The Care Quality Commission (CQC) has told The Priory Hospital Bristol that it must make urgent improvements to the quality its services.
Due to concerns raised by other agencies and identified while monitoring the service, CQC undertook an inspection of the wards for children and young people (CAMHS) at Bristol Priory on the evening of 24 August. Inspectors returned on 25 and 26 August to continue the inspection of CAMHS wards and also inspected the acute and inpatient wards for adults of a working age.
Following the inspection, CQC imposed conditions on the registration of Priory Hospital Bristol. Inspectors required the service to address the concerns identified immediately to ensure there were enough suitably qualified and competent staff on wards at all times and it had processes and practices in place to keep patients safe.
In July 2020, the provider, Priory Healthcare Limited along with NHS England, made the decision to close the Banksy CAMHS ward. In September 2020 they also chose to close The Brunel, their other ward for CAMHS patients. The young people using both wards were transferred to care more appropriate to their needs.
CQC’s Head of Hospital Inspection Karen Bennett-Wilson, said:
“The report for Priory Hospital Bristol makes for disappointing reading. Following the inspection, we took immediate action by imposing urgent conditions upon the hospital to ensure significant and immediate improvements were put in place.
“The leadership at the hospital has been in a period of upheaval for some time and there had been a number of changes to the hospital director, deputy director and medical director roles. In addition, senior leaders at Priory Healthcare lacked insight into many of the issues until this was raised with them, demonstrating a lack of oversight and assurance.
“We are continuing to work with other stakeholders and are monitoring the Priory Hospital Bristol closely. We will not hesitate to take further action if it fails to make the necessary improvements.”
Staff on the wards for children and young people did not always raise incidents or allegations of abuse appropriately. Staff had highlighted two incidents in care records that should have been reported to the local safeguarding authority, but this had not been done. CQC found that young people had been given medicines outside a legal framework and this had not been reported as an incident as required by regulations. In addition, the hospital did not have appropriate systems in place for managing medicines safely.
Staff raised concerns with the culture of the wards for children and young people adding that the closure of the wards had affected their morale. Staff on Brunel Ward said they felt undervalued and agency staff on both wards said that they did not always feel comfortable raising concerns.
CQC had previously told the hospital that it required improvements to be made to ensure it managed the risk presented by blind spots in the acute wards for adults of working age and psychiatric intensive care units. The hospital had installed anti-barricade doors and convex mirrors to manage the blind spot risks throughout the areas.
The layout of both Redcliffe and Upper Court wards allowed staff to observe all parts of the ward and most risks were properly managed. However, there had been a number of incidents of people who were going absent without leave due to the low fencing in the outside courtyard as patients with good physical health were able to climb the fence. Enhanced observations were used to manage this risk; but this was not always effective.
Staff on Redcliffe and Upper Court felt able to speak to leaders about any concerns, questions or improvement ideas.