Cygnet Hospital Beckton

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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 requires improvement. At this assessment the rating has improved to good. The service had made tangible improvements in its governance systems and was no longer in breach of regulations.

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

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.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The provider’s values were visible throughout the hospital and were part of mandatory training, which staff on both wards had completed. Staff supervision and appraisal records were linked to the values. Staff said they were proud to work for the provider and told us about applying its values in their work. They were confident that equity, diversity and inclusion were embedded in day-to-day practice through coproduction, culturally sensitive care, and recognition of patients' individual needs and preferences.

Patients had a voice in decision-making. Patients were involved in community and people’s council meetings, and participated in staff recruitment and training. Patients could access training, volunteering and employment.

Staff had opportunities to contribute to discussions about the service. In addition to staff meetings, the service organised awaydays where staff discussed teamwork, culture and future service improvements.

Staff could provide feedback through annual surveys. Most recent surveys on both wards were conducted in 2026, and their results were generally consistent with the feedback we heard from staff. For example, some respondents reported dissatisfaction with their workload and staffing levels. Most respondents were positive about their team and the provider, managerial support, and both their own and the service’s commitment to quality patient care.

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. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Since our last inspection, the service had appointed new leaders. The new managers had the skills, knowledge and competence to perform their roles, and a good understanding of the service they managed. Leaders demonstrated commitment to improving the areas of concern identified in our previous inspection and were aware where there was still more work to do. We saw tangible improvements in the governance systems at this inspection.

Staff we spoke with reported confidence in the local leadership. They described the managers as visible, approachable, supportive and responsive.

Training and development opportunities were available for staff. For example, we heard about some support workers training to become nurses. Several managers we met had progressed to their current roles after working for the provider since qualifying.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff we spoke with described a positive and open culture and said they were comfortable to raise concerns with managers if needed. Freedom to Speak Up (FTSU) information was clearly displayed, and each ward had a FTSU champion. Staff knew about the FTSU and whistleblowing arrangements.

Patients could raise concerns at weekly community meetings. ‘You said, we did’ feedback was displayed on the ward information boards. Patient representatives were involved in decision-making about the service. The service regularly collected feedback from carers through surveys.

Managers monitored feedback and complaints received. Staff discussed learning and themes identified from these.

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.

All staff had completed training in equity, diversity and promoting human rights. Staff we spoke with were confident that the service was open and inclusive for diverse groups of people, with equal opportunities for training and development available. For example, some staff shared how colleagues were supportive of their religious needs. Staff did not report any concerns about discrimination.

Staff were able to apply to work flexibly to account for personal circumstances, such as caring responsibilities or studies. Managers put reasonable adjustments in place for staff if needed.

The staff survey monitored if staff felt that they were treated equally and fairly irrespective of protected characteristics. The provider promoted inclusion networks that staff could join.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The service now had robust governance systems in place that supported safe and effective care delivery. There was now improved assurance that physical health monitoring and medicines administration were carried out in line with the provider’s expectations and national guidance. Leaders monitored audit outcomes so they were acted on. Staff said that oversight had improved and leaders proactively followed up any actions. Leaders now closely monitored staff compliance with training, supervision and employment checks. They had put effective mechanisms in place and took timely action when any non-compliance was identified.

There was a clear framework of what must be discussed in meetings at a ward, hospital and provider level to ensure that essential information was shared. Staff had implemented recommendations from reviews of incidents and complaints. We saw evidence of changes made as a result of learning.

The risk register detailed an appropriate range of risks specific to the hospital and was regularly reviewed. A business continuity plan was in place to ensure service delivery could continue in the event of emergency, such as adverse weather or staffing shortages.

Information systems had improved since our last inspection. The electronic patient record system now enabled more efficient record keeping and integration with audits. The hospital had just launched a new electronic prescribing and medicines administration (ePMA) system, reducing reliance on paper records. The service was developing its electronic safeguarding dashboard to streamline reporting through integration with the incident reporting system. Over 97% of staff across both wards had completed training in information governance.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for patients. They shared information and learning with partners and collaborated for improvement.

The service worked with external stakeholders including primary and secondary care, community teams, commissioners and local authorities. Staff involved key system partners when providing complex care.

Staff had developed links with other organisations in supporting people who faced additional barriers or inequalities. These included local carer support groups and Sports for Confidence, a community-based service aimed at improving access to physical activity for underserved groups. Staff worked with a local hospital to provide women’s health and sexual health screenings.

We received feedback from stakeholders who regularly worked with the service. They described a positive experience of working with the service as a partner agency.

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 patients. They actively contributed to safe, effective practice and research.

Innovation and quality improvement (QI) activities were taking place within the service. Staff held weekly practice QI meetings where they discussed ideas for improving practice. Recent and ongoing QI projects included staff retention, weight management for patients, and recycling initiatives on the wards.

Staff told us about innovative practice. For example, staff on Upping Ward told us about introducing safety cutlery which would not cause harm if ingested by a patient. Staff also recently introduced credit-card sized crisis plan cards for every patient on the ward which they carried on their lanyards. We heard how this enabled staff to respond quicker and offer personalised support without having to consult electronic or paper records.

The service was accredited through the Enabling Environments framework, a Royal College of Psychiatrists’ initiative focused on improving the quality of relationships and culture within services. The whole hospital had achieved accreditation with Triangle of Care, a quality improvement scheme aimed at improving support for carers.