Cygnet Hospital Woking

On this page

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

We reviewed all 5 quality statements in the caring key question. This means we looked for evidence that the service involved patients and treated them with compassion, kindness, dignity and respect. At our last inspection we rated this key question as Good. At this assessment the rating has remained Good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We always treat people with kindness, empathy and compassion and we respect their privacy and dignity. We treat colleagues from other organisations with kindness and respect.

We observed kind and respectful interactions between staff and patients on the wards. Interactions were appropriate and supportive, and it was clear that some staff and patients had developed positive relationships. During enhanced visual observations with patients, staff interacted positively with them and encouraged the person they were supporting to engage in meaningful activities and conversations.

All patients’ we spoke with said they were treated well, and staff were caring and compassionate. All said they liked the staff and got on well with them and staff were respectful and responsive in providing them with help and advice and listening.

Staff maintained the confidentiality of information about patients. Staff kept patient’s documentation confidential and were mindful of ensuring that patients were provided with a private space to make personal phone calls or talk to them about personal/private matters.

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

However, staff did not always understand the individual needs of patients, including their personal, cultural, social and religious needs. For example, for female patients with certain religious beliefs, staff had not considered the impact of having male only staff carrying out patients enhanced visual observations. Staff had not involved patients or their families in these decisions. Patients we spoke with told us they preferred to have female only staff as they felt more comfortable. This had not been reflected in patients care plans.

Staff said they felt able to raise concerns about any disrespectful, discriminatory, abusive behaviour or attitudes towards patients or staff and that action would be taken to address this. Staff said they had received training in the importance of maintaining boundaries in therapeutic relationships with patients and understood the importance of this.

We treat people as individuals and make sure their care, support and treatment meets their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Patients we spoke with told us that staff treated them as individuals and knew their likes, dislikes and interests. They were positive about staff and felt they were treated with dignity and respect. Patients felt supported to manage their own physical and mental health. Patients attended community meeting on the wards and were able to provide feedback and ideas for activities for the ward.

Staff and patient interactions we witnessed demonstrated that staff understood and respected the individual needs of each patient. Multidisciplinary patient reviews we observed were person centred and holistic. However, not all of the 16 care records we reviewed reflected this level of personalisation, 12 of them did not. Managers we spoke with acknowledged this and were able to describe work being undertaken in regard to this, including workshops with teams to review the quality or care plans and provide guidance and support staff.

The hospital had a sensory room that was accessible to all the wards to support neurodivergent patients. 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. Staff told us about some patients who required a more structured routine, and staff were allocated to support them with activities. A carer told us staff supported their autistic relative’s needs well and that their care and treatment plans reflected this.

Patients came from diverse cultural backgrounds. Staff recognised this and provided facilities to meet patients’ cultural, religious and spiritual needs, including access to a multi-faith room.

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

We promote people’s independence, so they know their rights and have choice and control over their own care, treatment. and wellbeing.

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

Each ward had regular community meetings to seek patient feedback. The wards had ‘you said, we did’ boards in the communal area on the ward. However, these were not always kept up to date. The white board on Kahlo ward had no information written on it.

Staff encouraged patients to remain as independent as possible, including keeping their bedrooms clean and tidy and managing their own personal affairs such as finances. They could personalise their bedrooms as they wished. Patients were supported to be involved in planning their activity programme which aimed to help them develop skills and techniques that would support them when they were ready to be discharged. Staff told us this was an integral part of their person centred-care approach.

Staff involved patients in their risk assessment risk management and actively sought their feedback on the quality of care provided to them. Staff ensured that patients had easy access to independent advocates.

We observed patients taking part in a range of activities including music and board games as well as sports activities. There was equipment and resources on the wards to help staff provide activities 7 days a week.

Staff supported patients to maintain relationships that were important to them. Patients were able to access phones to stay in contact with loved ones. There was a family friendly visiting room, located off the ward. Where appropriate staff encouraged family members and loved ones to support patients out on community leave.

We listen to and understand people’s needs, views and wishes. We respond to these in that moment and will act to minimise any discomfort, concern or distress.

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

Patients we spoke with told us that they were able to access staff when they required them. They told us that staff were responsive to their needs and although some patients favoured certain staff, they were positive about all the staff who cared for them.

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.

Staff we spoke with demonstrated a good knowledge of the patient group and were able to describe individual risks and how they would respond to immediate need. Individual information and updates were also shared at shift-to-shift handovers to ensure staff understood potential needs risks and the most appropriate and effective responses to them.

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 and redirecting patients in a positive and supportive way.

There were appropriate systems and processes in place to support staff in responding to patients’ immediate needs. There were nurse call alarms in bedrooms and staff carried personal alarms to summon help when required. Staff had access to emergency medical kits and a defibrillator if needed.

We care about and promote the wellbeing of our staff, and we support and enable them to always deliver person centred care.

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. They described a supportive culture with a focus on staff wellbeing. They told us that despite the high acuity and needs of the patients on the wards, staff and patient relationships remained positive with a collective goal of making sure everyone felt supported and had a good day.

There were processes for staff to feedback, raise concerns and suggest ways to improve the service. This included through supervision, team meetings and staff surveys. The provider recognised staff success within the service and wider organisation, for example, through staff awards.

Staff appraisals included conversations about career development and how it could be supported. Staffing levels were sufficient to enable staff to take planned breaks and annual leave. Through the organisaton, staff had access to support services including occupational therapy and an employee assistance programme.