Priory Hospital Solihull

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

Patients received care in an environment that supported their safety and wellbeing. Staff assessed and managed risks well. Staff worked with individuals to understand their needs and involved them in decisions that helped them stay safe. The use of restrictive interventions was low, and staff focused on proactive approaches such as positive behavioural support. The service worked closely with partner agencies to maintain continuity of care, ensured safeguarding concerns were raised promptly and acted on, and supported patient’s rights under the Mental Capacity Act.

Wards were clean, well maintained and appropriately equipped. Staff completed daily environmental checks and understood ligature risks and mitigations. Staffing levels were stable, with low sickness. Managers had covered most shifts with substantive staff. Mandatory training compliance was good. Staff generally managed medicines safely. Staff immediately addressed some minor issues we found around medicines during inspection.

We have not awarded this service a score for Safe.

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

The evidence showed a good standard. The service had a strong proactive and positive culture of safety, based on openness and complete honesty. They actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

Staff demonstrated a consistently high level of understanding about what incidents needed to be reported and how to do so. We reviewed a range of incident records and found staff had reported all relevant incidents. Staff recorded detailed accounts and clearly described what had happened, the immediate actions taken, and how patients were supported both during and after incidents. Oversight of incidents was strong. Ward managers reviewed every incident promptly to ensure information was complete, actions were proportionate and any learning identified and embedded. The service had not experienced any significant incidents in the previous 6 months. The last significant incident had been in February 2025, from which learning had been shared with all staff and across the wider organisation.

Learning was embedded across the hospital and extended beyond incidents, near misses and complaints. Staff actively used feedback from patients and families, alongside reflective discussions across a range of forums, to continuously improve practice. Well established systems ensured learning was identified, shared and acted upon, including daily multidisciplinary flash meetings attended by senior leaders, ward managers and MDT representatives, where incidents, emerging risks and areas of concern were reviewed and actions agreed. Learning was routinely discussed through staff, patient safety, safeguarding, clinical governance and complex case meetings, with the hospital director sharing learning regionally to support wider organisational improvement. Learning was communicated effectively through regular email updates and made accessible on paper and electronically on wards, ensuring staff had easy access to hospital‑level and regional learning.

Staff demonstrated a strong understanding of the duty of candour. They were open, transparent and honest with patients and families when things went wrong. We reviewed correspondence sent following a complaint, which included a clear apology, an explanation of what had happened, actions taken and learning identified from the investigation.

Learning had led to meaningful and visible improvements. Changes made in response to feedback included adjusting evening cleaning schedules to reduce noise at night, purchasing a gaming console at patients’ request, and developing a clear, structured flowchart to support staff when assisting patients with managing finances, including consideration of capacity.

Staff told us the service offered strong support to both patients and staff following incidents. This included structured debriefs and regular reflective practice sessions facilitated by the psychologist. If staff required further support, such as counselling, managers accessed this through the occupational health service.

The evidence showed a good standard. The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The service’s referral and admission processes ensured that staff received all essential information about the patient which was reviewed by the MDT to determine if the patient’s needs could be met. Information requested at the point of referral included past and present mental health history, physical health history, past and present risks, as well as medicines history / current prescriptions. Decisions were made using an MDT approach. The medical director reviewed referrals from the medical perspective, and therapy and nursing staff considered holistic needs, to include cognitive and physical abilities. The hospital director confirmed there was no pressure to admit all patients referred to the service. Emphasis was placed upon if the hospital could safely meet the needs of the patients, to aid their recovery, and support them to live in a community setting.

Most patients were from the local area, with 2 out of the 24 patients ‘out of area’. Staff encouraged, advocated and supported patients to keep in touch with family members and people important to them. Staff involved all the necessary healthcare and social care services to ensure patients had continuity of safe care, both within the service and post-discharge. We saw staff regularly maintained contact with patients’ local community teams and provided regular updates of progress. Staff routinely invited care co-ordinators to attend MDT review meetings, which could be attended virtually.

The evidence showed an exceptional standard. The service worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. They had a clear focus on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. They always shared concerns quickly and appropriately.

