Cygnet Manor

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

Responsive - This means we looked for evidence that the service met people’s needs. At this assessment, we rated this key question Good. This meant people’s needs were met through effective planning and delivery. The service collaborated well with external partners and people when planning and delivering care, treatment and future support. Staff completed the appropriate assessments and demonstrated a person-centred approach which ensured they responded quickly and effectively to the needs of people. Accurate information was readily available and given to people and their families whenever needed or requested. Training and processes were in place which enabled the service to identify possible bias, discrimination and barriers to treatment and how to act on this to support people appropriately. People’s families were encouraged and supported to be involved in all aspects of their care and treatment.

This service scored 82 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were at the centre of their care and treatment planning. The care plans we reviewed were comprehensive, consistent and reflected individual circumstances, preference and need. The service worked effectively with people, their relatives and external partners which ensured person-centred care was provided. One relative told us “My son has been in different hospitals for over 10 years, and this is the best yet. Everything the staff do, is personal to my son and his needs. I would really like my son to stay within Cygnet as he makes progress and has to move to a different hospital.”

Staff completed thorough assessments with people upon admission, which were reviewed regularly and updated accordingly to ensure care continued to effectively meet people’s needs, preferences and expectations. Care plans reflected physical health, mental health, emotional and social needs, including adjustments for protected characteristics under the Equality Act.

The service promoted and supported staff to undertake lead roles in different care and treatment areas, for example a carers lead. The carers lead worked closely with people and their relatives and supported them throughout their care and treatment journey with things like communication, representation, progress updates and visiting.

An external partner also attended the service weekly and delivered relaxation/wellbeing sessions for people using the service and staff. The sessions were well attended and all involved gave positive feedback. Mindfulness sessions were also facilitated by the psychology team. People using the service were also able to request ad hoc mindfulness sessions with the psychologist when additional support was needed.

Each person using the service had the option to have an individualised mood board attached to the outside of their bedroom door. Mood boards were used to enable people to express themselves and effectively communicate the way they may be feeling. Each mood board had different emoji graphics available for use. People were encouraged to use an emoji graphic to display their feelings. This enabled staff to vary their approach from person to person and dependant on mood type, it also ensured staff were able to effectively identify changes in mood and were able to offer person-centred support quickly if people were not feeling their best. Each mood board also had preferred words and ways to communicate with people, such as ways to enter the person’s room, greeting types, tones of voice and words or phrases not to use which could have a negative effect on their mood, mental state and presentation.

People and their relatives received accurate and up-to-date information about their diagnosis and treatment options, that clearly explained the benefits or potential risks of any planned treatment interventions. Shared decision-making and collaboration were promoted and supported. This safeguarded people’s preferences, autonomy and ensured their needs were met.

Staff demonstrated a good understanding of the diverse health and care needs of the people they supported and strived to deliver care that was joined up and flexible. Collaborative working was effective across the service’s wider teams and with external partners such as the Integrated care boards (ICB) to ensure care was consistent and met people’s individual needs.

The service supported people to involve their families in discussions and decisions about their care and treatment. When people moved between care provider’s or discharged back into the community, staff ensured the process was as smooth as possible with effective support in place. External partners were invited to attend care reviews and were involved in the discharge process. This ensured ongoing and collaborative care and maintained consistency which promoted and delivered better outcomes for people leaving the service.

Assessments ensured people received the right care, treatment and support for their current and future needs. By working closely and collaboratively with people, their relatives and external partners. The service provided effective joined-up care that met people’s needs, preferences and expectations.

Staff provided people with accurate and up-to-date information regarding their care and treatment in ways that they and their relatives could understand. The service used systems and processes to adapt information to the person's individual communication needs and preferences, including easy-read formats or information in different languages. If language barriers were identified, the service utilised advocacy and interpreter services to ensure any information provided to people and their families was understood.

The service provided a carers lead. With the consent of people, the carers lead communicated with people’s relatives on a regular basis. Information was provided to relatives regarding any events that had occurred within the care environment, along with updates on any progress made. The carers lead was accessible for family members to contact for information and support whenever the need arose. One family member told us “The staff are really good; they contact me with updates when needed and they keep me in the loop. I’ve also requested information and found them to be responsive and quick to provide what I’ve asked for.”

Clear policies and processes ensured the service managed people’s information confidentially and securely by adhering to General Data Protection Regulation (GDPR). Staff actively identified, recorded and reviewed people’s consent to share information preferences regularly and in line with the Accessible Information Standard. The provider’s website used Recite me, an assistive technology toolbar, which allowed users to customise their online experience to meet their individual communication needs. The assistive toolbar enabled visitors to the website to change font size and colour and also to have information translated into different languages.

Staff ensured people’s, relatives were regularly updated on care and treatment progress whilst maintaining privacy and confidentiality. The service displayed information about raising concerns or complaints throughout the environment and supported people to understand their rights.

The service involved relatives when appropriate and adhered to processes that ensured effective, timely and accurate information sharing and communication.

