We rated the Priory Hospital Hayes Grove as good because:
The service had addressed the concerns raised following our last inspection in February 2017. For example, the service had updated all ligature risk assessments and included steps to mitigate risks in these assessments. On Keston Ward, occupational therapists had developed an activities timetable to suit the needs and interests of patients. This included activities at weekends. Discharge planning on Keston Ward has also improved.
All the services provided care and treatment recommended by national guidance including medicines and psychological therapies. Psychological therapies included cognitive behavioural therapy, mindfulness, family therapy and anxiety management.
The service had robust policies and procedures to ensure that medically assisted withdrawal from drugs or alcohol was done safely in accordance with national guidance. This included monitoring patients’ symptoms of withdrawal four times a day using a nationally recognised assessment tool. All permanent staff had completed training and competency checks in ensuring the safety of patients withdrawing from drugs or alcohol.
Patients across all the services said that staff were kind, friendly and supportive. Patients said they felt comfortable talking to staff and they valued the support they received.
Multidisciplinary teams across all the wards worked well together. These teams had extensive knowledge, skills and experience of planning and delivering care to their specific patient groups.
Staff on Keston Ward maintained safety on the ward whilst providing a least restrictive environment. Staff implemented positive behaviour support plans that followed best practice in anticipating, de-escalating and managing challenging behaviour.
Patients’ representatives attended monthly clinical governance meetings and were involved in decisions about the service.
Services were provided in a comfortable, well-maintained and welcoming environment. Patients said the food was very good. The restaurant offered good quality meals including a range of healthy options.
However,
Staff on Keston Ward did not always carry out and record physical observations and examinations of patients. For example, we found that daily blood test for a patient with diabetes were not being completed every day. We also found that daily monitoring of vital signs for a patient with a complex co-morbidity had not been completed for six consecutive days.
The vacancy level for permanent nurses was above 50% on all wards. This meant that the service relied on agency staff to ensure there were sufficient staff on all shifts. Patients on Keston Ward and the at eating disorders service said the use of agency staff led to inconsistency in the quality of nursing.
Supervision sessions with staff were not held consistently. Records showed that discussions in supervision sessions were not always sufficient to develop staff and improve services.
Incidents were not always investigated in a timely manner. Findings from investigations into incidents were not always shared with ward staff.
The provider could do more to separate the male and female sleeping areas in order to increase patient’s privacy and dignity.