- Independent mental health service
Priory Hospital Enfield
Assessment report published 16 February 2026
Contents
Ratings - Forensic inpatient or secure wards
Our view of the service
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.
People's experience of this service
Approximately half of patients we spoke with provided very positive feedback about their experiences on the wards. Carer feedback was largely positive, indicating good involvement in patients’ care when possible, and welcoming, approachable, and professional staff. Five of 7 carers we spoke with were positive about the staff support to their relatives, and indicated that staff were warm, welcoming and flexible, they received clear information from staff including work towards discharge, the environment was clean, and there were suitable activities.
Patients provided mixed feedback. One patient said that they did not feel safe, and another felt staff were not always compassionate. 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. A relative reported that a staff member had behaved disrespectfully whilst observing their supervised visit. There was mixed evidence of patient involvement in care plans.
We saw staff engaging positively with patients on the wards during the inspection. Staff demonstrated a good knowledge and understanding of patients’ individual needs.