Cygnet Joyce Parker Hospital

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

At our last assessment we did not rate this key question. This is the first rated assessment for this service. We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

This key question has been rated as good. This meant people were supported and treated with dignity and respect. Staff were now treating patients with kindness and compassion and were no longer dragging patients during incidents of restraint. Staff met patients’ immediate needs. Patients were supported by staff who felt valued by their leaders and their colleagues.

However, staff did not always involve people as partners in their care and did not ensure patients had access to activities to promote and support their independence, health and wellbeing.

The service was in breach of regulations for person centred care.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We always treat people with kindness, empathy and compassion and we respect their privacy and dignity.

Staff treated patients with kindness, compassion and dignity in their day-to-day care and support. We observed staff being kind and compassionate towards patients during our site visits. Most patients told us staff were polite, friendly and always available. One patient told us staff spoke to each other and not to them when on their observations. Another patient told us staff were sometimes caring but this could vary day to day. We reviewed CCTV footage of 7 incidents across all wards that involved staff physical restraint of patients. Staff treated patients with kindness and dignity in the footage reviewed. We spoke with the relative of a recently discharged patient who told us staff treated them and their loved one with kindness. They also praised the service’s independent expert by experience for the emotional and practical support they provided to their relative.

We treat people as individuals and make sure their care, support and treatment meets their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff understood and met patient’s personal, cultural, social and religious needs. Staff created a care plan to support a patient who wished to observe Ramadan. Staff accessed an interpreter to support a patient whose native language was not English. A patient on Brook ward told us staff supported their religious needs and facilitated a visit to the cathedral. We observed staff discussed the religious needs of a patient at the morning meeting on Brook ward. Leaders told us they made links with the local Prevent team to identify safe mosques for patients to attend. We reviewed a patient care plan which confirmed this. They made links with other religious institutions and a multi faith leader and Imam were due to visit the service. However, on Beck and Blythe wards the multi faith rooms did not include an indicator for the direction of Mecca.

The provider did not always promote people’s independence, so people did not always have choice and control over their own care, treatment and wellbeing. People did not have access to a full range of activities to promote and support their independence, health and wellbeing.

Staff did not always support patients to understand their care and treatment. In care records reviewed we found minimal evidence of staff involving patients in planning their care and treatment. Patients spoken with told us they were not offered a copy of a care plan and 1 patient asked us what a care plan was. Leaders told us that following our feedback about lack of patient involvement in care plans they reviewed and introduced a new care plan template with additional prompts to capture patient views. The advocate and expert by experience were supporting patients to be involved in their care plans.

Staff did not ensure patient access to a range of activities to promote and support their independence, health and wellbeing. Five patients told us they were bored. We reviewed monthly reports produced by the expert by experience. The November 2024 report noted that “Activity provision on the wards was highlighted as an area requiring significant improvement. Service users reported a lack of structured or engaging activities, which has affected their overall experience” The December 2024 report stated, “Service users have reported feelings of boredom on the wards, indicating a need for more meaningful activities and engagement opportunities.” The January 2025 report stated, “A recurring theme in service user feedback is boredom on the wards, attributed to a lack of structured activities.” The February 2025 report stated “activities remain a concern for service users. There is a desire for a wider variety of structured activities to keep service users engaged and occupied throughout the day.” We spoke to an advocate who visited the service. They told us that patients were often bored and spent most of their time in their bedrooms. They had made suggestions for activities to staff. The CQC inspection team saw no activities taking place on wards across our 2 days on site. On Brook ward there was a multicultural cooking session timetabled for when we were on the ward, however there was no sign of this taking place. We reviewed community meeting minutes from December 2024 and January 2025 for all wards. Some actions were ongoing for over a month, including patients requests for gym/sports equipment. Patients on Blythe ward complained about a lack of activities in 3 of the meetings and repeatedly requested access to gym and sports equipment. We reviewed the provider’s activities/ offered declined report for January 2025. Across the 3 wards 3473 hours of activities were offered with 78 (2%) of hours declined. Blythe ward offered the most activities at 1611 hours (this equated to 51 hours per day). The report did not include details of what these activities entailed. We were not confident that this data accurately reflected activities taking place in the wards. The independent expert by experience was leading a Quality Improvement (QI) project looking at meaningful activities. The provider employed activity coordinators for each ward, covering 7 days a week. However, concerns were raised that the activity coordinators were used to complete other tasks and that they did not fully understand their role.

Staff supported patients to have access to their friends and family while they were using the service. There were visitors room on each ward for patients to meet up with family and friends. The provider advised patients had access to their own phones to enable contact with family and friends. We saw care plans on each ward that detailed arrangements for keeping patients’ families updated. We spoke with the relative of a recently discharged patient. They told us staff were very flexible about when they could visit, and they visited nearly every day. Staff supported them to visit their loved one when they were in seclusion.

We listen to and understand people’s needs, views and wishes. We respond to these in that moment and will act to minimise any discomfort, concern or distress.

Most staff prioritised patient’s needs, views, wishes and comfort and quickly anticipated these to avoid any preventable discomfort, concern or distress. We observed staff responding to patient’s immediate needs throughout our visit. This included requests for food and drinks. If staff were unable to provide what was needed straight away, they would explain this to the patient and give a timeframe for when they would be able to respond. A patient on Brook ward told us that staff were responsive to requests for mango juice and sorted this out. They said staff response time was “fantastic”. We observed staff deescalating and supporting patients when they were distressed. Patients told us they were able to access snacks and drinks when they wanted. Most patients were positive about the food provided; however, some patients described it as bland and unhealthy.

However, on Blythe ward we observed a patient asking staff if they could go to the shop for them, this was mid-morning. Staff told the patient not today, maybe tomorrow. It was unclear why this could not be facilitated on the day. A patient on Beck ward told us it takes forever for staff to sort anything out.

We care about and promote the wellbeing of our staff, and we support and enable them to always deliver person centred care.

The provider recognised and met the wellbeing needs of staff. These included the necessary resources and facilities for safe working, such as regular breaks and rest areas. We observed staff taking breaks throughout our visit to the service. Most staff were positive about the support they received from colleagues and leaders at the service. Staff morale had been low from the impact of all the changes, but this had improved. Staff told us they were treated equally and worked well as a team. One staff told us staff are more empowered to make decisions since changing from CAMHS to adults. Staff told us managers were open and supportive and encouraged them to raise concerns. Leaders promoted a culture of not tolerating abuse of discrimination against staff. This included arranging police support for staff reporting racist abuse.