Cygnet Hospital Harrogate

On this page

• 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 inspection we rated this key question good.

At this inspection the rating has remained good.

The service demonstrated strong and effective leadership, with senior leaders successfully embedding the organisation’s values of care, respect, trust, empowerment and integrity into everyday practice. Staff described a positive, open and non-hierarchical culture where they felt supported, listened to and able to raise concerns, with leaders visible and actively involved in ward life. Robust governance, auditing, risk management and information governance processes were in place, enabling the service to monitor performance, learn from incidents and drive continuous improvement. Patients, carers and staff were actively encouraged to provide feedback, which was used to make meaningful service improvements, while equality, diversity and staff development were strongly promoted. The service also demonstrated a commitment to innovation and quality improvement, receiving external recognition for its standards and implementing environmental changes to create a more inclusive and therapeutic setting for patients.

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. 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 senior leadership team had successfully communicated the provider’s vision and values to the frontline staff, at Cygnet Hospital Harrogate, and staff had a good understanding of these. The values were care, respect, trust, empowerment and integrity and were incorporated into the day-to-day work of the team.

We reviewed the induction information for newly appointed staff, which was a comprehensive document. It referred to understanding the patient within the clinical environment and translating that understanding into high-quality care (relational security). This was given high importance and with the intention that, by increasing this, the need for restrictive interventions could be reduced.

The team took steps to minimise the risk of a closed culture developing to create a safe environment which was free from neglect and abuse. They did this by fostering an open and transparent environment where incidents and safeguarding concerns were reported, CCTV was reviewed and monitored, and lessons learned from these were shared, with all staff, to enable improvements to be made.

Staff had the opportunity to contribute to discussions about the strategy for their service and could raise it in meetings, or in supervision sessions.

We scored the service as 4. The evidence showed an exceptional standard. The service had exceptionally 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 always did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles and had a good understanding of the services they managed. They could explain how the teams were working to provide high-quality care.

Leadership development opportunities were available, including opportunities for staff, such as ward manager development training and apprenticeship training both at level 3 and level 5.

Ward managers were highly praised by external partners regarding their management of the wards, and during our discussions with them, it was evident they knew their patients and their needs well. Staff commented that they felt like they were working within a positive culture. Members of the MDT team described feeling listened to and able to contribute without fear and felt respected.

Staff told us the leadership was non-hierarchical and that they worked together and supported each one another. Senior staff would support colleagues and patients when acuity was high, which was deemed to be part of the normal culture. This was observed whilst we were on site.

Staff were complementary about the hospital manager, stating they were a visible presence on the wards each day and that the ward managers were present and supportive.

Patients and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. The most recent service user satisfaction survey received 34 responses out of the 40 people who were offered them.

Managers and staff had access to feedback from patients, which could be given during their one-to-one time with their named nurse and through the complaints process. It was evident from this that staff used that information to make improvements to the service. For example, a patient needed clarification around diagnosis and treatment. A clear and documented procedure for admission and current diagnosis was then implemented into the first MDT meeting for patients entering the service.

The hospital had a whistleblowing policy in place. In the most recent staff survey, 83% of those who responded felt like they would be listened to if they raised concerns, while 97% were aware of the organisation’s freedom to speak up guardian.

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 worked for them.

The hospital had dedicated multicultural and LGBTQ+ leads in place whose role it was to ensure equality and diversity was championed within the service. They were aware of patients’ backgrounds and ensured this information was included in the admissions process and care plans.

Managers put reasonable adjustments in place for staff members to help them carry out their role. Staff were offered flexible working hours where needed, for example, if travelling some distance to the hospital.

Staff were offered continuous professional development opportunities, including time away from work to study, where required.

We scored the service as 3. The evidence showed a good standard. 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.

Staff had access to the equipment and information technology needed to carry out their roles.

The hospital managers had access to information which supported them in their management positions, including how the service and staff were performing and information on patients’ care.

Clinical audits took place to ensure compliance with policies and procedures. Audits took place quarterly for infection control, Mental Capacity Act and the Mental Health Act compliance. Observation, engagement and CCTV audits were monthly. These audits were effective in identifying any issues which were then actioned, accordingly. We observed ward rounds and morning meetings where regular agenda items were discussed, and a clear framework structure was followed to ensure that essential information, such as learning from incidents and complaints, was shared and discussed.

The service had a business continuity plan in place for emergencies. Risk issues and performance were monitored on a regular basis. Hospital managers maintained and had access to the risk register. We reviewed the register which included 7 current risks, these were updated when new risks were identified. Staff told us that risks were well managed and that they could identify these within the environment, which corresponded with those noted on the risk register. Staff at ward level knew how to escalate concerns and to whom.

The hospital had a robust information governance system in place which included maintaining the confidentiality of patient records. This was included in the hospital's risk assessment.

The hospital manager had the autonomy to close the wards to further admissions if continuing to admit patients would compromise the safety of patients or staff.

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 collaborated for improvement.

The hospital had good working partnerships with external providers such as safeguarding teams and advocacy services. Outside agencies who visited the hospital commented that there was a collaborative approach within the team and with the patients and there was no hierarchy.

Patients and staff were given the opportunity to meet with members of the provider’s senior leadership team and commissioners to give feedback if they wished.

Stakeholders commented that the hospital manager seemed approachable and open to discussion. A recent meeting was held to discuss difficulties with the advocacy provision considering the increase in referrals and ensuring there was a distinction between the IMHA role and that of the provider’s advocacy service.

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 contributed to safe, effective practice and research.

The medical lead for the hospital was awarded Cygnet Consultant of the year in 2024. The service was awarded a 3Q rating with NHS Wales in January 2026. This rating refers to the three core quality dimensions - Safe, Timely, and Effective - within the Health and Care Quality Standards.

Cygnet Hospital Harrogate staff were also working towards the Quality Network for Working-age inpatient wards (QNWA) accreditation. They had collated all the information required and were waiting for this to be heard at a panel in September 2026.

Innovations have taken place in the service. The hospital had undertaken a quality improvement project, following feedback from patients that the MDT sensory, physical and social environment on Haven ward was intimidating.

The OT service led an audit, alongside the clinical manager, to evaluate the environment in line with neurodiversity affirming principles, to support patients to feel more comfortable, supported and included, whilst recognising their unique strengths and experiences. Changes included painting in more neutral tones, with furniture to match, installing relaxing nature themed pictures, use of non-scented cleaning products and introducing a sensory box with fidget tools.

Information in different formats for those with learning disabilities was produced (with support from the Speech and Language Therapy service). The service had a plan to install a silent alarm system later in the year as the final stage, to complete the project.