The Priory Hospital Roehampton

Updated 17 February 2025

The Priory Hospital Roehampton is an independent hospital that provides support and treatment for people with mental health problems and substance misuse problems. This assessment took place at the two Child and Adolescent mental health wards (CAMHS). The rating for this service has been combined with previous inspections. The overall rating of Priory Hospital Roehampton has changed from requires improvement to good. As a result of this inspection, the overall rating for the assessment service group Child and Adolescent mental health wards has improved from requires improved to good. We carried out our on-site assessment on 26 and 27 March 2024, looking at improvements that had been made on the 2 Child and Adolescent mental health wards (CAMHS). We looked at 20 quality statements across all five key questions; safe, effective, caring, responsive and well led. During this assessments feedback from carers remained mixed and further improvements were necessary. This was a breach of Regulation 9, person-centred care of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service must make further improvements to ensure staff involve families and carers appropriately and involve them in their children’s care, including inviting parents and carers to meetings and providing them support where needed.

Updated 19 June 2024

The Priory Hospital Roehampton is an independent hospital that provides support and treatment for people with mental health problems and substance misuse problems. There were 7 inpatient wards at the hospital: • Garden Wing (private acute ward for adults of working age) • Upper court (private acute ward for adults of working age) • West wing (private acute and addictions ward for adults of working age) • East wing (specialist adult eating disorder ward) • Priory court (specialist child and adolescent eating disorder ward) • Lower court (child and adolescent mental health ward) • Richmond court (private child and adolescent mental health ward) We carried out our on-site assessment on 26 and 27 March 2024 on the 2 Child and Adolescent mental health wards (CAMHS) due to cases and notifications we received. We looked at 20 quality statements across all five key questions; safe, effective, caring, responsive and well led. In our inspection in 2023, the provider had been in breach of regulation regarding person-centered care. We told the provider the service on Lower Court and Richmond Court must ensure staff inform and involve families and carers appropriately and provide them with support where needed. Reg 9 (3) (g). During this assessments feedback from carers remained mixed and further improvements were necessary. This was a breach of Regulation 9, person-centred care of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The service must make further improvements to ensure staff involve families and carers appropriately and involve them in their children’s care, including inviting parents and carers to meetings and providing them support where needed.

Updated 3 May 2019

Updated 1 June 2023

Our rating of the acute wards for adults of working age and psychiatric intensive care units went down. We rated it as requires improvement because:

• We rated safe, effective, caring and well-led as requires improvement. We rated responsive as good.
• The service did not ensure that staff managed risks in the environment. Ligature risks and blind spots in the acute wards were not always well mitigated. Staff were not always available in areas of the ward and garden to observe and mitigate risk. Some staff were not aware of what a ligature points was and therefore their mitigations.
• Whilst some parts of the wards had CCTV, these cameras did not always cover all communal areas of the wards.
• The clinic room on Upper Court was small and cluttered which might make it harder for staff to locate equipment when needed.
• At the time of inspection, staff had not completed all mandatory training. Some face-to-face training modules, such as immediate life support training and restraint, had low completion rates. The service did, however, have a plan to ensure staff completed the training. All staff were booked to complete training by May 2023.
• Whilst lessons learned from incidents were shared across the hospital by senior staff, some staff we spoke with were unable to recall any learning from recent incidents.
• The ward multi-disciplinary teams were not always well connected with each other although team members felt this was starting to improve.
• Staff did not always complete physical health checks. There were gaps noted when reviewing patient’s medication administration charts on the acute wards. A patient who was on high dose antipsychotics did not have a completed form to show the patient’s physical health was being monitored.
• There were food items in the fridge which had expired. There were no plans in place to manage and dispose of the food from patients who were no longer on the ward.
• There was an overly restrictive blanket restriction in regard to leave for patients on the acute wards. Patients, including informal patients, only had access to escorted leave. If an informal patient wanted unescorted leave, this had to be assessed by a doctor, which meant a significant delay before a patient, for whom no legal authority for detention is in place, is allowed to exercise a legal right.
• Upper Court did not have information on advocacy services available to patients. Signs explaining informal patient rights were not visible on either ward.
• Some patients were not adequately involved in decisions about their care, some did not have a copy of their care plan and ward community meetings were not always taking place regularly.
• Some staff on Garden Wing felt some staff were unprofessional. Some staff felt it was sometimes difficult to work on the ward due to the difference in cultures. They felt managers who were not from an ethnic minority did not understand the problems they felt. However, managers attempted to support the team’s cultures to blend, and they felt able to speak to managers with any concerns.
• The governance processes had not identified the areas for improvement needed on the wards.

However:

• The ward environments were well equipped, well furnished and well maintained. The wards had enough nurses and doctors.
• The rooms and furnishings of the hospital supported patients’ treatment, privacy and dignity. Each patient had their own bedroom with an en-suite bathroom and could keep their personal belongings safe. There were quiet areas for privacy. Patients could make hot drinks and snacks at any time.
• Staff assessed risks to patients and themselves well and followed best practice in anticipating, de-escalating and managing challenging behaviour. Staff used restraint and rapid tranquilisation only after attempts at de-escalation had failed.
• Staff developed holistic, recovery-oriented 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.
• The ward teams had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received supervision and appraisal.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Most staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients.
• Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of the services they managed. They were visible in the service and approachable for patients and staff.
• Most staff felt respected, supported and valued. All staff could raise concerns without fear. However, some staff felt that issues relating to staff cultures which were causing issues in people working together were not being addressed.