Cygnet Bury Forestwood

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 last assessment we rated this key question Good. At this assessment the rating has remained Good.

This meant people’s needs were met through good organisation and delivery.

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 make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

Staff within the service had taken active steps to base patient care around individual needs and preferences. The service had recently completed a substantial recruitment process to increase the number of female support workers. This was to support those patients who preferred to be cared for by female staff, in particular whilst they were under observation.

All patients had a hospital passport which contained guidance on how best to care for and communicate with each individual patient. Patients were encouraged and supported to attend their ward rounds which included discussion on medication, risk assessment, observations and section 17 leave. Care plans were personalised and holistic and, in most cases, had been co-produced with patients.

Staff empowered patients to make their own decisions about their care and treatment. Patients were assumed to have capacity and patient rights, consent to treatment and medication were discussed with them in an age-appropriate way using a variety of communication aids.

Some patients wanted their own pets from home on the ward as part of pet therapy. These requests were individually risk assessed. Patients were supported with this and kept their pet in their bedroom as long as they were able to maintain caring for, feeding and keeping their pet’s environment and equipment clean. During periods of distress and emotional challenges some patients had requested the way in which they wanted their behaviour to be managed. This included staff using safe holds or the pods as a means of least restrictive intervention if other de-escalation had failed.

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

Staff ensured that patients had access to education. There was an onsite school and patients attended for half days throughout the week. Staff supported patients with homework, completing coursework and studying for exams. One patient had completed a GCSE exam whilst being cared for in seclusion.

Staff supported patients to maintain contact with their families and carers. Most patients had a mobile phone and access to other IT equipment to enable them to make video calls to their families.

Staff helped patients to access their chosen place of worship within the community. This included finding out where places were and what time services were scheduled. Patients with escorted or unescorted section 17 leave could attend their chosen place of worship in the community or staff contacted spiritual leaders to attend the ward where patients did not have leave.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

Staff made notifications to external bodies as needed. This included notifying commissioners, safeguarding and the Care Quality Commission.

Information governance systems included confidentiality of patient records. Patient records were stored electronically and any paper records such as section papers were stored in a locked cabinet before being scanned onto the system.

The service complied with the Accessible Information Standard.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain There were notice boards on all the wards with information on patients’ rights, Mental Health Act, advocacy services, complaints, safeguarding and medication.

The information provided was in a form accessible to the particular patient group. This included easy read information and staff made information leaflets available in languages spoken by patients.

Staff ensured carers, families and commissioners were regularly updated about the patient’s progress. There was a daily template that staff completed to update families on their loved one. This could then be emailed to them or if they preferred staff would phone them to go through the information. Where patients had agreed, families were invited to their meetings and they received the minutes of the meeting afterwards. Staff informed families of incidents when they occurred.

We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.

The provider had recently updated their complaints policy which was available on the staff intranet. Between April 2024 and April 2025 there were a total of 20 complaints across the 4 wards. An additional complaint was received that had been investigated by the Care Quality Commission regarding the care and treatment of a previous patient from between 2022 and 2023.

The total number of complaints was 20, with 12 being partially upheld, 6 not upheld and 2 upheld. The most common theme within the complaints was quality of care and other themes included poor communication, medication and the Mental Health Act.

The ward with the highest number of complaints at 7 was Primrose ward; Wizard House received 5 complaints and Buttercup and Mulberry wards received 4 complaints each.

Staff received feedback on the outcome of the investigation of complaints and acted on the findings. An example of lessons learned because of a complaint regarding the care and treatment of a secluded patient on Primrose ward was that diet and fluid charts must be completed for all individuals whilst in seclusion; the charts are now embedded within the seclusion booklet templates. On Buttercup ward, a patient had not always received the gluten free meal option that they required so the catering manager and chef were asked to devise meal plans with any patients who had a specific diet/allergen requirement.

There were complaints posters on the wards and patients and carers told us that they knew how to complain if they needed to. Staff supported patients to complain and handled complaints appropriately. They protected patients from discrimination and harassment.

Managers ensured that complaints were investigated in line with the complaints policy and that complainants received a response.

We make sure that everyone can access the care, support and treatment they need when they need it.

The service supported and made adjustments for disabled people and those with communication needs or other specific needs. There were disabled bathrooms, wide corridors and staff bought specialist beds and equipment for those patients with specific needs.

Other adjustments included the use of wheelchairs and shower chairs if required.

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

Staff ensured patients had access to post-discharge care, for example, section 117 aftercare, community mental health services and crisis services. Managers and staff worked to make sure they did not discharge children and young people before they were ready. Work was undertaken with local teams to ensure that appropriate levels of care were in place upon discharge. Staff supported patients to visit services that they were being transferred to or escorted them on home leave as prescribed.

Staff planned for patients' discharge, including good liaison with care managers and care co-ordinators. Staff followed up to ensure that the people required attended discharge planning meetings

Discharge was never delayed other than for clinical reasons. This occurred when there were difficulties in finding a suitable onward placement for a patient.

In the last 12 months, there was one delayed discharge from Mulberry ward. This was because the patient needed a bespoke placement; at the time of the inspection a transition plan had been started to support the move.

We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Patients spoke directly to staff, used the comments box, completed the patient survey, attended the ward community meeting or had input into the monthly Peoples’ Council meeting. Patients and carers were also encouraged to complete a survey post discharge.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff were trained in equality, diversity, inclusion and human rights. This training was mandatory and compliance was at 100%.

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

Staff supported patients to make decisions about their care and treatment and their future, including patients who were considering decisions around gender transition.

Staff created personalised care plans to account for the patient’s needs, wishes and feelings. Staff held weekly one to one sessions with patients and attempts were made to co-produce care plans with patients. Staff offered all patients a copy of their care plans although some patients did not want this.

Staff ensured that all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs. This involved liaison with case managers, social workers, care coordinators, families and local community mental health services. Professionals could attend patient meetings via teams if they were unable to attend in person.