Cygnet St. Williams Also known as Cygnet Behavioural Health Limited

On this page

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

This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question as good. At this assessment the rating has remained 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.

This service scored 85 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

During our inspection, we observed how staff were interacting with patients. Staff attitudes and behaviours showed that they were discreet, respectful and responsive, providing patients with help, emotional support and advice at the time they needed it.

Staff supported patients to understand and manage their care, treatment or condition. For example, we saw evidence in care records and prescription charts that staff had supported some patients to self-medicate. One patient told us staff accompanied them at a family funeral overseas. Carers highlighted staff provided excellent care, paid attention to detail and they had noted significant improvement in their loved one’s presentation.

Staff directed patients to other services when appropriate and, if required, supported them to access those services. We saw evidence in care records that staff had supported patients to access appointments with GPs, podiatrists and dentists.

We spoke with 4 patients and 3 carers. They told us that staff treated them and their loved ones well and behaved appropriately towards them. Patients told us they had regular one-to-one time with their named nurse. Patients said staff made the effort to get to know them and asked them how they wished to be treated. Comments included:

• “They have got to know me in-depth. Since I came here, I have been thoroughly diagnosed…. it’s the best thing in the world for me”
• “All the staff are brilliant”
• “I have not met a single staff who hasn’t had a positive, supportive attitude. They have also facilitated things when he (the patient) has expressed an interest”
• “When he (the patient) came here I was stressed and used to visit every day. Staff said, ‘you are welcome here every day.’ Now I know he is in good hands”
• “They have kept me informed. I am always sent a copy of the minutes of carers’ meetings and kept up to date”
• “We (family members) are involved in his care; it’s a two-way thing”

Staff understood the individual needs of patients, including their personal, cultural, social and religious needs.

Staff said they could raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes towards patients without fear of the consequences.

Staff maintained the confidentiality of information about patients. All staff were required to complete information governance training which was centred around ensuring patient information was stored securely and in line with the General Data Protection Regulation.

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.

The service made adjustments for disabled patients. For example, all areas of the service building were wheelchair accessible and there was a lift in operation. Staff met patients’ specific communication needs.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, how to complain and so on.

The information provided was in a form accessible to the particular patient group (for example, in easy-read form ).

Staff made information leaflets available in languages spoken by patients.

Managers ensured that staff and patients had easy access to interpreters and/or signers.

Patients had a choice of food to meet the dietary requirements of religious and ethnic groups and to account for allergies and intolerances.

Staff ensured that patients had access to appropriate spiritual support. There was a church at the rear of the service building which accommodated all faiths. The service was in the process of updating its designated multi-faith room at the time of our inspection.

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.

Staff ensured patients had access to independent advocacy support.

Staff used various tools and methods to communicate with patients on the wards. Information could be provided in easy read for patients with a learning disability. Online translation services could be used to produce information in different languages.

Staff gave patients access to activities, such as board games, quizzes, music events, horse therapy, visiting a local reptile shop, swimming and, visits to train museums and seaside resorts. Patients could attend the service’s breakfast club. To support patients with their life skills, staff enabled patients to shop for food of their choice and cook it themselves, or with the support of staff where needed. Two of the 4 patients we spoke with said activities had been occasionally cancelled but did not indicate this was due to staffing issues. A third patient said they were bored during the day and the fourth patient was satisfied with the level and types of activities offered. Carers reported that there were plenty of activities available for their loved ones and staff actively encouraged participation. Carers believed activities helped with achieving physical goals such as walking.

The occupational therapy team devised therapeutic activities following discussions with patients and staff on the wards. Care records evidenced staff provided both group and individualised activities for patients.

Patients care plans included the patient's choices and preferences, allowing for activities to be arranged accordingly.

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.

We saw evidence in care records that staff were aware of and dealt with any specific risk issues, such as the risk of falls and substance misuse problems, and care planned for these accordingly. Care records also evidenced that staff identified and responded to changing risks to, or posed by, patients.

Staff used de-escalation techniques, such as re-direction and verbal de-escalation to reduce the need for physical interventions when patients’ behaviours became heightened.

We scored the service as 4. The evidence showed an exceptional standard. The service always cared about and promoted the wellbeing of their staff, and was exceptional at supporting and enabling staff to always deliver person-centred care.

Staff told us they felt respected, supported and valued. They felt positive and proud about working for the provider and within their team.

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

• Support from the onsite psychology team
• Managers referring staff members to occupational health when needed
• An employee assistance programme
• Health benefits from an external provider
• Support from an onsite mental health first aider
• Access to support for staff experiencing trauma
• The provision of flu vaccines to all staff members
• Staff wellbeing days, which included physical health checks by the physical health nurse such as electrocardiograms, physiological observations, smoking cessation advice, and weight management guidance
• Physiotherapy support for specific health issues.

The service’s staff sickness and absence were similar to the average for the provider.

The provider recognised staff success within the service. There was a ‘moment of thanks’ board where staff could post ‘thank you’ messages to their colleagues. Managers encouraged staff to post anonymous notes to recognise everyday acts of kindness, support, and teamwork. Managers nominated staff members for Characters of Care awards across the company. Recipients received a gift card as thanks in recognition of their contribution. Staff were also recognised for their work and successes in team meetings.

Staff appraisals included conversations about career development and how it could be supported.

Managers within the service monitored staff morale. This was done by monitoring the results of staff surveys, regional quality audits and, attitudes and behaviours in staff meetings. Managers also operated an open-door policy, so staff felt able to speak with them when they needed to share information or concerns.

The provider conducted a staff survey in relation to the service. Participation in the survey was high (43 out of 44 staff). All staff who responded felt supported, respected and valued by their managers. Ninety-eight percent of respondents stated the culture within the service was positive. Positive responses in relation to training and development, wellbeing initiatives, engagement and pride and communication had improved since the previous staff survey. However, 40% of respondents had experienced bullying or abuse from patients and 42% reported incidents of physical violence.

The provider had taken action to address some of the issues raised in the staff survey. For example, staff had access to mental health first aid and trauma risk management.