Cygnet Hospital Colchester

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

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

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

Staff felt respected, supported and valued. They said the service promoted equality and diversity in daily work and provided opportunities for development and career progression. They could raise any concerns without fear.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture that was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding and meeting the needs of people and our communities.

Staff were aware of the provider values of ‘Care, Respect, Empower, Trust, and Integrity’ and demonstrated these values in their day-to-day work.

The provider’s senior leadership team had successfully communicated the provider’s vision and values to the frontline staff in this service.

Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing, through regular team meetings and the People’s Council. All staff we spoke with felt well supported by senior leaders who were visible and approachable. Staff had the opportunity to step up into management roles when the need arose.

We scored the service as 3. The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. They had the skills, knowledge, experience and credibility to lead effectively and did so with integrity, openness and honesty.

Leaders were visible in the service and approachable for patients and staff. We spoke with 9 members of staff. All the staff we spoke with said the senior leaders were approachable and engaged well with staff and patients.

Leaders had a good understanding of the services they managed. They could explain clearly how the teams were working to provide high quality care.

We scored the service as 3. The evidence showed a good standard. The service created a positive culture where people felt that they could speak up and that their voice would be heard.

Patients and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. The service listened to patients in the community meetings and Peoples Council, and changes were either made or concerns openly discussed.

The provider had a freedom to speak up team, which provided support around raising concerns and whistleblowing. All staff we spoke with told us they felt confident in speaking up and in raising concerns or making suggestions for improvements.

Managers and staff had access to the feedback from patients, carers and staff and used it to make improvements. This included conducting staff, patient and carer surveys.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

Cygnet had a multicultural network with the aims of improving the workplace for colleagues, empower and support staff from an ethnic background and to ensure that Cygnet meets its statutory obligations.

Locally, workforce diversity was celebrated with cultural days and staff we spoke with told us they felt very well supported. The team was diverse with staff employed with various protected characteristics including being from an international background.

Staff did not raise any concerns about discrimination and all the staff we spoke with said they were treated fairly and had good opportunities for personal and professional development.

We scored the service as 3. The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance to manage and deliver good quality, sustainable care, treatment and support. The service act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

Our findings from the other key questions demonstrated that governance processes operated effectively at team level and that performance and risk were managed well. Governance arrangements were proactively reviewed and reflected best practice.

Clinical governance meetings were held regularly. The agenda was comprehensive, areas of concern were identified, and actions were taken to learn and improve. The meeting was chaired by the hospital manager and covered standard agenda items including actions from previous meetings, lessons learnt and risk levels of each ward including themes, improvements or deteriorations.

Staff had implemented recommendations from reviews of incidents, complaints and safeguarding alerts. For example, we could see that changes in practice were made after a shortage in medication was identified when a patient was going on extended leave.

Staff undertook or participated in clinical audits. For example, managers conducted a monthly medication record audit.

Staff maintained and had access to the risk register. The risk register for the hospital included 13 open risks. These included the risk of contraband items in patients’ property, physical security risks and ligature points. The risk register included a score for the consequence of each risk; the likelihood and actions being taken to address the risk and timescales for completing those actions.

The service had contingency plans for emergencies – for example, an outbreak of fire or a missing person.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure, including the telephone system worked and helped to improve the quality of care.

Managers had access to information to support them with their role. This included information on the performance of the service, staffing and patient care.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborate for improvement.

The service had developed a very good relationship with an NHS trust that commissioned the beds at the service.

Patients and staff could meet with members of the provider’s senior leadership team and commissioners to give and receive feedback.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

The service had a positive and robust approach to improvement and learning from incidents and we saw examples of where lessons had been learnt, and changes made after incidents.

Innovations were taking place in the service. They were working to increase standards to obtain the accreditation for Quality Network for Working Age inpatient services.

Staff on the ward had joined a peer support group where visits to other mental health providers provided opportunities for learning and making improvements to their own service.

The service participated in preceptorship schemes and the ward manager had supported 3 nurses through this process.