Priory Hospital Enfield

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• 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

Staff completed a detailed mental health and physical health assessment of patients’ needs at, or soon after, admission. They used the national early warning score (NEWS) tool to monitor and manage patients’ physical health and identify any deterioration.

Staff developed care plans that met the needs of patients identified during their assessments. Care plans were personalised, holistic and recovery oriented. However, we found mixed evidence of patient involvement recorded in care plans, with better recording of this in care plans on Keats Ward.

Staff provided a range of care and treatment interventions suitable for the patient group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence. This included medication, psychological therapies and occupational therapy support.

Staff took part in a range of clinical audits and used results from audits to make improvements. The ward team had effective working relationships with other relevant teams within the organisation and with relevant services outside the organisation.

Staff from all disciplines spoke positively about the team work on the wards, support from their colleagues, and had access to a reflective practice group. Managers provided staff with supervision and appraisal of their work performance. The wards had weekly multidisciplinary team (MDT) meetings that staff from all disciplines attended.

Staff supported patients to attend appointments for their physical healthcare and made referrals to other hospitals if they required advice or treatment about their physical health needs. A physical health nurse had been appointed to the hospital in January 2025 and was in the process of creating a competency document for nursing staff with particular focus on NEWS, electrocardiogram and phlebotomy skills.

Staff had access to the provider’s Mental Health Act (MHA) policies and procedures, as well as the Code of Practice. Staff explained to patients their rights under the MHA in a way that they could understand. Staff ensured that patients were able to take escorted Section 17 leave (permission for patients to leave hospital). Since the previous inspection, we found an improvement in staff ensuring patients were informed of their rights. Patients had access to an independent mental health advocate (IMHA).

Staff had a good understanding of the Mental Capacity Act (MCA) and the five statutory principles. Records confirmed staff completed patients’ consent to treatment and capacity assessments following their admission. As recommended at the previous inspection, the provider ensured that best interest decisions for patients, assessed as lacking consent to treatment, were recorded.

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.

Staff completed a detailed mental health and physical health assessment of patients’ needs in a timely manner at, or soon after, admission. Staff regularly reviewed patient care plans and involved the patient and their family or carer in this process when appropriate.

Staff used the national early warning score (NEWS) tool to monitor and manage patients’ physical health and identify any deterioration.

Care plans were personalised, holistic and recovery oriented. We found mixed evidence of patient involvement recorded in care plans, with better recording of this in care plans on Keats Ward.

Staff provided a range of care and treatment interventions suitable for the patient group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence (NICE). This included medication, psychological therapies and occupational therapy support.

Staff developed care plans that met the needs of patients identified during their assessments. There were a small number of cases where we did not find care plans for all risks identified, such as patients receiving Lithium treatment or on high dose antipsychotics.

The medical team prescribed medicines to treat patients’ conditions, which were safe, effective, and evidence based.

There was effective use of the National Early Warning Scores (NEWS). A physical health nurse for the hospital started in January 2025 and was creating a competency document for the nursing team.

There was clinical psychologist and occupational therapy input on each ward. However, they could not always provide one on one psychological input for each patient and some patients told us that they had not been able to access individual psychology for over 6 months, when they had wanted to.

Staff helped patients live healthier lives by supporting them to take part in programmes or giving advice. They offered patients the opportunity to see a smoking cessation specialist, and access nicotine replacement therapy. There was no dual diagnosis worker available for the hospital, for patients who had substance misuse issues in addition to their mental health diagnosis.

Staff took part in clinical audits, and managers used results from audits to make improvements. Staff had access to quality assurance dashboards including current information about performance with medicines administration, infection control procedures, care plans, risk assessments, and the Mental Health Act 1983.

There was a recovery tree posted prominently on each ward, including personal messages from patients who had stayed on the wards.

Staff from different disciplines worked together as a team to benefit patients. They supported each other to make sure patients had no gaps in their care. The ward team had effective working relationships with other relevant teams within the organisation and with relevant services outside the organisation.

