Cygnet Hospital Maidstone

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We reviewed all 5 quality statements in the caring key question. This means we looked for evidence that the service involved patients and treated them with compassion, kindness, dignity and respect. At our last inspection we rated this key question as Requires Improvement. At this assessment the rating has changed and is now rated as Good. This meant people were supported and treated with dignity and respect; and involved as partners in their care. Staff treated patients with compassion and kindness. They respected patients’ privacy and dignity. They understood the individual needs of patients and supported patients to understand and manage their care, treatment or condition. Staff involved patients in care planning and risk assessment and actively sought their feedback on the quality of care provided. Staff informed and involved families and carers appropriately.

We have not awarded this service a score for Caring.

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

We scored the service as 3. The evidence showed a good standard. The service always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

We observed staff on both wards interacting with patients in a discreet, respectful and responsive way. Staff provided patients with emotional support and advice when needed.

Staff supported patients to understand and manage their care, treatment or condition. Staff made every effort to include patients in their care and made sure that information was written in a way that people could understand it.

Patients said staff treated them well and behaved appropriately towards them. Staff understood the individual needs of patients, including their personal, cultural, social and religious needs. However, one patient felt staff did not respect their individual choice by allowing them to attend activities in their pyjamas.

There was a space for people to pray and special dietary requirements were met. Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences.

Patients said managers were visible on the ward and that they made themselves available to staff and patients.

Staff maintained the confidentiality of information about patients.

We scored the service as 3. The evidence showed a good standard. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Both Roseacre and Bearstead wards made adjustments for disabled patients or patients with poor mobility. For example, there was step free access to premises and by meeting patients’ specific communication needs. We saw samples of easy read leaflets and posters.

Staff ensured patients had access to information on treatments, local services, patients’ rights and how to complain.

Managers ensured staff and patients had easy access to interpreters and/or signers where they were needed.

Patients on Roseacre ward had access to a fully functional sensory room, and a de-escalation room with terrace for fresh air. Patients gained access to the sensory room based on their risk assessments. Both wards had access to quiet rooms.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances. For example, one patient on Roseacre ward told us the service provided them with halal food when they requested it. Patients had choices of food. Both wards had a food menu pasted on a board which patients had access to. Patients had the opportunity to give feedback about their food during community meetings.

Staff ensured that patients had access to appropriate spiritual support.

We scored the service as 3. The evidence showed a good standard. The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Patients told us they could access community leave when they were assessed as ready to do so.

Staff knew how each patient preferred to be supported. An advocate visited the hospital several times each week, they told us managers and staff promoted advocacy and were positive about the work being undertaken on the ward.

Staff described how they supported patients to make decisions daily. Where it was difficult to engage patients in therapeutic activities, efforts were made to find areas of interest the patient would respond to. We saw examples of discussions about activities in community meeting minutes.

Staff supported patients visiting shops and facilities in the local town with the aim of increasing independence, choice and control. For example, staff told us that patients had access to a recovery college to access training courses and achieved qualifications.

We scored the service as 3. The evidence showed a good standard. The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

Staff were aware of and dealt with any specific risk issues, such as risks to self or others and care planned for these accordingly. Responses to risk, such as levels of observation were altered when they needed to be either increased or decreased to meet the most current needs of each patient.

Staff identified and responded to changing risks to, or posed by, patients. They did this immediately following incidents and at multi-disciplinary meetings.

Staff used de-escalation techniques to reduce the need for physical interventions when patients become distressed.

We scored the service as 3. The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff, and supported and enabled staff to always deliver person-centred care.

Staff told us they felt respected, supported and valued. Staff said they felt confident raising concerns, knowing their voice was heard and respected. One staff member told us they felt positive and proud about working for the provider and being part of their team. However, another member of staff told us staff did not always work together to achieve a common goal.

Staff had access to support for their own physical and emotional health needs through an occupational health service.

Staff sickness and absence rates were low.

The provider recognised staff success within the service. For example, the service held staff awards. Senior managers provided staff with positive feedback when they did something well and leaders told us positive feedback from carers was shared in the morning meetings they attended.

Staff told us the provider encouraged career development, and that yearly appraisals included conversations about career development and how staff could be supported to engage in their development. The provider supported a cohort of healthcare support workers to apply for and complete a nursing qualification.