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We are carrying out checks at Cygnet Hospital Woking. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Good

Updated 24 April 2018

We rated Cygnet Hospital Woking as Good because:

  • There were enough suitably qualified and trained staff to provide care to a safe standard. Skilled staff delivered care and treatment. Throughout the two wards, the multidisciplinary team was consistently and pro-actively involved in patient care and everyone’s contribution was considered of equal value. The staff were kind, caring and motivated and we saw good, professional and respectful interactions between staff and patients during our inspection.
  • Patients’ risk assessments and plans were robust, recovery focused and person centred. The assessment of patients’ needs and the planning of their care was thorough, individualised and had a focus on recovery. Staff considered the needs of patients at all times. Physical healthcare assessments and associated plans of care were thorough and consistently delivered to a high standard.
  • Patients had access to a variety of psychological therapies described as best practice in The National Institute for Health and Care Excellence guidance. This therapy was delivered either on a one-to-one basis or in a group setting, as part of the treatment programme. There was a varied, strong and recovery-orientated programme of therapeutic activities and treatment groups available every week.
  • There was evidence of best practice in, and all staff had a good understanding of, the Mental Health Act 1983 (MHA), the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) and the associated Codes of Practice.
  • There were many examples of initiatives implemented to involve patients in their care and treatment. Patients told us that the staff consistently asked them for feedback about the service and how improvements could be made. Patients were appointed as ward representatives and a ‘people’s council’ met regularly and ensured good communication between patients, staff and managers. The service was responsive to listening to concerns or ideas made by patients and their relatives to improve services. Staff considered these ideas and used them when they could. Staff had developed pamphlets for children to explain why their parents had been admitted to a psychiatric ward. The pamphlets were presented as stories, were age appropriate and used pictures to get the information across.
  • The service had clear guidance in place to report incidents and support staff learning when things had gone wrong.
  • Ward staff provided clinical quality audits, human resource management data and data on incidents and complaints. The information was summarised, updated daily and presented in a key performance indicator dashboard. Staff had good access to robust governance systems, which enabled them to monitor and manage the wards effectively and provide information to senior staff in the organisation and in a timely manner.
  • All staff had good morale and said they felt well supported and engaged with a visible and strong leadership team, which included both clinicians and managers. Staff were motivated to ensure they achieved organisational objectives. Without exception, staff spoke highly about the senior management team.

However:

  • The senior management team had only been in post for four months and staff had concerns about the stability of this team, given the hospital had 11 managers over a ten-year period.

Inspection areas

Safe

Good

Updated 24 April 2018

We rated safe as good because:

  • The ward environments were safe and clean.

  • There were enough suitably qualified and trained staff to provide care to a safe standard.

  • Arrangements were in place for staff to provide effective support for patients.

  • Senior managers were flexible and responded well if the needs of patients’ increased and additional staff were required.

  • All staff had received training in safeguarding adults and children at risk.

  • Patients’ risk assessments and plans were recovery focused and person-centred.

  • Blanket restrictions were always revisited and reviewed. Staff and patients audited restrictions, together, every month.

  • The service had clear mechanisms in place to report incidents and to support learning when things went wrong.

Effective

Good

Updated 24 April 2018

We rated effective as good because:

  • The assessment of patients’ needs and the planning of their care was thorough, individualised and had a focus on recovery.

  • Patients had good access to physical healthcare, including access to specialists when needed.

  • There was evidence of best practice in, and all staff had a good understanding of, the Mental Health Act 1983 (MHA), the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) and the associated Codes of Practice.

  • Patients had access to a variety of psychological therapies as described as best practice in The National Institute for Health and Care Excellence guidance. This therapy was delivered either on a one-to-one basis or in a group setting. Skilled staff delivered care and treatment. Throughout the wards, the multidisciplinary team was consistently and pro-actively involved in patient care.

Caring

Good

Updated 24 April 2018

We rated caring as good because:

  • Staff were kind, caring and motivated and we saw good, professional and respectful interactions between staff and patients during our inspection.

  • There was evidence of initiatives implemented to involve patients in their care and treatment.

  • Patients told us that the staff at the hospital consistently asked them for feedback about the service and how improvements could be made. Patients from each ward were appointed ward representatives and met regularly with other patients, at the ‘people’s council’, to receive feedback, which in turn they discussed with staff and managers.

  • A series of mental health educational seminars were held for patients’ family, friends and carers.

Responsive

Good

Updated 24 April 2018

We rated responsive as good because:

  • The management of the beds on both wards was robust and effective.

  • The service model optimised patients’ recovery, comfort and dignity.

  • The needs of patients were considered at all times by staff.

  • There was a varied, strong and recovery-orientated programme of therapeutic activities available every week.

  • Self-help leaflets were widely advertised on managing depression, anxiety, voices, self-harm and substance misuse and trauma.

  • Staff had developed pamphlets for children to explain why their parents had been admitted to a psychiatric ward. The pamphlets were presented as stories, were age appropriate and used pictures to get the information across.

  • The service was particularly responsive to listening to concerns or ideas made by patients and their relatives to improve services. When staff were able to, these ideas were taken on board and implemented. For example, catering staff had met with patients to discuss their dietary requirements and food preferences.

Well-led

Good

Updated 24 April 2018

We rated well-led as good because:

  • All staff had god morale and said they felt well supported and engaged with a visible and strong leadership team, which included both clinicians and managers. Staff were motivated to ensure they achieved organisational objectives. Without exception, staff spoke highly about the senior management team.

  • Governance structures were clear, well documented, adhered to and reported accurately. These are controls put in place so that managers can assure themselves that the service delivered is effective and delivered to a good standard.

  • Managers and their staff were fully committed to making positive changes. Changes had been made to ensure improvements to quality were mad.  For example, patients took part in auditing any rules on the ward, implementing a least restrictive practice strategy and action plan.
  • However:
  • The senior management team had only been in post for four months and staff had concerns about the stability of this team, given the hospital had 11 managers over a ten-year period.

Checks on specific services

Child and adolescent mental health wards

Inadequate

Updated 13 October 2017

Forensic inpatient/secure wards

Good

Updated 24 April 2018