Priory Hospital Solihull

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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 service 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 assessment the rating has changed to outstanding. This meant service leadership was exceptional and distinctive. Leaders and the service culture they created drove and improved high-quality, person-centred care.

The service was exceptionally well‑led. Leaders had created a clear and consistent vision that placed patient’s, their rights and their recovery at the centre of the service. Staff at all levels understood this shared direction and demonstrated a strong commitment to delivering high‑quality, person‑centred care. The culture was open, transparent and inclusive, and there was a strong sense of pride among staff in the work they did to support patients’ progress.

Leaders were visible, knowledgeable and compassionate. They understood the service in depth and were respected by staff and patients. The organisation supported leadership development through structured coaching, accredited management courses and opportunities to build skills in areas such as confidence, feedback and difficult conversations.

There was an exceptionally positive culture around speaking up. Concerns raised were handled sensitively and resolved promptly. Patients consistently told us they knew who they could talk to if they were unhappy, and survey results showed high levels of trust and feelings of safety.

Governance systems were strong, comprehensive and consistently applied. Leaders had clear structures for communication and oversight, supported by regular audits and effective daily risk and performance monitoring.

The service had excellent relationships with partner organisations. External professionals told us that staff worked collaboratively, communicated well and were receptive to feedback. Partners were routinely invited to contribute to reviews and care planning, helping ensure a seamless approach to support. There was a strong culture of learning and improvement.

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.

The evidence showed an exceptional standard. The service had a very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.

The hospital had a clear and shared focus on rehabilitation and recovery, underpinned by a well‑understood vision to deliver high‑quality, person‑centred care that supported people to build independence, confidence and a meaningful future beyond hospital. An inclusive, culturally sensitive and non‑discriminatory approach was embedded within the organisation’s values and was evident in everyday interactions between staff, patients and visitors. Patients we spoke with consistently told us they felt respected, heard and safe, and that care was delivered in a way that reflected what mattered most to them.

Staff at all levels demonstrated a strong understanding of the hospital’s vision and values and described a collective commitment to making a real and lasting difference to the lives of the people they supported. This shared direction was evident in day‑to‑day practice, with staff working in partnership with patients to understand their needs, identify personal goals and actively support recovery and wellbeing. Staff across the multidisciplinary team spoke with pride about their work and their role in patients’ recovery journeys, with several telling us they felt privileged to be part of this process.

This strong sense of shared purpose and ownership was reflected in staff feedback. Results from the 2025 staff survey showed that 94% of respondents understood how the work they did contributed to making a difference to the people they cared for, and 94% said they felt the hospital was effectively led. Eighty percent of staff reported that they felt comfortable bringing their true self to work and were satisfied with the organisation’s efforts to improve equality, diversity and inclusion. Staff we spoke with during the inspection echoed these findings, describing the service as inclusive, supportive and empowering.

Leaders provided visible, values‑driven leadership. The senior leadership team had effectively communicated the provider’s vision, values and expectations through a structured induction process, reinforced through ongoing training and development. This ensured staff across clinical and non‑clinical roles understood how the organisation’s values translated into practice. We spoke with non‑clinical staff who shared the same outlook and commitment, with two staff describing patients as being like an extended family.

The organisation was actively developing its approach to tackling inequality and promoting equity. Application of the Patient and Carer Race Equality Framework (PCREF) was evolving following its launch within the organisation in March 2025. Staff had access to PCREF information through the provider’s intranet, and at hospital level PCREF was a standing agenda item at monthly clinical governance meetings. Leaders and staff regularly reviewed Mental Health Act and restrictive practice data to identify any emerging themes, demonstrating a commitment to understanding and addressing potential inequalities in experience and outcomes.

Senior leaders actively encouraged openness, learning and improvement. Staff told us the organisation listened to ideas and suggestions from patients, staff, relatives and external stakeholders to support improvement initiatives where these would enhance care and treatment. We saw examples of staff‑led improvement proposals being approved, including at additional cost, demonstrating that leaders prioritised quality, safety and experience. Staff and patients were routinely consulted when changes were being considered, reinforcing a culture of transparency, trust and shared ownership.

