The Priory Hospital Dewsbury

On this page

• 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

This means we looked for evidence that people's care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people's outcomes were consistently good, and people's feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We looked at 4 care records on this ward during the assessment. We found that staff completed a comprehensive mental health assessment of each patient in a timely manner at, or soon after, admission.

Staff assessed patients’ physical health needs in a timely manner after admission. People’s physical health needs were being met, there were useful records to evidence this.

Staff developed care plans that met the needs identified during assessment. Care plans were personalised, holistic and evidenced that family members had been involved where patients themselves had not been due to their cognitive impairment. Some care plans did reflect the voice of the patient and genuine collaboration was demonstrated. Other care plans were more generic but efforts to engage patients in the process were documented. Input from family members had been sought and documented accordingly.

Staff updated care plans and risk assessments, when necessary, as a result of changes to risk, developments in peoples progress or changes to people’s personal circumstances.

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 NICE. These included medication and psychological therapies and activities intended to help patients retain their living skills. Although we could see evidence that these activities were on offer at some points, there were currently vacancies within the multi-disciplinary team that limited patients’ current access to them. We did not observe many activities taking place during our time on the ward in spite of there being a fully furnished and equipped reminiscence room which we were told could be utilised by patients at any time.

Staff ensured that patients had good access to physical healthcare, including access to specialists when needed. Whilst looking at care records we saw lots of examples of patients being supported and encouraged to attend and engage in appointments relating to their physical health.

Staff participated in clinical audit, benchmarking and quality improvement initiatives. We saw evidence of a wide range of periodic audits being carried out. These audits contained detailed actions where necessary, for example where administrative errors were seen in paperwork that should be completed.

At the time of our visit the team did not include the full range of specialists required to meet the needs of patients in the service. There were vacancies for several roles, such as Occupational Therapist and Clinical Psychologist. However, recruitment was underway to rectify this issue, and temporary staff had been drafted in to support the team in the interim. Some permanent support workers were rostered on for periods of time as acting occupational therapist’s assistants. They would be tasked with undertaking and facilitating activities for the patients and it gave the staff member a varied work pattern. If then required, Bank or Agency were utilised to backfill the support worker role, should observation levels have dictated this was required. The team had access to doctors and nurses, social workers, pharmacists, speech and language therapists and dieticians, to meet the needs of the patients on the ward. However, during our time on the ward we saw little evidence of ward-based activities despite care plans stating that “daily routine should be encouraged and promoted”.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the patient group. Managers provided new staff with appropriate induction and offered a flexible approach to induction, ongoing training or communication sharing, considering different learning styles.

Managers provided staff with supervision and appraisal of their work performance and ensured they had access to regular team meetings. The percentage of staff that had an appraisal in the last 12 months was 100%. The percentage of staff that received regular supervision was 100%.

Managers ensured that staff received the necessary specialist training for their roles. A series of bespoke sessions had been made available to staff that were intended to increase their ability and confidence in supporting the patient group. Such training included End of Life Care, Tissue Viability, Crisis Management all of which had a 100% compliance and DOLs which was at 93% compliance level. The training was made available in both face-to-face sessions or online training modules, dependent upon the training being delivered. The training system informed managers when a staff member’s individual training units were due to expire. They then ensured they were booked for updates as needed.

Staff held regular and effective multidisciplinary meetings and shared information about patients at effective handover meetings within the team. Handovers were carried out between each shift change and were attended by all staff on duty.

The teams had effective working relationships, including good handovers and partnership working, with other relevant teams that supported their patients, such as, care co-ordinators, community mental health teams and safeguarding teams.

Staff supported patients to live healthier lives, supporting with their dietary and fluid intake and considering how sleep hygiene aided their physical health. Staff told us about other provisions, such as smoking cessation programmes, but at the time of our assessment it was not felt appropriate for the current patients on the ward. Staff told us this would be offered if appropriate. Some patients’ care plans specifically addressed areas relating to heathy eating, considering exercise to promote a positive mood and mental state and also referenced the promotion of a healthy sleep routine. We saw ward-based displays that promoted healthy and balanced meals and offered patients information on the daily menu on offer.

Staff used recognised rating scales to assess and record severity and outcomes, these were used for both mental and physical health outcomes. Staff were able to show how patients were progressing through their treatment and there were examples of positive treatment episodes where patients had moved on to new placements or returned to previous ones.

Staff used technology to support patients effectively, for example accessing and storing medical results electronically where needed and the majority of the patients’ records were stored electronically which made information sharing simpler. Staff also used equipment such as hoists, safety pods and sensor mats to aid and support patients in their care. Staff also showed us the fully equipped and furnished reminiscence room that contained a TV that showed programmes and played music relating to the era that the patient was born in.

Staff took all practical steps to enable patients to make their own decisions albeit many of the patients lacked capacity and best interest meetings had taken place, or family members had been invited to have input. There were a number of different ways that patients could feed into the development of the service and the way it operated. People had previously been offered a range of activities in and out of the ward and in the community where it was possible and appropriate for each patient. However, due to the decreased MDT there were not as many options offered at the time of our assessment. People were offered a range of options at mealtimes.

We looked at mental capacity paperwork for 6 patients. For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions such as treatment, finances and vaccinations. When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history.