Arbour Lodge Independent Hospital

Updated 13 February 2024

Arbour Lodge Independent Hospital is run by Barchester Healthcare Homes Limited. It is a hospital that provides 24-hour support, seven days a week, for up to 20 patients with organic and/or functional mental health problems. The hospital had recently built an extension to expand the service from what was originally 13 beds to 20 beds. As well as the additional bedrooms, there was an extra lounge for patients. The focus is providing support to people whose behaviour may challenge. The service is for men aged 50 years old and above. At the time of this inspection, there were 19 patients living at the hospital. The hospital was registered in May 2011. The regulated activities at Arbour Lodge Independent Hospital are assessment or medical treatment for persons detained under the Mental Health Act 1983, diagnostic and screening procedures, treatment of disease, disorder or injury, nursing care and personal care.

A registered manager was in post. The registered manager was also the controlled drugs accountable officer. There have been eight previous inspections carried out at this service with the most recent being on 10 and 11 July 2018 when it was rated as good. We identified that the following improvements were required.

The provider must ensure that moving and handling assessments, including risk assessments for specific equipment and care plans, are completed and kept up to date for all patients who require these.

The provider must ensure that falls risk assessments are completed correctly and that falls care plans kept up to date and completed for all patients who require these.

The provider must ensure that re-positioning is taking place where indicated and recorded by staff.

At this inspection we checked each requirement and found that the necessary improvements had been made.

What people who use the service say

We spoke with 3 patients during the inspection. All 3 patients told us that there were always staff around and staff were kind, caring and treated them with dignity and respect. All 3 patients said that leave was rarely cancelled, and staff involved them in activities which they enjoyed. Patients said they had been offered a copy of their care plan and their wishes and feelings had been listened to. One patient said staff helped them to make their own meals and were encouraging them to develop their own independence. All 3 patients said they could give feedback about the service at community meetings. staff listened and tried to act upon what the patients said. One patient said that the communal areas could be noisy, but they had the option to go to another lounge. Another patient said that whilst the food was adequate, the vegetarian options could be improved upon.

We spoke with 5 carers during the inspection. All 5 carers said they felt the service was safe and clean, and that the décor was nice. One carer said the hot water in the bathroom had been problematic, but this had been resolved. All 5 carers said the nursing staff were visible in the communal areas. One carer said although generally possessions were safe, on 1 occasion their relative’s clothes had got mixed up with someone else’s.

All 5 carers said they had been invited to meetings about their relative and that generally communication was good. The carers all knew how to make a complaint and 1 carer said they had received a comprehensive response after making a complaint. One carer said they felt meal options were limited and carb heavy.

Updated 13 February 2024

See summary below.

Updated 13 February 2024

Our rating of this service ​stayed the same​. We rated it as ​good​ because:

• The service provided safe care. The ward environments were safe and clean. The wards 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.

• Staff completed risk assessments for each patient on admission, using the Sainsbury tool, and reviewed this regularly, including after any incident. We reviewed 6 risk assessments and found they were complete, up to date, reviewed monthly and updated after incidents. Falls risk assessments were in place where relevant and were reviewed monthly.

• Staff developed a comprehensive care plan for each patient that met their mental and physical health needs. Care plans were developed with patients and staff sought information from carers where appropriate. All care plans were personalised, holistic and recovery orientated.

• The ward team had access to the full range of specialists required to meet the needs of patients. Managers ensured 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.

• Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005. Staff had a good understanding of capacity and completed capacity assessments and best interests’ meetings when appropriate.

• Staff were discreet, respectful, and responsive when caring for patients. We observed that staff were kind, gentle and compassionate in their interactions with patients. They involved carers in patients’ care and worked to provide a supportive carers group for families.

• Staff encouraged patients to develop and maintain relationships both in the service and the wider community. Staff were aware of patients’ histories and encouraged them to maintain relationships with family, friends, and neighbours.

• Leaders had the skills, knowledge and experience to consistently deliver high quality personalised care. Leadership development was embedded into the service and there was a culture of staff development across all levels of the organisation.

• Managers and staff were clear about their roles and responsibilities and were committed and accountable to patients, colleagues and leaders. There were robust governance processes in place which were embedded into the service and managers had good oversight.

However:

• The clinic room was not tidy, and medicine pots were not always cleaned effectively after use.

• We found a bottle of unlabelled eyedrops in the clinic room.