The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. There was a continuous drive for staff to professionally develop. The hospital had 2 quality improvement coaches. Additionally, there were a number of coaching modules open for staff to complete. Managers had suggested completion of particular modules to individual staff members, to support their development. Examples of coaching modules included difficult conversations, giving effective feedback and confidence. A number of staff had chosen to complete a number of these modules.

Ward managers had the opportunity to develop their leadership through the organisation’s academy. Ward managers we spoke with had completed a management and leadership course, a qualification at level 4. Some registered nurses had also completed management and leadership courses at level 3. Staff told us they were able to apply for external courses and conferences, if they had identified a gap in knowledge.

Leaders had an excellent understanding of the service they managed. Senior staff explained to us how the teams worked together to provide the best possible care. The MDT worked collaboratively to achieve the best outcome for patients. Patients knew who the leaders within the hospital were, and also knew some of the wider, senior leadership team.

The evidence showed a good standard. The service was good at fostering a positive culture where people knew they could speak up and their voice would be heard.

The service had a positive and open culture in which staff, patients, families and carers felt confident to speak up and raise concerns. As described throughout this report, people were supported to share feedback, suggestions and concerns through a range of accessible routes. Staff facilitated weekly community meetings on each ward, providing patients with regular opportunities to raise issues and contribute to discussions about their care and the running of the service. In addition, lived experience partners regularly engaged with patients and fed back themes directly to senior staff. Patients also spent regular one‑to‑one time with their allocated nurse, which provided further opportunities to raise concerns in a safe and supportive way.

The service had clear and visible Freedom to Speak Up (F2SU) arrangements in place. There was a dedicated F2SU Guardian and several trained champions, and information about how to access F2SU support was clearly displayed on noticeboards across the hospital, including photographs and contact details. This helped ensure staff and patients knew who to approach and how to raise concerns if they felt unable to do so through other routes.

All staff were compliant with F2SU training, and champions had received a specific induction to their role. Staff had also received training in concerns and complaints. Staff we spoke with demonstrated a good understanding of the F2SU process and told us they felt encouraged and supported to speak up without fear of negative consequences.

Over the previous six months, one concern had been raised through the F2SU process. This related to the allocation of duties and communication about the staff rota. With consent, the concern was acted upon and resolved. Information about the number of concerns raised and any emerging themes was shared with the wider organisation and reviewed by the senior leadership team. This enabled learning to be identified and discussions to take place about whether changes or actions were needed more broadly.

Family members we spoke with told us they knew how to raise concerns and felt confident doing so. One relative described initially being unhappy with the provider’s response to a concern; however, this was resolved following further communication and fact‑finding.

Patients were invited to participate in an annual satisfaction survey. We reviewed the most recent results from December 2025, which showed a strong response rate, with 16 out of 21 patients participating. One of the highest‑scoring areas related to patients feeling safe on the wards and knowing who they could talk to if they were unhappy, further supporting a culture of openness and psychological safety.

Relatives and carers were also supported to provide feedback about the service. With patient consent, the hospital director shared clear information with carers about who to contact if they had queries or concerns. Carers were additionally provided with an email address to offer feedback or suggestions, supporting inclusive engagement and ongoing dialogue.

The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

The service supported a diverse workforce and patient group. Staff described a respectful culture where differences were recognised and valued. The provider carried out routine equality monitoring of staff to help ensure the workforce remained diverse and reflective of the people using the service.

Managers had made reasonable adjustments to support staff and promoted flexible working where possible. This included flexible hours, fixed days off and reduced hours to support individual circumstances such as childcare needs. Where staff had health‑related needs, managers referred them to occupational health to ensure duties were appropriate and fair. Adjustments were reviewed periodically to make sure they continued to meet both staff needs and service requirements.

We reviewed the most recent staff survey from April 2025, which had a strong response rate of 81%. Results showed that 80% of staff were satisfied with the service’s efforts to promote equality, diversity and inclusion, and 80% reported they felt comfortable being themselves at work.

