Priory Hospital Enfield

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that hospital leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

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 Well-led.

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

Staff were aware of and aligned with the hospital’s vision, applying its principles in their daily work. Staff were able to describe their collaborative approach to delivering patient care, highlighting effective teamwork and communication.

Staff had the opportunity to contribute to discussions about changes within the hospital and staff shared that senior leaders operated an open-door policy.

Managers had the necessary skills, knowledge, and experience to effectively lead and manage their team. They had a good understanding of the service they managed and were able to explain how the team worked together to provide care to their patients. At the time of the inspection, the hospital director had been in post for 3 months. Staff on the ward gave very positive feedback about their managers.

Leaders were visible in the hospital. Staff praised managers for being visible, approachable, and supportive, fostering a positive working environment. Senior staff demonstrated a proactive approach, swiftly addressing areas for improvement and driving positive change.

Staff we spoke with stated that they felt able to raise concerns and were aware of the whistleblowing policy.

The provider had a freedom to speak up policy and systems in place. This information was displayed for staff to see and there was a freedom to speak up champion. Staff we spoke with said they felt that they could speak up if something was not going well. They said there were opportunities to discuss the hospital and any improvement needed.

Patients had opportunities to give feedback on the service they received. For example, through community meetings, one-to-ones with staff and the complaints form.

Leaders appeared mindful about potential discrimination and inequality that might affect diverse staff groups. Staff members said they felt supported by managers around their needs. Whilst on site, we observed information in relation to LGTBQ+ or other areas where a staff member may feel marginalised by society, this was present within the staff rooms and throughout the administration building.

The service employed a diverse team of staff from international backgrounds. Employment practices promoted equality of opportunity. Managers said the service did not discriminate against staff from minority groups. Staff did not raise any concerns about discrimination.

Staff had access to the equipment and information technology needed to do their work. Staff said the information technology infrastructure, including telephone systems and computers worked well and was not a barrier to getting their work done. We did observe that nursing stations were small and provided limited access to computers.

Information governance systems included confidentiality of patient records.

The service had a structured framework for team and governance meetings, ensuring discussion of key topics, including incident learning and complaints, to drive improvement.

Managers held regular monthly governance meetings to review key areas, including health and safety issues, incidents, audits, and complaints, promoting a culture of transparency and improvement.

Managers and senior staff effectively addressed performance issues. Managers and senior staff had access to a range of information about the performance of the service, staffing and patient care.

Staff were aware of how to report incidents via their internal system, and incidents were regularly discussed in team meetings, driving learning and improvement from recent incidents.

The service raised safeguarding concerns when needed with the local authority.

The service worked well with other agencies including health and social care professionals and the local authority safeguarding team. The service had developed a good relationship with an NHS trust that commissioned the service through a block-booking arrangement. Staff engaged with their professional bodies and undertook specific roles within these organisations.

Patients, carers and staff could meet with members of the service’s senior leadership team to give feedback.

The provider had a quality improvement lead who visited the hospital regularly. The hospital had a number of ongoing informal quality improvement pieces of work, and there were plans in place to deliver the provider’s quality improvement training to staff and develop more formal quality improvement projects at this site. The areas the staff had already worked on included staff wellbeing, celebrating different ethnicities and women feeling safe at work, with the introduction of female only lounges for staff.

Staff were offered opportunities to develop and reflect. Mandatory training, supervision and appraisals were available to all staff.

We saw evidence that team meetings, nursing forums and clinical governance meetings all took place in line with their recommended time frames.