Priory Hospital Enfield

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the hospital met people’s needs.

At our last assessment we rated this key question requires improvement. At this inspection, the rating has now improved and is good.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

Staff met with patients regularly to understand their views on care and treatment. These discussions took place in one-to-one meetings with their named nurse and in multidisciplinary meetings. Staff monitored patients’ conditions and discussed any changes at daily handover meetings.

Each patient had their own bedroom, equipped with an ensuite bathroom and privacy windows they could adjust.

Patients were allowed smart phones and other electronic equipment whilst on the ward. This was individually risk assessed by staff.

Patients feedback on food offered at the hospital was mixed, with most patients liking something on offer.

The ward had a garden that was accessible on the ground floor. Staff said this was accessible to patients at any time they wished to use it. We saw that patients accessed and used this garden regularly throughout the day.

The service had plans in place for patients to access a kitchen on the hospital site, to gain assessment and support from an occupational therapist around daily living skills.

Staff supported patients to maintain contact with their families and carers. The hospital had clear processes and environments to support visiting families and friends. During the inspection we saw several visits from family members and staff supported patients to meet with them on the ward or visit the local area with their family.

Staff had regular telephone contact with patients’ families and health professionals. Family members, bed managers and care co-ordinators were all invited to multidisciplinary team meetings. The hospital facilitated attendance by video link if people were unable to visit the hospital in person.

Staff communicated with external services when planning for a patient’s discharge, in order to prepare for their discharge as well as possible.

Staff had the equipment they needed to do their job although, the nurses’ office was quite small. It was not always possible for staff to access a computer terminal when they needed one.

Managers had access to the information they needed to do their job. This included information on the performance of the hospital, staffing and patient care. This information was presented and discussed in monthly clinical governance meetings.

There was effective use of clear signs across doors on the ward, to let patients, staff and visitors know what each room was.

We observed posters in relation to patients’ rights and how to complain.

The hospital monitored patients’ Section 132 rights under the Mental Health Act. This is a requirement for hospital managers to provide detained patients with clear, accessible information about their legal rights and their detention.

Information governance systems included confidentiality of patient records. 85% of staff had completed Data Protection and Confidentiality training.

Staff made notifications to external bodies as needed. For example, CQC statutory notifications.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, and how to complain. We observed leaflets and posters on the walls with information for patients.

Staff completed a daily information board for patients, for example, how many staff were working and what activities were taking place During the inspection we identified two areas where more detailed information would be helpful for patients. The service recognised this and put plans in place to address this. One area was information around Independent Mental Health Advocacy services.

The other area was around information for patients about the different MHA sections and what these mean, such as leaflets or posters. Having this available will help patients better understand their rights and the support available to them from the outset of their admission.

The hospital displayed information about how to raise a concern in patient areas. Staff understood the policy on complaints and knew how to handle them. Patients said if they had any complaints, they would speak with nursing staff, their doctor or the ward manager in the first instance.

Managers investigated complaints and learned lessons from the results. Staff received feedback on the outcome of investigation of complaints and acted on the findings.

In the 12 months prior to the inspection, the hospital had received 7 complaints. We observed that complaints were acknowledged within 5 days. However, we saw in one complaint, that it was incorrectly addressed to the family and not the patient who had written the complaint. This was raised with senior managers at the hospital, who acknowledged the importance of accurate and person-centred communication, especially in formal correspondence.

Through their robust referral and assessment process, the hospital ensured they could meet the needs of patients that were admitted. When needed, staff made reasonable adjustments for patients.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the acute hospital was within a reasonable travelling distance.

Staff planned for patient discharge and worked closely with care coordinators and external services to plan a patient’s discharge. Staff confirmed they would not discharge a patient unless there was a safe placement that met their needs.

Through discussions with senior managers and staff, they appeared mindful about potential discrimination and inequality that might affect diverse patient groups, ensuring fair access to care and support.

The hospital admitted patients from diverse religious and cultural backgrounds. Staff asked patients about their religious and cultural needs when they were admitted to the ward. The hospital also employed staff from diverse backgrounds. This meant the hospital was able to utilise the ability of staff to speak to patients in their first language whenever this was possible. Staff would always book a translator if this was needed.

Of all staff, 100% had received and completed training in equality and diversity. The hospital displayed information in relation to LGTBQ+ and pictures to show that the hospital had celebrated cultural events, such as Black History Month and Diwali.

The multidisciplinary team planned for each patient’s discharge and return to their local area. Staff ensured that appropriate arrangements were in place to sustain the patient’s mental health. This included liaising with health and social care professionals in the patient’s local area to ensure they had appropriate accommodation to be discharged to and that a package of care was provided by the local mental health services.

We observed discussions regarding patient’s discharge at the multidisciplinary meeting and the action to be completed by staff to ensure a safe discharge for 2 patients including, speaking with the housing department and benefits agency.