Cygnet Joyce Parker Hospital

On this page

• 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

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 met people’s needs.

This key question has been rated as good.This meant people’s needs were met through good organisation and delivery. Staff ensured patients could get information and advice that was accurate, up-to-date and provided in a way that they could understand. Staff supported patients to make informed choices about their care and plan their future.

However, staff did not regularly involve patients and those close to them in planning and making shared decisions about their care and treatment. Staff did not always ensure that if patients fed back or complained they would be responded to.

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

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider 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.

Staff did not regularly involve patients and those close to them in planning and making shared decisions about their care and treatment. We reviewed care records for 12 patients across all wards. There was minimal evidence of staff involving patients in planning their care and treatment. We found minimal evidence of carers or other people close to the person being involved in planning their care and treatment. A patient on Beck ward told us they were not involved in developing their care plan and had not seen a copy. However, 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. We saw 2 patient care plans updated with their views on our return visit. We spoke with the relative of a recently discharged patient who told us they were fully involved in discussions about their loved one's care and treatment. They also said staff went out of their way to make changes to meet their loved one's needs, for example, moving their loved one to a ward with better access to outside space as they liked being outdoors.

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.

Leaders described how they worked with local health providers, including GP’s and hospital based specialists to ensure patients received continuous care for any physical health problems whilst they were in the service. External stakeholders told us that staff were open and responsive, and leaders were keen to be part of the wider health and social care system. Staff were in regular contact with patients’ home area teams to ensure continuity of care once discharged from the service.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

Staff ensured patients could get information and advice that was accurate, up-to-date and provided in a way that they could understand. Staff provided easy read versions of information. Leaders told us they ensure staff are aware of how they communicate with patients and ensure patients understand what is being said to them, especially when explaining their rights under the Mental Health Act.

Staff provided accessible information to patient’s family, friends and carers. Staff spent time with the patient’s family, explaining the care and treatment process and how decisions were made. Staff offered relatives access to a carer advocate if required. Staff provided carers with leaflets that explained patient rights, and a welcome pack with details about the wards.

Staff tailored information to meet individual patient needs. This included interpreting and translation for patients who did not speak English as a first language. The service could access interpreters when required and were supporting a patient whose native language was Persian. Staff and the interpreter spent time with the patient talking through care and treatment, safeguarding and complaints and supporting the patient to ask any questions. We saw this detailed in the patient’s care plan. We reviewed communication passports for 3 patients with learning disabilities and/or autism, staff used these to effectively communicate and support the patients.

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

Staff ensured patients and those close to them, knew how to give feedback about their experiences of care and support including how to raise any concerns or issues. Staff facilitated weekly community meetings on each ward, where patients could share feedback and raise any concerns. Leaders recently introduced the `People's Council' which was chaired by the independent expert by experience and attended by patient representatives from each ward as well as the general manager. Senior managers regularly visited the wards to gather informal feedback from patients. Cygnet's lead expert by experience visited the hospital recently and praised the service for its transformation and advised they received positive feedback from patients they spoke with. Patients had access to the independent expert by experience and advocates. We saw evidence of staff consulting patients on planned changes, for example, setting time that leave cannot be taken at night and the introduction of quiet hours overnight. We spoke with the relative of a recently discharged patient who said they were able to feedback in meetings about their relative's care and treatment and were kept fully involved. Cygnet facilitated a monthly provider wide `Carers, Family and Friends Virtual Drop-in' hosted by the director of nursing. Cygnet also provided an advice and liaison service for carers, family and friends. The provider gave examples of coproduction including patient involvement in designing the social hub, reviewing blanket restrictions and developing a safeguarding charter. We reviewed monthly reports produced by the expert by experience. The January 2025 report stated, "Service users and their families have expressed satisfaction with the care provided, with some referring to the wards as a `five-star hotel". We reviewed monthly reports produced by the independent advocate between November 2024 and January 2025. During this time independent advocates visited the service 22 times and facilitated 177 direct advocacy sessions. The reports stated "Independent advocacy supported clients to raise 1 formal internal complaint in November. This has now been closed. Independent advocacy supported clients to raise 1 formal internal complaint in December". The provider reported 23 complaints received between 1 November 2024 and 31 January 2025 (Blythe- 13, Brook- 6 and Beck- 4). Of these, 4 were upheld. For the same period the provider reported 24 compliments received. (Blythe- 11, Brook- 8 and Beck-5). Fifteen compliments were received from patients, 6 from relatives/carers and 3 from external healthcare professionals. A patient on Brook ward said he "fully trusts the staff and that they have his best interests at heart", on Blythe ward an external professional said "the team have been incredible, they have really adapted well to the new service line. It's some of the best team working I have seen at Joyce Parker Hospital" and on Beck ward a relative emailed the doctor to say "thanks for your great help, thank you for everything".

