming and engaging lighting. This supported patients to engage in activities on the ward. The therapy room provided an additional soft sensory space for patients to use.

The hospital had considered how to support patients to develop or acquire skills helpful for their day-to-day life and employed a maths teacher who visited the ward weekly. We observed several patients engaged with and enjoying the maths lessons.

Staff assessed and met patients’ needs for food and drink and for specialist nutrition and hydration. We saw completed nutrition and hydration monitoring forms for patients who required them.

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

The ward had regular multidisciplinary meetings where staff from different professional backgrounds discussed patient care and any updates to the service/hospital.

Staff shared information about patients at effective handover meetings that took place at the end of each shift. In every morning handover meeting, staff discussed any incidents from the previous 24 hours, updates to patient risk and any changes in presentation

The hospital site had a physical health lead. Staff were aware of who this was and could ask them for any advice related to physical health needs.

Staff identified and recorded patients’ physical health needs in their care plans. Patients’ pulse, temperature, weight, height, and blood pressure were checked frequently. Staff wrote notes on each shift detailing patients’ medication, food/fluid intake, hygiene and sleep.

Staff ensured patients got access to physical health care, including specialists if needed. Patients were seen promptly by a doctor if they felt unwell.

Staff supported patients to live healthier lives. For example, supporting issues relating to substance misuse. Patients could access several groups to support living and learning about a healthy lifestyle. Patients were encouraged to go on walks with staff in the local community.

Staff monitored patients’ health, mental state and their wellbeing. Any changes in a patient’s presentation were discussed at the daily handover meetings.

Staff used recognised rating scales to assess and record severity and outcomes for patients. For example, the Health of the Nation Outcome Scales.

Staff took all practical steps to enable patients to make their own decisions about care.

For patients who might have impaired mental capacity, staff assessed and recorded capacity appropriately. Within the 4 care records we reviewed, we found appropriate capacity assessments for certain decisions, such as consenting to treatment and finances. Whilst on inspection we did raise a query regarding a missing assessment in relation to consent to engage in sexual relationships. We were informed that this was completed after our visit.

If a patient was detained under the Mental Health Act 1983, their detention and treatment followed the Act’s requirements and code of practice. Staff supported patients to understand how the Mental Health Act applied to their situation and that patients understood their right to appeal their detention.