Cygnet Sherwood Lodge

Updated 30 April 2019

Cygnet Behavioural Health Limited is the provider company for Cygnet Sherwood Lodge. The hospital has 26 beds altogether. The hospital offers inpatient services for people with a learning disability or autism, who have offending or challenging behaviour and complex mental health needs. The hospital is a modern, purpose-built building with one ward across two floors. Seventeen of the beds are a specialist high dependency complex care service for men with learning disabilities and other complex needs. The other nine beds are known as an enabling environment and are upstairs on the ward.

There was a registered manager in post. 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.

On the day of inspection 17 patients were restricted patients. Restricted patients are mentally disordered offenders who are detained in hospital for treatment and who are subject to special controls by the Secretary of State for Justice. There were a further eight patients on a section 3 and one patient held under a Deprivation of Liberty Safeguards.

Cygnet Sherwood Lodge is registered with the CQC to provide the following regulated activities:

• Assessment or medical treatment for persons detained under the Mental Health Act 1983.
• Treatment of disease, disorder or injury.

The CQC last inspected the hospital in 2015 and rated them as Outstanding.

Since the last inspection the Mental Health Act team visited in May 2018. They found staff did not always record appropriate risk assessments for section 17 leave and the responsible clinician had not indicated whether a copy of leave form had been given to the patient or other relevant people. The manager had provided action plans to address these issues and no concerns were found on this inspection.

Updated 30 April 2019

We rated this service overall as outstanding because:

• The service provided safe care. The ward environments were safe, thoroughly clean and recently redecorated. The number of nurses and doctors working at the hospital was well above the bare minimum required for safe care. Staff took a proactive approach to anticipating and managing risk to patients. They rarely used restrictive practices. The service contributed to research and development of national guidance on medicines and led the way in developing good practice in care.
• There were comprehensive systems to keep people safe, which took account of current best practice. The whole team was engaged in reviewing and improving safety and safeguarding systems. Patients were at the centre of safeguarding and protection from discrimination. There was a genuinely open culture in which all safety concerns raised by staff and patients were highly valued as being integral to learning and improvement.
• Staff had a truly holistic approach to assessing, planning and delivering care and treatment to patients. They developed holistic, recovery-orientated care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients cared for in a learning disability rehabilitation ward and in line with national best practice guidance.
• Managers actively encouraged the safe use of innovative and pioneering approaches to care and how staff delivered it.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured these staff received training, supervision and appraisal. The ward staff worked well together as a multi-disciplinary team and with those outside the ward who would have a role in providing aftercare.
• The management team recognised the continuing development of the staff’s skills, competence and knowledge was integral to ensuring high-quality care. They proactively supported and encouraged staff to acquire new skills, use their transferable skills, and share best practice.
• Staff ensured that patients who were detained under the Mental Health Act 1983 (MHA) understood and were empowered to exercise their rights under the Act. The provider supported staff to understand and meet the requirements of the Mental Health Act Code of Practice, working effectively with others to promote the best outcomes with a focus on recovery for people subject to the Mental Health Act.
• Staff treated patients with compassion and kindness, respected their privacy and dignity and understood the individual needs of patients. Staff actively involved patients and families and carers in care decisions where able.
• Staff empowered patients to have a voice and to realise their potential. They showed determination and creativity to overcome obstacles to delivering care. Staff ensured that patients’ individual preferences and needs were always reflected in how care was delivered.
• Staff, teams and services were committed to working collaboratively and had found innovative and efficient ways to deliver more joined-up care to patients.
• There was a holistic approach to planning people’s discharge, transfer or transition to other services, which staff started on admission. 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.
• Staff were consistent in supporting patients to live healthier lives which included identifying those who needed extra support. There was a targeted and proactive approach to health promotion and prevention of ill-health.
• The service took patients that had already spent a long time in care and enabled them to move into lesser dependant services in a reasonable time frame. This is the aim of Transforming Care.
• There was a compassionate, inclusive and effective leadership at all levels. Leaders demonstrated the high levels of experience, capacity and capability needed to deliver excellent and sustainable care.  Leaders had a deep understanding of issues, challenges and priorities in their service, and beyond.

Updated 30 April 2019