​We rated Arbury Court as

good

because:

• Ward environments, including clinic and seclusion rooms, were safe and clean. Almost all staff were compliant with mandatory training. Individual risk assessments were up to date and included all relevant information. Staff followed the principles of least restrictive practice and used de-escalation and positive behaviour support to manage conflict where possible. Safeguarding procedures were effective and medication was stored and administered correctly. Serious incidents were investigated, and lessons learned were shared with staff.
• Patient care plans were up to date, holistic and recovery-focused. Care plans were informed by detailed assessments. Patients had their physical healthcare needs assessed and treated where necessary. Patients had access to evidence-based psychological and occupational therapies that were appropriate to their individual needs. Most staff were up to date with clinical supervision and appraisal. Practice was compliant with the Mental Health Act and Mental Capacity Act.
• Patients and carers were mostly positive about the staff and the service. Patients described staff as supportive, friendly, respectful and caring. Patients were involved in their own care, in staff recruitment and training, and in making decisions about the running of the hospital. Patients and carers said that the service responded to their complaints and concerns.
• New referrals were assessed and admitted quickly. Arbury Court staff worked closely with commissioners and patients to plan discharge. There were rooms and facilities available for a wide range of patient activities, as well as a recovery college and a real work programme. Individual needs (including mobility, learning disability and cultural needs) were catered for. The service effectively responded to complaints.
• The provider’s vision and values were reflected in staff behaviour and attitudes. There was an effective clinical governance structure in place. Electronic ‘dashboards’ were used to monitor and improve the care of individual patients and the overall performance of the wards and hospital. Managers had responded to staff concerns about patient aggression and incidents, for example by employing a psychotherapist to support staff. Staff told us that they felt supported and able to raise concerns. Arbury Court had a very low sickness rate.

However

• A number of patients had missed doses of physical health medication due to a lack of stock. Staff did not always fully monitor and record a patient's physical health during clozapine initiation and after rapid tranquilisation.
• Staff and patients told us that wards were busy and that there were not always enough staff to meet needs.