The Care Quality Commission (CQC) has carried out a well-led inspection of Priory Group, as part of CQC’s risk-led assessment of independent health providers’ leadership.
Between 1 and 24 September 2022, CQC looked at the leadership and operations of the organisation using information and feedback from a variety of sources. This included engagement with stakeholders, people using services and their relatives and Priory Group staff.
Overall, inspectors found Priory Group leaders were largely aware of current issues and making progress to address key areas for improvement. However, inspectors also identified several areas which presented concern and found more work was needed.
At the time of the inspection, staff turnover across the organisation was very high nearing 40%. In some services this was having an impact on the quality and safety of care delivered. While Priory Group was aware of this challenge, identified it as a high risk for the organisation, and was taking some steps to address it, there was not a clear approach for ensuring that they fully understood the reasons for the turnover and were systematically making improvements.
More dedicated resource was needed to develop and embed co-production throughout all levels of the organisation. There was scope to ensure people using services were routinely involved in staff recruitment and training; were active participants in the quality assurance processes including the internal quality and compliance team; were active participants in quality improvement projects; and that peer support workers were widely employed.
Additionally, the arrangements for staff to speak up were not working as it should be. This meant there was a risk of the senior leadership team not knowing about things that got in the way of staff delivering high quality care. The number of contacts by staff across the organisation with the speak up guardian was low and the Priory Group had not explored different models for how the speak up arrangements could be delivered effectively across its services.
However, inspectors reported the provider had developed a good governance structure to create clear lines of accountability. They also had appointed two non-executive directors who provided independent challenge.
The Priory Group also used several methods to identify areas or services that needed additional input and support to improve quality of care, including an internal compliance team and an internal patient safety team, who visited services. In addition to this, learning and development was promoted across the organisation to support staff to work with people who use services.
The Priory Group was also working effectively in partnership with external stakeholders. They were an active partner in 22 provider collaboratives, and regularly met with commissioners to develop an understanding of the challenges within the systems and services needed to meet the needs of the population at a local level.
Director of Mental Health at the Care Quality Commission (CQC), Chris Dzikiti, said:
“Our review of Priory Group’s leadership found progress had been made to address known issues, and work was continuing. There was positivity from senior staff about improvements implemented by the new Chief Executive and we heard that the board and operational leadership team carried out regular visits to services.
It was also good to hear about the focus on learning and development to support staff gaining the necessary skills and knowledge and about the way the Priory Group was working with wider stakeholders across the system to understand and meet the needs of local people.
“But significant work remains to be done. The arrangements for staff to speak up was not working as it should be. This meant there was a risk of the senior leadership team not knowing about concerns preventing staff from delivering high quality care. Additionally, work to champion the voice of people using services and include them in the planning and delivery of their care must be strengthened.
“It is also concerning that at the time of the inspection staff turnover was very high and, in some services, this was having a negative impact on the quality and safety of care. Leaders were aware of this challenge and while changes were being made there was not a clear approach for ensuring that they fully understood the reasons for the turnover. This needs to be urgently addressed to ensure better continuity of care.
“We will continue to monitor and engage with Priory Group closely to ensure improvements are made and sustained so that people receive high quality, good care.”
Read the report
Well led assessment report for the Priory Group published on 8 December 2022.