Staff supported people and their relatives to provide feedback or raise concerns. People knew how to complain, and the service displayed clear information on how to access support, including advocacy and interpreter services and external organisations. For example, the Patient Advice and Liaison Service (PALS). One person told us, “Staff have helped when I was worried about something, they told me what was happening and what had been done and helped me to feel okay.”

In the 3 months prior to our assessment, the service received 1 formal complaint from a person’s relative. We found evidence that the complaint had been addressed appropriately, documented accurately, information and updates shared regularly with all concerned, with a positive outcome reached. People were encouraged to share their opinions and feedback during community meetings. We reviewed the community meeting minutes and found feedback or concerns had been clearly recorded, with any matters raised being responded to promptly with clear actions and outcomes and feedback provided to those involved.

Relatives were supported and encouraged to share feedback through feedback on care forms, quick response codes (QR), the carers lead and also directly with service leaders via an in-person visit or telephone call.

Staff valued feedback and looked on it positively as a tool for continuous improvement. Staff received regular updates on all complaints, actions taken and outcomes. The learning from this enabled the service and its staff to identify any areas in need of address and make positive changes when a need was identified.

By involving people in feedback and communicating actions taken, the service built and maintained trust. This ensured people, their relatives and visitors to the service felt valued, listened to, respected and included.

The service ensured people accessed care, treatment and support in a way that worked for them and met their individual needs. By using effective communication and assessment processes, they identified and removed barriers to care, particularly for people with complex needs, enduring mental illness, or protected characteristics under the Equality Act.

Upon completion of the appropriate assessments, people were supported with any identified mobility needs and provided with the appropriate equipment. The service ensured that assistive technology aids were available and provided when assessed and deemed necessary.

Medical cover was consistently available throughout the day and night. Doctors attended the service promptly in cases of emergency, if any issues were identified, or concerns raised out of hours. People were promptly transferred to the local acute hospital if the need for increased medical support and intervention was identified.

The service worked collaboratively with external organisations to improve access and transitions between services. The service coordinated and worked collaboratively with GP’s, the community forensic mental health team and integrated care boards to plan and facilitate care, treatment and support that was tailored to meet each person’s individual needs.

The premises were accessible, and the environment supported access for all people using or visiting the service. Staff were aware of social impact, with the service being part of the Cygnet disability network partnership initiative and Cygnet learning disability and autism steering group. The service and its staff worked closely with other services nationally to improve health and address inequalities for people who may be disadvantaged across the region.

The service planned and had the appropriate links to aftercare provision, such as the community forensic mental health team crisis services and the local authority social care team. Discharges happened when clinically appropriate. The service worked collaboratively regarding discharge with external partners. This ensured the appropriate ongoing care and support was in place, with the goal being better outcomes for people who used the service.

Staff effectively captured the views of people who may be at risk of experiencing inequalities or poorer outcomes and used this feedback to enhance person-centred care and support. People felt empowered to share their views and were encouraged and supported to do so. The service promoted a culture where people’s voices were heard, their views and opinions respected, and feedback acted on.

There were effective policies in place which ensured the service adhered to the principles of Equality, Diversity and Inclusion (EDI). The policies aimed to safeguard against disadvantage for vulnerable people or those with protected characteristics and to promote fairness across all aspects of care within the organisation and to ensure the service was accessible.

Staff effectively supported people with equality and human rights and adhered to legislation. Reasonable adjustments were made to meet each person’s social, cultural and religious needs, for example, by working with independent communication support services and providing information in multiple formats to support individual need. Religious and cultural leaders were welcomed to visit the service to spend time with people if this was requested or a need identified.

The service was part of the organisational Patient and Carer Race Equality Framework (PCREF). The Patient and Carer Race Equality Framework aimed to improve mental health outcomes for people from racialised and ethnically diverse communities. It created a better understanding of racialised communities across the workforce, coproduced improvement strategies with racialised people and carers and embedded anti-racism practice throughout services. The intention was to create more equitable and inclusive mental health services that worked better for everyone.

All staff completed mandatory organisational Equality, Diversity and Inclusion training, which built upon existing knowledge and ensured any potential inequalities or discrimination were recognised and addressed effectively. The service had an Equality, Diversity and Inclusion lead and steering group and staff were alert to the risks of unfair treatment and were needed took the necessary actions to address any disparities in equity in people’s experiences and outcomes.

This approach ensured care was inclusive, responsive and effectively delivered to meet the individual needs of people most at risk of potentially experiencing poorer outcomes.

The service supported people and their families to plan ahead and make important and informed decisions about their future care, treatment and support. Relatives took part in discussions and decisions that reflected people’s wishes, needs and preferences.

Staff worked collaboratively with people to create individualised care plans that included their preferences and personal needs, their views were captured and their voices heard. Care, treatment, transition and discharge planning was reviewed regularly and amended to meet people’s expectations and any change in needs.

When required staff supported people to complete advance care plans, such as Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) documents and Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) documents.

The service collaborated effectively across their teams and with external partners when formulating plans for people with complex needs. This promoted consistency, continuity and coordinated support across different care and support settings. Staff ensured people received compassionate and effective care which was focused on their long-term wellbeing, future plans and successful outcomes.