The Care Quality Commission (CQC) has told Partnerships in Care Limited, the provider of services at Priory Hospital Arnold in Nottingham to make further improvements following an inspection in January.
CQC carried out a focused inspection at Bestwood and Newstead wards to look at how safe and well-led the hospital is. This was due to concerns raised following incidents that had occurred. This included the death of someone following a period of leave without permission and another person who left the hospital without permission via the roof and sustained an injury.
Following this recent inspection, the provider remained in breach of regulations in relation to staff training, restrictive practice, ineffective information systems and manging items which may present a risk to people.
Due to the focused nature of this inspection, the hospital was not re-rated, therefore the previous rating of inadequate remains overall and for being safe and well-led. Effective, caring and responsive weren’t included in this inspection and remain rated as requires improvement.
Following this latest inspection in January, the service will remain in special measures which means it will be closely monitored and re-inspected to assess whether improvements have been made. If insufficient improvements are made, CQC will not hesitate to take further action which could include closing the service.
Priory Hospital Arnold provides two acute mental health wards on Newstead and Bestwood wards. It also has a psychiatric intensive care unit on Rufford and Clumber wards.
Greg Rielly, CQC deputy director of operations in the Midlands, said:
“When we inspected Priory Hospital Arnold, we were concerned to find the provider still hadn’t made sufficient improvements to the safety issues we identified at our previous inspections. The service wasn’t well-led, and processes didn’t ensure that wards ran smoothly, and people were kept safe. This sadly resulted in two people being able to leave the service without permission and coming to harm.
“We found staff didn’t always search people after they’d been on leave to check they hadn’t brought any disallowed items onto the ward, which was an issue at the last inspection. Also, staff didn’t learn from incidents where people had come to harm after accessing items which should have been safely stored away to keep people safe.
“Additionally, staff didn’t assess and manage risks well. Records of injuries following an incident were inconsistent and staff didn’t know how to manage risks after they had taken place. Also, they didn’t observe people appropriately to ensure they didn’t come to any harm.
“The standard of care at Priory Hospital Arnold is totally unacceptable. The leaders in this service must address the issues identified as a matter of urgency so people receive the safe care and treatment they deserve.
"The hospital will remain in special measures and we will be keeping it under close review.
“We will not hesitate to take further action if we don’t see significant improvement. Even if this results in the CQC taking action which results in the closure of the hospital."
Inspectors found:
- Staff on Bestwood and Newstead were not aware of the missing persons policy
- It did not have the right number of gender specific staff to manage the risks and care needs of females
- The number of new staff on the ward was high, and there was a lack of experienced staff who knew people well. The staff that were new to the service had not received sufficient training on how to safely manage the risks of people
- The wards had a high proportion of staff on duty who were agency staff, who were unfamiliar with people’s needs and risks
- Enhanced observation records were not always completed properly to reflect when people were accessing leave from the hospital
- Staff did not understand and discharge their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005
- The service did not ensure that staff had received sufficient training to be able to care for people is a safe and caring way.
However:
- Leaders were visible and approachable for people and staff
- People had regular one to one sessions with their named nurse.