- Independent mental health service
Cygnet Lodge Salford
Assessment report published 30 May 2025
Contents
Ratings - Long stay or rehabilitation mental health wards for working age adults
Our view of the service
Mental Health Act
Ninety-seven per cent of staff including nurses and health care support workers had received training in the Mental Health Act (MHA) including bank staff that was 83% compliant. Staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice, and the guiding principles. However, some support worker staff we spoke to told us they had not received any training in the Mental Health Act.
Staff had access to administrative support and legal advice on the implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were. The provider had relevant policies and procedures that reflected the most recent guidance. Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.
Patients had easy access to information about independent mental health advocacy. Staff usually explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done it. Audits showed Section 132 rights had not always been completed as outlined in paragraph's 4.28 and 4.29 of the MHA Code of Practice.
Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this has been granted. Staff requested an opinion from a second opinion appointed doctor when necessary.
Staff stored copies of patients' detention papers and associated records (for example, Section 17 leave forms) correctly so that they were available to all staff that needed access to them. Audits showed there were gaps in the Section 17 leave forms and risk assessment in place that had not been signed and dated by the patient's responsible clinician. The service displayed a notice to tell informal patients that they could leave the ward freely.
Care plans referred to identified Section 117 aftercare services to be provided for those who had been subject to section 3 or equivalent Part 3 powers authorising admission to hospital for treatment. Staff did regular audits to ensure that the Mental Health Act was being applied correctly.
Mental Capacity Act
Ninety-seven per cent of substantive staff had received training in the Mental Capacity Act (MCA) With 83% of bank staff having received training. Some staff had a good understanding of the Mental Capacity Act. However, some support worker staff we spoke to told us they had not received any training in the Mental Capacity Act.
There were no Deprivation of Liberty Safeguards (DoLS) applications made in the last 6 months to protect people without capacity to make decisions about their own care. The provider had a policy on the Mental Capacity Act, including Deprivation of Liberty Safeguards. Staff were aware of the policy and had access to it. Staff knew where to get advice from within the service regarding the Mental Capacity Act, including Deprivation of Liberty Safeguards. Staff took all practical steps to enable patients to make their own decisions.
For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis regarding significant decisions. When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture, and history. The service had arrangements to monitor adherence to the Mental Capacity Act. Staff audited the application of the Mental Capacity Act and acted on any learning that resulted from it.
People's experience of this service
We spoke with 6 patients during the site visits. We also spoke with 2 carers or family members. Patients told us that they had access to all the information they needed and were provided with their rights under the Mental Health Act. Patients and carers told us they knew how to raise concerns about their care and treatment. They said they were able to access independent advocacy and were positive about the advocate.
Patients told us they were able to give feedback about their care and these were positive. They told us they enjoyed the pet therapy. They also said they felt listened to and staff were caring. Patients told us they were involved in their care pans if they wanted to and participated in discussions around their discharge. They said the food was mostly good and there were activities available if they wanted to access them. We observed some good positive staff interactions when completing a short observational for inspection (SOFI) tool.
While the people we spoke with expressed, they were happy with their care, our assessment found some elements of the care did not meet the expected standards. Commissioners provided positive feedback about the service and completed regular visits and meetings with the service.