Cygnet Lodge Brighouse

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• 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 inspection we rated this key question Good. At this assessment, the rating has remained good.

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

The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity and relatives were positive about the facilities. Staff supported patients with activities outside the service, such as voluntary work and encouraged them to maintain family relationships. The service met the needs of all patients – including those with a protected characteristic. Staff helped patients with communication needs, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and implemented lessons learned across the full staff team.

Staff found effective ways to communicate with patients so that they understood their care and treatment, including people with communication difficulties.

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.

Feedback from the staff and the management team, external partners and relatives conveyed a theme of person-centred care. Every effort was made by staff to ensure patients were at the centre of their care and that their voices were heard. Regular meetings by the multidisciplinary team ensured that discussions took place as to how to respond to any changes. Within the care plans we reviewed, it was noted that there was evidence of patient’s active involvement in plans concerning them and that their voices and expressions were included throughout.

We spoke with the occupational therapist and occupational therapy assistant, who informed us the team ran individual and group sessions based on people’s individual needs. There were activities scheduled each day and they varied from life skills to the allotment groups, walking groups and shop to cook. They were appropriate for the patient population.

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 and patients told us that they had access to activities both within and outside of the hospital environment. There was access to a nature reserve where patients could get involved with caring for the birds. There was an opportunity to shop in the local community and use of an allotment to develop gardening skills. Staff facilitated patients to attend local places of worship, if they wished to.

Patients were supported to maintain contact with their families and carers. There was a visitor’s room to accommodate face-to-face visits and a telephone patients could use if they did not have access to a mobile phone.

The information technology suite could be used for educational purposes and there was a library space on site.

Community meetings took place on site and enabled all patients and staff to attend and express any concerns and requests. We looked at minutes of the meetings, and it was evident that discussions had been taking place regarding celebrating Eid and culturally inclusive food to eat. It was noted that action had been taken for an Imam to visit the ward. Suggestions had been collated for menu changes and what patients would like to see added to that.

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.

We observed several information posters and leaflets within the hospital. At the last inspection it was noted that access to advocacy services had not been clear, but at this inspection there was documentation that made sure patients knew how to access this which demonstrated improvement.

Regular audits were undertaken to ensure there were no gaps in record keeping, Mental Health Act documentation or Deprivation of Liberty Safeguards paperwork. There was an information governance system in place to maintain confidentiality of patient records.

Information regarding medicines was noted on prescription charts and medicines records. Care records kept up to date information and medicines information was provided and discussed on ward rounds. Patients were given a copy of their care plan, if they wanted this.

Families of patients told us that there was lots of accessible information available and that welcome packs were provided to them on their relative’s admission. Medications were discussed with relatives and reviewed. Relatives commented that they felt involved in care decisions and felt confident to raise concerns if they had any and were involved in discharge planning.

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 and families reported that they knew how to raise concerns or to complain. There were a multitude of ways people could provide feedback, such as directly to staff, through an independent advocate or within meetings. Relatives were invited to attend ward rounds and provide feedback.

We requested information on formal and informal complaints made to the service in the 12 months prior to our inspection. There were 2 formal and 2 informal complaints, all of which had been concluded. Of the formal complaints, 1 was upheld and one partially upheld. The informal ones were satisfactorily concluded. The complaints were recorded on a central database.

Management team members reported a good relationship with the Community Mental Health Team (CMHT), who attended meetings in person, or virtually, and they were contactable if presentations changed or there were any incidents that needed to be shared.

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.

Before patients were admitted to the ward, members of the management team visited and gave them all the information they needed. If accepted for admission, there was a transition period and transport provided, if required.

The length of stay for patients varied, but the average was 36 months and there was evidence of active discharge planning in their records. Families had a say in the location to which their loved ones were to be discharged. This was also transitional, with visits to the new service, and the occupational therapist was also involved in sourcing furniture and other support.

There was collaboration evident with local authorities, the integrated care board and other providers regarding discharge planning. Staff ensured patients had access to post-discharge care – for example, Section 117 aftercare, community mental health services and future support from providers.

There was evidence that the needs of people with mobility issues could be met and reasonable adjustments were made for those who needed them, to enable them to fully integrate into the environment.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital.

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 were trained in equality and diversity and compliance at the time of our inspection was 89%.

Staff within the hospital promoted a culture in which the people using the service and their relatives or carers felt empowered to give their views. Relatives we spoke with confirmed that they were invited to relevant meetings and discharge planning.

There was a multicultural lead within the service who attended meetings and shared information with the rest of the team.

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, including at the end of their life.

Staff supported patients in making decisions regarding their care and treatment, involving relatives and advocates and holding best interest meetings where necessary. Care records we reviewed showed personalised care plans to account for the person’s needs and wishes and people we spoke with told us they were involved in creating these. Relatives told us they were included in the discharge planning process.

Substance misuse work was undertaken at the service and stakeholders described it as “motivational and educational” promoting awareness around substance misuse issues and smoking cessation practices.