We rated The Priory Hospital Nottingham as outstanding because:

• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment of each patient and care plans reflected patients’ views. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice and worked well to involve patients in decisions about their care by informing them of their treatment options. Staff engaged in clinical audit to evaluate the quality of care they provided and learned from these to improve their practice.
• Staff treated patients with compassion and kindness, respected their privacy and dignity and understood the individual needs of patients. They actively involved patients, families and carers in care decisions to make sure patients were active participants in their care and treatment.
• The service provided safe care. The ward environment was safe and clean. The ward had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare. We saw evidence of effective working with teams external to the organisation and had positive feedback from these organisations about the quality of the communication from the hospital.
• Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Patients were discharged promptly once their condition warranted this.
• The service was well led, managers were actively engaged in supporting the staff and patients on the ward and the governance processes ensured that ward procedures ran smoothly.

However:

• Although staff maintained equipment well, staff did not record when clinical equipment was cleaned. Staff reported they cleaned all clinical equipment before and after every use, but had not recorded this.
• The blood glucose monitoring machine calibration was not part of the external audit company’s audit schedule and there were no records to suggest this machine had been calibrated. However, this did not present an immediate risk to patient safety as the machine was less than 12 months old and therefore was not yet due for calibration.

We rated The Priory Hospital, Nottingham as good because:

• Staff were positive, kind, and caring towards patients. Staff knew patients and understood their individual needs. Patients were routinely involved in their care planning and reviews.
• Families and carers were welcomed in the hospital and involved in care planning and decision-making where appropriate.
• There were enough staff on each shift to meet the needs of patients. This meant that activities and escorted leave were not cancelled.
• Detailed assessments of patients’ mental and physical health needs were completed and used to inform care plans. Care plans were up to date, holistic and recovery orientated.
• Patients had access to psychological therapies, and therapeutic and social activities.
• The environment was clean and maintained, with areas for patients to see visitors and make phone calls in private.
• Ligature risks were reduced with individual up to date risk assessments and observations as required.
• Staff knew how to recognise different forms of abuse and how to report it.
• Patients had their rights under the Mental Health Act explained to them on admission.

We spoke with two of the five patients receiving treatment at the hospital and spoke with two members of staff and the manager to help us assess whether the hospital was meeting essential standards of quality and safety.

Patients were involved in their care and treatment and were treated with dignity and respect. One patient told us, "The staff couldn't have been kinder, everyone has been brilliant, I couldn't have met nicer people, they have never judged me."

The patients we spoke with received care and treatment which met their needs and ensured their wellbeing and safety. A patient commented, "The detox is going well and they have bent over backwards for me. The group work has been very good. It's been a really nice experience."

We found the premises to be clean, warm, comfortable and well maintained.

Staff were recruited effectively and the provider took steps to make sure they had the information they needed to be assured that staff were suitable to work with vulnerable patients.

Complaints were responded to and investigated. One patient said, "I haven't complained as I have no complaints. If I did they would deal with it I am certain."

When we inspected the service there were seven people receiving in patient care. We spoke with two of these; one patient was going through an initial detoxification treatment and the other was receiving treatment and support to help them rehabilitate back into their own home following detoxification. We asked them for their views and experiences of the care, treatment and support provided.

The patients we spoke with both told us that the staff had been very helpful in supplying information to support them in making choices about their care and treatment. They both said the staff had made sure they understood what they were signing up to, why these restrictions were required and checked that they had understood this. This showed that the staff ensured that consent to treatment was informed and valid.

Both of the patients told us that the staff had involved them as fully as possible and where open about all aspects of their care whilst at the clinic. They both said the staff had been flexible when they needed more time to complete a piece of therapy work, which they found helpful. They reported feeling supported and safe, which enabled them to focus on achieving their treatment goals.

The patients we spoke with were fully aware of the medication which was prescribed for them and they understood why it had been prescribed. They told us the staff had told them about any possible side effects. They said they received their medication at the correct times and when required. The patients we spoke with told us they felt able to talk to staff if they wished to discuss any aspect of their medication regime.

Both of the patients we spoke with were overwhelmingly positive about the staff team at the clinic. They both told us the staff understood the issues they faced in facing their addictions and one patient said the staff had helped them understand the causes of their behaviour. One patient told us, “the staff are supportive, they’re helpful and friendly but they don’t wrap me in cotton wool, which is what I need.”

They were both fully aware of the complaints procedure and told us they would talk to staff if there was any aspect of their care and treatment that concerned them.