Cygnet Hospital Wyke

On this page

• 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 has remained good. This meant people’s needs were met through good organisation and delivery.

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.

The service recognised the importance of delivering care in a person-centred way. The care plans we reviewed showed evidence of patient involvement by reflecting individual needs and preferences. Staff we spoke with could also describe how care plans were adapted to reflect patients' individual cultural and social needs.

Patients we spoke with were mostly positive about their involvement in decision-making. We heard from patients about how staff took time to explain decisions to them and how they were supported to be involved in their ward round. Carers we spoke with also told us how they felt staff at the service carefully considered patients preferences and worked to involve patients in decision-making where possible, particularly surrounding the use of medicines. Staff told us that they could access advice from a speech and language therapist where necessary to ensure that patients communication needs were met. This helped to support patient involvement in care planning and decision-making.

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 ensured that patients had access to opportunities which supported their recovery. Staff told us how occupational therapy support focused on developing different skills to support life in the community after discharge. For example, they told us how they had learned from speaking with patients that communication and social interactions were the biggest challenges patients had faced when trying to maintain employment. They had therefore developed a focus on this within group work by working on skills such as active listening and turn-taking in conversation. We also heard about occupational therapy group sessions that supported other life skills such as managing change and assertiveness.

Patients were supported to access the community wherever possible. Staff told us how they worked creatively to support patients on Bennu ward to access leave from the service through a walking group facilitated by occupational therapy staff. Staff told us how they felt proud that they were able to support patients admitted to a PICU to access time away from the ward and spoke about how they felt supported by the service in facilitating this.

Patients were also supported to access their chosen place of worship within the community where this was possible. Staff told us that when patients could not access leave to attend places of worship, they supported them in other ways to ensure their religious needs were met. For example, the service had a multi-faith room containing a variety of resources for different faiths.

Staff supported patients to maintain contact with their families and carers. Patients told us how they had been visited by family members at the service, and how staff had supported them to maintain contact with them between these visits. One patient told us about how they had difficulty using a phone to contact their family and said that staff provided them with support to enable this.

Patients’ preferences in relation to family and carer involvement were also respected, such as when a patient did not want someone from their family to be involved in their care. Staff we spoke with also told us how they would support patient privacy during visits. Visits could take place in an available room on the ward or off the ward.

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 notifications to external bodies as needed. They responded promptly and openly when follow up information was required.

Information for patients relating to local services, patients’ rights, and how to complain to the provider and other regulatory bodies were displayed prominently around both wards. The format in which this was provided appeared accessible to the patient group.

Staff we spoke with were aware of the importance of ensuring that patients communication needs were met when providing them with information.

The carers we spoke with told us that communication from the service was mostly "very good". Carers told us how they found the communication from staff reassuring and responsive. They told us how staff would proactively contact them to update them on how their relative was doing, and that they felt included in their relative's care.

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.

Patients we spoke with knew how to complain or raise concerns and told us they would feel comfortable doing so. Carers we spoke with told us that they were not aware of a specific process for making a complaint. However, they told us they would feel comfortable raising concerns with staff if required.

Patients could share feedback through a variety of forums, including regular community meetings held on each ward. Most feedback was addressed quickly.

The service had a complaints process and held a log of formal and informal complaints. The log supported staff to ensure complaints were responded to in a timely manner, and to identify any themes or trends in the complaints submitted. The log contained 7 formal complaints submitted in the 6 months prior to our inspection. One of these had been withdrawn, three had not been upheld upon investigation, two were still undergoing review, and one had been partially upheld. The service had also received 6 informal complaints in the 6 months prior to our inspection, all of which had been resolved with patients satisfied with the outcomes.

We saw evidence that action was taken promptly in response to both formal and informal complaints. During our inspection, we observed a member of the leadership team on their way to discuss a complaint with a patient that they had submitted earlier that day.

Patients were also able to share positive feedback with the service, and this was encouraged. During our inspection, we observed a patient sharing positive feedback with staff during an informal conversation about their care and plans for the future. The staff member offered the patient a formal complement form and encouraged them to document their feedback so that they could share it with other staff in the team.

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.

There was adequate medical cover day and night, and a doctor could attend the ward quickly in an emergency.

Staff made sure that patients could still access routine physical healthcare, and a regular dental clinic was held on site so that patients who could not leave the hospital were able to access dental care.

The service worked to ensure that patients with complex physical health or mobility needs received appropriate care and support. Staff we spoke with told us that these needs were considered as part of reviewing every referral and where they could not be supported, they would not admit the patient to the service. For example, the service did not have equipment in place to support service users with more significant mobility needs such as a hoist or adapted bath. Staff told us that if this equipment was required to safely support a patient, they would not be able to accept the referral. We saw evidence in referral documentation that mobility and physical health needs were considered as part of reviewing referrals and that some referrals were rejected on this basis.

Staff told us that where a physical health or mobility need developed whilst a patient was already admitted to the ward, they sought specialist input and made adjustments where possible. They shared an example of a patient who had developed difficulties with their balance whilst admitted to the ward. A review of their physical health had been conducted at the local hospital once these needs were identified, and an appropriate falls risk assessment and care plan had been put in place. The service had adjusted staffing accordingly and had been able to continue to support them on the ward. Staff told us that where adjustments like these were not sufficient to support a patient on the ward, they would work with the relevant commissioner to support the patient to move to a more appropriate placement.

Patients were sometimes discharged from the service on what staff described as a "homeless pathway". Staff we spoke with expressed this was never their preference and shared concerns for the potential impact this could have on patients. They told us it could often be challenging to identify the Local Authorities responsible for aftercare arrangements under the Mental Health Act and gain their involvement. Staff at the service made clear efforts to build relationships with Local Authorities to try and overcome these challenges. However, they told us that the complexity of these arrangements meant this was a source of frustration when advocating for patients and supporting a safe plan for discharge.

When patients were discharged in an unplanned way, at short notice, or on the "homeless pathway", staff followed the discharge policy by alerting local mental health services and other community agencies. Arrangements were made for mental health follow-up and any necessary medication in the short term. GP practices were also notified of the discharge in cases where the patient had an identified GP surgery, and contact was made with families were appropriate.

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 and the wider organisation promoted a culture which aimed to ensure that patients and carers felt empowered to give their views.

Staff received mandatory training in equity and diversity, and in promoting human rights. Training compliance on both wards was 100% for equity and diversity, and 97% for promoting human rights.

Staff at the service worked to embed the principles of the Patient Carer Race Equality Framework into their ways of working. For example, processes were being implemented to examine data from incidents, seclusion episodes, and safeguarding events to identify any themes or trends related to ethnicity.

The service also held regular multi-cultural days to educate staff and patients about different cultures. Staff told us that these were an opportunity for staff and patients to share learning and reflect on their experiences relating to equality, 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.

Patients were supported by staff to make plans for their future. Staff worked to involve patients in decisions surrounding their care and treatment at the service and in their discharge planning.

A small number of staff told us that discharges could occasionally feel "rushed" and this could limit their ability to plan meaningful support in the community. However, most of the patients and carers we spoke with told us about their or their relative's plans for discharge and spoke positively about the service's support when planning for the future.