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.