The evidence showed an exceptional standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

The hospital had clear and well‑embedded governance arrangements that supported the delivery of high‑quality, safe and equitable care. A clearly defined governance framework set out what should be discussed at ward, team and hospital level. This enabled staff to identify risks to quality, safety and equity early, ensuring timely, proportionate action was taken. Learning from incidents, safeguarding concerns and complaints was consistently shared, reviewed and acted upon.

Shift‑to‑shift handovers were detailed and effective, supporting continuity of care and safe risk management. Daily multidisciplinary flash meetings followed a structured agenda and provided clear oversight of patient and environmental risks, incidents, safeguarding issues, concerns raised, identified learning and agreed actions. Responsibilities were clearly allocated and followed up. Monthly clinical governance meetings had a comprehensive and consistent agenda, providing senior oversight and assurance.

The service demonstrated a proactive, learning‑focused approach to incident management. Staff reviewed incidents regularly, with incidents analysed by ward, categorised and examined for emerging themes and patterns. The multidisciplinary team, alongside patients where appropriate, used this learning to update positive behavioural support plans, care plans and risk assessments. This ensured staff had a shared and current understanding of how to support patients safely, using the least restrictive and most person‑centred approaches. In addition, staff held monthly patient safety meetings to review ward dynamics, emerging safety issues, the environment and planned activities or therapy, helping to proactively reduce the likelihood of conflict or incidents.

Safeguarding governance was robust. Staff responded promptly to safeguarding concerns and made timely notifications to relevant internal and external agencies, including the Local Authority. Records showed staff consistently considered how best to protect patients while upholding their rights and freedoms. Where required, staff completed capacity assessments and ensured patients were kept informed and involved throughout the safeguarding referral process. Monthly safeguarding meetings were held alongside routine ward and hospital meetings, ensuring safeguarding matters were accurately captured, monitored and actioned, and that strong oversight was maintained.

Leaders were assured of organisational performance through the triangulation of data, audit findings, lived experience feedback and external assurance through quality visits. This enabled leaders to focus on patterns, trends and root causes rather than isolated issues, and to use this information to challenge practice, learn and drive improvement.

The service had a structured internal audit programme that enabled continuous monitoring of quality and compliance. Audits covered key areas including infection prevention and control, care records (including care planning, safeguarding and Mental Health Act compliance), physical health, blanket restrictions, and observation and engagement. Audit findings were used constructively. Staff took timely and proportionate actions in response to identified issues, to maintain high standards of care and drive continuous improvement.

Governance arrangements also supported effective partnership working. Staff demonstrated a clear understanding of how to work collaboratively with teams within and outside the organisation. Clinical records evidenced regular and effective communication with external healthcare professionals to support monitoring of physical health needs, alongside ongoing liaison with commissioners, care coordinators and community mental health teams, particularly during discharge planning and transition.

Governance systems were inclusive and empowering. Staff at all levels were encouraged to identify risks, raise concerns and contribute to service improvement. The organisation demonstrated a strong learning‑focused governance culture, with insight from staff, people who used the service and partner agencies who directly informed decision‑making and action. The hospital‑level risk register included both operational and environmental risks. These were RAG‑rated and aligned to the service’s strategic objectives and regulatory responsibilities. Managers ensured both operational and strategic risks were regularly reviewed, with clear mitigating actions in place. Each risk had an allocated risk owner who assumed responsibility for monitoring, progressing and providing assurance on actions. Risks were reviewed routinely, updated or closed as required, providing assurance that emerging risks were identified early, actively managed and reduced wherever possible.

The service had clear and accessible plans and policies for emergency situations, including resuscitation and fire evacuation. Staff were familiar with these arrangements, and relevant policies were easily accessible. The information technology and equipment required for day‑to‑day work were available, reliable and supported safe and effective care delivery.

Information governance arrangements were robust. Staff adhered to confidentiality and data protection requirement. Compliance with training in data protection and confidentiality was 92% at the time of our inspection. Patient‑identifiable information was not visible through office windows, supporting privacy and confidentiality.

Ward managers had access to comprehensive and timely information to support their management responsibilities. This included performance data from routine monitoring and audits, such as safeguarding and incident reports, as well as staff‑related information including supervision, training and attendance. Managers used this information to monitor performance, identify development needs and provide appropriate support, strengthening leadership and accountability at ward level.

