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

Cygnet Grange

Overall: Requires improvement read more about inspection ratings

39-41 Mason Street, Sutton In Ashfield, Nottinghamshire, NG17 4HQ (01623) 669028

Provided and run by:
Cygnet Learning Disabilities Midlands Limited

All Inspections

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

We assessed Cygnet Grange Hospital from 12 May 2026- 28 May 2026. This assessment included an onsite inspection visit.

We assessed Cygnet Grange Hospital as the rating was aged. Cygnet Grange Hospital was last inspected in April 2019 and rated as good.

Cygnet Grange consisted of 1 ward, a long stay ward for men with 8 beds (6 patients at the time of our site visit)

At this assessment we found breaches of regulations 12 (safe care and treatment) and 17 (good governance) in relation to safety and cleanliness of the environment; not completing accurate observation records and governance. We found the provider addressed breaches of regulation 12 identified at the previous inspection in relation to staff not always effectively monitoring patients’ physical health with the use of tools to assess and respond to clinical changes in patients.

The service was in breach of regulations 12 (safe care and treatment) and 17 (good governance).

We have asked the provider for an action plan in response to the concerns found at this assessment.

Mental Health Act and Mental Capacity Act Compliance Summary

Mental Health Act

Staff were trained in the Mental Health Act, the Code of Practice and the guiding principles. The provider had relevant policies and procedures that reflected the most recent guidance that staff had easy access to. 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. Staff requested an opinion from a second opinion appointed doctor when necessary. Staff stored copies of patients' detention papers and associated records correctly.

Mental Capacity Act Staff had a good understanding of the Mental Capacity Act, in particular, the 5 statutory principles. The provider had a policy on the Mental Capacity Act, including deprivation of liberty safeguards. Staff took all practical steps to enable patients to make their own decisions. When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the patient’s wishes, feelings, culture and history. The service had arrangements to monitor adherence to the Mental Capacity Act.

During an assessment of the hospital overall

We assessed Cygnet Grange Hospital from 12 May 2026- 28 May 2026. This assessment included an onsite inspection visit.

We assessed Cygnet Grange Hospital as the rating was aged. We last inspected Cygnet Grange Hospital in April 2019, which resulted in a rating of good for the service.

Cygnet Grange is part of Cygnet Learning Disabilities Midlands Limited. Cygnet Learning Disabilities Midlands Limited is the registered provider. Cygnet Grange, located in Sutton in Ashfield, Nottinghamshire, provides 8 rehabilitation beds for adult males with an acquired brain injury. At the time of inspection, there were 6 patients, 5 patients were detained under the Mental Health Act 1983, and 1 patient was admitted on an informal basis.

The hospital has 2 floors, communal areas and offices on the ground floor and patient bedrooms and a nursing station on the first floor. A registered manager and nominated individual were in post during this inspection.

The service had Closed-Circuit Television (CCTV), in place within the service to support patient safety and security. Staff were aware of its purpose, and its use was proportionate and monitored.

Cygnet Grange Hospital was registered with CQC in November 2012 to deliver the regulated activities:

  • Assessment or medical treatment for patients detained under the Mental Health Act 1983
  • Treatment of disease, disorder or injury. The service had a controlled drugs accountable officer and a Registered Manager.

Patients admitted to this hospital have a diagnosis of established or suspected acquired brain injury, alcohol-related brain injury, Korsakoff’s Syndrome, Huntington’s disease or early onset dementia with rehabilitation potential. Patients might be detained under the Mental Health Act (1983), admitted under Deprivation of Liberty Safeguards (DoLS) or be admitted on an informal basis. Patients might also present with mental health disorders, cognitive impairment, organic psychiatric disorder or organic personality change, dysphagia or other communication problems and abnormal movements or restricted mobility.

At this assessment we identified breaches of regulations 12 (safe care and treatment) and 17 (good governance).

At this assessment we assessed 1 assessment service group; Long stay or rehabilitation mental health wards for working age adults where we assessed all quality statements.

We have assessed the location against ‘right support, right care, and right culture guidance to make judgements about whether the provider guaranteed patients with an acquired brain injury respect, equality, dignity, choices, independence and good access to local communities that most patients take for granted. Staff completed appropriate training to enable them to support patients.

We rated the location as requires improvement. In Long stay or rehabilitation mental health wards for working age adults we found breaches of regulations 12 (safe care and treatment) and 17 (good governance) in relation to safety and cleanliness of the environment; not completing accurate observation records and governance.

We have asked the provider for an action plan in response to the concerns found at this assessment.

