Cygnet Lodge Lewisham

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding.

This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 90 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff attitudes and behaviours when interacting with patients showed that they were respectful and responsive, providing patients with help, emotional support and advice at the time they needed it.

Staff consistently spoke about patients in a respectful, caring and compassionate way during meetings. We observed many positive interactions between staff and patients. Staff knew their patients well, discussed their preferences when making decisions and sharing information, and the patients appeared comfortable around staff.

Staff celebrated their patient’s achievements and milestones, for example, having a special meal on their birthday and holding graduation ceremony parties when their patient’s completed educational courses.

In the dining room, a large board had information for patients related to the hospital for that day. For example, how many staff were working and what was on the food menu.

We spoke with 10 patients and 4 carers.

Patients told us staff were kind and treated them well. They told us staff were available on the ward to support them when needed. A patient told us ‘the staff are the best thing about this place’. All patients told us they were shown around the ward and were introduced to staff and patients when admitted.

Carers told us staff had positive attitudes and were kind. A carer told us their relative received ‘great treatment and excellent care’. One carer told us they felt the service had improved over the last year, especially in their communication with them. Another carer told us the hospital had been very supportive in their son’s autism diagnosis and that he had ‘made more progress here, than anywhere else’.

Staff maintained the confidentiality of information about patients. Documentation was stored in locked rooms, not accessible to patients.

Staff upheld patients’ privacy and dignity. For example, patient bedroom viewing panels were seen to be closed, protecting the individual’s privacy.

Staff told us they could raise concerns about disrespectful behaviour or attitudes towards patients without fear of the consequences. For example, we were told some staff were speaking their native language in patient areas. Staff were able to raise these concerns with managers, and felt the issue had been taken seriously and was being addressed.

The service carried out surveys with patients and carers in order to continually improve the service and experience for patients. The most recent survey was in April 2025. All 5 patients reported staff were caring and supportive. They all reported they were involved in decisions about their care and felt they were treated as individuals. All 5 carers reported they were involved in their relative’s care and were kept updated. All carers reported staff were polite and approachable.

A patient at the service recently died following an unexpected heart attack. The hospital held a ceremony for their patients and staff, where they planted a tree in their garden in their former patient’s memory. The service also provided debriefs for staff and patients following this sudden incident.

Staff made adjustments to support patients where needed. For example, providing information in easy read format. We observed staff in the handover meeting discussing providing a patient with easy read information on their medicines.

Patients had access to spiritual, religious and cultural support. There was a small multifaith room in the hospital, which contained religious text. Patients were also supported to attend church.

The hospital had a multicultural week, where they celebrated a different culture each day. Staff and patients were involved in creating different foods and a range of activities from different regions, including music, games and dancing.

The hospital was not accessible for disabled patients. The hospital had stairs leading to the front door, and was set over 3 floors. The manager spoke of plans to add a ramp and disabled parking to make the hospital more accessible. They had approval to create the dropped curb, however, were awaiting approval to remove a tree from the front garden.

The hospital did not have a sensory room to support neurodivergent patients. The service did however have adjustable lighting. Some doors had soft closure fittings, and the hospital had a plan to fit all doors with soft close fittings in 2026. Managers told us they carried out extensive assessments prior to admission, and patients were not admitted if their needs could not be met on the ward. They did have neurodivergent patients on the ward; however, they did not require adjustments to the environment. One patient required a more structured routine, and staff were allocated to support them with activities. A carer told us they felt their son’s autism was managed well by the service, and told us the team took his autism into consideration when creating his treatment plans.

The service provided a variety of food to meet the dietary and cultural needs of individual patients

We saw staff had created an information board to share how lesbian, gay, bisexual and transgender (LGBT+) patients would be welcomed and supported at the hospital. They had also allocated a staff member to be their LGBT+ lead, and this information was visible on the ward for patients to see.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, and how to complain. We observed leaflets and posters on the walls with information for patients.

Patients had regular ward rounds where they met with the multidisciplinary team to discuss their care and treatment. We observed 4 ward rounds and saw detailed discussions with patients, their carers and their community teams.

Patients were supported to maintain relationships and networks that were important to them. We saw evidence of staff arranging family visits, and supporting a patient to attend a church in their native language, helping them to engage with their community.

Patients had access to activities and opportunities in the local community, promoting their independence and wellbeing. This included football groups, voluntary work and educational courses. The hospital had supported patients to attend a local football match, allowing them to attend activities they enjoyed. When appropriately risk assessed, the hospital supported patients to access Section 17 leave to support their hobbies, interests and work. For example, the hospital agreed for a patient to have extended day leave to be able to attend music festivals as part of their interests and work as a photographer.

Staff supported patients to be more independent with their activities of daily living. For example, they assisted and encouraged their patients to change their bedsheets, do their laundry, shop for their own food and to cook and prepare their own meals and snacks.

Last year, patients were supported to create a Christmas song. The song was written, played and sung by patients, with the support of the music therapist. A patient also video recorded patients and staff singing the song, which was uploaded onto their website.

An advocate visited the service each week and told us they observed patients were involved in their care, and that patients could meet with doctors to discuss treatment plans regularly outside of ward rounds.

We met with 2 members of the team who were an expert by experience, that is, they had experience of using services. One worked for the provider and the other worked for an external agency. The external expert by experience told us they attend community meetings, join in activities, and met with staff and patients. They also told us they are involved in creating recovery plans to support a patient’s discharge.

Patients told us staff gave them emotional support and advice when they needed it.

Staff identified and responded to changing risks to, or posed by, patients. Staff met daily to discuss the needs of the patients. We saw examples of multidisciplinary staff updating risk and care plans when patient needs changed. For example, a patient with a newly identified risk of falls was moved to a ground floor bedroom.

Staff knew their patients and they were aware of their specific risks. For example, some patients had diabetes and epilepsy. Appropriate care plans were in place to support the physical health needs of these patients, as well as detail the plan for staff to follow, should there be any incidents.

Staff used de-escalation techniques to reduce the need for physical interventions when patients’ behaviours became heightened. We saw examples of staff de-escalating situations well.

Patients we spoke with told us they felt able to raise any concerns they had with the ward staff or ward manager. Patients also had access to weekly community meetings where they could raise their concerns about issues on the wards. When patients raised concerns in these meetings, we saw actions being documented and followed up.

All staff told us they felt respected, supported and valued by their colleagues and managers. They spoke very positively about working at the hospital and they were proud of the work of their team. One staff member told us this was ‘the best place I have worked’. Many staff had worked at this hospital for a number of years, and told us a key reason for this was the support they received and a positive team culture.

The hospital recognised staff success within the service. For example, employee of the month awards, voted for by their peers. The staff member received some chocolates and a certificate. We also saw photos of staff members celebrating birthdays and work milestones with their colleagues.

Staff had access to support for their own physical and emotional health needs through an occupational health service. Staff told us they received support from managers when they were involved in distressing incidents, as well as meeting with specially trained trauma informed practitioners.

Staff appraisals included conversations about career development and how it could be supported. Staff told us the hospital supported their professional development. For example, they offered nursing and occupational therapy apprenticeship programmes to staff.

The hospital had a recent team away day, where they focused on improving patient care and team bonding.