Arbury Court

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our previous inspection we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

Staff completed comprehensive mental and physical health assessments and involved the patient and other relevant professionals in the assessment. Staff were experienced and new staff received a thorough induction. Oversight of supervision had improved since our previous inspection. The ward team included or had access to the full range of specialists required to meet the needs of patients on the ward. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

We scored the service as 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We looked at 6 care and treatment records for the ward; this was all current patients on the ward.

During admission, staff completed comprehensive mental health assessments which involved the ward doctor who could also support a review of medicines. The hospital’s physical health nurse also supported in assessments of a patient’s physical health needs. The records showed these assessments occurred during or soon after admission for all patients, any delays were due to a patients’ presentation during admission, and their inability to engage. Physical health was monitored using National Early Warning Score 2 (NEWS2), which helped to identify and respond to physical deterioration, and staff used other tools such as Malnutrition Universal Screening Tool (MUST) to assess physical health.

Staff used the Short Term Assessment of Risk and Treatability Tool (START) to structure patient’s risk assessments, and develop personalised, holistic and recovery-oriented care plans. Care plans were comprehensive and dynamic, information in the care record was easy to find and understand.

Care records were regularly reviewed and updated following ward rounds or when things changed, such as following an incident.

People receive person-centred, evidence-based care that was responsive to their individual needs, preferences and aspirations, recognising their strengths, cultures and histories. For example, we observed measured and insightful discussions related to how a patient’s menstrual cycle might impact their mental health and how any distress could be mitigated.

All patients we spoke with understood and felt involved in their care and treatment plans, apart from one who had only arrived onto the ward the day before our visit. Patients were routinely invited into the ward round to discuss their care and treatment, unless there was a specific reason it would not be safe for them to do so. We observed how staff supported a patient who was unable to attend their ward round, ensuring that they had the chance to discuss their care and treatment and outcomes from the ward round.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well

The service and wider hospital had a multidisciplinary team that ensured patients could access a range of specialists, either through the ward or a referral. This included consultant psychiatrists, GPs, a physical health nurse, occupational therapists, psychologists and social workers. Patients could access additional specialists when required and the service was able to easily access the local physical health hospital. For example, a number of patients were accessing individual psychology sessions. Staff could easily refer other patients to psychology when they identified a need. The ward had its own occupational therapist assistant who provided a daily activities schedule for patients to engage with.

Staff provided a range of care and treatment interventions suitable for the patient group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence.

Staff were involved in regular clinical audits, including medication, care plans, physical observations and environmental checks. The ward manager was completing benchmarking and was looking to find areas for quality improvement.

Staff were experienced and qualified and had the right skills and knowledge to meet the needs of the patient group.

During the previous inspection of the service, there were concerns regarding appraisals data, with appraisal dates not being recorded. The data received during this inspection showed that all staff had previous appraisals dates and dates for when the next appraisal was due. Staff received yearly appraisals that were staggered through the year, at the time of the inspection 85% of staff had received an appraisal. Staff who were overdue appraisals were clearly identified and staff on long term leave, such as maternity leave where also clearly identified. For staff on Hartford, there was 8 out of 55 staff members overdue an appraisal, one was on maternity leave, and the other 7 had been due an appraisal between November 2025 and January 2026.

Staff received regular supervision; however, staff told us that supervision was not always provided by the same individual, which meant that staff did not always get consistency between supervisions.

Managers gave each new member of staff a full induction to the hospital before they started work. Staff received a thorough induction package prior to commencing work. Staff also had a local induction on the ward.

Managers ensured that there were regular team meetings, including daily handover meetings at 8am, and team meeting minutes were available for staff who were unable to attend team meetings.

Staff were able to access to additional training, particularly around physical health observations, such as phlebotomy. Staff also completed the HOPE(S) model training, a clinical model that aimed to reduce long term segregation.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff, teams and services worked together with people to effectively deliver coordinated, consistent person-centred care and treatment. They had regular and effective multidisciplinary meetings, which external professionals were invited to.

Teams also had regular daily handovers between shifts to share information about patients, however it was noted by managers that due to recent staff and shift changes the effectiveness of these meetings needed to be reviewed. They were considering when and how to best share information, such as what time would catch the most amount of staff.

Plans for transition, referral and discharge considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. For example, one patient was about to be transferred to an acute ward and staff discussed how to support them with this transition. They considered practical steps and accessing the local community more on unescorted leave, as well as one-to-one psychology input to develop a personalised relapse prevention plan.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

Activity groups helped to promote healthy lifestyles for patients, such as walking and netball groups, and staff encouraged patients to engage in these activities. The lounge area of the ward had various posters promoting healthy living, and physical health awareness. An occupational therapist attended the ward every day who was able to support activities on and off the ward. We observed patients requesting to go to the hospital’s gym and staff supporting to help facilitate this.

Staff discussed patient’s physical healthcare needs routinely in the ward round and supported patients to access appointments related to these, where necessary. For example, one patient was referred to the pain clinic. People were as involved in monitoring and reviewing their own health and wellbeing needs as possible. This included being involved with regular monitoring and reviewing with the service. For example, during the ward round patients were involved in discussions around their medicines, the side effects and how they were managing. These discussions included whether or not the patient had capacity to consent to taking the medicines.

Patients we spoke with told us they felt supported to manage their own health needs and were encouraged to make healthy choices and to be physically active where possible.

We scored the service as 3. The evidence showed a good standard. The service routinely monitored people’s care and treatment to continuously improve it.

Staff used recognised rating scales to assess and record severity and outcomes such as Health of the Nation Outcome Scales. Staff engaged in clinical audits, to ensure monitoring and oversight.

Staff consistently monitored patient’s physical health, mental state and wellbeing, and staff responded with additional support or referrals when the need was identified.

The senior leadership team had also introduced a board round meeting, which ward staff would attend to ensure oversight of patients. The review included any recent incidents, discharge planning and physical health. The aim of the meeting was to monitor care and highlight any areas for improvement.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

People’s rights and decisions around consent were understood and respected by staff and the service. Staff understood the importance of making sure people knew what they were consenting to and the importance of obtaining consent before they delivered care, support or treatment. During the ward round we observed patients’ understanding of their care and treatment plans, including medicines, being checked through discussions with them around their understanding of their illness and what was being treated.

Consent to care and treatment was always sought in line with legislation and guidance. Staff understood the relevant consent and decision-making requirements of legislation and guidance; this included the Mental Capacity Act 2005 and other relevant national guidance. For example, we observed discussions around a patient’s ability to consent to medicine for a physical health condition and whether a best interest’s decision would need to be considered in relation to this.