The multi-disciplinary team consisted of a consultant psychiatrist, a specialist doctor, clinical psychologist and occupational therapist (OT) with support from an assistant OT and support from a social worker. There were daily multidisciplinary team meetings on each ward.

Staff had access to a reflective practice group. Staff from all disciplines spoke positively about the team work on the wards and support from their colleagues.

Staff made sure they shared clear information about patients and any changes in their care, including during handover meetings. The teams had effective daily handovers between changes in nursing shifts briefing all on-coming staff about each patient on the ward as well as any incidents which had occurred. Since the previous inspection, managers had introduced a structured handover record sheet for use on each ward to ensure all clinical and non-clinical information was passed on.

The service provided new staff with a corporate and local induction. The local induction included orientation to the ward and reading various policies and procedures. Staff attended regular business meetings, and the managers supported staff to attend. Managers dealt with poor performance promptly and effectively.

Managers provided staff with supervision and appraisal of their work performance and completed detailed supervision and appraisal records for each member of staff. In the 6 months prior to the inspection, monthly clinical supervision rates had been above 90% for each ward with the exception of May 2025 when this rate was at 85%. Over the same time period, 100% of staff on all wards had received managerial supervision.

The wards had weekly multidisciplinary team (MDT) meetings that staff from all disciplines attended. Staff worked together effectively to review each patient and manage their progress as well as their discharge or transfer. There was also a referrals and admission meeting where new referrals were discussed amongst the ward managers and consultants.

Staff liaised with patients’ community care coordinators, and other wards across the hospital. Staff also communicated with social services as well as the patients’ GPs and other organisations that provided support to the patients. They advised that they could arrange a GP, dentist, or other relevant health appointments for patients as needed.

Staff supported patients to live healthier lives if they wanted to. Staff assessed all patients for their weight and height and checked whether they smoked and or misused substances. Staff encouraged patients to give up smoking and provided patients with nicotine replacement therapy because the service had a no smoking policy, in line with national guidance.

Staff supported patients to attend appointments for their physical healthcare and made referrals to other hospitals if they required advice or treatment about their physical health needs. We saw examples of good joint working with external specialists regarding patients’ physical health conditions.

A physical health nurse had been appointed to the hospital in January 2025 and was in the process of creating a competency document for nursing staff with particular focus on NEWS, electrocardiogram and phlebotomy skills.

Staff completed a range of audits to provide assurance on regulatory compliance. For example, there were audits on the completion of risk assessments, care plans, and infection control. Staff took part in clinical audits, and managers used results from audits to make improvements. Staff had access to quality assurance dashboards including current information about performance with medicines administration, infection control procedures, care plans, risk assessments, and the Mental Health Act 1983. Results of audits were discussed in handover meetings and supervision, with action plans put in place to improve performance.

A pharmacist or pharmacy technician visited the wards regularly. The pharmacist carried out a monthly audit of medicines on each ward. The pharmacist raised any concerns about the prescribing for individual patients with the doctor concerned and nurse in charge.

Staff had access to the provider’s Mental Health Act (MHA) policies and procedures, as well as the Code of Practice. Staff explained to patients their rights under the MHA in a way that they could understand. Staff ensured that patients were able to take escorted Section 17 leave (permission for patients to leave hospital) when this had been granted, and this was evident in their records.

Since the previous inspection, we found an improvement in staff ensuring patients were informed of their rights. Staff requested an opinion from a second opinion appointed doctor when necessary. Patients had access to an independent mental health advocate (IMHA).

Staff had a good understanding of the Mental Capacity Act (MCA) and the five statutory principles. Records confirmed staff completed patients’ consent to treatment and capacity assessments following their admission.

Staff could access support on the MCA and Deprivation of Liberty Safeguards (DoLS) from the social worker covering their ward. As recommended at the previous inspection, the provider ensured that best interest decisions for patients, assessed as lacking consent to treatment, were recorded.

At the time of the inspection 97% of staff had completed training in the MCA and 92% had completed training in the MHA.