Cygnet Views

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence that patients’ care, treatment and support achieved good outcomes and promoted a good quality of life, based on the best available evidence.

At our last inspection, we rated this key question as Requires Improvement. At this inspection, the rating changed to Good. This meant patients’ outcomes were consistently good, and feedback from patients confirmed this

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 reviewed 6 care records during our assessment. Staff completed comprehensive mental health assessments promptly at, or shortly after, the time of admission. They also assessed patients’ physical health needs without delay. We found no concerns regarding the timeliness or completeness of these assessments.

Staff developed care plans that reflected the needs identified during the assessments. These plans were personalised, holistic, and recovery oriented. Staff regularly reviewed and updated care plans in response to changes in patients’ needs. However, discharge planning was not always clearly documented in the care plan section. In some cases, discharge-related information appeared scattered across other parts of the clinical record, which may reduce clarity and continuity of care.

Staff involved patients in the assessment of their needs and supported them to participate fully in the process. They took account of individuals’ communication preferences and needs, ensuring that patients could understand and engage with their care planning.

Staff used a range of validated assessment tools to ensure they captured a full picture of each person’s mental, physical, emotional, and social wellbeing. Assessments were up to date, and staff demonstrated a clear understanding of patients’ current needs

Staff delivered a range of care and treatment interventions suitable for the patient group. These interventions followed guidance from the NICE and leaders regularly shared updates through governance meetings. Interventions included psychological therapies such as Dialectical Behaviour Therapy (DBT) and Cognitive Behavioural Therapy (CBT), as well as structured activities. The occupational therapy team had begun developing a gardening project to support rehabilitation, although this remained in the planning stages.

Patients had timely access to physical healthcare support and were referred to specialists when needed. Staff assessed and met patients’ nutritional and hydration needs, including providing specialist dietary support where appropriate.

The multidisciplinary team included doctors, psychologists, occupational therapists, pharmacists, and other allied health professionals. This ensured care addressed patients’ physical, emotional, and psychological needs.

Managers identified individual staff learning needs through supervision and appraisal and offered development opportunities. When performance concerns arose, leaders responded promptly and effectively.

Staff were encouraged to take part in quality improvement projects and clinical governance. Clinical audits were completed regularly and delegated to staff to support shared ownership and team learning. Following the latest regional quality review, the service identified new quality improvement actions. There was evidence of a positive learning culture, supported by governance systems that promoted continuous development and effective practice.

Patients were actively involved in their care planning and received treatment based on current evidence. Staff ensured individuals understood their options and worked in partnership with them to deliver appropriate, person-centred care.

Staff held regular and effective MDT meetings every weekday. We observed one such meeting where topics such as medication, appointments, and changes in risk were discussed thoroughly. Staff also carried out detailed and professional handovers between shifts to ensure that essential patient information was consistently shared and acted on.

Teams worked collaboratively both within the hospital and with external services. This included effective coordination with care coordinators, community mental health teams, and crisis services. Community teams and social workers were actively involved in discharge planning and placement decisions, which helped ensure smooth and well-supported transitions for patients.

Information sharing was timely and well managed. When patients moved between services, relevant staff and partner agencies collaborated to assess needs and coordinate care, ensuring continuity and reducing the need for people to repeat their history. Staff had easy access to up-to-date patient information needed to plan and deliver care effectively.

Feedback from external professionals confirmed strong collaborative working. A social worker commented, “I have found this service to be responsive to any concerns, and they are happy to discuss ways of working effectively with my patient. They respect the views of social workers, and MDT working is good.” A clinical quality officer added, “We maintain regular communication with the unit and relevant stakeholders and have no concerns regarding the service.” Another stakeholder praised the MDT’s communication: “They keep me abreast of the patient’s progress, whether good or not, and use various strategies to engage the patient. Observation levels are reviewed daily, and I receive timely updates.”

Staff actively encouraged and supported patients to make healthier choices and improve their overall wellbeing. While levels of patients’ engagement varied depending on individuals’ needs and motivation, the service provided regular opportunities and resources to support healthier lifestyles.

On the ward, patients had access to therapy kitchen to help develop daily living skills and promote healthy eating. The Speech and Language Therapist recently introduced a traffic light system in the dining room, which uses colour-coded labels to highlight the nutritional value of foods.

Patients could participate in a walking group, swimming sessions, and structured personal hygiene workshops. A physical health lead nurse visited fortnightly, spending time with patients individually to support physical wellbeing and advise the wider team on any concerns or strategies. Patients also had access to onsite- beauty salon which we observed being used by some of the patients. Patients also had access to 2 enclosed gardens with seating areas where they could relax.

The service maintained strong links with the local GP practice and the Learning Disability liaison nurse at Chesterfield Royal Hospital, ensuring timely access to physical health checks and specialist input when required. Patients were supported to understand and monitor their own health, with regular reviews carried out in partnership with relevant healthcare professionals.

The provider had also introduced a healthy weight coach initiative through Cygnet. Three staff members from different disciplines at the service had expressed interest in becoming trained coaches, further demonstrating the team’s commitment to long-term health promotion and improving patients’ quality of life.

Staff used a range of recognised clinical tools to monitor patient progress and evaluate outcomes. These included the Health of the Nation Outcome Scales (HoNOS), NEWS2, and the Waterlow score. Outcome data was regularly recorded and reviewed to support care planning, monitor change, and adjust treatment where needed.

The psychology team carried out the EssenCES ward atmosphere survey every six months. It is ashort assessment questionnaireused to assess three characteristics of the atmosphere in wards: the feeling of safety of the persons involved the experienced therapeutic support and the cohesion among the patients. Findings were discussed in governance and reflective practice meetings and were also displayed in the unit to promote transparency and shared learning. Quality of Life data was collected every two months and used to support continuous improvement in how care was delivered.

Clinical data, including blood test results and physical health observations, was accessible via electronic systems. Patient progress was also tracked digitally, allowing teams to review outcomes consistently and respond promptly to emerging needs.

Patients were actively involved in tracking their own progress through care reviews and multidisciplinary meetings. One carer told us, “Clear, consistent boundaries have sharply reduced severe self-harm behaviours”, highlighting the impact of personalised, outcome-focused care.

Staff demonstrated a strong commitment to delivering care that aligned with clinical best practice while also reflecting the priorities and goals of patients themselves. Outcome data supported the view that patients experienced real and sustained improvements in both mental and physical health.

Staff supported patients to understand and consent to their care and treatment. Mental capacity was routinely assessed and clearly recorded in relation to specific decisions, in line with the MCA)2005. These assessments were decision-specific and carried out by the appropriate staff based on the nature of each decision.

When a patient lacked capacity, staff followed MCA principles and made best interest decisions that reflected the person's known wishes, values, culture, and history. Families, carers, and advocates were included in these decisions where appropriate. One carer told us, “I am always invited to ward rounds remotely and get called afterwards. My views are heard even when staff disagree.”

Patients were supported to understand their care options using communication methods tailored to individual needs. Staff used accessible language and formats, with tools created by the Speech and Language Therapy team. Easy-read materials and other aids helped ensure patients could make informed choices.

Staff showed a clear understanding of how consent interacts with the MHA. (When patients were detained under the MHA, staff continued to involve them in decisions as much as possible and applied the least restrictive principles consistently, including with medication and restraint.

Consent and capacity considerations were embedded in care planning and reviewed regularly. Staff were confident in applying both the MCA and MHA and clearly understood the differences. Patients were consistently encouraged to take part in decisions about their care, supporting dignity, autonomy, and inclusion in line with best practice and human rights law.