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Cygnet Storthfield House Good

Reports


Inspection carried out on 3 and 4 December 2018

During a routine inspection

We rated

Cygnet Storthfield House as good because:

  • The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
  • Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients cared for in a mental health rehabilitation ward and in line with national best practice guidance. Staff engaged in clinical audit to evaluate the quality of care they provided.
  • The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured staff received training, supervision and appraisal in line with the providers policy. The ward staff worked well together as a multi-disciplinary team and with those outside the ward who would have a role in providing aftercare.
  • Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
  • Staff planned and managed discharge well and liaised well with services that would provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason.
  • The service worked to a recognised model of mental health rehabilitation. It was well led, and the governance processes ensured ward procedures ran smoothly.

However:

  • Staff had not completed intermittent observations of patients as per the Mental Health Act Code of Practice and the Cygnet policy and procedure.

Inspection carried out on 11 - 12 January 2016

During a routine inspection

We rated Cambian Storthfield House Hospital as good because:

  • Patients told us they felt comfortable. They said staff were friendly, helpful and treated them with respect. They were confident that staff would meet their physical healthcare needs. Relatives felt that patients were safe and well cared for.

  • Care records were complete. They contained up to date risk assessments and care plans that the patients were involved in creating. There was a comprehensive treatment pathway. Outcome measures were used that allowed patients to see their progress. Good multidisciplinary relationships supported patients holistically.

  • The team reported incidents. There were processes in place to review incidents and for the team to identify learning. The team were proactive at trying to pre-empt incidents rather than reactive once incidents had occurred.

  • Staff received appraisals and supervision. The hospital supported staff to complete training and develop. Staff completed necessary training. Staff understood their role to safeguarding patients and took actions to do this.

  • There was a range of therapies available to patients, both group and individually based. Patients could influence activities provided through a planning meeting. Activities were available seven days a week.

However:

  • The hospital did have fixed ligature points that could pose a risk to individuals’ intent on harming themselves. Ligature points are fixtures to which people might tie something to strangle themselves.

  • We found staff understanding of the MCA and DoLS was variable. One staff member gave an excellent overview whilst other staff members could not give any of the guiding principles.

  • There was no joint record of both informal and formal complaints. This made it difficult to assess the total number of complaints received. It could also make it difficult for the staff team to identify themes and potential learning.

  • A review of two policies and procedures had not taken place as planned. The clinical and corporate governance policy was in place but not reviewed in October 2013, as planned. The policy for mission statement, standard operating procedures (SOP) and organisational structure was in place but not reviewed in June 2014, as required.

Inspection carried out on 25 February 2014

During a routine inspection

During our inspection we spoke with seven people who used the service, two relatives, four members of staff and a health care professional.

People using the service talked positively about staff and the way they were treated. One person said, "I am OK here, I feel I have done well. I like the staff and have no complaints." A relative told us, "This is the best placement X has ever had. X trusts them and likes being there and is always happy to return."

A health care professional told us, "I feel comfortable placing people there. Staff are cooperative, professional and communication is good. De-escalation skills are excellent."

We saw that people's consent to care and treatment was gained in accordance with legislation.

People were informed of the status of their detention and their rights under the Mental Health Act. Not everyone was aware of the length of their detention and when it would end.

We saw that people received the care and treatment they needed to meet their individual needs. A range of therapeutic activities and support were available to promote people's rehabilitation.

There were enough staff on duty at all times with the training, skills and experience to meet people's needs.

We saw there were effective systems in place to respond to any comments or complaints.

People had access to advocates who supported them in their monthly reviews and at other times they needed them.

Inspection carried out on 29 October 2012

During a routine inspection

We spoke with four people using the service, three members of staff and the management team during the visit. We spoke with four visiting professionals by telephone following the visit and received written feedback from another.

People expressed their views and were involved in making decisions about their care and treatment. They told us that they liked using the service. One person said they liked the staff and confirmed that they were treated respectfully. One person told us that a request for specific cultural food had been accommodated.

People we spoke with were positive about the care that they received and praised the staff. They were able to tell us how they had improved since using the service. One person told us �it�s pretty good here� and another said they were happy with the support provided and described it as �absolutely fine�. The people we spoke with confirmed that their activity plan occurred as planned and one person told us activities were �never cancelled�.

People told us they liked the staff and that they listened and were helpful. One person described them as �very good�.

Reports under our old system of regulation (including those from before CQC was created)


Mental Health Act Commissioner reports

Each year, we visit all NHS trusts and independent providers who care for people whose rights are restricted under the Mental Health Act to monitor the care they provide and check that patients' rights are met. Immediate concerns raised by patients on those visits are discussed, if appropriate, with hospital staff.

Our Mental Health Act Commissioners may carry out a number of visits to each provider over a 12-month period, during which they talk to detained patients, staff and managers about how services are provided. In the past, we summarised themes from the visits and published an annual statement followed by the provider's response where applicable. We are looking at different ways to indicate the outcomes of our monitoring in the future.