Priory Hospital Arnold

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service provided care and treatment in a way which made patients feel safe, supported and listened to. Patients we spoke with felt they were treated with dignity, respect, felt they were treated as individuals, and were encouraged to be involved in their care and treatment plans. The provider minimised restrictive practices, and managed risk well. Staff on all wards were familiar with policies and procedures used to safeguard patients and maintain a safe environment whilst using a least restrictive approach.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients felt supported and felt staff got to know them and their preferences. Patients felt listened to and were encouraged to feedback on their experience of care within the service.

Staff told us they felt supported by the management team to raise concerns. All incidents and complaints were investigated thoroughly with outcomes and feedback given to all involved. There were regular patient safety, team and de-brief meetings to discuss incidents, complaints and lessons learnt.

Staff had access to a freedom to speak up guardian (Freedom to Speak Up is about encouraging a positive culture where people feel they can speak up and their voices will be heard, and their suggestions acted upon) in place. However, no issues had been raised to them in the last 3 months.

Patients told us if they felt concerned regarding their mental or physical health, they were able to approach staff, knowing they would respond appropriately. Patients felt involved with decisions regarding their care and were involved when transferring to a different ward or hospital.

Staff assessed referrals into the service to ensure the care and support available was suitable for the patient. All patients are offered individual time with their named nurse or keyworker, and where possible this relationship was maintained to provide continuity. Staff regularly reviewed risk assessments and updated these to reflect patients’ current risks and needs. Staff told us they had good communication with colleagues both internal and external to the service to enhance quality of care and support provided.

Partners told us they were able to attend weekly ward rounds and regular care programme approach meetings. They felt staff involved all relevant partners and community teams at the appropriate times in patient treatment including housing teams and community mental health teams.

The provider had weekly ward round meetings that involved internal and external partners. Staff ensured all relevant partners had copies of discharge plans.

Patients told us they felt safe, supported and able to approach staff if they had any concerns or felt unsafe. Staff supported them to manage risks and would act where needed to keep them safe and offer support.

Staff demonstrated a good knowledge of safeguarding and knew how to identify and report safeguarding concerns. They were able to identify different forms of abuse and the signs associated with these. Staff attended regular patient safety and safeguarding meetings where important information and lessons learned were shared.

Staff were observed having good quality meaningful engagement with patients and appeared to display a genuine interest in the patient. Staff were observed having a caring and compassionate approach when engaging with patients. Safeguarding information was displayed on the ward notice boards.

Staff had access to a clear process when raising a safeguarding. Managers had regular meetings with the local authority safeguarding team to discuss progress on investigations. Priory Arnold had had 22 safeguarding incidents between January 2024 and March 2024, all were involved with the local authority and where required managers had put appropriate actions in place.

Patients told us they felt safe and supported on the ward and staff supported them to manage risks. They could approach staff if they felt their health was deteriorating and were confident staff would respond to their concerns. Where items had been removed or restricted to manage risk, this had been explained to them.

Staff told us they always attempted to keep patients as safe as possible. Patients and staff were aware of potential risks on the ward. Staff had a person-centred approach and involved patients, where possible when completing and reviewing risk assessment and care plans. Staff utilised a least restrictive approach, attempting to use de-escalation and distraction techniques before using physical intervention when incidents occurred. Staff had completed mandatory training including the services reducing restrictive intervention training to manage risk and incidents. Staff attended a thorough shift handover. Staff checked patients in and out of the service when they had section 17 leave and completed security searches where appropriate. Patient risk was managed through observation levels dependent on level of risk, which was agreed by a multi-disciplinary team. We saw patient observations were completed efficiently. Staff said that they had a risk item register which was updated accordingly.

Staff had access to a patient search policy in place this was a detailed policy that gave clear guidance on when staff would carry out searches on patients, patient belongings and patient rooms. It guided staff to always seek consent form the patient first and constituted to a justifiable search. There were several banned and restricted items on the ward area to help maintain patient safety.

Patients told us they felt safe and supported to manage any risks on the ward.

There was a security nurse on every shift who completed checks of the environment and relevant equipment to ensure the ward was safe. Where concerns were identified they were reported and acted on quickly.

