Cygnet Hospital Woking

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

We reviewed all 7 quality statements in the responsive key question. This means we looked for evidence that the service met people’s needs. At our last inspection we rated this key question as 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 make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

Patients we spoke with felt largely involved in their care, they informed us they would attend their multidisciplinary team meetings. If patients did not want to attend for any reason, they told us staff would always ask if they wanted to share any concerns, wishes or feedback. Carers and family members were also able to attend multidisciplinary team meetings alongside or on behalf of the patient (in person or via video link).

Staff we spoke with demonstrated a good understanding of patients and their individual needs. They were able to give examples of how they delivered personalised care and how they considered patients’ needs, wishes, goals and preferences. However, assurance processes had identified that written care plans were not as personalised and individual as they could be. The service was involved in a range of projects to improve this including the delivery of co-production sessions by an individual with lived experience. There was a project ongoing to improve care plan documents and contents.

We observed several meetings including the daily multidisciplinary meeting and individual patient multidisciplinary review meeting. They were well structured, comprehensive, holistic and personalised. Discussions were centred around the patient’s present and future best interests and care and treatment needs. Staff demonstrated a good understanding of individual patients’ history, presentation, strengths and goals. Patients and family members views were sought.

Each patient had their own bedroom with ensuite and privacy windows they could adjust. Patients could keep possessions in their bedrooms or their secure lockers. There was also a locked storage cupboard for larger patient property.

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

Patients had access to activities within the community. The service had access to transport to support patients in getting out in the community. Patients also used public transport.

Staff ensured that patients maintained contact with people important to them in their local area. Staff had regular telephone contact with patients’ families, where appropriate, and health professionals. Family members, care co-ordinators and other key professionals involved in patient’s care were all invited to multidisciplinary team meetings. The service facilitated attendance by video link if they were unable to attend in person.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

Patients were provided with a ‘Patient Information Booklet’ on admission which provided useful information about the hospital. A variety of Information was on display on all the wards. There were notice boards in place throughout the wards and in areas where visitors had access. For example, information on how to raise a concern, complaint, or share compliments and also how to access an independent advocate. A series of leaflets and posters were also available explaining different treatments and therapies.

Staff supported, informed and involved families or carers. Families or carers were invited to ward rounds, where appropriate.

The service had access to translation services and provided information leaflets in languages spoken by the patient and local communities.

Leaders and managers had access to information to support them with their management role. This included information on the performance of the service, staffing and patient care. This information was presented and discussed in meetings to review performance such as clinical governance meetings.

Information governance systems included confidentiality of patient records. All staff had completed mandatory training on information governance awareness.

Staff made notifications to external bodies as needed. For example, the service submitted statutory notifications to the Care Quality Commission in accordance with the requirements of their registration and safeguarding referrals to the local authority. This was tracked and monitored by managers and leaders and discussed during daily meetings to ensure appropriate reporting and action was taken.

We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.

Patients we spoke with told us that they felt listened to and generally involved in making decisions about their care. They attended weekly community meetings where they were able to give feedback and make suggestions.

The shift-to-shift handovers, morning meetings and staff meetings provided an opportunity for staff to discuss key issues, to learn and improve the service. Staff told us that they felt listened to and involved in decision making.

Staff we spoke with understood the provider’s complaints policy. They were able to explain the complaints process and how they would support patients who wished to raise a concern. They told us they would try and resolve any concerns informally first. Staff told us patients were free and supported to raise concerns or complaints and could do so without fear of discrimination.

Managers investigated complaints and identified themes. They shared feedback from complaints with staff and learning was used to improve the service. During our inspection, we reviewed five complaints that had been investigated by the service. Policies and procedures had been followed, and responses to the complainant were done in a timely manner and detailed specific outcomes. The service used compliments to learn, celebrate success and improve the quality of care. In the six months prior to the inspection, there had been five formal and 3 informal complaints for Picasso ward and four formal and three informal complaints for Kahlo ward received by the service. The service reviewed the themes from complaints and identified learning and took action to make improvements. Some of the themes from the complaints received included therapeutic interventions, quality of care and staff attitudes.

We saw that information on how to complain was provided to patients, carers and family members. The complaints process was displayed on posters and leaflets available on the wards and within the hospital and on their intranet page.

We make sure that everyone can access the care, support and treatment they need when they need it.

Referral, assessment and admission processes considered the needs of patients with different protected characteristics, and the service made reasonable adjustments to avoid discrimination and meet individual’s needs. The service had clear exclusion criteria to ensure they could safely support the needs of the patients.

Staff did however make reasonable adjustments for patients where possible. For example, providing a more structured, individualised routine for patients with autism and providing information in easy read formats.

Managers and staff, we spoke with told us they were working hard to build a culture to prevent discrimination and inequalities. This was supported by training and guidance. In meetings we observed, we saw staff talking about these topics.

We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

Leaders and staff were alert to discrimination and inequality that could disadvantage different groups of patients in accessing care, treatment and support. Staff completed equality and diversity training as part of their mandatory training programme. They were aware of the resources available to them to support patients during their care and treatment, including translation services and religious and spiritual support. There was space that could be used as a multi faith room, and a range of food options were available to support patent’s dietary requirements.

Referral, assessment and admission processes considered the needs of patients with different protected characteristics, and the service made reasonable adjustments to avoid discrimination and meet need. Staff we spoke with were able to give examples of where adjustments had been made or were in place to support patients with mobility and physical health concerns.

Managers we spoke with told us patient experience and outcome was considered when reviewing incidents involving patients, for example, the use of restraint, seclusion and rapid tranquilisation.

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

Where appropriate, staff supported patients to consider longer term decisions about their care, treatment and discharge. Patients we spoke with were involved in discussions about their future and discharge planning.

Staff regularly reviewed the long-term plans for patients in terms of their treatment goals and objectives for discharge or the transfer of care to a different service, where appropriate.

There were processes in place to facilitate the planning and delivery of discharge or transfer of care and staff worked well with other professionals to ensure patients could access the services and support they needed.