Cygnet Hospital Wolverhampton

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

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

Good: Leaders had the skills, knowledge and experience to perform their roles. Staff knew and understood the provider’s vision and values and how they applied to the work of their team. Most staff felt respected, supported and valued although, some staff felt that when raising concerns leaders’ responses were variable. Governance processes operated effectively. Performance and risk were managed well. Teams had access to the information they needed to provide safe and effective care. Staff collected and analysed data about outcomes and performance. They used this to identify improvements.

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 have a shared vision, strategy and culture that is based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding and meeting the needs of people and our communities.

Leaders told us that the hospitals visions and values were focused on delivering person centred care and working in collaboration with the patient and the multi-disciplinary team to ensure positive outcomes and effective recovery.

Most staff we spoke to understood the vision and values of the organisation and believed the hospital was delivering care in line with these values.

The service ensured the required multidisciplinary teams were in place, including psychology, occupational and other therapy staff. Most staff told us there was effective team working between these staff groups and ward-based staff. However, 2 staff members we spoke to told us there were some tensions between the disciplines. We observed the culture across both wards was generally positive and staff worked well together. Staff told us how their views were listened to, and they had the opportunity to contribute to discussions about the strategy for their service, especially where they could see how things could be improved. However, some staff felt that there was some ‘favouritism’ from leaders, and they felt that their opinions were not heard or recognised. Leaders told us that staff meetings had been held to discuss any concerns that staff had about allocation of work and fairness to make changes where needed and improve staff morale.

We have inclusive leaders at all levels who understand the context in which we deliver care, treatment and support and embody the culture and values of their workforce and organisation. They have the skills, knowledge, experience and credibility to lead effectively and do so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. Managers understood the needs of the patient group and worked towards patients achieving the best outcomes for them.

Both patients and staff told us that managers were visible and approachable, and that management had an open-door policy. We saw this in practice on the wards with ward managers offices being open to staff who were able to ask for advice or support throughout the day. Managers also made themselves available for patients if they wanted to speak to them.

We saw that managers had been promoted internally and encouraged to develop professionally with support from the provider. We were told that the service supports ‘growing their own’ and has development opportunities for all staff. Staff were encouraged to develop their skills and training opportunities were available for all staff.

We do not always create a positive culture where people feel that they can speak up and that their voice will be heard.

The hospital had a Freedom to Speak Up Guardian. Contact details were displayed in the staff areas. Most staff we spoke with felt confident their voice was listened to and felt they could approach managers directly if they needed to raise a concern. However, three staff members did not feel that their concerns regarding the referral process and inappropriate admissions were always listened to. Staff told us that a staff member had come to harm from a patient during a serious incident on the ward. Staff had raised concerns that the patient’s risk history was not shared appropriately during the referral process. Two staff members felt that they did not always have a say in whether a patient was eligible for the ward and when they raised concerns the response from leaders was variable.

We were told by staff that the service had some support workers who were on sponsorships from other countries. These staff had highlighted, through freedom to speak up, that they had at times felt they had a higher workload which made them feel excluded. Management had recognised from feedback that some of the staff had not fully understood requirements under the sponsorship. They looked at additional ways in which they could support this cohort and ensure that communication channels were open. By doing this they had seen an improvement in this cohort’s morale.

Patients and carers had opportunities to give feedback on the service they received in a manner that reflected their individual needs. Patients told us staff had responded positively to their feedback and changes had occurred following this. Community meetings took place on a regular basis on both wards and changes had been implemented as the result of feedback from these.

We value diversity in our workforce. We work towards an inclusive and fair culture by improving equality and equity for people who work for us.

The hospital promoted equality and diversity within the service. Managers put reasonable adjustments in place for staff members to help them carry out their role. This included opportunities to change hours or ways of working due to personal circumstances such as caring responsibilities and health issues.

There were equality and diversity networks available to staff within the wider organisation. This included the equity, inclusion and diversity network, multicultural network, women’s network, LGBTQ+ network and the disability network. Information about these networks was available in staff areas and included on induction. The most recent staff survey findings around staff being aware of the networks and groups ranged from 12% of staff not being aware of any groups to 81% of staff being aware of the Equity, Diversity and Inclusion Group. 82% of staff felt that the organisation recognised the challenges and inequalities faced by people due to their protected characteristics. 74% felt that the organisation acted fairly with regards to suspensions and disciplinary procedures regardless of protected characteristics.

We have clear responsibilities, roles, systems of accountability and good governance to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.

There were systems in place to review incidents, performance issues and planning. Monthly audit processes gave staff a good oversight of the service and where improvements were required. The leadership team was committed to developing the service ensuring improvements were being continually made. Staff had implemented recommendations from reviews of incidents, complaints and safeguarding alerts at the service level. This included changes to the restricted items such as certain vapes and ensuring patients were searched when they returned to the service.

Managers had access to a risk register for the service which included 9 recorded risks, 5 of which had been resolved. The remaining risks included risks associated with the new building settling and cracks appearing in the walls, absconding risks due to the height of a fence at the rear of the property and exposure of risk items in the garden as the earth settled. The risk register included a score for the severity of each risk; actions being taken to address the risk (including immediate mitigation) and timescales for completing those actions.

Staff had access to the equipment and information technology needed to do their work. Information governance systems included confidentiality of patient records.

We understand our duty to collaborate and work in partnership, so our services work seamlessly for people. We share information and learning with partners and collaborate for improvement.

Patients were admitted from across England and Wales and were often not from the local area. Managers and staff shared information with commissioners, who were routinely involved in reviewing patient’s care and progress. Commissioners were positive about their engagement with the service and did not raise any significant concerns. Staff told us it could be difficult when patients were moved relatively quickly when a bed became available in their local area which could impact on the continuity of care, but this was a decision made by commissioners. The service had made good working relationships with many of the commissioners Staff worked in partnership to extend the length of a patient’s stay if it was in their best interests to remain.

Managers and staff worked with other services, both within Cygnet Healthcare and in the broader community, to share information and learning. This included working with other healthcare services, and patient support groups such as advocacy and experts by experience.

Prior to the hospital opening, the managers had made significant steps to form links and partnerships in the local community. They had approached the local shopping centre and supermarkets who now worked with them and offered a safe space for patients who may be visiting the centre if they needed support. They had done the same with the local hospital emergency department who were also able to understand the support needs of patients who needed medical care. We were told how this initiative with the hospital had been positive with patients being well supported by emergency staff who understood their care needs. It had also been reciprocal that when members of the public who were experiencing a decline in the mental health had approached the service they had been able to refer them to the hospital or provide a safe space whilst they waited for partner agencies to come to offer appropriate support.

We were also told about the links that had been formed with police, housing, and charities in the area. They had also worked with more specialist services such as veteran support service, ex-offenders, rehabilitation work and substance misuse services. The service also had links with the asylum seeker charities such as the Red Cross to support patients with their immigration status and access to public funds.

We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome and quality of life for people. We actively contribute to safe, effective practice and research.

The service focussed on continuous learning and improvement across the organisation. The service had a positive and robust approach to improvement and learning from incidents and all staff we spoke to were able to give us good examples of where lessons had been learnt and changes made after incidents.

Staff were looking at ways to improve the environment for patients including occupational therapy making use of the corridor space and developing a sensory circuit for patients.

Staff used quality improvement methods and knew how to apply them. The service was working towards achieving the ‘Triangle of Care’ level 1 accreditation from the Carers Trust, which is a charity that promotes support for unpaid carers.