Cygnet Sedgley House and Cygnet Sedgley Lodge

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question as outstanding. At this assessment the rating has changed to requires improvement. The service was in breach of legal regulation in relation to good governance.

Requires improvement: This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We have a shared vision, strategy and culture that is based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding and meeting the needs of people and our communities.

Staff knew and understood the provider’s vision and values were displayed around the hospital.

Staff said they worked well together to ensure that patients received a good high-quality service. Staff said they enjoyed working with the patients and seeing them progress.

Staff were complimentary about the provider and gave examples of being able to ‘grow’ in the company. Several staff had started as support workers and become qualified nurses or managers with the support of the provider.

We have leaders at all levels who understand the context in which we deliver care and treatment, however not all staff felt supported and suitably supervised by leaders. Leaders have the skills, knowledge, experience and credibility to lead effectively, but some staff did not believe this was always done with openness and honesty.

Managers and leaders knew the service well and had a good understanding of the services they managed. The hospital manager and the 2 ward managers were relatively new in post, although they had worked in the service for a number of years. Leadership opportunities and associated training was available for staff.

However, not all staff felt supported and suitably supervised by their managers. Some staff felt that managers were not always visible and approachable and they did not always feel listened to. One staff member gave an example of a concern they raised which was investigated appropriately and no changes were made.

Eleven of the 24 staff we spoke with had concerns that they were left to manage the wards and patients when they did not feel adequately supported and managers could be at times dismissive of their concerns and not help out when required. Some staff said morale was low. However, other staff were complimentary about the leadership at the hospital. A new Cygnet hospital had opened in Wolverhampton about 6 months prior to our assessment. Many staff had left to work there which had caused the staff left to feel unsettled for a time although managers had now provided some stabilisation.

Staff we spoke with differed in their response to what they perceived the culture to be like at the hospital. Half of the staff we spoke with felt culture had improved since recent changes in management, whilst the other half did not. Those that did not, said that managers were not available to speak with when they needed them or they did not fully listen when they had concerns and changes were not made.

A recent culture assessment had highlighted that the service may have concerns about culture and the site may be at risk at developing a poor culture. Measures had been put in place to ensure staff felt supported such as drop-in sessions with the manager and human resources. The service had implemented team building events. Staff had the opportunity to raise concerns and changes had been made.

We have not always created a positive culture where people feel that they can speak up and that their voice will be heard.

Staff we spoke to had differing opinions of whether they felt confident to speak up and raise concerns. We spoke with 24 staff. Eleven staff said they did not feel supported by managers and they did not effectively listen to them when they did raise a concern. They said there was a culture of not feeling safe to speak up for fear of victimisation and if they did, nothing was done and changes did not occur.

The hospital had a freedom to speak up process although some staff told us they were not confident that their concerns would be treated objectively or not taken seriously. Some staff believed that there was favouritism and they would be ‘targeted’ if they did speak up and their concerns were ‘ignored’.

There had been 1 whistleblower concern about the manager which was still being investigated at the time of our assessment.

However, other staff said managers had an ‘open door policy’ and were encouraged to raise concerns and speak up. Freedom to speak up processes were in place and promoted across the service. Previous concerns had been investigated independently and appropriately.

We value diversity in our workforce. We work towards an inclusive and fair culture by improving equality and equity for people who work for us.

The provider invited staff to participate in the annual staff survey. The latest results were from Spring 2024. Overall, results were positive and there had been improvements since 2023. Staff gave us examples of specific working patterns the provider had put in place to help them balance work/life balance such as those with carers responsibilities.

We have clear responsibilities, roles, systems of accountability and good governance to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.

Managers had efficient and comprehensive governance arrangements in place and had relevant information at hand to ensure the service was performing well.

Managers attended regular clinical governance meetings and had sufficient oversight from leaders within the organisation.

We reviewed monthly governance meeting minutes. These were attended by a range of staff. Managers had clear expectations of what care and support the service aimed to provide.

The service had a risk register in place with mitigations in place to help reduce the risk. There were 2 risks identified. These risks were discussed within governance meetings alongside other issues including complaints, incidents, meaningful activity, staffing, staff training and safeguarding. Each area was discussed in detail and where required appropriate actions were put in place, which were then reviewed at the next meeting. Staff completed audits to provide assurance and made improvements where required.

We understand our duty to collaborate and work in partnership, so our services work seamlessly for people. We share information and learning with partners and collaborate for improvement.

Staff told us that had good relationships with wider partners including the local authority, housing, social care, and commissioning.

External partners who were involved in the patients care were invited to attend and provide feedback at multi-disciplinary meetings.

Staff said senior staff had visited the hospital and made themselves available to speak with.

We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome and quality of life for people. We actively contribute to safe, effective practice and research.

The hospital participated in quality improvement initiatives and projects. Staff were involved in a quality improvement project related to discharge planning to ensure it is discussed regularly and patients had access to an easy read visual discharge plan.