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Cygnet Hospital Colchester Good

Inspection Summary


Overall summary & rating

Good

Updated 9 September 2021

Cygnet Hospital Colchester was placed into special measures by the CQC Chief Inspector of Hospitals in May 2019. This followed findings of significant concerns about the safety and leadership of the service. Since then the CQC has continued to monitor the service closely and has found some improvement. We have judged that enough improvement has been made to remove the provider from special measures.

Our rating of this location improved. We rated it as good because:

The service provided safe care. The ward environments were safe and clean. During this inspection, we found the provider had made improvements since our inspections in 2019 and 2020. Staff were now following the provider’s infection prevention control policy and disposed of clinical waste appropriately and managers had ensured processes of monitoring and learning from restraint incidents had improved. Managers held de-briefs with staff to ensure learning had been identified after incidents of restraint. Managers also ensured improvements had been made to ligature risk assessments which were comprehensive with timeframes for actions to be completed and staff ensured alarms were regularly checked, there were enough of them and they were repaired if necessary.

The wards had enough nurses and doctors. Staff assessed and managed risk well. Patients were involved in managing their own risks whenever possible. Improvements were made since our inspection in 2019 where staff now completed daily risk assessments of patients and risk assessments of patients prior to going out of the hospital. Patients, where possible, were involved in developing their positive behavioural support plans.

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. Staff met patients’ physical and sensory needs. Staff minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.

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. This had improved following our inspection in 2019 where staff did not receive regular supervision for their work. 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 discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.

Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. Patients had their communication needs met and information was shared in a way that could be understood. Staff involved patients and families and carers in care decisions.

The service managed beds well. At the time of the inspection beds were available. Although there were some delays to patients being discharged, staff worked actively with commissioners and allocated staff to improve timeliness of discharges. Advocates would assist patients with their discharge, where necessary.

Staff supported patients through recognised models of care and treatment for people with a learning disability or autistic people. Patients were supported to be independent and had control over their own lives. Their human rights were upheld, and they made choices and took part in activities which were part of their planned care and support. Staff supported them to achieve their goals and ensured their care, treatment and support plans, reflected their sensory, cognitive and functioning needs. Care focused on people’s quality of life and followed best practice.

The service was well led, leadership was good, and governance processes helped the service to keep people safe, protect their human rights and provide good care, support and treatment. The provider had made significant changes to their senior management team and had ensured staff were now in roles to enhance improvements to systems and processes at the service. Managers had made improvements to their processes in ensuring duty of candour was followed.

We found that the provider had made improvements to their recruitment, selection and appointment of staff policy. Since our last inspection in 2020, staff files were now in line with the provider’s policy when recruiting, selecting and appointing all new staff.

Staff said the changes in leadership and management were positive and had improved their experience of working at the service. Staff were keen to talk to us about the improvements they had made to the service and were passionate and enthusiastic in demonstrating this.

However:

Although some work had been completed on diversity and ethnicity at a local level, the provider had further work to do in ensuring their action plan for the Workforce Race Equality Standard was fully embedded.

Although infection prevention control guidelines were followed and the service was clean, staff on Highwoods ward, had not always recorded that they had cleaned high touch areas every three hours in line with the provider’s Covid-19 Healthcare Cleaning Manual and Schedule policy.

Staff on Oak and Larch Court did not always clearly document in people’s records when their next yearly physical health checks were due to ensure that appointments were not missed or delayed. The provider acknowledged this during our inspection had had plans to make immediate improvements.

Inspection areas

Safe

Good

Updated 9 September 2021

Effective

Good

Updated 9 September 2021

Caring

Good

Updated 9 September 2021

Responsive

Good

Updated 9 September 2021

Well-led

Good

Updated 9 September 2021

Checks on specific services

Wards for people with a learning disability or autism

Good

Updated 9 September 2021

Our rating of this service improved. We rated it as good because:

  • Please see overall summary.

Long stay or rehabilitation mental health wards for working age adults

Good

Updated 9 September 2021

Our rating of this service improved. We rated it as good because:

  • Please see overall summary.

Acute wards for adults of working age and psychiatric intensive care units

Good

Updated 9 September 2021

Our rating of this service improved. We rated it as good because:

  • Please see overall summary.