The Care Quality Commission
  • Hospital
  • Independent hospital

The Priory Highbank Centre

Overall: Requires improvement read more about inspection ratings

Walmersley House, Walmersley Road, Bury, Greater Manchester, BL9 5LX (01706) 829540

Provided and run by:
Priory Rehabilitation Services Limited

Important: The provider of this service has requested a review of one or more of the ratings.

All Inspections

26 and 27 January 2022

During a routine inspection

Priory Highbank Centre is operated by Priory Rehabilitation Services Limited and provides in-patient mental health services for adults and specialist neurological rehabilitation for adults and children.

The service is run from a large detached Victorian property set within its own grounds. It has a total of 34 beds for patients of all ages with a brain injury or a neuro-disability which as well as a long-term high dependency rehabilitation unit for patients who have a diagnosis of mental disorder.

Within the service there are three units:

  • The Walmersley unit (upper and lower Walmersley) provides a service for patients requiring complex care and slow stream rehabilitation over the age of 16 years, with 19 inpatient beds. 15 inpatient beds were located in the upper Walmersley unit and 4 inpatient beds in the lower Walmersley unit. At the time of our inspection lower Walmersley was closed to in-patients.
  • Torrance House (formerly known as Lynne House) – provides a service for patients requiring complex care and slow stream rehabilitation from birth to 17 years old, with 5 inpatient beds.
  • Robinson House provides a service for male patients aged 18 and over who have a diagnosis of mental disorder, with 10 inpatient beds.

Facilities include a family sitting room, designated therapy areas, dining and outside areas, fully adapted gym, and a self-contained flat which can be used for patients and their families.

The Priory Highbank Centre was last inspected by CQC in December 2018 and was rated ‘good’ overall. We inspected this service using our next phase inspection methodology and carried out an unannounced inspection on 26 and 27 January 2022.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Our rating of this service went down.

We rated this service as requires improvement overall because:

  • The service did not have enough support staff or allied health professional staff to meet people’s care and treatment needs. The service approach to staffing levels did not adhere to national guidance such as the British Society of Rehabilitation Medicine (BSRM). Not all staff received and kept up to date with their mandatory training.
  • The service failed to deliver the clinically assessed required therapy hours to patients.
  • Managers did not always have supervision meetings with staff to provide ongoing support and development.
  • The maintenance of equipment was not always monitored and placed people at risk.
  • Leaders were not always visible and approachable in the service. Not all staff knew what the vision, corporate values and strategic goals were. The service did not have an open culture where all staff felt they could raise concerns without fear. Not all staff felt respected, supported and valued.

However, we found that:

  • The service had enough medical and trained nursing staff with the right qualifications, skills, training and experience to keep patients safe from avoidable harm and to provide the right care and treatment. The service used systems and processes to safely prescribe, administer, record and store medicines.
  • The service made sure staff were competent for their roles and managers appraised staff’s work performance,
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and took account of their individual needs.
  • It was easy for people to give feedback and raise concerns about care received. The service treated concerns and complaints seriously and investigated them.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with four requirement notices that affected long term conditions. Details are at the end of the report.

5 December to 6 December and 13 December 2018

During a routine inspection

Priory Highbank Centre is operated by Priory Rehabilitation Services Limited and provides in-patient mental health services for adults and specialist neurological rehabilitation for adults and children.

The hospital has a total of 34 beds comprising of 24 rehabilitation beds for patients of all ages with a brain injury or a neuro-disability and along term high dependency rehabilitation unit for 10 male patients aged 18 and over who have a diagnosis of mental disorder.

Facilities include designated therapy areas, dining and outside areas, a family sitting room and a self-contained flat which can be used for patients and their families.

The Priory Highbank Centre was last inspected by the CQC in December 2016 and was rated ‘good’ overall. We inspected this service using our next phase inspection methodology and carried out an unannounced inspection on 5 ,6 and 13 December 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Our rating of this hospital stayed the same.

We rated this hospital as requires Good overall because:

  • The service provided a safe and clean environment with enough staff to keep patients safe.
  • Staff cared for patients with compassion and provided emotional support to patients to minimise their distress. Staff involved patients and those close to them in decisions about their care and treatment.
  • Managers across the hospital promoted a positive culture that supported and valued staff, creating a sense of common purpose based on shared values.

However, we found that:

  • The service did not consistently notify the Care Quality Commission of reportable incidents, which occurred whilst services were being provided in the carrying out of a regulated activity.

  • Care plans were not fully holistic and recovery orientated in relation to discharge planning.

  • ​Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice that affected long-term conditions. Details are at the end of the report.

    Ellen Armistead

    Deputy Chief Inspector of Hospitals

6,7 December 2016

During a routine inspection

We rated long stay/rehabilitation mental health wards for working age adults at the Priory Highbank Centre as good because :

  • The building was clean, and safely maintained. Building and safety assessments including ligature risk assessments were regularly assessed.
  • Compliance with mandatory training was high. Staff received regular clinical and managerial supervision and an annual appraisal.
  • Patients were involved in decisions about their treatment and care and were regularly consulted with.
  • Rehabilitation was embedded in the delivery and culture of the service. Patients played an active role in their care.
  • Care and treatment was underpinned by best practice and national guidance.
  • A spiritual, personal and cultural education group provided patients with opportunities to explore and discuss qualities, virtues and values needed in daily living.
  • Patients had access to advocacy services.
  • Patients we spoke to were positive about the service they received.
  • There were clear processes for access and discharge from the service. The service worked with referral and partner agencies to ensure appropriate assessments and treatments were delivered.
  • The service had a clear set of vision and values. Staff were aware of these and reflected them in their daily practice.
  • Staff morale was very positive. Staff felt supported by senior managers within the service and the provider organisation. Senior managers were visible to staff and were considered approachable and available.
  • There was a governance structure to support the delivery of care. The service monitored performance. Senior managers carried out regular quality checks at the service.
  • The service had trialled the multiple errands test to evaluate whether it was a valid tool for the mental health population.

