Priory Hospital Arnold

Updated 23 June 2023

Priory Hospital Arnold is provided by Priory Healthcare Limited and registered with the CQC to provide the following the following regulated activities.

• Assessment or medical treatment for persons detained under the Mental Health Act 1983
• Treatment of disease, disorder, or injury
• Diagnostic and screening procedures.

The hospital provides two acute mental health wards for men and women on Newstead and Bestwood wards. The Hospital provides a psychiatric intensive care unit on Rufford ward for women, and a psychiatric intensive care unit for men on Clumber ward.

There have been 20 previous CQC inspections of Priory Hospital Arnold.

We carried out a comprehensive inspection in August 2022, due to concerns raised by a Mental Health Act Reviewers (MHAR) visit in July 2022, along with whistleblowing concerns raised from staff and patients about patient safety. We inspected Bestwood, Newstead and Rufford Wards unannounced. We inspected all five key questions: Safe, Effective, Caring, Responsive and Well led. The service was rated inadequate overall, with safe and well led rated as inadequate and effective, caring, and responsive as requires improvement.

The previous report was published on 25 January 2023, and the service remains in special measures.

We issued requirement notices for breaches of regulation 9, 10, 12, 15, 17 and 18.

At this inspection, we visited Bestwood and Newstead Wards unannounced during the evening of 24 January 2023, due to concerns raised following incidents that had occurred at the hospital. On 28 December 2022, we were informed of the death of a patient following a period of leave without permission. We were informed of a further leave without permission on 15 January 2023, where a patient had left the hospital via the roof and sustained an injury.

There are16 beds on both Bestwood Ward and Newstead Wards. Wards at this location are commissioned by a local mental health trust.

This was a focused inspection where we inspected key elements of two of the five key questions: Safe and Well led. Safe and well led has consistently been rated as Inadequate since March 2021.

What people who use the service say

We did not speak to patients and carers during this inspection as it was an unannounced night visit.

Updated 23 June 2023

Our rating of this location stayed the same. The hospital remains in special measures.

We rated it as inadequate because:

• We have not seen sufficient improvement to the safety of patients since a previous inspection published in March 2020, where the rating for safe has remained inadequate.
• The governance processes and the way the service was consistently led did not always ensure that patients remained safe.
• The provider did not always deliver safe care to patients. Although they minimised the use of restrictive practices, they did not always manage this well. Staff did not manage items which could present a risk to the patients and this led to incidents where harm may occur. They had not learnt from previous incidents where patients had been harmed through access to items which should have been safely stored to keep patients safe..
• Patients privacy and dignity was not always protected. This was primarily towards women who used the service where sanitary bins were not routinely available and led to women having to hand used items for sanitary use directly to staff.
• Patients did not routinely feel that they were treated with kindness and compassion by non-regular staff whose aim was to care for them. Although patients said regular staff who knew them well treated them with kindness and compassion, and supported them.
• There was a lack of training for staff to support patients with a personality disorder. The provider had not met its aim of providing training for staff since the previous inspection. This meant that patients did not receive a consistent approach from staff that impacted on their care pathway.
• The environment and furniture required improvement. Patients said that furniture was poor and not fit for purpose. There was a lack of provision of furniture to support outside places.
• Patients said there was not enough to do and were bored. There was were concerns about access to psychological therapies and that activities were not age appropriate.

However:

• The provider actively involved patients and families in care decisions.
• 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 engaged in clinical audit to evaluate the quality of care they provided.
• The provider managed medicines well and followed good practice with regard to safeguarding.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• The service managed beds well so that a bed was always available locally to a person who would benefit from admission and patients were discharged promptly once their condition warranted this.
• Managers ensured that staff received supervision and an appraisal, and mandatory training was mostly up to date.

Updated 25 January 2023

We rated this service inadequate.

See summary above for more information.