Staff were observed completing observations in both the communal lounge area and bedspace corridor depending on the location and observation level of patients. There appeared to be adequate staff numbers to care for and support patients outside of the observational demand. The ward office was situated with a good view of the ward which enabled any staff in the office to observe the environment and provide care and support if needed. There were calming suites and quiet rooms on the ward where staff were observed having 1 to 1 time with patients away from the busier communal environment. All doors and windows appeared secure with doors accessed using a key or fob.

Managers had completed and regularly reviewed ligature risk assessments. these clearly highlighted areas of risk and appropriate mitigations in place to help reduce the risk level. Staff completed regular environmental audits and where areas of improvement had been identified an appropriate action plan was put in place.

Patients told is they felt staff were well trained and able to keep them safe. They felt able to approach staff if they felt their health was deteriorating. They attended their multi-disciplinary team ward round meetings, 1 to 1 meetings and felt involved in decisions around their care including changes to prescribed medication. Staff supported them and offered support and advice around staying well.

Staff told us safe staffing numbers were in place and these were adjusted to reflect patient needs. Wards were very rarely short staffed and there was capacity to increase staff at short notice if required. Patient activities and leave were sometimes delayed but rarely cancelled due to staffing issues. All staff had a pinpoint personal alarm which were used to request support at the time of incidents and maintain ward safety. Managers told us there was an ongoing recruitment drive and all staff had completed a comprehensive mandatory training.

We saw sufficient staff were in place to complete prescribed patient observations, complete observations in communal areas and to provide patient support outside of the observational demands including 1 to 1 key worker meetings. The ward office was situated with a good view of the ward which allowed staff in the office to observe the environment and provide support where needed.

Staff rotas reviewed showed the service had a high usage of bank and agency workers. In April out of 30 days, 4 wards, across 2 shifts, with a total of 240 shifts there were 45 shifts which consisted of more than 50% agency staff. This meant 19% of shifts consisted of more than 50% agency staff. However, the service assured us that most agency workers were regular to the service and therefore knew patients and their needs. The service always met safe staffing levels and managers always ensured there were regular permanent staff on each shift on every ward. All staff had completed mandatory training and completed relevant updates. The service had a mandatory training compliance on over 90%. Managers supported staff with regular managerial supervision. The managerial compliance rate was over 95%.

Patients told us they felt safe and supported to manage any risks on the ward. No concerns were raised around infection, prevention and control.

Staff demonstrated a good knowledge of infection prevention and control. They were able to detail the steps taken to maintain safety of patients and the environment. Staff had completed mandatory training for infection control and felt the training relevant to their role and gave them knowledge in the area. Staff knew of measures to put in place and partners to inform in the event of an outbreak.

The ward appeared unclean in some areas, with both décor and furniture was stained from old spillages and in need of replacement. But was not ripped and therefore, could be cleaned to a good standard if required to maintain infection, prevention, and control requirements. The leadership team assured us that this was in the process of being addressed, with decorators attending the site and the furniture being replaced in the very near future. There were cleaning stations situated around the ward and a fully functional sluice room was available.

Staff had access to various detailed infection prevention and control policies. These gave detailed guidance on hand hygiene, through to isolation guidance in case of an outbreak. The policy was created and reviewed by a provider specific infection prevention and control team.

Patients told us they felt staff were well trained and able to support them. Patients were able to approach staff if required for support and attended their multi-disciplinary ward round meetings. Patients felt involved in decisions around their care including changes to prescribed medication. Staff supported them and were able to offer guidance and advice around staying well.

Staff had access to the services medicines management policy. The on-call doctor attended the ward when a patient was admitted and completed the admissions process which included the formulation of a medicines chart. Medicines reconciliation was completed regularly, and relevant observations were completed dependant on individual treatment plans. All patients received information leaflets about their medicines, and this was discussed with patients in their multi-disciplinary ward round meetings where medicines were reviewed regularly.

All clinic rooms and medicines fridges were clean and staff had access to all appropriate equipment. Medicines were stored, managed and dispensed in line with national guidance including the management of controlled medicines. Staff had access to relevant patient medicines documentation, including information on patient allergies.

All clinic rooms medicines charts were maintained electronically. All medication records had a photograph of the patient to enhance safe dispensing. Staff followed safe prescribing practices and the service medicines policy. All clinic rooms were well stocked with relevant well-maintained equipment available for use.