Cygnet Elowen 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

Caring – this means we looked for evidence that the service involved patients 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 were generally discreet, respectful and demonstrated a caring attitude towards patients. Patients and relatives described staff as kind and approachable, and staff used respectful language when talking about people. Staff recognised patients’ individual needs, including cultural and personal preferences, and worked to build positive, trusting relationships with patients and their families.

Patients were treated with dignity and respect, and staff sought to understand what mattered to them. Staff responded to urgent needs promptly and supported patients during periods of distress, with care that was usually calm and supportive. Although some restrictions on choice and control were necessary to maintain safety, staff explained these clearly and aimed to minimise their impact, helping patients feel listened to and supported. Staff felt supported and valued by leaders and had access to wellbeing resources, which helped them maintain a positive and person‑centred approach to care.

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.

Staff treated patients with kindness, compassion, and dignity. This was also reflected in the respectful language they used to describe people. They demonstrated a caring attitude, and relationships with patients and their families. Staff also worked respectfully with each other and colleagues from other organisations, fostering a culture of kindness and mutual respect.

Care and treatment were generally delivered in line with patients’ preferences and wishes. However, some patients reported that their preferences regarding staff gender were not always accommodated. Most patients felt that staff listened to them and communicated in a kind and respectful way, although a few noted that some staff were kinder than others.

Staff respected patients’ privacy and upheld their dignity, while balancing the need for checks and safety under the Mental Health Act. They took the time to understand patients’ care and support needs, wishes, and choices, and the service provided sufficient time for staff to develop trusting relationships with patients and their families.

Patients had access to keyworkers and reported positive relationships with them. Staff knew patients well and understood their personal histories and how those impacted them. We observed staff interactions with patients that were person-centred rather than task-focused, and staff addressed concerns discreetly, maintaining confidentiality. The overall atmosphere of the service was friendly and inviting.

Staff treated people as individuals and tailored care, treatment, and support to meet their personal needs and preferences. They recognised and respected people’s cultural, social, and religious requirements, including those relating to sexual and gender identity. Staff considered relevant protected equality characteristics, though some risk assessments could have been more thorough to ensure that people with protected characteristics, such as transgender patients, were fully safeguarded.

Staff met people’s communication needs, enabling them to participate in their care and support. For example, one patient said, “When I’m low, I find it easy to write things down, and I communicate that way; staff are respectful of that.”

During the inspection, staff demonstrated awareness of individual needs. One patient had a nut allergy, and staff displayed a poster at the ward entrance to alert everyone, maintaining a nut-free environment. Facilities were provided to support religious practice, including a multi-faith room, even when no patients required it at the time.

Care plans included detailed information about personal, cultural, social, and religious needs, communication requirements, preferences, strengths, and aspirations. Where relevant, staff considered protected characteristics when documenting and delivering care. Care records reflected person-centred support that met individuals’ requirements, and policies aligned with best practice guidance on equality, protected characteristics, culture, and religion. Communication tools were used effectively to ensure people could engage in their care and support fully.

Staff supported patients to have choice and control over their care and treatment by involving them in care plan reviews and ward rounds. Although patients were detained, which limited their ability to make certain decisions or act fully independently, staff ensured they remained involved in day-to-day decision-making wherever possible. This helped maintain a sense of autonomy despite the restrictions in place. Some patients reported that their preferences regarding the gender of staff were not always accommodated, and this was identified as an area for improvement.

Equipment and adaptations were available to promote independence, particularly for patients with mobility needs. Patients felt supported to maintain their independence. For example, one patient who used a wheelchair had adjustments made to their environment, including lowering a sink to enable independent use. Patients confirmed they were able to receive visits from friends and family, which supported their wellbeing and social connections.

There was clear evidence that patients had sufficient opportunities to engage in meaningful activities, supported by appropriate staffing and resources. A wide range of meaningful activities was available within the service, and patients spoke positively about these opportunities. Activities included group sessions such as animal therapy, which was particularly popular, creative arts, and dialectical behaviour therapy (DBT) skills groups. Patients could also access one-to-one sessions, including guided journaling and relaxation. Patients reported having input into activities and valued the proactive approach of the activities coordinator. Comments included, “Activities are very good,” and “We have a lot of input in activities. The activity coordinator is really good and proactive.”

Staff supported patients to access the local community when appropriate through Section 17 leave, which allowed detained patients to leave the ward under agreed conditions as part of their care and recovery. Staff demonstrated a strong focus on promoting independence and choice, with one occupational therapist stating, “We tend to focus on what they do have control over and the choices they can make.”

Care plans included detailed information about patients’ day-to-day preferences, routines, interests, and relationships, supporting personalised care. Rotas included dedicated roles for facilitating activities, and care records reflected that patients were offered choices, participated in activities, and maintained contact with others.

Staff remained alert to patients’ needs and identified changes in mood, behaviour, and physical wellbeing. They responded promptly to immediate needs, including clinical concerns, physical health issues, and emotional distress, and escalated situations appropriately when urgent support was required. Staff used care plans, monitoring charts, and observations to guide their responses and maintain patient safety. They also applied de-escalation techniques effectively to reduce the need for restrictive or physical interventions when behaviours became heightened.

Staff responded quickly to signs of sensory overload. They recognised patients’ triggers and acted early to prevent avoidable distress. They used tools such as sensory ladders to support recognition of escalating distress and to help patients communicate their level of need. These visual tools supported understanding and engagement, particularly within a trauma-informed approach.

While some patients reported that staff did not always listen to their views, needs, and wishes, staff demonstrated an understanding of how to recognise patients’ needs and respond appropriately. At the time of the assessment, all patients communicated verbally, but staff also recognised and supported alternative methods of communication, such as writing things down when patients felt unable to speak. Staff identified when patients required urgent support and acted promptly to ensure their immediate needs were met.

Staff reported feeling respected, valued, and supported by their colleagues and leaders. They expressed pride in working for the provider and in their teams. Staff had access to support for their physical and emotional wellbeing, including occupational health services, and sickness and absence rates were in line with provider averages.

The provider recognised staff achievements and appraisals included discussions about career development and opportunities to improve skills. Staff had the necessary resources for safe working, including regular breaks and rest areas, and were able to provide feedback, raise concerns, and suggest service improvements.

There was a culture that normalised staff wellbeing through inclusivity, active listening, and open conversations. Staff reported feeling supported if struggling at work and could access personalised support that considered the diversity of the workforce, with both proactive and reactive measures in place.