Cygnet Hospital Maidstone

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We reviewed all 7 quality statements in the well-led key question. This means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. 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 the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. Leaders had the skills, knowledge and experience to perform their roles. Staff knew and understood the provider’s vision and values and how they applied to the work of their team. Staff felt respected, supported and valued. Governance processes operated effectively. Performance and risk were managed well. Teams had access to the information they needed to provide safe and effective care. Staff collected analysed data about outcomes and performance. They used this to identify improvements.

We have not awarded this service a score for Well-led.

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

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff knew and understood the provider’s vision and values and how they were applied in their work. The provider’s senior leadership team had successfully communicated the provider’s vision and values to the frontline staff in the service. The values were displayed in the ward offices.

Leaders ensured staff related to the values of the service. Leaders discussed core values with staff in their supervision and personal development reviews. Values were considered in quality walk arounds.

Staff described a positive working culture within the service and spoke highly of their colleagues. For example, one staff member told us they had seen a significant positive shift in the culture of the ward. Staff moving away from resistance to change towards a more open, collaborative, and patient-focused environment. The current team worked well together with a highly approachable clinical manager. One staff member said they felt confident about raising concerns, knowing their voice was heard and respected.

Staff told us they had confidence in their team and trusted their colleagues.

We scored the service as 3. The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders had the skills, knowledge and experience to perform their roles. Leaders had a good understanding of the services they managed. They were aware of service performance and aware of challenges faced by the service. They collaborated with one another and other staff to develop solutions or mitigations and were supported by management at provider level.

Staff felt supported by managers and told us mangers were approachable and engaged well with them. Leaders were visible within the service and had the experience, capacity, capability, and integrity to ensure that the organisational vision could be delivered, and risks were well managed.

Leaders demonstrated a passion for the service and the people who use it. Leadership development opportunities were available, including opportunities for staff. For example, the managers informed us they were happy with leadership development support from the organisation and had received leadership/apprenticeship training and foundation of management training which was funded by the provider.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The service had a freedom to speak up process if staff wished to raise concerns confidentially. Staff told us they felt they could raise concerns with their managers without fear and that they would be dealt with appropriately. The hospital had a Freedom to Speak Up ambassador, who met monthly with senior management to resolve issues. However, one staff member felt it was sometimes difficult to raise concerns.

Leaders at provider level collected staff feedback. We reviewed the hospital-wide staff survey for February to April 2024. Staff understood how their work made a difference to patients’ lives and they felt supported by their line managers.

Patients had the opportunity to provide feedback about the service. They knew how to raise concerns and received a response. Staff facilitated regular community meetings on the wards, which were dynamic and gave patients the opportunity to give feedback and receive updates about progress or changes following their feedback.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

The provider had a range of equity, diversity and inclusion networks that staff could access.

The service employed a diverse team of staff from international backgrounds. Employment practices promoted equality of opportunity. Staff did not raise any concerns about discrimination.

Staff who had experienced racial abuse from patients were encouraged to report these internally and to the police. Staff felt supported by managers following these incidents.

Staff could apply for flexible working agreements to support them with their personal circumstances such as caring responsibilities and health issues. Managers put reasonable adjustments in place for staff members to help them carry out their role.

We scored the service as 3. The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.

There was a clear framework of what must be discussed on each ward, to ensure that essential information, such as learning from incidents and complaints, was shared and discussed amongst the teams. Managers used a range of mechanisms to ensure that staff were kept up to date, such as team meetings, newsletters and handover meetings.

Staff had implemented recommendations from reviews of deaths, incidents, complaints and safeguarding alerts at the service level.

Staff undertook or participated in local clinical audits. The audits provided assurance and staff acted on the results when needed.

Staff understood the arrangements for working with other teams, both within the provider and external, to meet the needs of patients. Teams within the hospital worked well together to work towards the shared goal of delivering effective care and treatment. External stakeholders told us that staff demonstrated a good understanding of the need for joint working.

Staff maintained and had access to the risk register at location level. Staff at ward level could escalate concerns when required. Staff concerns matched those on the risk register.

The service had plans for emergencies. For example, adverse weather or a flu outbreak.

Staff had access to the equipment and information technology (IT) needed to do their work. The IT infrastructure, including the telephone system, worked well and helped to improve the quality of care.

Information governance systems included confidentiality of patient records.

Team managers had access to information to support them with their management role. This included information on the performance of the service, staffing and patient care.

Information was in an accessible format, and was timely, accurate and identified areas for improvement.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Leaders engaged with external stakeholders such as commissioners and external partners. Staff maintained relationships with the local authority and police liaison. Managers said they had good working relationships, collaborated well with these services and that information sharing relating to safeguarding and risk management was consistent. They shared information and learning with partners and collaborated for improvement.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.

We saw evidence of continuous learning and improvement during our assessment of the service. Throughout our assessment, staff demonstrated an ability to reflect on their own practice and the approach of the service. The service had conducted recent quality improvement projects informed by feedback and data. The manager informed us that Bearstead ward had recently gone through accreditation by the Royal College of Psychiatrists. They described the impact of this process on staff’s approach and explained the value of patient involvement in the project.