The evidence showed an exceptional standard. The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always share information and learning with partners and collaborate for improvement.

The service demonstrated a deeply embedded and outcomes‑focused approach to partnership working. Staff at all levels clearly understood their responsibility to work collaboratively across the local system to support people’s recovery, rehabilitation and discharge. External professionals consistently provided positive feedback about partnership working at Priory Hospital Solihull, describing effective, trusting and well‑established relationships, with staff keeping partners well informed and actively involved throughout people’s care journeys.

The hospital also worked closely with a local university, providing long‑term placements for psychology students undertaking a doctorate programme and facilitated placements for student nurses. This strengthened links with education providers, supported workforce development and contributed to ongoing learning and delivering evidence‑based practice.

External professionals were fully involved in planning, providing and reviewing people’s care. Staff regularly invited them to meetings where care was discussed and shared reports in advance so they could prepare. Partners told us staff listened carefully to their views and, where possible, used their suggestions when planning care.

The hospital worked closely with other organisations in an open and honest way, rather than only working together when necessary. External professionals said the service welcomed feedback and challenge and was open about how it worked. Several partners told us staff were willing to change how they worked if this would lead to better care and improved outcomes for people.

External professionals also highlighted strong leadership in partnership working. They spoke positively about the hospital director’s visible passion, motivation and drive to continually improve the patient experience. Partners said the service demonstrated a strong focus on lived experience and peer involvement throughout the patient journey, which helped shape care, engagement and improvement activity.

The hospital maintained strong, sustained relationships with local community and advocacy services, supporting people to access opportunities beyond the hospital environment. Staff actively encouraged and supported engagement with voluntary organisations offering vocational experience, local colleges providing educational courses, and community support groups such as Alcoholics Anonymous and Narcotics Anonymous. External partners and community organisations told us this network of collaboration had a positive and meaningful impact on people’s recovery, confidence and independence, supporting smoother transitions and longer‑term outcomes.

The evidence showed an exceptional standard. The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

The service demonstrated a strong and well‑embedded approach to learning, improvement and innovation, which leaders clearly recognised as central to delivering high‑quality and equitable care. Staff described a culture where learning was continuous, and where reflection, feedback and problem‑solving were part of everyday practice. Leaders encouraged openness and honesty about challenges and used these as opportunities to learn and improve, rather than to assign blame.

Although the hospital was not accredited by the Royal College of Psychiatrists at the time of our assessment, it took part in a peer review scheme run by the wider organisation. Staff told us this was a valuable process that allowed practice to be reviewed constructively and supported shared learning across services.

The service invested in its staff to ensure quality improvement was embedded across the organisation. Staff were given dedicated time and strong organisational support to lead and take part in improvement work. They were confident in using quality improvement methods and applied these consistently to improve care and outcomes. The organisation offered different levels of quality improvement training, from introductory sessions through to leading projects and coaching. At the time of inspection, both the hospital director and medical director were trained quality improvement coaches.

Over the past 2 years, the hospital had led several meaningful quality improvement projects. One project focused on increasing meaningful activities outside core therapy hours after staff and patients identified gaps in evening and weekend provision. This led to the creation of 2 full‑time activity coordinator posts, which patients said had improved their experience, with staff reporting higher levels of participation and enjoyment.

The service also undertook a thematic review of incidents where patients had returned late from section 17 leave. By working with patients, the multidisciplinary team and local police, staff redesigned care plans and risk assessments so responses were more proportionate and person‑centred. This helped staff feel clearer and more confident about how to respond appropriately.

Further improvement work included projects on Millison Ward to reduce blanket restrictions and involve patients more in decisions about their care, and on Arley Ward to reduce incidents of aggression by strengthening Positive Behavioural Support. These projects were shaped by patient and staff feedback and led to clearer communication, improved staff confidence, reduced incidents and better patient understanding. Learning from this work was shared across the hospital and is being used to support further improvement.

The hospital actively contributed to national research, including participation in a major study on the effectiveness of inpatient mental health rehabilitation services between 2021 and 2026. This work helped strengthen national understanding of best practice, while also supporting staff learning and development within the service.