Updated 9 October 2017
We rated Cypress as requires improvement because:
- There was a lounge on the ground floor which could be used for women if required, but it was not designated solely for women, and there was not always a quiet room for patients to meet visitors. The building had few adaptations for patients with physical disabilities.
- Blood pressure monitoring equipment and scales had not been calibrated.
- 45% of staff were overdue for one to one supervision and 36% were overdue for annual appraisal. One appraisal was overdue by was more than three months.
- Staff did not have access to the electronic care notes system used by the local NHS provider. This led to duplication of records. There were ongoing discussions about providing the ward with access to the NHS provider’s records for patients referred to the ward.
- Although there were a number of clear policies on the Mental Health Act on the organisation's website, all of these were overdue for review and none had been revised in the light of the new Mental Health Act Code of Practice, which came into force from 1 April 2015.
However:
- Staffing levels were good. Activities were rarely cancelled due to lack of staff and patients told us there were always enough staff. Staff offered patients one to one time twice a day and patients said staff were always available if they needed them. The manager had authority to increase staffing levels temporarily if needed, and could provide an individual with constant one to one time for up to 72 hours if required.
- There had not been any serious incidents reported on the ward in the last 12 months.
- Staff knew what incidents should be reported and understood safeguarding procedures. When incidents occurred, staff were debriefed. There was a portable alarm system and this was tested every day.
- Medicines, including controlled drugs, were stored securely and staff checked the temperature of the fridges that were used to keep medication.
- Care plans, which were referred to as work plans, were personalised, holistic and recovery focused. A physical health check form was completed when patients were admitted and patients could access specialist care when needed.
- Communication was good within the team and with other professionals. A detailed handover was conducted daily between the early and late shifts and there were brief handovers at the beginning and end of the day. There were regular multi-disciplinary team meetings and clinical reviews and staff attended handover meetings at the local acute ward.
- We observed friendly and informal interactions between staff and patients. The staff were respectful, positive and flexible. Patients were generally very positive about the ward.
- Patients were able to personalise their bedrooms, had keys to their rooms and access to the kitchen to make their own drinks and snacks. Patients told us that they liked the homely atmosphere.
- Patients were only moved if clinically appropriate. Discharge from the ward was carefully planned and beds could always be accessed on return from leave.
- There were a range of activities that staff facilitated during the week. Staff encouraged patients to see friends and family. Patients were encouraged to get used to doing things on their own as part of their recovery and in preparation for moving on.
- Most staff said they felt confident to raise concerns without fear of victimisation and spoke very positively about the team manager and clinical lead. Staff were motivated and enthusiastic and spoke favourably of working on the ward.