Archived: Arbury Court

Updated 1 June 2016

Arbury Court is registered to provide the regulated activities: treatment of disease disorder or injury; assessment or medical treatment for persons detained under the Mental Health Act 1983; and diagnostic and screening procedures. The service has a registered manager and an accountable officer.

Arbury Court provides one core service: forensic inpatient and secure wards.

Arbury Court provides secure inpatient services for up to 74 women with a mental illness or personality disorder.

Arbury Court has two medium secure wards and four low secure wards. Delamere and Oakmere wards are medium secure and both have 11 beds. Low secure services are provided on Cinnamon and Rosewood wards, which have 11 beds each, and Appleton and Heathfield wards, which have 15 beds each.

We have inspected Arbury Court four times since registration with the Care Quality Commission (CQC) in 2010. The last inspection took place on the 23 September 2013, and the service was found to be compliant with the regulations.

Updated 1 June 2016

We rated Arbury Court as outstanding because:

• Patients were actively involved in their risk assessments and care planning. This included training patients to complete their own risk assessment with staff.
• Care plans were patient centred and recovery focused. Patients had an assessment of their needs which included their mental and physical health and level of risk.
• The service had implemented a positive behavioural support programme called RAID (reinforce appropriate implode disruptive). This was a philosophy of care that focused on patients’ positive behaviours, strengths and recovery.
• Patients were actively involved in making decisions about the service. This included through the patients’ council and community meetings.
• The majority of patients and carers we spoke with were positive about staff and felt they treated them with respect and kindness. Interactions between staff and patients were friendly and respectful.
• The service used a ‘dashboard’ to oversee key information about patients. This improved patient care because staff routinely reviewed this and acted when they saw gaps.
• The service used information from the dashboard to monitor and improve the quality of care. This was monitored locally, corporately through Partnerships in Care, and by the service’s commissioners.
• The provider used a staff satisfaction tool that showed staff at Arbury Court were generally positive about the service. This was reflected in our conversations with staff.
• There were adequate facilities for patients within the hospital which include activity and therapy rooms, and secure storage for patients’ possessions including valuables and restricted items.
• Patients received care from a multidisciplinary team that included doctors, nurses, occupational therapists, psychologists, social workers and healthcare support workers and activity workers. The service employed a registered general nurse and healthcare assistant who led on patients’ physical healthcare needs. All patients were registered with a local GP.
• Patients had access to occupational therapy and had at least 25 hours of planned activity per week. There was a programme of ‘real work’ opportunities where patients were interviewed, selected, trained and paid to do jobs in the hospital.
• The use of seclusion was in accordance with the Mental Health Act code of practice.
• There were security procedures for the safety of patients, staff and visitors.
• Restraint, enhanced observation, seclusion and long-term segregation were used with patients. This was routinely reviewed, and changed to least restriction when possible.
• The service had high levels of incidents. However, it reviewed and acted upon these at a local and corporate level.
• Staff received regular supervision and appraisal.
• Permanent, bank and agency staff covered nursing and healthcare worker vacancies. The service had a recruitment strategy and an employment engagement lead to increase recruitment and retention in the service. Staffing allocations were reviewed daily and weekly to ensure that safe staffing levels were maintained, and that patient care was provided including therapy, leave and activities.
• Staff implemented safeguarding policies to identify and report potential abuse.
• The nature of service meant that there were necessary restrictions imposed, particularly with regards to safety and security. Staff were mindful of this and the use of blanket restrictions, when applied, was with consideration.
• The service had implemented a healthy eating and fitness programme. The service was balancing its duty of care to patients who were overweight or clinically obese, with patient choice and least restrictive practice.
• Overall, staff managed and administered medication appropriately.
• Overall, the Mental Health Act was implemented in accordance with the code of practice.

Updated 1 June 2016