Arbury Court

Updated 21 February 2024

Arbury Court is an independent hospital, part of Elysium Healthcare Limited and was registered with CQC on 21 October 2016. The service has a registered manager in post.

Arbury Court is registered to provide the following regulated activities:

• Treatment of disease, disorder or injury
• Diagnostic and screening procedures
• Assessment or medical treatment for persons detained under the Mental Health Act.

The hospital has up to 82 beds for women aged over 18 years with mental health needs. All patients are detained under the Mental Health Act.

The hospital provides two core services: Forensic inpatient or secure wards (5 wards); Acute wards for adults of working age and psychiatric intensive care units (1 ward).

There are 44 low secure beds across 3 wards:

• Daresbury ward has 15 beds
• Hartford ward has 14 beds
• Alderley ward has 15 beds.

There are 27 medium secure beds across 2 wards:

• Delamere ward has 12 beds
• Oakmere ward has 15 beds.

There is 1 psychiatric intensive care unit:

• Primrose ward has 11 beds.

The service was last inspected in August 2023. We rated safe and caring as requires improvement, and well-led as good; but did not inspect effective or responsive.

A previous inspection in May 2022 rated effective as requires improvement and responsive as good. The service had requirement notices with regards to specialist staff training and supervision, which it has now addressed.

What people who use the service say

Most patients we spoke with were generally positive about staff, and had staff they could talk with and felt supported. They had access to psychology and occupational therapy. Patients attended their multidisciplinary team meetings, and were generally positive about these. Some patients were not happy about being in the hospital. Some patients said there were delays in getting feedback following assessments or if there were changes to their leave.

Patients were generally aware of their care plans, although their level of involvement varied. Most patients were aware of their rights under the Mental Health Act. Patients were generally aware of their discharge plans, particularly on the low secure wards. Patients had access to physical healthcare including a GP and practice nurse.

Patients with a learning disability or autism had mixed views about how much staff were able to support them. Some patients were positive, others thought staff tried hard but did not always have the necessary skills, and others thought that the service did not take this into account.

Patients were supported to keep in touch with their families.

There were mixed views about activities in the hospital. Some patients were positive about the activities available, but others said there was a timetable which often did not happen, or that the activities were boring. Many patients had access to leave, and some patients to education and work-based opportunities, within and outside the hospital.

Patients were generally aware of the advocacy service and were positive about this. Patients knew how to make a complaint or raise concerns. There was mixed feedback about patients’ satisfaction with the outcome of complaints.

Patients had mixed views about the food provided by the service. Some patients liked it but others did not or said that the quality and choice offered varied. Patients had access to snacks. Some patients told us that snacks were restricted on some wards, to help patients manage their weight.

Updated 21 February 2024

Our rating of the forensic inpatient or secure wards stayed the same. We rated it as requires improvement because:

• At a previous inspection in August 2023 we found that safe and caring required improvement.
• Not all patients had an up to date consent to treatment in line with the Mental Health Act Code of Practice.
• The documentation of and response to complaints was not in line with the provider’s policy and could be improved.

However

• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice.
• 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.
• Staff understood and mostly discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
• Staff worked with commissioners and other providers to support patients to move onto a suitable placement on discharge.

Updated 21 February 2024

See the summary above for details.

Updated 20 November 2023

Our rating of this service improved. We rated it as good because:

• The ward environments were safe and clean but in need of a refurbishment. Ligature risk assessments were up to date and security checks were carried out regularly. The ward had enough nurses and doctors. Staff assessed and managed risk well, patients all had up to date, relevant risk assessments.
• Staff followed good practice with respect to safeguarding. Staff had received appropriate safeguarding training and there were systems in place to support staff make safeguarding referrals when required.
• Staff had completed a range of mandatory training that was appropriate to the needs of the service.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients.
• The service was well led, and the governance processes ensured that ward procedures ran smoothly. Leaders had a good understanding of the service. There were systems in place for monitoring and managing risk and managers collated and used this information effectively. The service had a culture of learning.

However:

• The service did not ensure that infection control risks were eliminated from food preparation areas. We found a mop and a bucket with filthy water in the ward kitchen.
• The service recorded high levels of restraint.

The acute and psychiatric intensive care unit (PICU) accounts for a small proportion of hospital activity. The main service was the forensic service. Where arrangements were the same, we have reported findings in the main service section.

We rated this service as good because it was, effective, caring, responsive and well led, but safe required improvement.