The Care Quality Commission
  • Mental Health
  • Independent mental health service

Cygnet Brunel

Overall: Good read more about inspection ratings

Crow Lane, Henbury, Bristol, Avon, BS10 7DP (0117) 440 1080

Provided and run by:
Cygnet Behavioural Health Limited

All Inspections

During an assessment of Long stay or rehabilitation mental health wards for working age adults

Mental Health Act and Mental Capacity Act Compliance

Mental Health Act

All staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles. Staff had received training in the Mental Health Act and the service was 100% compliant.

Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.

The provider had relevant policies and procedures that reflected the most recent guidance. Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.

Patients had easy access to information about independent mental health advocacy.

Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done it.

Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this had been granted.

Staff requested an opinion from a second opinion appointed doctor when necessary.

Staff stored copies of patients' detention papers and associated records, such as, Section 17 leave forms, correctly and so that they were available to all staff that needed access to them. We reviewed Section 17 leave forms and they were in good order. These were also regularly audited.

Mental Capacity Act

Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles. All staff had received training in the Mental Capacity Act and Deprivation of liberty safeguards.

The provider had a policy on the Mental Capacity Act, including Deprivation of liberty safeguards. Staff were aware of the policy and had access to it. Staff knew where to get internal advice from within the provider regarding the Mental Capacity Act, including Deprivation of liberty safeguards.

Staff took all practical steps to enable patients to make their own decisions. For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions.

When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. We saw evidence of best interest decisions recorded in patient records.

The service had arrangements to monitor adherence to the Mental Capacity Act every 3 months. The service took action when learning had been identified by Mental Health Act visits and audits.

During an assessment of the hospital overall

We assessed Cygnet Brunel on 26 and 27 November 2025. This was an unannounced comprehensive inspection to update the previous 2018 rating for this service.

At this inspection we assessed all 34 quality statements across all five key questions. At the previous inspection all key questions were rated good. At this inspection we found that all key questions were still good.

Our inspection team comprised 4 Mental Health Inspectors and 1 Specialist Adviser.

Before the inspection visit, we reviewed information that we held about the provider, including from other organisations and feedback from patients.

Cygnet Brunel is a purpose-built long stay rehabilitation unit for men of working age. The unit is registered to accommodate up to 32 people. At the time of the assessment there were 30 people admitted across four wards. We visited all four wards as part of this assessment.

Cygnet Brunel is registered with CQC to deliver the regulated activities of treatment of disease, disorder or injury; assessment or medical treatment for people detained under the Mental Health Act 1983; and caring for people whose rights are restricted under the Mental Health Act. The service supports the Level 1 Neuropsychiatric Rehabilitation pathway, accommodating Level 1 & 2a patients across all four wards. Cygnet Brunel has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We visited the following wards as part of the assessment:

Clipper ward,10 beds for male patients affected by acquired brain injury with complex physical health support requirements.

Pilot ward, 10 beds for male patients with a co-morbid diagnosis of acquired brain injuries and organic behaviour disorders.

Yawl ward, 6 beds for male patients requiring a slower neuropsychiatric rehabilitation pathway towards discharge.

Ketch ward, 6 beds for male patients in the post-acute rehabilitation stage preparing for discharge.

During the inspection visit, the inspection team:

• spoke with 4 patients who were using the service

• spoke with the registered manager and regional manager

• spoke with 22 other staff members; including psychiatrists, doctors, psychologists, occupational therapists, a pharmacist, nurses, healthcare assistants and the facilities manager

• looked at 16 care and treatment records of patients

  • reviewed 20 prescription records

• reviewed a sample of three staff personnel files

• carried out a specific check of the medication management and prescribing practises and looked at a range of policies, procedures and other documents relating to the running of the service.

At this assessment we identified no breaches of regulations.

6 and 7 August 2018

During a routine inspection

We rated Cygnet Brunel as good because:

  • Staff completed thorough assessments of patients. Assessments were holistic and staff used these to inform individualised care plans for patients. Staff ensure that all assessments, including risk assessments and care plans were updated regularly.
  • Staff kept detailed records of patients’ care and treatment. Records were clear, up-to-date and easily available to all staff providing care.
  • The service provided treatment and care for patients that followed a recovery focused model. Staff supported patients with their physical health and encouraged them to live healthier lives. They ensured that patients were offered a minimum of 25 hours of therapeutic activity each week.
  • Staff had appropriate training that enables them to meet the needs of patients and keep them safe.
  • The team included or had access to the full range of specialists required to meet the needs of the patients on the ward.
  • Staff understood their roles and responsibilities under the Mental Health Act 1983, the Mental Health Act Code of Practice and the Mental Capacity Act.
  • Staff treated patients with compassion, kindness and supported their individual needs. Staff involved patients and those close to them in decisions about their care, treatment and changes to the service.
  • The service was accessible to all who needed it and took account of patients’ individual needs. Staff helped patients with communication, advocacy and cultural support. Patients had their own bedrooms where they could keep personal belongings safely.
  • The service treated concerns and complaints seriously, investigated them and learned lessons from the results, and shared these with all staff.
  • The culture at the hospital was developing. Most staff felt supported and respected by managers. Staff worked well together as a team despite experiencing lots of staffing changes since the unit opened in October 2017.

However:

  • The physical environment of the wards was not suitable for the patient group. It did not support the needs of the patients or the model of care. There were blind spots and a lack of space for patients to freely walk around in. We observed several near misses where patients almost walked into each other. Some communal rooms could not be observed from outside the room and doors did not have observation panels meaning a door could be opened onto another patient.
  • The process for making best interests decisions for patients was not well documented. When patients lacked capacity to make their own decisions, staff made and recorded decisions in the patients’ best interests. However, there was no evidence that staff were involving family and carers in this process.