Improvements have been made at Bristol’s main private psychiatric hospital following a damning inspection and two ward closures last year.
Health regulator the Care Quality Commission (CQC) has inspected the Priory Hospital Bristol in Stapleton, which is run by the Priory Group, the UK’s largest private provider of mental health services.
Last year, the Cable revealed that two wards for children and young people were closed down amid staffing problems. First, the decision was made to close Banksy ward in July, after commissioners NHS England had concerns about staffing, incident reporting and management. Then the other ward for children, Brunel, closed in September, leaving Bristol temporarily without any residential beds for children.
The Priory Group, which receives hundreds of millions of pounds from the NHS to provide care across 450 facilities in the UK, was sold by the US’s Acadia Healthcare to Dutch private equity firm Waterland for £1.08bn in December 2020.
The CQC demanded urgent improvements after identifying serious issues at the Priory Bristol during an inspection in August last year. Inspectors found a lack of robust oversight from senior management, serious staffing problems, poor management of medicines and inappropriate use of rapid tranquillisation.
But now the regulator has welcomed improvements at the hospital, giving it an overall rating of Good. All areas were rated as Good by inspectors, except safety, which was downgraded to ‘requires improvement’.
Following the inspection in April, the CQC report praised senior leadership, compassionate care, patients and carers being involved in care decisions, and support for staff. They also found the management of safeguarding procedures had improved after a safeguarding lead had been appointed and staff were trained and understood how to recognise and protect patients from abuse.
However, the CQC raised other concerns, including the high number of registered nurse vacancies (60%), patients missing out on occupational therapy because of staff vacancies, agency staff not having access to patient electronic records, patient records not being updated regularly and key emergency items such as defibrillation pads missing.
Karen Bennet-Wilson, the CQC’s head of hospital inspection for mental health, said she was pleased with the “considerable improvements”, and that the leadership had clearly “worked hard to address our concerns”.
“People said that staff were caring and respectful and that the ‘help and support had been faultless’. It was also pleasing to hear that staff felt positive and proud about working at the hospital.
“Although there is still more work to do, and we have pointed out further areas for improvement, the service has come a long way and leaders and staff deserve to be congratulated for the hard work they have put in to turn the service around.”
No longer caring for children
The hospital now only cares for adults, after the two children’s wards closed last year. Patients and their families told the Cable about serious incidents of self harm, as well as issues with safeguarding and communicating with families. The CAMHS wards were replaced with an adult acute ward, Blackwell, and a psychiatric intensive care unit for adults called Purdown.
The Cable can now reveal that the Priory Bristol has been found to have not complied with data protection obligations in the case of one parent. The ruling by the Information Commissioner’s Office (ICO), said that clinical notes relating to a female patient on the Brunel ward for young people were accidentally sent to the wrong family.
The hospital completed an investigation and identified learning outcomes and improvements to processes, but the family said they were not informed of this outcome until more than two months later. The ICO have since told the Priory they need to ensure all staff attend mandatory training, and that all policies and prosecutors are updated to meet GDPR.
The mother previously told the Cable about the “traumatic experience” during her daughter’s stay at the hospital, which abruptly ended when the ward closed in September last year. She had serious concerns about the quality of care, safeguarding and communication. “In some ways, I regret having her admitted,” she said.
The bigger picture
The two ward closures left Bristol without any overnight mental health beds for children, because the NHS unit in the city was under refurbishment. Bed availability is a big issue in the mental health sector because it can mean young people are sent for treatment miles away from their families.
The Riverside inpatient unit, which is run by local NHS trust Avon and Wiltshire Mental Health Partnership, closed in March 2020 and reopened in June this year – albeit three months later than planned. The £2 million refurbishment means the number of beds has increased from 10 to 12.
In June, NHS England announced that 12 additional mental health beds will be created in the South West, as part of a £40 million investment to address the impact of the pandemic on children and young people’s mental health. A spokesperson for NHS England told the Cable that the final arrangements for where these beds would be had not yet been made.
A spokesperson for the Priory Hospital Bristol said: “We are delighted the CQC recognises the significant efforts we have made, and has rated the hospital as ‘good’ for being effective, caring, responsive and well-led.
“Staff work tirelessly for the patients we have the privilege to care for, and this is reflected in the report, with inspectors describing how staff treat patients with ‘compassion and kindness’, and highlighting positive statements from patients.”
They added that improvement had been made to address the CQC’s feedback, including the recruitment of eight nurses.