Safeguarding was embedded within everyday practice across the service. All clinical staff completed mandatory safeguarding training for adults, children and young people, and staff we spoke with demonstrated a confident and consistent understanding of how to recognise and raise safeguarding concerns. Staff provided clear and relevant examples of how they protected patients from abuse, harassment and discrimination, including those with protected characteristics under the Equality Act. Safeguarding leads were trained to level 4. Training compliance remained above 90% at the time of our assessment for all levels.

The service went beyond mandatory training requirements to strengthen safeguarding practice. In addition to level 1, 2 and 3 training, staff received focused ‘7‑minute brief’ sessions covering specific safeguarding themes. These included domestic abuse, neglect and acts of omission, organisational abuse, financial and material abuse, coercion and control, stalking, and the impact of these experiences on patients’ mental health.

Between 1 July and 31 December 2025, the service raised 14 safeguarding concerns. Staff had reviewed themes and had found physical abuse and financial abuse identified as the most common. Eight concerns related to the service and 6 related to external agencies or individuals. Of the referrals made to the local authority, 13 were closed following review, with feedback confirming the actions taken by the service had been appropriate and effective. The remaining concern related to a historic allegation not connected to the service.

The service actively promoted safeguarding awareness for both staff and patients. As part of National Safeguarding Week, safeguarding leads held drop‑in sessions / a coffee morning for staff and patients. This focused on what safeguarding meant in practice, how to raise concerns, and how people could support one another to stay safe within the hospital and in the community. Some patients shared real life examples of how they had been supported with previous safeguarding concerns.

Staff ensured children and young people visiting the service were supported safely. Staff demonstrated flexibility in facilitating visits to promote meaningful contact for patients as and when necessary.

The service kept restrictions to a minimum and did not apply blanket restrictions to all patients, unless clinically justified, and on a short-term basis only. Each ward had its own restrictions register, which was maintained by the ward managers, and overseen by the director of clinical services. All restrictions were reviewed monthly by the MDT. This fed into the monthly clinical governance meetings, where discussions took place routinely.

The level of restrictive interventions used was kept to a minimum and used as a last resort. Please see under the quality statement involving people to manage risks for further information.

Mental Capacity Act

Staff demonstrated an excellent understanding of the Mental Capacity Act. They consistently presumed capacity and took practical steps to support patients to make their own decisions. Where there was uncertainty, staff undertook decision‑specific capacity assessments and recorded these comprehensively. Assessments clearly reflected consideration of individual wishes, feelings, beliefs, culture and life history. Staff showed confidence in recognising fluctuating capacity and had responded appropriately.

Mental Capacity Act training was mandatory and compliance was at 98%. Staff made Deprivation of Liberty Safeguards (DoLS) applications when required, with oversight provided by the on‑site Mental Health Act administrator. Although no DoLS applications had been required in the previous 12 months, systems were in place to ensure timely action if needed. The administrator regularly audited records to ensure legal requirements had been met and information remained current. The provider had a policy on the Mental Capacity Act, including Deprivation of Liberty Safeguards. Staff were aware of the policy and had easy access to it.

The evidence showed an exceptional standard. The service consistently worked well with people to fully understand and manage risks by thinking holistically. They provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them. Staff assessed and managed risks to patients and themselves well and followed best practice in anticipating, de-escalating and managing challenging behaviour. Staff used restraint only after attempts at de-escalation had failed.

We reviewed 10 patients’ care records during this inspection. Records were consistently detailed, personalised and proactively maintained by staff, including following any risk‑related incidents. Risk assessments clearly demonstrated an individualised, person‑centred approach, with risks identified early, reviewed continuously and managed in partnership with patients. Risk planning was routinely co‑produced through multidisciplinary input, enabling complex and overlapping needs to be understood by all. The MDT provided a trauma informed and psychologically safe culture which focused upon early identification of deterioration and emerging risks.

Patients we spoke with confirmed that risks were discussed regularly and meaningfully with them during MDT meetings, supporting shared understanding and active involvement in managing their own safety. Two patients gave clear examples of how staff supported them to understand and manage specific physical health risks. Staff routinely offered patients copies of their care plans, although not all patients wanted these.

