Cygnet Hospital Colchester

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• 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 had remained good. This meant patient’s needs were met through good organisation and delivery. Staff managed beds well. A bed was available when a patient needed one. Patients were not moved between wards except for their benefit. Patients did not have to stay in hospital when they were well enough to leave. The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service, such as work, education and family relationships. The service met the needs of all patients – including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

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 scored the service as 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff regularly met with patients to understand their views on care and treatment. These discussions took place in one-to-one meetings with nurses and in multidisciplinary team meetings. Staff monitored patients’ conditions and discussed any changes at handover meetings.

The service provided therapeutic and recreational activities. A timetable of therapeutic activities was shared with patients, this included shopping, cooking, music, arts, life skills, community access, cycling and cognitive games. Patients also had access to Sports for Confidence, and the service had a partnership with a local health club. Patients told us there were plenty of activities available, and they enjoyed the gym, however patients said activities were not always catered to their interests and they found some of them boring.

Patients had access to psychology input either in groups or 1-1 sessions, including Psychoeducation this was intended to foster a patient’s knowledge and understanding in a range of key subjects such as diagnostic issues, role of medication, emotional regulation and physical health issues.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff supported patients to maintain contact with their families and carers. All patients we spoke to told us they were supported to maintain contact with the people who were important to them. Staff told us they were able to support visits from children in an area away from the ward environment.

Staff supported patients to maintain contact with people in their local area. Staff ensured family members and care co-ordinators were invited to multidisciplinary team meetings. The service facilitated attendance by video link, if people were unable to attend the hospital in person.

Staff provided access to spiritual support with visiting Christian and Muslim religious leaders, and access to spiritual support for other faiths was available when required.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made sure patients could access information on treatment and local services. Staff explained that information was provided for patients if it was needed. Staff displayed information about safeguarding, infection control, the Mental Health Act and the independent mental health advocacy service.

Staff had access to equipment and information technology needed to do their work, the nurse’s station had enough room and access to computers for staff to be able to sit and do their work.

Leaders had access to information to support them with their role. This included information on the performance of the service, staffing and patient’s care. This information was presented and discussed in clinical governance meetings.

Staff made notifications to external bodies as needed. The service submitted notifications to the Care Quality Commission in accordance with requirements. The service submitted safeguarding referrals to the local authority.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

During the last year there had been 6 complaints for Ramsey Unit - 3 had been withdrawn, 2 had been partially upheld and 1 not upheld. Patients, relatives and carers knew how to complain or raise concerns. Patients said if they had any complaints, they would speak to staff or the ward manager in the first instance. There was information on the wards about how to make a complaint and how to access advocacy. Patients told us they knew how to access an independent advocate.

Staff understood the policy on complaints and knew how to handle them. Staff knew how to acknowledge complaints and tried to swiftly resolve complaints informally with patients.

We viewed the compliments log for the hospital and saw a high number of compliments recorded from patients, family members and external stakeholders praising staff and the care and treatment at the hospital.

Staff facilitated community meetings and a monthly people’s council to enable patient to discuss complaints and concerns. All managers, staff and patients were invited to attend the people’s council, and everyone had an equal opportunity to raise concerns and suggest improvements for the hospital as well as provide positive feedback. These meetings were jointly led by a patient and a staff member. Following the meeting an action log was completed with a lead person and date for completion identified.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

The service ensured patients could access care, treatment, and support tailored to their individual needs. Through effective assessment processes, staff identified and removed barriers to care, particularly for individuals with complex needs or protected characteristics under the Equality Act 2010.

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

The service had clear criteria for accepting patients on to the wards and did not accept anyone whose physical health needs could not be met. The service had arrangements for people requiring disabled access.

Staff planned patients discharge from the wards and had effective liaison with care co-ordinators. Staff supported patients during transfers between services. Staff ensured patients had access to post-discharge care, including section 117 aftercare, community mental health services and crisis services.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff within the service promoted a culture in which patients using the service felt empowered to give their views.

The service admitted patients from diverse religious and cultural backgrounds. Staff asked patients about their religious and cultural needs when they were admitted to the ward. The service provided culturally appropriate food. The service employed staff from diverse backgrounds. This meant the service was able to utilise the ability of staff to speak to patients in their first language whenever this was possible.

Staff shared adjustments that had been made to accommodate patients with diverse needs. Information was also made available in various formats and languages upon request to ensure accessibility.

The service had clear policies aligned with equality, diversity, and inclusion principles to prevent disadvantage and promote fairness for all, including those with protected characteristics. The service had signed up to the Patient and Carer Race Equality Framework (PCREF). PCREF is a national framework, launched by NHS England, designed to tackle racial disparities in mental health care and improve outcomes for diverse communities.

At the time of inspection 97.4% of staff had completed mandatory training in diversity and inclusion.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of patients with complex needs. The multi-disciplinary teams within the service were made up of consultant psychiatrists, specialty doctors, nurses, healthcare support workers, psychologists, occupational therapists and other support staff.

The multidisciplinary team planned for each patient’s discharge and return to their local area. Staff ensured that appropriate arrangements were in place to sustain the patient’s mental health. This included liaising with other professionals in the patient’s local area to ensure they had appropriate accommodation to be discharged to and that a package of care was provided by the local mental health services.