Staff did not always ensure that if patients fed back or complained they would be responded to. We reviewed community meeting minutes from December 2024 to January 2025 for all wards. On Beck and Blythe wards there were several actions that were ongoing for over a month, including an action to source a games console cable and for staff training to facilitate patient access to the gym, with limited feedback on progress. One patient on Blythe ward said there was no point feeding back as it doesn't change anything. A staff member on Brook ward said patients sometimes raised concerns and didn't get a response from managers. However, there was evidence of completed tasks and feedback following actions being taken forward, for example, patients requesting drinks and fruit at the `People's Council' meeting which has now been sorted.

Leaders gave examples of learning from complaints, for example, a patient complained about being searched in a communal area. Although there were no other patients around staff were reminded that this was not appropriate and to use the search room. Leaders advised formal complaints are thoroughly investigated and responded to. They shared the investigation report following a complaint made by a relative last year. This was thorough and reviewed all aspects of the patient's care and treatment, including a review of CCTV footage.

Staff did not always ensure patients were kept informed about how their feedback was acted on. Each ward displayed a `you said, we did' board. On Beck ward the `we did' section was blank. On Brook ward the `we did' section was rubbed out and on Blythe ward there was nothing recorded in either section.

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

The provider ensured patients could expect their care, treatment and support to be accessible, timely and in line with best practice, quality standards and legal requirements, including those on equality and human rights. This included making reasonable adjustments for disabled people, addressing communication barriers and having accessible premises. Leaders advised all hospital areas were accessible, and no issues were identified in a recent Disability Discrimination Act review. Larger bedrooms were available if required as well as bariatric beds. There were parking facilities for people with a disability. Staff were involved in the local community, for example, supporting fundraising events for charity. Staff accessed specific cultural and spiritual support for patients who needed this. Staff made reasonable adjustments for patients, for example, patients with mobility issues were provided with walking aids and shower chairs.

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.

Staff were trained in equality, diversity, inclusion and human rights. The provider reported 100% of staff completed equality and diversity training as of 7 March 2025.

Staff ensured equal access to therapeutic opportunities for a patient whose first language was not English. Staff did this by involving the interpreter in all aspects of the patient’s care and treatment.

Leaders and staff were alert to discrimination and inequality that could disadvantage different groups of people using their services. Leaders challenged ward managers to go on their ward, relinquish their keys and be a patient for half an hour to see how quickly staff responded and how restrictions impacted on patients. Restrictions on the wards were in line with expectations for an acute and PICU service. We reviewed blanket restrictions on each ward. Staff completed and regularly reviewed blanket restriction logs for each ward with patients. Each restriction included a risk reason and detailed the impact on patients. Individual patient restrictions, for example, seclusion and enhanced levels of observations, were reviewed daily with the aim to reduce and remove as soon as possible.

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future.

Staff supported patients to make informed choices about their care and plan their future. We found evidence of discharge planning in care records reviewed. We reviewed the care record of a recently discharged patient on Beck ward. We saw the MDT and community care coordinator were involved in the discharge process. Staff involved patients home area teams, including safeguarding teams, when planning patients’ discharge from the service.