Cygnet Victoria House

Updated 18 October 2022

Cygnet Victoria House is a 26 bed mental health inpatient service for male patients. The service is split across two wards.

Albert Ward is a 9 bed psychiatric intensive care unit and accepts emergency and crisis admissions. It provides intensive, short-term, individualised care for patients detained under the Mental Health Act.

Victoria Ward is a 17 bed ward for patients with acute mental health problems. It provides a treatment for men who are experiencing an acute episode of mental illness and require an emergency admission.

The hospital has a registered manager who is also the hospital director.

The service has been registered with the Care Quality Commission since 17 November 2010 to carry out the following regulated activities:

• assessment or medical treatment for persons detained under the Mental Health Act 1983 and,
• treatment of disease, disorder or injury.

The service was inspected to determine if the regulatory breaches we identified in the last 2 previous inspections in April 2021 and October 2018 had been addressed. These were in relation to:

• a lack of communal space on Albert ward
• staff having ineffective oversight of patients on Victoria ward
• the service’s governance processes being ineffective in identifying errors and omissions in its environmental risk assessments and audits, monthly incident reviews and incident records
• the overuse of blanket restrictions on the wards
• staff not being up to date with their mandatory training
• medicines not being properly authorised under the Mental Health Act and,
• qualified medical and nursing staff not being trained in immediate life support.

What people who use the service say

We spoke with 6 patients and 5 carers during our inspection. Patients said staff treated them well and behaved kindly. However, two carers told us they were not kept informed of their loved ones’ progress and felt communication from staff was poor.

Three patients and a carer told us they did not know how to make a complaint. However, the service clearly displayed information about how to raise a complaint in patient areas. The carer said if they needed to raise a complaint, they would look on the provider’s website to find out how to do so.

All 6 patients we spoke with said they enjoyed the food they were given.

Updated 18 October 2022

Our rating of this location improved. We rated it 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 and in line with national guidance about best practice. 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 that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary 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 in care decisions.
• Staff managed patient admission to the service effectively.
• The service was well led, and the governance processes ensured that ward procedures ran smoothly.

However:

• We observed a seclusion review taking place and were concerned that there were 10 members of staff outside of the room which caused some anxiety for the patient, particularly when the staff members were talking about them. We were also concerned that a staff member who the patient had threatened to harm was present.
• The acoustics of the seclusion room caused speech to echo and distort over its communications system and this posed potential issues if voices became raised due to heightened behaviours or for people with communication difficulties.
• Two of the five carers we spoke with said they felt communication from staff was poor although one did not know if this was because their loved one did not want them to be involved.
• There were no systems in place to enable patients to have the ability to speak with managers above hospital director level.

Updated 18 October 2022