WORK is ongoing to make improvements at an independent mental health hospital in Warrington, following concerns about the service.
It follows a focused unannounced inspection by the Care Quality Commission at Arbury Court, an independent hospital, part of Elysium Healthcare Limited, on Townfield Lane, Winwick.
While it was rated “Good” for being effective and responsive it was found to require improvement for Forensic inpatient or secure wards.
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).
Most patients spoken to 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.
Rating of the forensic inpatient or secure wards stayed the same. They were rated requires improvement because:
• At a previous inspection in August 2023 inspectors 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.
Action the service SHOULD take to improve:
• The provider should ensure that all patients have their consent to treatment reviewed in accordance with the Mental Health Act Code of Practice. (Regulation 11)
• The provider should ensure that all complaints are documented and responded to appropriately, and in keeping with their policies.
• The provider should consider further improvement of the positive behavioural support plans, so they are fully informed by a more detailed formulation of patient’s needs and reviewed through an improved functional analysis, especially for those patients who could not or declined to be involved.
A spokesperson for operators Elysium Healthcare said: “The safety and wellbeing of our patients is always our highest priority, and we are grateful to the CQC for this latest inspection report.
“We were pleased to be rated ‘Good’ in the three areas of being effective, responsive and well-led. This result is a real recognition of the hard work and dedication of all of the team.
“However, we recognise there are still some improvements to be made, particularly with regard to documentation systems and we have already formulated and implemented a robust action plan to address this issue.
“We are committed to the ongoing improvement of our vital services, and we continue to work closely with the CQC.”
A full copy of the report can be read by CLICKING HERE
