Priory Hospital Enfield

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 changed to Requires Improvement.

At the previous inspection we found that action should be taken to review the effectiveness of the internal governance assurance framework to ensure they were fit for purpose and highlights issues requiring attention to senior staff. At the current inspection we found that although leaders understood what the local risks were and had quality assurance measures in place, oversight was not sufficient to find and address errors in staff documentation of seclusion, medicines administration, and rapid tranquilisation.

We did find several areas of good practice. There was a clear framework for the discussion of important information such as learning from incidents, complaints, audits and alerts and staff met regularly at business team meeting to discuss this. Staff had implemented recommendations from reviews of deaths, incidents, complaints and safeguarding alerts at the service level. A patient representative attended clinical governance meetings. Since the previous inspection, the service had also introduced a new structured staff handover record for use between shifts and had appointed a physical health nurse for the hospital. Leadership development opportunities were available, including opportunities for staff below ward manager level. Staff spoken with during the inspection felt supported by their colleagues and managers. They knew how to use the whistle blowing process and how to contact the freedom to speak up guardian.