17-18 April 2019

During a routine inspection

Our rating of this service stayed the same. We rated Cygnet Grange as Good because:

  • The service provided safe care. The hospital environment was safe and clean. The hospital had enough nurses, doctors and senior multidisciplinary staff. Staff assessed risk well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
  • Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients cared for in a mental health rehabilitation hospital and in line with national guidance about best practice.
  • The hospital team included or had access to the full range of specialists required to meet the needs of patients. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with those outside the hospital who would have a role in providing aftercare.
  • Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They involved patients and families and carers in care decisions.
  • Staff planned and managed discharge well and liaised well with services that would provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason.
  • The hospital used a person-centred model of mental health rehabilitation that met the individual needs of patients.

However;

  • Staff practice to monitor and record patients’ physical health was not always good. This included not always effectively monitoring patients’ physical health with the use of tools to assess and respond to clinical changes in patients. We also saw examples of staff omissions in recording the outcomes of routine physical health observations. For example; staff failing to record dates, times and signatures, records written unclearly or without necessary corrections.

  • The provider’s physical health audit had not identified shortfalls in the completeness and quality of recording by staff when completing the ongoing monitoring of patients’ physical health.

21 August 2017

During a routine inspection

We rated CAS Grange as good because:’

  • The environment was clean and well maintained. The provider carried out annual health and safety audits such as ligature and environmental risk assessments. The hospital had management plans and emergency equipment in place to ensure patient and staff safety.
  • The provider had assessed appropriate staffing levels for each shift, which the hospital followed. All staff received regular supervision, an annual appraisal and completed mandatory training which gave them the skills to meet patient needs.
  • Staff completed patients’ comprehensive risk assessments and regularly reviewed and updated them as a multidisciplinary team which ensured all identified risks were managed.
  • Staff reported incidents, the registered manager provided staff with the opportunities to learn lessons to ensure that practice was improved.
  • The multidisciplinary team routinely assessed, monitored and supported patients with their physical health care needs and access to a comprehensive range of primary healthcare services.
  • Interactions we saw between staff and patients were caring, positive and friendly. Feedback we received from patients and carers said staff had a good understanding of the patients they cared for.
  • The hospital maintained effective links with outside organisations to support patients with a programme of daily activities and rehabilitation process.
  • The provider responded to and investigated complaints. Patients and relatives were provided with responses to complaints and staff were provided with lessons learnt from complaints
  • The managers provided good leadership and support to staff. Staff felt supported by the registered manager and multi-disciplinary team and morale was good.
  • The provider had developed key performance indicators for staff and outcome measures to monitor the quality of care provided to patients.

However:

  • CAS Grange used a form to record capacity which did not include the diagnostic test; therefore the form was legally incorrect in accordance with the Mental Capacity Act 2005.

13 April 2016

During an inspection looking at part of the service

We rated Cambian The Grange as good because:

  • The environment was clean and well maintained. The provider had carried out environmental risk assessments and had management plans and emergency equipment in place to ensure patient and staff safety.
  • The provider had appropriate staffing levels on shifts with staff that received regular supervision, mandatory training and had the skills to meet the needs of the patients.
  • Staff completed patients’ comprehensive risk assessments and regularly reviewed and updated them as a multidisciplinary team to ensure that all identified risks were well managed.
  • Staff reported incidents and the managers provided staff with the opportunities to learn lessons to ensure that practice was improved.
  • The multidisciplinary team routinely assessed, monitored and supported patients with their physical health care needs and access to a comprehensive range of primary healthcare services.
  • Staff treated patients with respect and dignity and involved them in their care and treatment planning. Patients were able to give feedback about how the service was run.
  • The unit maintained effective links with outside organisations to support patients with daily programme of activities and rehabilitation process.
  • The managers provided good leadership and support to staff. Staff felt supported by team managers and morale was good.
  • The provider had developed key performance indicators and outcome measures to monitor the quality of care provided to patients.

However;

  • The provider did not review and updated the Mental Health Act (MHA) policies and procedures to reflect the revised MHA code of practice. Only 61% of staff had received training in MHA.
  • The care plans did not have specific goals, patients’ views on what mattered to them and detailed interventions on how staff should support patients.
  • Staff did not participate in a wide range of clinical audits to monitor the effectiveness of the service provided.

15 April 2013

During a routine inspection

We found that systems were in place to involve patients in their care, treatment and support programmes.

We found that patients received input and treatment from health care professionals when required.

Patients who used the service told us that they were encouraged to undertake a comprehensive range of social activities within the home environment and within the broader community.

Patients told us that they felt safe and felt the staff had the right qualifications, skills and knowledge to perform their duties in a safe manner.

We found that the organisation had an effective recruitment process in place which adhered to current legislative requirements and promoted the safety of patients.