The Priory Hospital Dewsbury

Updated 25 November 2021

The Priory Hospital Dewsbury is an independent mental health hospital that provides care and treatment for up to 32 male patients across two wards. The hospital is registered to carry out the following regulated activities:

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

At the time of the inspection, there was an overall manager in place who had applied to become the Registered Manager of the hospital. The previous registered manager left at the end of September 2021.

The Priory Hospital Dewsbury delivers in-patient rehabilitation services for adults with mental health problems and in-patient services for adults with dementia. The hospital has two wards for the two different groups of patients.

Hartley ward is a 16 bed long-stay rehabilitation ward for adults of working age. It provides care and treatment for male patients suffering complex and enduring mental health needs including those with an undiagnosed or early onset memory related condition. At the time of the inspection, there were 10 patients detained on Hartley ward. Patients on this ward included individuals who had their detention supervised by the Ministry of Justice.

Jubilee ward is a 16 bed older persons' inpatient ward. It specialises in dementia care and offers care and treatment for male patients with neuro-cognitive conditions. The service cares for patients presenting with very agitated or aggressive behaviour and provides assessment and treatment through to end of life care. At the time of the inspection, the ward had 14 patients, all of whom were detained either under the Mental Health Act or on a Deprivation of Liberty Safeguard, (DoLS).

We last inspected The Priory Dewsbury in March 2020. At that time the service was rated overall requires improvement with a good in the caring domain. We issued the provider with four requirement notices under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to person centred care, premises and equipment, dignity and respect and good governance.

At this inspection, we rated the hospital as requires improvement overall with good in the safe and caring domains. We issued the provider with three requirement notices under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to person centred care, dignity and respect and good governance.

What people who use the service say

Hartley ward: long stay/rehabilitation mental health wards for working age adults

We spoke with six patients on Hartley ward. One patient said that they could not access all their escorted leave due to there not being enough staff on the ward and another patient said food was not of a good quality. One patient said staff did not always check on him at night and said the bedroom doors were noisy when patient observations were completed.

We spoke with relatives of two patients. Whilst one relative was unable to comment, one relative told us they were happy with the care being received and that staff were always very helpful. Both relatives told us escorted leave had been cancelled due to there not being enough staff to facilitate the leave and one relative told us that the food was not always good.

Jubilee ward: Wards for older people with mental health problems

We spoke with seven patients on the ward; our conversations were limited due to their dementia. They told us that the staff were good, they liked their room and the food.

We spoke with the relatives of six of the patients. They told us they felt their relatives were safe at the hospital and were well looked after by staff. Most of them informed us that they felt involved with their relative’s care plan and they were aware of how to complain if needed. Not all relatives had attended a review meeting and were unsure if they had been invited. One carer told us they had requested to attend but informed it was not appropriate.

Updated 25 November 2021

Our rating of this location stayed the same. We rated it as requires improvement because:

• The service was not well led. Some of the systems in place were not effective to assess, monitor and improve the quality and safety of services provided. There was an unclear framework to ensure managers disseminated information in a structured manner. Managers had limited oversight and assurance on some aspects of the hospital such as sharing lessons learnt, training and appraisal compliance, cleanliness and maintenance, and timely and accurate record keeping.
• Patients on Hartley ward with a learning disability had not had a positive behaviour support plan created in line with national guidance.
• The facilities on the wards did not fully support the privacy and comfort of the patients. Staff were unable to discreetly observe patients in their bedrooms during the night without disturbing them.
• Jubilee ward required further improvements to ensure it was dementia friendly. The garden area did not create an environment to encourage patients to remain active. Plans for improvement were not robust.
• Ligature risk assessments were not kept on Hartley ward or updated following every admission to the ward.
• There was limited access to the electronic system for agency staff and the use of the electronic systems was very slow.
• Staff on Hartley ward did not always regularly review and update care plans when patients' needs changed.
• The services banned and restricted items list was not service or ward specific and was not reviewed regularly and updated depending on the patient group.

However:

• The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• Staff provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice.
• The ward team included or had access to the full range of specialists required to meet the needs of patients on the ward. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness and understood the individual needs of patients.

Updated 25 November 2021

Our rating of this service stayed the same. We rated it as requires improvement because:

• The service was not well led. Some of the systems in place were not effective to assess, monitor and improve the quality and safety of services provided. There was an unclear framework to ensure managers disseminated information in a structured manner. They had limited oversight and assurance on some aspects of the hospital such as, sharing lessons learnt, training and appraisal compliance, cleanliness and maintenance, and timely and accurate record keeping.
• Patients with a learning disability had not had a positive behaviour support plan created in line with national guidance.
• The facilities on the ward did not fully support the privacy and comfort of the patients. Staff were unable to discreetly observe patients in their bedrooms during the night without disturbing them.
• Ligature risk assessments were not kept on the ward or updated following every admission to the ward.
• There was limited access to the electronic system for agency staff and the use of the electronic systems was very slow.
• Staff did not always regularly review and update care plans when patients' needs changed.
• The services banned and restricted items list was not service or ward specific and was not reviewed regularly and updated depending on the patient group.
• Patients were not always supported by the appropriate advocate when attending Mental Health Act related meetings.
• There was limited interaction between ward staff and senior managers who staff said were remote and disconnected from the ward.

However,

• The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• The ward team included or had access to the full range of specialists required to meet the needs of patients on the ward. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness and understood the individual needs of patients.

Updated 25 November 2021

Our rating of this service stayed the same. We rated it as requires improvement because:

• The service was not well led. Some of the systems in place were not effective to assess, monitor and improve the quality and safety of services provided. There was an unclear framework to ensure managers disseminated information in a structured manner. They had limited oversight and assurance on some aspects of the hospital such as, sharing lessons learnt, training and appraisal compliance, cleanliness and maintenance, and timely and accurate record keeping.
• The ward required further improvements to ensure it was dementia friendly. The garden area did not create an environment to encourage patients to remain active. Plans for improvement were not robust.
• The facilities on the ward did not fully support the privacy and comfort of the patients. Staff were unable to discreetly observe patients in their bedrooms during the night without disturbing them.

However:

• The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• Staff developed holistic, person-centred 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 ward team included or had access to the full range of specialists required to meet the needs of patients on the ward. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff treated patients with compassion and kindness and understood the individual needs of patients.