Arbury Court

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs. At our previous inspection we rated this key question good. At this assessment the rating has remained as good. This meant people’s needs were met through good organisation and delivery.

Patients felt involved in their care, staff worked with patients to ensure conversations were open and honest, and individuals could make decisions about their care and treatment. The service met the needs of all patients – including those with a protected characteristic. Patients felt confident to raise concerns and complaints with staff, and there were regular community meetings for people to join. Staff planned for patients’ discharge and involved external teams to ensure continuity of care and treatment.

We have not awarded this service a score for Responsive.

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

We scored the service as 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Most patients we spoke with felt involved in their care, particularly after they’d settled on the ward. We observed how staff involved and engaged patients during the ward round; patients were able to give their preferences on their care and treatment. For example, one patient preferred a specific type of medicine. This was fully discussed and explored within the ward round. Carers and family members were also able to attend multidisciplinary team reviews and were also included in discussions where appropriate. The MDT review we observed during our inspection was comprehensive, holistic and personalised.

Patients had regular one-to-one meetings with their named nurse as well as their key worker. Managers were conscious of the importance of these discussions and if a patient had been declining one-to-one meetings, staff were encouraged to consider why this might be and how engagement might be better supported.

Staff worked with people when their needs changed to consider the care and treatment options which best met their changing needs. For example, one patient was able to have an open discussion with staff about incidents that had happened on the ward the previous week and discussed with the ward psychologist a plan tailored to their needs that would keep them safe over the following week.

Each patient had their own bedroom, equipped with an ensuite bathroom, however, patients did not have keys to their bedrooms. Patients were able to request a key if they wished, and this would be risk assessed. There were no lockable spaces for patients on the ward which meant that patients were not in control of safekeeping their personal belongings, other than giving any items to staff to keep in the security room space.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Patients were supported to maintain contact with their families and carers, and the services had processes in place to support families and friends visiting their loves ones in a safe and welcoming environment. Staff supported patients to maintain contact with their families and carers where appropriate and patients had access to their own mobile phones, which had been risk assessed by staff. If a patient did not have access to a mobile phone, there was also a ward mobile phone for patients to use when they needed to.

Patients also had access to voluntary work opportunities within the hospital, such as the onsite café. There was a dedicated occupational therapy assistant who coordinated these opportunities.

The occupational therapies team offered a variety of classes to attend. Alongside exercise and walking groups they also offered groups that supported patients when returning to their communities, such as lessons on driving theory.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed. Incidents were regularly reported and then reviewed by senior leadership to ensure all relevant bodies such as safeguarding and the Care Quality Commission had been informed.

The service had information governance systems in place to ensure the confidentiality of patient records. Care records were mostly kept on electronic systems which required staff to log in, and any paper records such as observation records were safely stored. Staff told us that they could easily access patient records.

The hospital monitored patients’ Section 132 rights under the Mental Health Act. This is a requirement for hospital managers to provide detained patients with clear, accessible information about their legal rights and their detention.

Patients told us they knew how to raise concerns and complaints with staff; they understood their care and treatment and regularly had their rights explained to them.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The ward had received one complaint in the last 3 months; no complaints were upheld or referred to the Ombudsman in this time. There were no particular themes or trends that had been identified from recent complaints. Managers investigated complaints and learned lessons from the results. Staff received feedback on the outcome of complaint investigations and acted on the findings.

Most of the patients we spoke with knew how to complain and were confident to do so. Staff we spoke with were aware of how to handle a complaint and knew the importance of protecting patients from discrimination and harassment when they had raised a complaint.

The hospital completed patient surveys to gather their feedback on their care and treatment and offered family, friends and carers experience surveys. Satisfaction surveys for occupational therapy were also completed quarterly by patients receiving occupational therapy to identify potential areas for improvement.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

During the admission and referral process, the MDT reviewed each individual to ensure that the needs of patients with mobility issues could be met. The team were responsive to patients who potentially had more complex needs and would take the time to consider what adaptation could safely be made to provide safe care and treatment for the patient. The ward and the wider hospital were accessible, with all patient areas being on the ground floor.

Staff ensured that reasonable adjustments were made for patients when required, for example providing a shower chair to a patient who required to safely and independently bathe.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the acute hospital was within a reasonable travelling distance.

Staff could identify and took appropriate action when there was a gap in a person’s care. This included where people may be eligible to receive more care or support. We observed discussions with commissioners around a patient’s entitlement to Section 117 aftercare services and how they made sure the right people were contacted to get this in place.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The ward had community meetings, which gave patients the opportunity to give feedback and raise concerns, empowering patients to give their views. Patients had regular access to independent mental health advocacy services, who regularly attended the ward. Patients also had regular one to one time with their key worker or named nurse, which allowed them to raise concerns, and staff were conscious of monitoring patient’s wellbeing during these interactions.

Staff ensured that patients had access to translation services to ensure that patients understood their care and treatment. Patients were able to receive written information in different languages when required.

Staff were trained in equality, diversity, inclusion and human rights as part of their mandatory training and the completion rate for the service was 98%.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The hospital had recently implemented a board round, with each ward having their own focused meeting. These included the nurse in charge, social worker, occupational therapist, psychiatry and psychology. Each patient was reviewed to monitor their progress, recent incidents, physical health, observations levels and discharge planning. The aim was to identify how a patient was progressing and if there were any gaps in their care and treatment that might be preventing discharge. These meetings had only recently been established at the time of our inspection, so the outcomes and value of the board round meeting was still being monitored.

We observed discussions regarding patients’ discharge planning during MDT meetings. Staff planned for each patient’s discharge and involved any required teams from the patient’s local area to ensure that there was continuity of care and appropriate packages of care and accommodation to ensure safe discharge. When a person was supported by more than one service or by unpaid carers, staff worked in a transparent, collaborative, flexible and open way to make sure care was joined up for people.