Cygnet Brunel

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 rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

Patients were not moved between wards except for their benefit. Patients did not have to stay in hospital when they were well enough to leave. The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service, such as work, education and family relationships. The service met the needs of all patients – including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The service described themselves as a ‘rehabilitation community’ that was inclusive and welcoming of staff and patients from all backgrounds and orientations. The service supported the translation of the ACE III cognitive assessment tool into one patient's previously untranslated third language, allowing a more refined cognitive assessment and greater focus of treatment on areas that had not improved since the previous assessment.

The service had a patient representative on each ward. Meetings which involved the review or development of the service, had both patient, family and staff representatives included.

Feedback was sought and documented directly from patients and family in daily interactions and care plan reviews. One patient has chaired his own ward rounds since joining Ketch Ward. Carers and families were contacted twice weekly by a new full time family liaison lead to give them updates. Staff told us families and carers were invited to ward rounds and other meetings either remotely or in person according to their preference.

The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

When appropriate, staff ensured that patients had access to education and work opportunities. The service offered the Recovery Colleges that focused on empowering individuals by providing a range of co-produced educational courses designed to enhance understanding of mental health, mindfulness and healthy living, blending lived experience with professional support. Patients from this service were studying Polish, men's health and the food service industry via the inhouse cafe.

Patients nominated staff for monthly awards and maintained a patient run Café. Patients organised cinema nights and pool tournaments with a large chalk board installed in the atrium activity area. Activities and a sessional therapies programme were provided over a 7-day period, including breakfast group and a popular conversation café. The hospital had 2 bookable minibuses to take patients into the community for activities or visits to primary care services. One of the vehicles was wheelchair accessible.

One patient enjoyed attending the Warmley Wheelers cycle park. The hospital had monthly visits from unusual animals including snakes, spiders, skunks and a porcupine. A patient showed us a photo they had taken with a visiting fox. From Monday to Friday staff offered a structured program for both group and individual sessions whilst weekends were more flexible. Staff told us that due to the nature of their patient group, many of the activities were on an individual basis. A gymnasium was available for patients to use with staff supervision. The service also sought co-production and co-facilitation involvement from external charity organisations like Headway – the Brian Injury Association and the Citizen’s advice Bureau which worked 8 hours per week with patients across all wards.

The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs using picture exchange communication system (PECS) and speech and language therapist (SALT) input.

The service complied with the Accessible Information Standard. Tailored documents demonstrate condensed monthly goals, care plans with visual representation and headings like 'what we are working on this month'. Patients on Ketch Ward were moving from nurse led medication to self-medication with visually represented guidance. The service adapted all patient documentation as required. The service provided French speaking patients with translation services and was trialling an App for one patient with communication difficulties.

Notifications are made to external bodies as required and information governance systems and handovers we observed and care records we inspected used patient initials to protect patient confidentiality.

The service received 3 informal complaints in the last 12 months that were closed to satisfaction with no further action. The service received 6 formal complaints in last 12 months. 5 of these complaints were partially upheld and 1 complaint was fully upheld. No complaints were referred to Ombudsman in the last 12 months.

Patients knew how to complain or raise concerns. Staff knew how to handle complaints appropriately and had received training. Advice on how to complain was displayed in every ward and communal area. When patients complained or raised concerns, they received feedback. Staff received feedback on the outcome of investigation of complaints in weekly staff meetings. The ward held weekly community meetings every Friday which fed into the hospital-wide monthly people’s council meeting.

The evidence showed an exceptional standard. The service was exceptional at ensuring people could access the care, support and treatment they needed when they needed it.

Staff ensured the needs of patients with mobility issues were met – for example, wheelchair users were placed in bedrooms at ground level or had access to lifts. Bedrooms were generous in size, and homely. We saw that many of the patients had chosen to personalise their rooms. Each door to a patient’s bedroom was personalised with a different colour and pictures to help patients to orientate to their own bedrooms. All rooms had toilet and shower facilities although some were larger than others to allow the use of wheelchairs, walking frames and hoists. Patients had different beds and equipment according to their specific needs. Staff told us there was no issues getting specialised equipment.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital. Staff planned for discharge with families and patients. Staff told us an estimated discharge date was set within a month of admission, but this was dependant on any identified needs. Staff told us that the majority of patients on Clipper Ward would be eventually moving on to nursing homes. Care plans included discharge planning from the point of admission and detailed plans for section 17 leave and section 117 aftercare provisions.

The service reported a 30% decrease in 2025/2026 stays over 180 days compared to 2024/2025. 7 patients have experienced delayed discharge in 2025/2026. Staff told us this is because finding suitable onward accommodation is challenging due to the lack of suitable placements in the Southwest, especially for the youngest patients in the patient group and delays in the allocation of Social workers by Local Authorities. These challenges are outside of the control of the service.

The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage. Staff were trained in equality, diversity, inclusion and human rights.

The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff create personalised care plans to account for the patient’s needs, wishes and feelings. Staff ensure all relevant healthcare professionals and other relevant bodies are involved in planning the care and treatment of people with complex needs. Procedures were in place for the receipt and scrutiny of detention paperwork. The MHA office was based on site, and staff told us the MHA administrator was supportive and helpful. Detention paperwork we viewed appeared to be in order and included all the information required. Approved mental health professionals’ reports were available where necessary and contained details of the nearest relative.

Section 17 leave was well managed by staff. We found that leave authorisations were clear and specific to number of escorts and duration and were reviewed regularly in ward rounds by the responsible clinician. Staff completed risk assessments prior to leave commencing. Staff told us that all patients had some form of leave even if it was simply to attend medical appointments.