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Continuing Patient Safety Issues Found at Nottingham Mental Health Hospital

An independent mental health hospital in Nottingham remains rated 'inadequate' overall and in special measures following its latest inspection by the health care regulator.

Priory Hospital Arnold, which provides acute and psychiatric intensive care services and is run by Partnerships in Care Limited, has been instructed to make further service quality improvements by the Care Quality Commission (CQC).  

The service was previously 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.

An unannounced CQC inspection was then conducted in August 2022 due to concerns received regarding incidents that had occurred at the hospital, and inspectors found a number of ongoing patient safety issues,

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

'Safety Still an Issue'

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," he said.

"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."

Furthermore, people using the service were not always treated with kindness and compassion by non-regular staff, he said, "although we did hear, regular staff who knew people well were supportive, as well as kind and compassionate".

CQC will continue to monitor the service closely and "if sufficient improvements are not made and embedded", they "will not hesitate to further use our enforcement powers to ensure people receive the safe and appropriate care they deserve", Mr Rielly added.

During this latest inspection, CQC 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 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, on the positive side, 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 suitable treatments in line with national best practice guidance; staff engaged in clinical audit; 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 for necessary admissions and people were discharged promptly once appropriate; and managers ensured that staff received supervision and an appraisal, and mandatory training was mostly up to date.

Comprehensive Action Plan

In a statement issued to Medscape News UK, a spokesperson for Priory Hospital Arnold said: "We are obviously disappointed by this report, but since the inspection 5 months ago, we have worked extremely hard to implement a comprehensive action plan that addresses all areas raised with us by the CQC. Both its inspectors, and those who commission our services, have commented positively on the progress we have made. The hospital has a new director who is overseeing continuous improvement and is leading a team which is fully committed to ensuring our patients receive the compassionate and safe care they deserve."