Cygnet Hospital Stevenage

Updated 14 September 2021

Cygnet Hospital Stevenage is part of the Cygnet Health Care group which was founded in 1988 and offers a range of services for individuals with mental health needs and learning disabilities within the UK. Cygnet Hospital Stevenage opened in May 2006 and consists of six wards:

• Orchid Ward – Women’s Acute Inpatient ward with 14 beds
• Chamberlain Ward – Specialist PICU Service for Men with 12 beds
• Pattison Ward – Specialist PICU Service for Men with 12 beds
• Peplau Ward – Men’s Medium Secure ward with 14 beds
• Saunders Ward – Men’s Low Secure Mental Health ward with 15 beds
• Tiffany Ward – Women’s Low Secure Mental Health ward with15 beds

At the time of inspection 78 patients were receiving care and treatment. At the time of inspection, there was a registered manager and a nominated individual in post.

Cygnet Hospital Stevenage is registered to carry out the following regulated activities:

• Treatment of disease, disorder or injury.

• Assessment or medical treatment for persons detained under the Mental Health Act 1983.

We last inspected this service in January 2020. We did not rate this inspection. The inspection carried out in January 2020 was a focused, unannounced inspection to follow up on specific concerns we had relating to the safe domain.

The last comprehensive inspection of Cygnet Hospital Stevenage took place 08 to 10 January 2018. The provider received an overall rating of Requires Improvement with rating for each of the five key domains as follows:

• Safe: Requires Improvement

• Effective: Good

• Caring: Good

• Responsive: Good

• Well Led: Requires Improvement

Following the January 2020 inspection, we served a Notice of Decision due to immediate concerns we had about the safety of patients. We issued enforcement actions in relation to:

Regulation 12- Safe Care and Treatment – (Notifications to the CQC, risk assessments, observation records and management)

Regulation 17 – Good governance – (medication errors)

Following the Notice of Decision in January 2020, we met with the provider weekly and all conditions relating to the Notice of Decision were removed in March 2020. During the current inspection we found that the provider had maintained all improvements following our focussed inspection in January 2020.

What people who use the service say

We spoke briefly with five patients during our inspection. Four patients were positive about Cygnet Hospital Stevenage and said that the staff were very good, and they felt supported. Patients said they felt safe. One patient said they had not been able to go to the gym due to short staffing.

Updated 14 September 2021

Our rating of this location improved. We rated it as good because:

• The service provided safe care. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• Observation records were completed fully, and included thorough reviews.
• Staff had completed and kept up-to-date with their mandatory training. The mandatory training programme was comprehensive and met the needs of patients and staff.
• Staff engaged in clinical audit to evaluate the quality of care they provided.
• Managers ensured that staff received training, supervision and appraisal.
• The service was well led, and the governance processes ensured that ward procedures ran smoothly.

However:

• Some areas of the hospital were visibly unclean. The processes in place to monitor cleaning schedules were not robust enough to ensure that all patient areas had been fully cleaned.
• The hospital had vacancies for support staff and could not always find bank and agency staff to cover shifts. The provider had put in place steps to mitigate the risk to staff and patients.

Updated 14 September 2021

Our rating of this service improved. We rated it as good because:

• The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• Staff completed thorough risk assessments of ward areas and individualised risk assessments with patients and updated these regularly and/ or when risk presentation changed.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the ward. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team.
• Managers celebrated staff successes and had developed strategies to boost team morale.
• The provider had worked hard to reduce vacancy rates.

However;

• Extra Care Area suite 1, which was in use by a patient from forensic inpatient or secure wards was not clean.

Updated 14 September 2021

Our rating of this service improved. We rated it as good because:

• Staff completed thorough risk assessments of ward areas and individualised risk assessments with patients and updated these regularly and / or when risk presentation changed.
• Covid-19 cleaning records were thorough, and all clinic rooms were visibly clean with cleaning schedules in place.
• Managers celebrated staff successes and had developed strategies to boost team morale.
• The provider had worked hard to reduce vacancy rates.

However:

• The decommissioned de-escalation room on Pattison ward was damaged and unclean. However, this was not being used at the time of inspection. Following the inspection, the provider told us they had no intention to reuse the room as a de-escalation room. In addition, extra care area 2 had been used by two patients without it being fully cleaned in-between uses.
• Some staff members said they felt the wards were short staffed.