All inspections: The Priory Hospital Dewsbury

We rated The Priory Hospital Dewsbury as requires improvement because:

We found poor practice in relation to the management of medicines. Staff had not recorded the medication stock correctly and some medicines that were in stock were out of date. Medication records were not always accurate; which meant that patients did not always have their medication as prescribed. Staff did not always risk assess patients who self- administered their medications nor did they monitor patients on anti-psychotics for side effects. There was no effective system for reporting medication errors.
New systems and processes did not highlight concerns with regard to medication errors.
Ligature cutters were not easily accessible to all members of staff. The provider had not accurately assessed the ligature risks. The provider had not mitigated all ligature risks.
Inspectors identified safeguarding incidents during our inspection. Patients had not felt comfortable disclosing these to staff.
Staff had not updated risk assessments after incidents occurred.
Patients were not always involved with risk assessments.
Staff did not always update patient care plans to reflect decisions made at multi-disciplinary team meetings.
Physical health checks were not all carried out as described in patients care plans.
Staff did not always treat patients with kindness. We saw two examples of staff treating patients disrespectfully.
Seniors managers did not always identify areas for improvement.

However:

Systems were in place for reporting and monitoring incidents. Staff debriefs usually occurred immediately after an incident. Incidents were scrutinised by the providers safeguarding lead.
Staff had the qualifications and skills they needed to carry out their roles effectively.
There were a range of professionals to care for patients.
Staff informed patients of their rights at the time of initial detention, which continued throughout their detention.
Community meetings took place daily.
Patients knew how to complain and the provider dealt with complaints in line with their policy.
Patients had regular leave from the hospital.
Activities were meaningful and available to most people wishing to attend.
Staff took part in a listening event to enable them to say how they would improve the service.
Senior managers regularly visited the service.

We found The Priory Hospital (Dewsbury) promoted the independence of its patients. Patients' privacy and dignity were also promoted. We found evidence that staff obtained, and considered, the views and wishes of patients as part of the care planning process meaning patients were involved in decisions regarding their care and rehabilitation.

The hospital provided an advocacy service to its patients which helped ensure patients' rights were promoted and their views were respected.

We found the hospital had taken appropriate steps to meet patients' different needs. For example, we saw the hospital made use of interpreters, and for patients who had difficulties with communication picture cards were used.

We found patients' individual abilities to make decisions for themselves were considered. Where patients did not have the ability to make decisions on their own, we saw support was provided and if necessary decisions were taken in their best interests. We found evidence that the hospital had followed correct legal processes in relation to patients who were detained under the Mental Health Act, particularly in relation to ensuring patients were assessed by independent doctors, and making sure the rights of detained patients were given to them.

We found evidence that a range of both risk and care needs assessments had been carried out. We saw care plans were in place to meet assessed needs and to reduce and manage identified risks. We found care needs were regularly reviewed and care records were up to date.

The majority of comments we received from patients were positive. One patient told us: "Staff are good. They help if I struggle with anything". Another patient said: "Staff are nice... It's all right here".

We found some aspects of medicines management which required improvement. For example, we saw one patient had not been receiving some of their prescribed medication and staff had not acted on this.

There was evidence of an effective management team being in place and we found numerous examples of good practice in relation to how quality standards were monitored and checked.

Please note: In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

The Priory, Dewsbury had consent policies and procedures in place. We saw people had their treatment explained to them and the hospital were acting within the requirements of the Mental Health Act 1983.

Care plans were comprehensive and demonstrated clear assessment of the needs of individual patients. On admission a 72 hour initial care plan was implemented to allow a full assessment of need to be carried out, once the patient had the opportunity to adjust and settle into the ward.

We found that care was provided in a clean, organised but relaxed environment. Individual bedrooms and public areas had fixtures and fittings that had been appropriately risk assessed for ligature points. Patients had access to gardens and external designated smoking areas. They also had access to a gym, mountain bikes, faith room and computers.

One person told us they had been given information about hospital prior to admission and were happy with the care they received. They told us they felt involved in planning their care and could access the things which were important to them such as their music.

Archived: The Priory Hospital Dewsbury

All Inspections

2 and 3 November 2015

During a routine inspection

13, 14 November 2013

During a routine inspection

11 December 2012

During a routine inspection