However;

  • The hospital should ensure that all staff understand the principles of the Duty of candour.

6 to 7 December 2016

During a routine inspection

The Priory Highbank Centre is operated by The Priory Group and provides specialist neurological rehabilitation for adults and children and mental health services for adults. The hospital has a total of 34 beds comprising of 24 rehabilitation beds for patients of all ages with brain injury or a neuro-disability and a 10 bedded slow stream rehabilitation unit for patients with a diagnosis of mental disorder.

The Priory Highbank Centre was last inspected by CQC on 17 February 2014, where they met the essential standards they were inspected against.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 6 to 7 December 2016, along with an unannounced visit to the hospital on 19 December 2016.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Where we have a legal duty to do so, we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

This report will demonstrate the findings of the neurological rehabilitation services provided to children and adults at the hospital. Mental health services at the hospital were inspected on the same dates and the findings can be found in a separate report.

Services we rate

We rated this service as good overall.

We found areas of good practice in rehabilitation services provided to children and adults:

  • There were adequate numbers of suitably qualified, skilled and experienced staff (doctors, nurses, health care assistants and therapists).
  • There were systems in place to keep people safe and safeguarded from harm. The service had procedures to investigate and learn from incidents.
  • The environment was visibly clean, procedures were in place to prevent the spread of infection and equipment was well maintained and appropriate for the service.
  • There were systems in place to ensure the safe storage, use and administration of medicines.
  • Mandatory training completion was high and the majority of staff had received monthly clinical supervision and an appraisal within the last year.
  • Patients received care in accordance with national guidelines and patient outcomes and progress were regularly evaluated and reviewed.
  • The service made adjustments to meet the needs of patients. Patients had access to a wide range of person centered activities at the hospital and off site, including attending school, trips to the theatre or cinema.
  • While the service received very few complaints, it had a complaints process in place which all staff were aware of. Complaints were shared with staff to identify learning.
  • Patient and relative feedback about receiving care or treatment at the service was mainly positive.
  • A family liaison officer and a consultant psychologist were available to support relatives and patients if required.
  • There was good local leadership in children and adults’ services.
  • Staff felt supported and confident in the management of the service. Staff worked well together and there was a positive culture. We observed positive staff engagement and this was supported by what staff told us.
  • The service had a clear vision and strategy, which were understood by staff.
  • The service had appropriate governance structures in place and systems to identify manage and mitigate risks.

There were no breaches of regulations. However, there were areas where the provider should make some improvements, to help the service improve. These were:

  • The provider should take appropriate actions to ensure staff are able identify and escalate any changes to a patient’s medical condition in a consistent and timely manner, such as through the use of an early warning score system (EWS) tool.
  • The provider should take appropriate actions to improve communication with patients’ relatives or carers, so they are better informed and fully understand the treatment and services provided.
  • The provider should take appropriate actions to ensure there is regular medical staff oversight at the hospital, such as through a formal medical advisory committee (MAC).
  • The provider should take appropriate actions to comply with same-sex accommodation guidelines.

17 February 2014

During a routine inspection

During the inspection we spent most of our time on Walmersley Unit. We spoke with one patient and four relatives. Comments made included; 'Really good care; very pleased with everything. I have no complaints'. 'I am so pleased with the progress that has been made. The intensive physiotherapy has helped so much'. 'The nursing care is good'.

We saw that the patients' care records contained detailed information to show how they were to be treated, supported and cared for. An inspection of their care records also showed that they had access to other health and social care services. We were also made aware of the systems that were in place to make sure that information was passed on when a patient's care was transferred to another service.

We inspected the management of medicines on Walmersley Unit and saw that arrangements were in place to ensure that the patients received their medicines safely and as prescribed.

Adequate equipment and adaptations were available to ensure the patients' needs were met. Staff we spoke with had an in depth knowledge of the specialised equipment that was in use.

The patients were cared for by sufficient staff who were suitably qualified and had the skills and competencies to care for them safely.

26 October 2012

During a routine inspection

As far as they were able to do so, patients were involved in decision making about their care and treatment. We spoke with three patients who told us the following; 'I know about my care and the future plans for me. They talk to me and I know what I have to do'. 'The staff are competent, they know what they are doing. Staff listen to me and follow my requests'. 'I have seen my care plan and I attended a case conference last week'.

Patients were well cared for and their care records contained detailed information to show how they were to be supported and cared for. Two of the patients we spoke with told us; 'It is definitely good care here. It is better than being in hospital. I like it here. They are always egging me on to do more'. 'I have an excellent standard of care. They have helped me to get walking again'.

Systems were in place to help protect patients by ensuring that staff were safely recruited and suitably trained in the safeguarding of children and vulnerable people. We spoke with nine staff members who told us they had been trained in the protection of children and vulnerable adults. They also told us that they would feel confident in reporting any issues of abuse.

3 February 2011

During a routine inspection

The people that we spoke to told us that they were happy with the care provided and they felt that the staff knew what they were doing.

They felt that this was the best place to be in due to the expertise of the staff.

They also told us that they felt involved when it came to decision making about the care and treatment provided.

Mental Health Act Commissioner reports

Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff.

Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. We are looking at different ways to indicate the outcomes of our monitoring in the future.