Staff communicated with patients in ways that consistently promoted understanding, choice and involvement. Where information was not initially understood, staff adapted their approach using repetition, alternative explanations and accessible formats to maximise understanding and support informed decision‑making. Easy read materials were readily available, and advocacy was actively promoted. Patients we spoke with were confident about who their advocate was, how often they visited and how to access their support.

Staff supported patients to make advance decisions when appropriate. We saw clear evidence of person‑centred discussions, including advance care planning for a patient with physical health needs, where their wishes regarding resuscitation were sensitively explored, clearly recorded and respected.

Staff actively sought out, encouraged and valued patient feedback about safety and restrictions. We observed community meetings where patients were fully involved in discussions about restrictions, the rationale for these and how risks could be managed in less restrictive ways. Restrictions were individually risk assessed, clearly care planned and reviewed regularly through MDT oversight. The service demonstrated a strong commitment to least‑restrictive practice, balancing safety with independence and choice.

The service rarely used physical interventions or restraint. Staff consistently described restraint as a last resort and placed strong emphasis on anticipating and responding to early signs of deterioration to reduce the likelihood of incidents. Patients had personalised positive behavioural support (PBS) plans and ‘keeping safe’ care plans, which were co‑produced and clearly described how staff should support individuals when communicating distress.

Between 01 July and 31 December 2025, there had been 5 restraints (none of which were in the prone – chest down position). There had been 0 restraints on Millison ward; 1 on Arley ward, and 4 on Elkin ward. The use of rapid tranquilisation was rare. This had last been administered by staff in November 2024.

The evidence showed a good standard. The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff undertook daily checks of the care environment to maximise patient safety. Any areas needing action were escalated to the relevant team (for example the maintenance team), and staff would include this in the shift handover. The maintenance log was up to date and confirmed all reported tasks or concerns had been actioned in a timely way. Patients we spoke with confirmed this.

Staff could not easily observe patients in all parts of the wards. However, curved mirrors had been fitted to aid visibility in areas the service had recognised were blind spots. The hospital director ensured the ligature risk assessment was completed annually. We saw each of the 3 wards had a ligature risk assessment. There were 6 assessments in total across the hospital, to ensure the Occupational Therapy block, grounds and all outside areas had been covered.

All identified ligature risks had clear and relevant mitigations in place. An example of this included certain areas of the wards used by patients under staff supervision. Staff were aware of the ligature risk assessment and knew how to access this. Each ward had visual ‘heat maps’ which identified the higher risk areas of the wards clearly. Staff knew where ligature cutters were located, in the event these were needed.

The wards were single gender and complied with guidance on eliminating mixed sex accommodation.

Staff had alarms to summon assistance and could also radio for support if required. Patients had access to nurse call systems and could summon help from staff if needed.

Clinic rooms were fully equipped with accessible resuscitation equipment and emergency medicines that staff checked regularly.

The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The service had a clear and stable staffing establishment across all 3 wards. The registered nurse establishment totalled 21.6 posts, with 21.4 filled and a vacancy of 0.2, while support worker numbers were above establishment at 24.4 posts. Sickness and turnover were low. Staff sickness over the last 6 months had averaged at 1.9%, which is below the national average. Staff turnover over the past 6 months had varied between 0 and 2%.

Ward managers planned rotas in advance and used a clear escalation process to manage any gaps, with substantive staff prioritised. Bank and agency staff were used when regular staff could not provide cover. On average, agency registered nurses covered 10.7% of shifts each month and bank registered nurses 1.4%. Agency support workers covered 9.5% of shifts and bank support workers 0.5%. Managers covered the majority of shifts with substantive staff, with bank and agency staff used as a supplementary resource rather than the primary means of staffing. All bank and agency staff received an induction to the area they would work and had to be up to date with mandatory training to be eligible for booking. Over the past 6 months, there had been just 1 short-term staffing incident, which was safely managed.

