The Care Quality Commission (CQC) has rated the Priory Ticehurst House as Good overall following a comprehensive inspection.
The Priory Ticehurst House in East Sussex provides inpatient mental health services for adults and young people. CQC has rated the service Good for being safe, effective, caring, responsive and well-led following the inspection which took place in November 2018.
CQC inspected the child and adolescent high dependency unit and the hospital’s three acute psychiatric wards. The hospital’s second child and adolescent ward was not inspected because it had been temporarily closed due to lack of referrals.
This comprehensive inspection was conducted to check that the hospital had addressed the problems that CQC identified during a focused inspection of the high dependency child and adolescent mental health ward in June 2018. The June inspection was undertaken after CQC had been alerted to concerns about the care and treatment of young people and about staff skills and induction.
When CQC inspected Priory Ticehurst House in June 2018, it found it to be in breach of regulations relating to safe care and treatment, staffing and notification of incidents. CQC told the provider it must make improvements to ensure that:
- information about young people’s risk is consistent across the different recording systems.
- young people are appropriately monitored following administration of rapid tranquilisation and records are completed.
- clear, accurate and up-to-date records are maintained including staff rotas.
- all staff receive an induction appropriate to their role before they undertake duties
- all staff have regular supervision.
- CQC are appropriately informed of all notifiable events (this was specifically about patients who were admitted to a hospital emergency department).
When CQC returned in November 2018, inspectors found that the hospital had made these improvements.
CQC inspectors found that the hospital provided safe care and staff assessed and managed risk well. Staff worked to minimise the use of restrictive practices and followed good practice with respect to safeguarding.
Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff monitored patients’ physical health regularly and managed patients’ physical health needs well across all wards.
The wards had enough staff on shifts and the ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisals and ward staff worked well together as a multi-disciplinary team and with those outside the ward who would have a role in providing aftercare.
Staff treated patients with compassion and kindness, respected their privacy and dignity and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
Leaders had the skills, knowledge and experience to perform their roles, had a good understanding of the services they managed and were visible in the service and approachable for patients and staff. The service demonstrated that governance processes operated effectively at ward level and that performance and risk were managed well.
Dr Paul Lelliott, CQC’s Deputy Chief Inspector for Hospitals (and lead for mental health) said:
“Last year, CQC received troubling information about the safety of young people at Priory Ticehurst House. We responded by undertaking an unannounced, focused inspection of the hospital’s child and adolescent mental health service in June 2018. This confirmed that the provider was not doing enough to ensure that the young people under their care were kept safe. We told the Priory what it needed to do to rectify this. When we inspected again in November, we were satisfied that improvements had been made.
“Staff had improved the way in which they assessed and managed risk. Staff on all wards undertook daily checks of the risks that the ward environments might pose to patients and took steps to mitigate these risks. They assessed the risks to individual patients, ensured that staff were present in the ward areas so that they could observe patients who might be at risk and had made some modifications to the building. Staff were confident in identifying and reporting abuse, as well as reporting incidents. Managers investigated incidents and shared lessons learned with the whole team and wider service
“Although the wards continued to rely heavily on agency staff, many of these agency staff worked at the hospital on a regular basis and so knew the patients and the ward routine.
“Although we have rated Priory Ticehurst House as Good, there is still room for further improvement. We concluded that all bank and agency staff received an induction to the wards before starting work, but we found that it had not completed the induction checklists for all agency health care assistants that worked on the wards. Also, we have reminded the provider that it is expected to inform CQC of all serious incidents affecting patients. Failure to do so will result in further action being taken.”
The provider has been told it should make the following improvements to ensure that:
- all staff alarms are consistently stored, accounted for on handover sheets and routinely tested to ensure their efficiency.
- clinic rooms are clean and tidy and that medicine cabinets and sharps bin are located in safe places in clinic rooms.
- all staff are reminded of the fire evacuation procedure for staff, visitors and patients.
- all agency induction checklists are completed.
- all ligature risk action plans clearly identify their progress of completion.
You can read the report in full on CQC’s website by clicking on www.cqc.org.uk/location/1-127132351
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