Cygnet Hospital Oldbury

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this newly registered service. This key question has been ratedGood

Good: This meant people were supported and treated with dignity and respect; and involved as partners in their care.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

We do not always treat people with kindness, empathy and compassion and we respect their privacy and dignity. We treat colleagues from other organisations with kindness and respect.

We observed positive interactions between staff and patients. Staff were discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it. Feedback from patients across the hospital was mixed. Out of the 5 patients we spoke with on Emmeline, 4 told us that some staff were not always caring. These patients gave examples of staff being rude and unhelpful. All patients on Rosa told us that staff treated them with kindness and compassion. One patient told us that staff were amazing and very helpful.

Patients across both wards told us that staff were not always visible and that they spent a lot of time in the office. Two patients on Emmeline ward told us that some staff spoke in their own language in front of patients and that staff had argued in front of them.

Staff supported patients to understand and manage their care, treatment or condition. Staff understood the individual needs of patients, including their personal, cultural, social and religious needs.

All patients told us that staff were respectful of their privacy and always knocked on their door. This was observed during our inspection.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences. Managers told us that they had previously had a patient who was transgender. They had implemented additional training to ensure that staff had the skills to support patients with protected characteristics appropriately.

Staff maintained the confidentiality of information about patients.

We treat people as individuals and make sure their care, support and treatment meets their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff and patient interactions we witnessed demonstrated that staff understood and respected the individual needs of each patient. Some patients had displayed their personal preferences on their bedroom door and told us that staff adhered to this.

Multidisciplinary patient reviews we observed were person centred and holistic. However, not all care records we reviewed reflected this level of personalisation and lacked patient voice.

The service made adjustments for disabled patients and met patients’ specific communication needs. We saw evidence that patients that spoke a different language had been supported appropriately through access to interpreters

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on.

Staff ensured that patients currently in the service could obtain information on a variety of topics such as treatments, local services, patients’ rights, and complaints. Information was displayed on the walls of the wards, such as general advocacy details and ward activities.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. One patient told us that vegetarian options were limited on the menu.

We promote people’s independence, so they know their rights and have choice and control over their own care, treatment. and wellbeing.

Staff told us that they supported patients to have choice and control over their own care, treatment and wellbeing. Patients reported being involved in their care through attendance at meetings and were able to share their views. This was not always evidenced within care plans. Most patients said they had been offered a copy of their care plans.

Staff made sure patients could access information on their rights and how to complain. Information about the Mental Health Act and making complaints was displayed on a notice board.

Most patients had access to their own mobile phone and were able to make calls in private. Staff told us that patients could access the hospital phone when required. One patient told us that staff did not allow the use of the hospital phone and would say it hadn’t been charged each time they had asked.

Staff supported patients to maintain relationships and networks that were important to them. The service had visiting rooms off the ward, which could be booked for visits. Carers reported regular contact from their relatives and that staff ensured they were kept up to date.

We listen to and understand people’s needs, views and wishes. We respond to these in that moment and will act to minimise any discomfort, concern or distress.

All staff that we spoke to were passionate and committed to supporting patients to receive quality care. Staff told us that about the importance of getting to know their patients well so that they could anticipate their needs and potential triggers. We observed staff responding to immediate needs on our visit and ensuring that patients were given a timeframe for when they were able to respond. Some patients did not feel that this was always the case. Patients on Emmeline ward told us that some staff were not always visible on the wards and were not readily available to attend to their needs.

Staff understood the purpose of de-escalation and used techniques to reduce the need for physical interventions when patients’ behaviours became heightened. This was evidenced on the review of incident reports where staff had documented actions taken to support patients.

We care about and promote the wellbeing of our staff, and we support and enable them to always deliver person centred care.

Staff told us that they felt respected and supported. Staff told us that leaders were supportive and felt that their contribution was encouraged and valued.

During the inspection we observed a patient using racist language towards staff and visitors. Staff told us that they have a zero tolerance approach to racism and felt comfortable challenging this in the most appropriate manner with the patient however on review of the care plan there was no evidence of racism being an issue. Staff told us that they did feel supported by the organisation and were encouraged to always log discrimination via the incident reporting mechanisms.

Staff said they worked well together and were proud of the way they had developed the service and gave good, compassionate care to patients.

Staff had access to support for their own physical and emotional health needs through an external health service.

Staff told us that they had conversations about career development and how it could be supported.