Cygnet Hospital Wolverhampton

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

This means we looked for evidence that the service met people’s needs.

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

Good: This meant people’s needs were met through good organisation and delivery.

Good: The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities within the service. The service met the needs of all patients including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We make sure people are at the centre of their care and treatment choices and we decide, in partnership with them, how to respond to any relevant changes in their needs.

The service had taken steps to put people at the centre of their care and treatment. Staff developed care plans around patients’ individual needs and preferences. Most care plans included elements of the patient’s voice. However, this was not always evidenced consistently and reasoning for this was not always recorded. Patients told us that they had not been given copies of their care plans and could not remember if they had been offered. Staff and leaders explained how they took steps to include patients in their care planning but due to their acuity at different stages of their treatment they did not always wish to engage fully. However, the patients we spoke to felt that staff were caring and responsive.

Staff regularly met with patients, and we saw evidence that discussions around care and treatment took place in one-to-one meetings with nurses and in multidisciplinary team meetings. Staff told us that patients were at times reluctant to be involved in care planning. Staff shared a pre ward round form with patients to fill in points they would like to discuss. If the patient did not complete this then staff tried to engage them in a conversation more informally to help involve them wherever possible. Staff monitored patients’ conditions and discussed any changes at handover meetings.

The service provided therapeutic and recreational activities to meet the needs and personal interests of patients. There were activity coordinators on the wards with a set programme of activities that patients could engage with. Patients told us that there were things to do on the ward and most patients appreciated being able to access the onsite gym.

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

Staff supported patients to maintain contact with their families and carers. Where consent was given by the patient, family members were involved in their relative’s care. We spoke to the services family liaison lead who ran carer drop-in sessions twice a week and larger community drop in’s once a month. The family liaison lead would also meet with families when patients were admitted and discharged. One carer had praised how staff had involved them in the patients care and allowed access to MDT’s remotely if they could not attend in person.

Patients told us they were able to call family and carers told us how their family members were updated by staff on their progress.

The hospital admitted a number of patients from outside of area. They had taken steps to work with commissioners and hospitals in the areas where they saw a number of patients coming from to create contacts and continuity of care.

Staff ensured that patients had access to appropriate spiritual support. The hospital had a multi faith room that was well utilised. The service had links with the local churches, mosque and other religious settings in the local community.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

Staff made notifications to external bodies as needed. The service submitted notifications to the Care Quality Commission in accordance with the requirements of their registration. The service also submitted safeguarding referrals to the local authority.

The service could support and make adjustments for disabled people and those with communication needs or other specific needs. We saw examples of leaflets written in an easy read and accessible formats.

Staff made sure patients could access information on treatment, local services, their rights and how to complain. Key information was displayed on noticeboards throughout the ward including, patient rights, safeguarding processes and activities available at the hospital. Patient information leaflets were written in an accessible format, and the service could access the leaflets in different languages when needed. Managers made sure staff and patients could get help from interpreters or signers when needed. When reviewing one patient file their communication needs had been recorded and the use of a communication ‘grab bag’ was implemented to support them. The service had also utilised staff who were able to use British sign language (BSL) from another hospital within the group to help support a patient who used sign language until additional staff who communicate using BSL could be sourced.

We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We involve them in decisions about their care and tell them what’s changed as a result.

The service had a complaints policy in place. The policy provided detailed information on how to report a complaint and what to expect during the complaints process.

The service had received a total of 27 complaints for the six months prior to our visit. 14 of these had been dealt with at the early resolution stage with 13 going through a formal investigation. Of the 13 that had had a formal investigation 3 were upheld, 6 were partially upheld, 3 were not upheld and 1 was withdrawn. We did not identify any reoccurring themes in complaints made.

The hospital had clear processes in place to manage complaints. All patients said they knew how to complain and were confident in doing so. When speaking to two patients we were told how staff listened and responded to complaints. Such as, reducing the amount of salt in the food and supporting someone to buy more clothes when they had complained they didn’t have enough clothing. We also reviewed the friends, family and carers satisfaction surveys which were mainly positive with most areas scoring 4 or 5 stars out of a 5-star rating.

Staff said they knew how to handle complaints appropriately and efficiently and managers provided feedback on the outcome of investigations and acted on any findings.

We make sure that everyone can access the care, support and treatment they need when they need it.

The wards were located over two floors and had facilities that met the needs of patients with mobility difficulties. All communal areas and bedrooms were spacious and accessible. Managers told us they would always assess whether they could meet a patient's needs safely on admission. Rooms on the downstairs part of the hospital were most suitable for patients with mobility issues, although lift access was available if required.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was directly opposite the local acute hospital and had a good relationship with the staff in the emergency department should they need to attend.

Staff carefully planned patients’ discharge we saw evidence of discharge planning within care plans, multidisciplinary meetings and patient ward rounds. Staff supported patients with transitions into future services and placements. We were told by staff and a patient’s family how they had supported one patient to clear and clean their home in preparation for discharge. Staff told us their priority was always the wellbeing of the patient and wanted to ensure that discharges were as safe as possible. Some staff did however explain that some discharges were made quite quickly when a bed became available closer to the patient’s ordinary residence.

Staff told us how they would allow patients to stay on the ward for as long as they needed to ensure that they were discharged to a suitable placement. Staff invested their time and support to prevent people from being discharged homeless. Feedback from patients had been positive about the level of support they had received around discharge.

In the 6 months prior to our inspection there has been no delayed discharges caused by issues within the service. However, we were told about 1 case where the discharge had been delayed due to external components of care not acting in a timely manner. The provider evidenced how they had worked to bring all partners together to ensure that the patient was able to be discharged with an appropriate package of care.

We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Patient and carers feedback was collated through community meetings, patient and carer satisfaction surveys, compliments and complaints.

The service admitted patients from diverse religious and cultural backgrounds. Staff asked patients about their religious and cultural needs when they were admitted to the ward. Staff from different ethnicities were encouraged to share their cultures with the patients an example of which was when staff members had cooked dishes which were culturally significant to them. The service also held events celebrating cultural and religious festivals. These included Ramadan and Eid, Christmas, Black History Month, and Diwali. Events were co-designed with patients to ensure their voices and traditions were represented.

Staff shared that adjustments were made to accommodate patients with diverse needs. Information was also made available in various formats and languages upon request to ensure accessibility. Translation services had also been made available.

All staff were trained in equality, diversity, inclusion and human rights with a compliance rate of 100% at the time of the inspection. The service had undertaken an equality impact assessment to identify any communities that could be negatively impacted by any changes made to service delivery ensuring the services provided were non-discriminatory.

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

Staff supported patients to make informed choices about their care and plan their future. We found evidence of discharge planning in care records reviewed. The multidisciplinary team worked in partnership with external agencies including local mental health teams to ensure a safe discharge.

The service had a dedicated social worker who worked closely with patients and other agencies to support with discharge planning. We saw that they identified barriers that patients may face both on the ward and within the community so as issues with benefits and supported patients to overcome these.

For patients who had complex needs we saw that staff ensured that all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment.