Cygnet Hospital Beckton

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that patients’ care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

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

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We have not awarded this service a score for Effective.

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

The service made sure patients’ care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The service had strengthened its processes to complete comprehensive mental and physical health assessments. Staff completed a comprehensive assessment of each patient in a timely manner at, or soon after, admission. Staff made sure patients had access to physical healthcare, including access to specialists as required.

Patients had their physical health assessed soon after admission and regularly reviewed during their time on the ward. Staff supported patients with their physical health needs and worked collaboratively with specialists when needed. If a patient refused to engage with physical health assessments this was clearly recorded and regularly revisited.

On-going monitoring of health conditions and healthcare investigations was in place. These included regular monitoring of blood samples, heart rate, urine tests, weight monitoring and electrocardiogram (ECG).

Staff developed care plans that met patients’ needs identified during assessment. We reviewed 8 care records. We found that care plans were personalised, holistic, recovery oriented, and reflected the patient's assessed needs. Staff regularly reviewed and updated care plans. We spoke with 3 patients, all told us they were involved in their care planning.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

Staff provided a range of care and treatment suitable for patients in the service and were delivered in line with, guidance from the National Institute for Health and Care Excellence. Patients had access to medication, psychological therapies, and activities, these included psychology sessions, music sessions, games, recovery college, social hub, pampering, and arts and crafts. Patients we spoke with were positive about the choices available. All spoke highly of music sessions but felt there was a lack of varied activities over the weekend.

Staff participated in clinical audits, benchmarking, and quality improvement initiatives. Managers used audit results to make improvements by implementing and monitoring action plans. Following a CCTV review of staff searches of patients on return to the hospital, it identified that some staff required refresher training, which had subsequently been delivered.

The team included a full range of specialists required to meet the needs of patients in the service. This included nursing staff, ward doctors, consultant psychiatrist, psychologists, occupational therapists, and social workers. Staff on the Acute and PICU Wards received additional specialist training in crisis management which included enhance PMVA training.

Managers provided a complete induction to new members of staff. They also supported staff with regular supervision. Staff told us, they used supervision to discuss current patients, to reflect and learn from practice, to review incidents and for personal support.

The percentage of staff that received regular clinical supervision was 96% for Svanna Ward and 93% Hooper Ward, and for managerial supervision 96% for Svanna Ward and 89% Hooper Ward. At our inspection in December 2024, bank staff who worked across all wards at the hospital, did not receive appropriate supervision. At this inspection we found improvements, supervision compliance was at 90% for bank staff.

Managers supported staff with regular appraisal of their work performance. The percentage of staff that received regular appraisal was 92.3% for Svanna Ward and 90% for Hooper Ward

Managers made sure staff had access to attend regular team meetings. Where staff could not attend, team meeting minutes were available.

Managers dealt with poor staff performance promptly and effectively.

The service worked well across teams and services to support patients. They shared their assessment of patients’ needs when they moved between different services.

Staff held regular multidisciplinary meetings to discuss patients care. The multidisciplinary team and staff worked together to understand and meet patient’s needs. Patients were invited to discuss their care and treatment. Family, carers, and professionals could join the meeting either face to face or through the hospital’s IT system, to support patient discharge planning.

Staff shared information about patients and any changes to their care. The hospital had daily safety huddle meetings each morning, with managers and wider clinical team in attendance, where staffing, referrals, admissions, incidents, planned discharges, and any other relevant matters where discussed. Each shift held a handover where incidents, patient care and risk were discussed.

Staff worked effectively together with other health and social professionals to deliver effective care and treatment. When required, staff referred patients to external agencies, including GP, dentist, and local authority social services.

Care co-ordinators regularly attended ward round meetings. Staff reported they had good relationships with commissioners, and local authority social services.

The service supported patients to manage their health and wellbeing to maximise their independence, choice and control. The service supported patients to live healthier lives and where possible, reduce their future needs for care and support.

The occupational therapy team offered activities targeted toward patient’s wellbeing for example, smoking cessation, fitness groups, gym, table tennis, basketball, and healthy snack preparation, with mindfulness facilitated by the psychology team. 

Sports for Confidence (an initiative to widen access to physical activity) offered sessions such as swimming, aqua aerobics, and walking at a local sport centre. Therapy animals visited the hospital to promote mental wellbeing.

The service routinely monitored patients’ care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of patients themselves.

Staff used recognised rating scales to assess and record the severity of patients’ conditions and care and treatment outcomes. These included ‘Health of the Nation Outcome Scales’ (HoNOS), the Glasgow Antipsychotic Side-effect Scale (GASS) and the National Early Warning Score 2 (NEWS2). We observed a ward round where staff reviewed and discussed a patient’s GASS score with them, alongside their medication and any associated side effects. Staff used the findings to inform care and treatment decisions, support continuous improvement, and promote positive outcomes for patients.

Staff supported patients with physical health monitoring by ensuring timely access to results, including blood tests and electrocardiograms (ECGs), enabling appropriate follow-up and treatment where required.

The service told patients about their rights around consent and respected these when delivering person-centred care and treatment.

Staff gave patients every support to make specific decisions for themselves before deciding a patient lacked the mental capacity to do so. Staff assessed and recorded capacity to consent appropriately. They did this each time a patient needed to make an important decision. We saw evidence that staff documented patients capacity to consent to care and treatment on admission and appropriate intervals.

Staff we spoke with could give examples of assessing capacity on a decision-specific basis, such as relationships and friendship. Where a patient was assessed as not having capacity, staff described how decisions would be made in the patient’s best interest, taking into account their wishes, feelings, culture, values, and personal history.