Cygnet Kenney House

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• 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.

The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service, such as appointments, community activities and family relationships. 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 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We do not always 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.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Patients told us that since there had been a new chef, they felt listened to regarding their food preferences and menus were shared with them in advance.

Patients said the service did not tailor their responses to distress in an individualised way and some responses were not helpful from staff, for example staff said to patients, when they were upset, “Don’t cry”. Patients also told us that there were not enough staff to support them when needed, especially to sit and talk with.

Records showed and patients told us that they were involved in their ward rounds and felt listened to by the multidisciplinary team.

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.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff ensured that patients had access to community opportunities.

Staff supported patients to maintain contact with their families and carers. Visits took place in the service or patients had leave to spend time with their family in the community or at families’ homes.

Staff supported patients to access their chosen place of worship within the community.

We do not always provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

We scored the service as 2. The evidence showed some shortfalls. The service did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed. Records showed that referrals had been made to the safeguarding team. CQC Notifications had been submitted where required.

Information governance systems included confidentiality of patient records. Staff locked their computers when not using them and paper records were stored in locked rooms, either the nursing office or clinic.

The service mostly complied with the Accessible Information Standard. Each care plan had a communication section which included patient’s communication preferences of written communication, and this was facilitated within ward rounds. However, we reviewed 3 care plans for patients who were diagnosed autistic or in the process of being assessed for autism, their communication section of the care plan did not always advise staff how best to enable patients to communicate and how staff should respond if patients were overwhelmed or finding it difficult to communicate. However, positive behaviour support plans and one page profiles were in place which included strategies for staff to use if patients were distressed.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on. We saw there was a comprehensive welcome booklet for the ward which included information on treatments, the multidisciplinary team and patients’ rights.

The information provided was in a form accessible to the particular patient group. We saw easy read models of care information which was more accessible for patients.

Staff made information leaflets available in languages spoken by patients. The service could access interpreter service where needed.

Staff did not always ensure carers, families and commissioners were regularly updated about the patient’s progress. Stakeholders and carers told us that the service was not proactive at sharing information and that they had to contact the service for an update.

We make it easy for people to share feedback and ideas or raise complaints about their care, treatment and support. We do not always involve them in decisions about their care and tell them what’s changed as a result.

We scored the service as 2. The evidence showed some shortfalls. The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve people in decisions about their care or tell them what had changed as a result.

There had been 2 complaints since the service had opened.

One complaint had been upheld regarding staff not completing the patient observations as prescribed and the other complaint was still being investigated.

There had been no complaints referred to the Ombudsman since the service opened.

Patients knew how to complain or raise concerns.

When patients complained or raised concerns, they told us that it took a long time to receive feedback. Patients also told us that the complaints process was not always followed in relation to receiving complaint correspondence in a confidential and timely manner.

Staff protected patients who raised concerns or complaints from discrimination and harassment.

Staff knew how to handle complaints appropriately.

Staff received feedback on the outcome of investigation of complaints via the lessons learnt bulletin and complaints were discussed at the daily managers meetings.

The service had received compliments in relation to staff attitude and the service supporting patients in their recovery journey.

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

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff ensured the needs of patients with mobility issues were met, for example there was a lift up to the ward.

Staff made reasonable adjustments for patients – for example, a patient preferred to communicate via writing with the multidisciplinary team, and this was accommodated and recorded in their care plan.

Carers were involved in their loved one’s assessment and contributed to the development of their care plan.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital.

Staff ensured patients had access to post-discharge care. The service liaised with patients care coordinators and they were invited to ward rounds.

Staff planned for patients’ discharge, including good liaison with care managers/co-ordinators.

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.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their 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. There were weekly community meetings that patients were involved in. Patients told us that they felt listened to, however the community meeting minutes did not always include actions from previous meetings, therefore we did not know if all actions had been achieved.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff were trained in equality, diversity, inclusion and human rights with 100% compliance.

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.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Staff supported patients to make decisions about their care and treatment and their future. Patients told us and records confirmed their wishes and preferences were discussed within their ward rounds.

Staff created personalised care plans to account for the patient’s needs, wishes and feelings.

Staff ensured all relevant healthcare professionals and other relevant bodies are involved in planning the care and treatment of people with complex needs. Records showed that external professionals were involved relating to physical health care requirements, and care coordinators attended the ward rounds.