Nottingham mental health hospital remains rated inadequate and in special measures following CQC inspection

25 Jan 2023 09:14 PM

The Care Quality Commission (CQC) has told leaders at Priory Hospital Arnold to make further improvements to the quality of services following an inspection in August.

CQC carried out this unannounced inspection, due to concerns received regarding incidents that had occurred at the hospital.

Priory Hospital Arnold, run by Partnerships in Care Limited provides acute mental health services for adults on Newstead and Bestwood wards. As well as a psychiatric intensive care unit on Rufford and Clumber wards.

Following this latest inspection, the hospital remains rated inadequate overall, and for being safe and well-led. Responsive and effective remain rated as requires improvement. The rating for caring has declined from good to requires improvement.

The service was placed in special measures following an inspection in March 2021 and remained in special measures following two further inspections in June 2021 and December 2021. Following this latest inspection in August, the service will remain in special measures which means it will be closely monitored and re-inspected to assess whether improvements have been made. If insufficient improvements are made, CQC will not hesitate to take further action. 

Greg Rielly, CQC deputy director in the Midlands, said:

“During our August inspection of Priory Hospital Arnold, we were concerned that people’s safety was still an issue following several previous inspections, where areas of improvement have been highlighted to the provider. Although some improvements have been made, these had not been fully embedded, and the service wasn’t improving fast enough to mitigate any risks to people and support their recovery.

“Although we found the service minimised the use of restrictive practices, this wasn’t always handled well. Additionally, staff didn’t manage items which could put people at risk or learn from previous incidents where people had been harmed through access to items which should have been safely stored to keep them safe.

“There was a lack of training for staff to support people with a personality disorder. The provider hadn’t met its aim of providing training for staff since our previous inspection. This meant that people didn’t receive a consistent approach from staff which had an impact on their care.”

“People using the service weren’t always treated with kindness and compassion by non-regular staff. Although we did hear, regular staff who knew people well were supportive, as well as kind and compassionate.

“We will continue to monitor the service closely and if sufficient improvements are not made and embedded, we will not hesitate to further use our enforcement powers to ensure people receive the safe and appropriate care they deserve.”

Inspectors found: 

• There was not sufficient improvement to the safety of people since a previous inspection in February 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 people remained safe
• People 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
• The environment and furniture required improvement. People said that furniture was poor and not fit for purpose
• People said there was not enough to do and were bored. There were concerns about access to psychological therapies and that activities were not age appropriate.

However, inspectors also found:

• The provider actively involved people 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 people 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 regards to safeguarding
• The service managed beds well so that a bed was always available locally to a person who would benefit from admission and people 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.