Cygnet Kidsgrove Hospital

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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 rated Good.

This meant people were supported and treated with dignity and respect; and involved as partners in their care. Staff treated patients with compassion and kindness. They respected patients’ privacy and dignity. They understood the individual needs of patients and supported patients to understand and manage their care, treatment or condition. Staff involved patients in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately.

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.

The evidence showed some shortfalls. The service did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

We spoke to 4 patients whilst on Crocus ward and 6 patient carers in total. We received mixed feedback about staff attitudes and behaviours when interacting with patients. Some patients told us that certain staff were kind and understood how best to support them, while others were described as less approachable.

One patient stated that although staff would knock on doors, they did this at night whilst patients were sleeping which disturbed them. Another patient stated that staff would sleep during observations at night and would speak in their own language or discuss their own private life in front of patients. We were also told that had been one incident of a male staff member shining a torch into a bedroom despite the patient being naked and having to shout out that they needed privacy.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences.

Staff maintained the confidentiality of information about patients which was stored on the electronic system or in paper files on the ward.

The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made adjustments for disabled patients and met patients’ specific communication needs. There was lift to access the ward, which some patients with limited mobility were seen to use, with staff support.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights and how to complain. Information was displayed on the walls of the wards, such as general advocacy details and ward activities.

Leaders were aware of how to access interpreters and/or signers although there had not been a need for this service since the hospital had opened.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. However, one patient told us they had multiple food allergies, which made ordering meals on site difficult, and as a result they often had to source their own food from elsewhere the ward did provide food choices, but they were repetitive.

There was a multi‑faith room available on the ward, and the service had links with a local church for patients who wished to attend.

The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Patients were informed about their rights, whether informal or detained under the Mental Health Act. Staff explained their rights in ways patients could understand and repeated information when needed. Staff provided information in accessible formats where appropriate. Patients told us they had access to independent advocates where needed and that they knew how to complain and give feedback if they wished.

Patients and their families told us staff were often unavailable to speak to when needed. They reported this had a negative impact on their wellbeing. One family member stated that they had not been invited to ward rounds and another had not been involved in discharge planning.

The evidence showed some shortfalls. The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

All patients we spoke to told us that staff were not always responsive to their needs. We observed patients waiting at the nurse’s office door or being unable to get staff attention due to the lack of available staff present on the ward.

Staff were aware of and dealt with any specific risk issues, such as falls and ensured patients had corresponding care plans in place. We saw that specific risk issues were considered in risk assessments and observations were used to help reduce risks. These levels were regularly reviewed to ensure they were the least restrictive option.

Patients consistently reported that they felt staffing levels on the wards were low. One individual explained that when they knocked on the nurses’ office door, they often had to wait a considerable time without anyone responding. We observed that staff were extremely busy during our visit to the ward, and on several occasions patients were seen sitting outside the nursing office for extended periods while waiting for staff to attend to their needs.

A patient told us that despite being on the ward for several weeks, they only had access to a limited number of changes of clothes. This concern had been raised with staff but had not been addressed, resulting in the patient repeatedly wearing dirty clothing. When we spoke with staff and reviewed the patient’s inventory, we confirmed that this was the case and that the patient had not been adequately supported in relation to their clothing needs. We were assured that this issue was rectified while we were onsite, with the patient being supported to return home to collect additional belongings.

Another patient that they hadn’t been provided with basic hygiene items. They also stated that they had not been supported to access the laundry despite needing help in this area. This was raised to staff whilst on site and hygiene items were purchased.

The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Staff told us they felt respected, supported and valued. One staff member raised concerns about feeling unsupported regarding upcoming visa-related processes, but this was an isolated case.

The service operated an ‘Employee of the Month’ scheme to recognise staff for their work. Nominations were open to anyone involved with the service, including staff, visitors, external professionals, patients and relatives. Staff who were nominated but did not win received an email informing them they had been put forward and outlining the reasons for their nomination.

Staff reported feeling well supported by both the ward leadership team and regional leaders, who were regularly visible on the ward. They also confirmed they could access support for their own physical and emotional wellbeing through an external occupational health service. We observed a staff support poster displayed in the staff room. However, it was unclear how frequently staff were making use of the break room, as staff told us they often had meals with patients on the ward and staffing pressures limited opportunities to take breaks away from the clinical area.

Staff told us that reflective practice sessions were available to them. However, due to staffing levels and ability to leave the ward, these sessions were not accessible to all staff.

Staff told us they had opportunities to discuss career development and how this could be supported. They also shared that some leaders within the service had progressed internally, having worked their way up through the organisation before recently taking on their current leadership roles.