Staffing levels flexed in line with patient numbers and acuity, with additional staff provided to support escorted leave where needed. There were enough staff across the hospital to carry out physical interventions if needed, for example restraint, although this was rarely used. Staff had been trained and were up to date with all relevant restrictive interventions training, including restraint. There was adequate medical cover day and night and a doctor could attend the ward quickly in an emergency. Patients and staff consistently told us there were enough staff available. Patients placed emphasis upon various other MDT members being on and off the ward, as well as the nursing staff. The hospital had a full complement of staff including doctors, a psychologist, psychology assistant, occupational therapist and occupational therapy assistants.

Staff had received and were up to date with mandatory training. Compliance with mandatory training was over 90%. The training staff received was appropriate for the patient group using the service.

The evidence showed a good standard. The service assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

We undertook a tour of the hospital during our inspection. The hospital was visibly clean and had adequate furnishings which were in good condition. The hospital had a team of housekeeping staff. We saw housekeeping staff working over the 2 days of our visit. Many patients spoke highly of them and said they did a good job keeping the hospital clean. Cleaning schedules were in place to ensure housekeeping staff cleaned all areas of the hospital.

Clinic rooms, bathrooms and toilets were tidy and well presented. All patients had ensuite bathrooms. We saw adequate hand-washing facilities on each ward. Some hand hygiene posters were displayed to reinforce best practice among staff, visitors and patients.

Staff stored chemicals safely in line with safety requirements. The service had many policies relating to infection prevention and control (IPC). Their ‘infection prevention and control arrangements policy detailed staff responsibilities around IPC and monitoring adherence to relevant policies. The hospital had a designated IPC lead who ensured routine audits were completed, and any shortfalls acted upon. Routine IPC audits included examining cleanliness, handwashing and mattress condition. We reviewed the most recent audits across all 3 wards. Compliance in the different areas ranged between 94% and 98%. Where there had been issues identified, action had been taken. For example, mattresses had been replaced, and ward managers / IPC lead were undertaking spot checks to ensure staff adhered to the ‘bare below the elbow’ policy. Staff compliance with IPC training was 100%.

Staff adhered to the safe storage of foods and had received relevant training in food hygiene / handling. We saw items in fridges appropriately labelled with date of opening. Staff had completed regular temperature checks to ensure foods were stored at the correct temperature.

The evidence showed a good standard. The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

During this inspection, we found some minor issues which we relayed to nursing staff, who took immediate action. These had not resulted in any harm. Individual patient labels of 2 insulin pens were absent. Although staff stored these in named containers, there was a risk these could be mixed up.

One insulin pen had no date of opening and had been stored in the fridge after opening (instructions were, once opened to keep at room temperature). Staff had not administered this since it was placed in the fridge. The medication was in date. Staff discarded this. We found one box of urine dip sticks had expired. Staff discarded this immediately.

Overall, staff followed good practice in medicines management (that is, transport, storage, dispensing, administration, medicines reconciliation, recording, and proper disposal). Staff followed national guidance, which featured in medicines policies.

Managers ensured medicines reconciliation was completed prior to new patients arriving. Staff gathered information on medicines prescribed and previously used medicines at the point of referral, in line with best practice.

Medical and nursing staff had access to a variety of medical examination equipment to undertake routine examinations and tests. The hospital had a separate space to ensure privacy. Managers ensured equipment used were calibrated regularly to optimise working, such as the blood sugar monitoring devices.

The service had a contract with a pharmacy who attended the hospital weekly, undertook monthly medicines audits, and attended the clinical governance meetings quarterly. This enabled any recurrent themes or concerns and any learning around medicines management to be discussed. The pharmacy also offered staff training sessions online, as a schedule, which meant sessions were more flexible than previously, making it easier for staff to attend.

As required medicines had not been overused or used for extended periods of time without a doctor’s review. No patients at the service had required rapid tranquillisation. Staff reviewed the effects of medicines on patients’ physical health regularly and in line with national guidance. We saw patients had corresponding care plans detailing how staff monitored patients who were prescribed certain high-risk medicines. Staff had followed these and had recorded physical health observations at the times expected. In line with best practice, staff used recognised tools for monitoring potential side effects of medicines prescribed.