Cygnet St. Williams Also known as Cygnet Behavioural Health Limited

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs. At our last assessment we rated this key question as good. At this assessment the rating has remained as good. This meant people’s needs were met through good organisation and delivery.

Staff managed beds well. A bed was available when a patient needed one. Patients were not moved except for their benefit. Patients did not have to stay in hospital when they were well enough to leave. The design, layout, and furnishings of the building supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service, such as work, education and family relationships. The service met the needs of all patients, including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result.

This service scored 82 (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 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

We saw evidence in care records that staff developed care plans aligned with patients’ needs to promote independence, including considerations such as personal care, leave planning, family support and facilitating home visits for patients who had been placed out of their home area.

Patients could personalise their bedrooms. Patients had lockers in which to securely store their possessions.

Staff empowered patients to make their own decisions about their care and treatment. Staff supported patients to self-medicate. There were community meetings during which, patients had the opportunity to give feedback about activities, food, what was working well and what could be improved. Staff acted upon feedback from patients. For example, staff had discussed patients’ feedback about the food choices being repetitive and as a result, the menu was changed so patients had more variety.

We scored the service as 4. The evidence showed an exceptional standard. The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

When appropriate, staff ensured that patients had access to education and work opportunities. The service promoted patient education and work opportunities as part of its weekly programme. Through a community outreach initiative, patients could engage in volunteering with local charities, including activities such as dog walking, litter picking, assisting at community gardens, and supporting charity shops. Patients had organised onsite fundraising events and raised money for a cancer charity.

Education and training pathways were facilitated by the service’s occupational therapist, enabling patients to access courses at the local college, apply for volunteer roles, and pursue roles within the organisation such as ‘expert by experience’. Occupational therapy sessions included curriculum vitae writing, interview practice, skills development, and coordination with training providers. Success stories included a patient who worked for a charitable organisation being named employee of the month on 2 occasions and another patient had been supported in obtaining a driving licence.

Staff supported patients to maintain contact with their families and carers. Patients had access to mobile devices and could use telephones within the service to contact their loved ones.

Staff supported patients to access their chosen place of worship within the community. There was a church at the rear of the service building which accommodated all faiths.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff made notifications to external bodies as needed. We reviewed incidents that had happened within the service and saw evidence that safeguarding referrals had been sent to the local authority and statutory notifications had been sent to the Care Quality Commission when required.

Information governance systems included confidentiality of patient records.

The service complied with the Accessible Information Standard.

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. Staff made information leaflets available in languages spoken by patients.

Staff ensured carers, families and commissioners were regularly updated about the patient’s progress.

We scored the service as 4. The evidence showed an exceptional standard. The service was exceptional at enabling people to share feedback and ideas, or raise complaints about their care, treatment and support. They always involved people in decisions about their care and told them what had changed as a result.

In the last 12 months, 3 complaints had been made about the service; 2 formal and 1 informal. One formal complaint was upheld, and appropriate action was taken, and the other two complaints were not upheld. None of the complaints had been referred to the Parliamentary and Health Services Ombudsman.

Patients and carers knew how to complain or raise concerns.

We saw evidence that patients received feedback when they complained. We reviewed the two formal complaints, and, in each case, the patient had been sent a letter to explain the outcome of the complaint, including details of how the complaint had been investigated.

Staff protected patients who raised concerns or complaints from discrimination and harassment. Complaints were dealt with by senior managers within the service in a confidential manner.

Staff knew how to handle complaints appropriately.

Staff received feedback on the outcome of investigation of complaints during team meetings, appraisal and supervision sessions and via a communication book and acted on the findings.

Complaints were used to improve the care and treatment within the service. Staff had received additional international dysphagia diet standardisation initiative (IDDSI) training following a complaint from a patient in relation to their diet. The patient was prescribed a pureed diet due to swallowing difficulties and risk of choking. Their complaint was that they disliked the food and did not want to eat it. Staff discussed this with the patient and suggested giving them meals sourced from an outside catering company who provided food for people on IDDSI diets. The patient agreed to this and, as a result, staff were able to prepare healthy, nutritious meals made to the correct IDDSI level, which were made from the patient’s own food choices.

A patient had shared an idea for a group based on occupational therapy sessions they had done with the occupational therapist. The patient wanted to start a drawing group where an image/word was placed in the middle of the table and then everyone had to draw this in their own style, using paint, clay, colour pencil, shading etc. The occupational therapist suggested to the patient that they could facilitate the group together which was agreed. The new group was added to the activities timetable.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff ensured the needs of patients with mobility issues were met. For example, wheelchair users were placed in bedrooms at ground level or had access to lifts.

Staff made reasonable adjustments for patients. Staff could arrange for signers, interpreters or for information to be provided in a variety of formats to support people with communication issues, as well as referring patients to the service’s onsite speech and language therapist. Staff had also given patients walking aids and shower seats to meet their mobility needs. Staff adapted times for food, drink, medication and other aspects of care to enable Muslim patients following Ramadan to engage in fasting.

There was adequate medical cover day and night, a doctor could attend the ward quickly in an emergency and the hospital was within a reasonable travelling distance to the local acute hospital.

Staff ensured patients had access to post-discharge care. For example, staff undertook 72-hour checks on patients post discharge and referred patients to community mental health teams when required.

We saw evidenced in care records that staff planned for patients’ discharge, including good liaison with care managers/co-ordinators.

In the last 12 months, there were 2 delayed discharges within the service. The first delay was due to difficulty securing a suitable placement for a patient in their home city. The second delay was due to the absence of a consistent social worker. The patient had 3 previous social workers who had each left their role in quick succession.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

Staff were trained in equality, diversity, inclusion and human rights.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

At the time of our inspection, none of the patients using the service had advanced decisions or do not attempt cardiopulmonary resuscitation orders in place.

Staff create personalised care plans to account for the patient’s needs, wishes and feelings.

Staff ensured all relevant healthcare professionals and other relevant bodies were involved in planning the care and treatment of people with complex needs.