Cygnet Lodge Salford

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.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and did not always decide, in partnership with them, how to respond to any relevant changes in their needs.

The ward round process did not facilitate meaningful patient engagement, and some patients told us they were not able to say what they wanted to in their ward rounds. A lot of patients did not always want to engage with the group activities on offer and said they were bored.

Some patients said they were not involved in their care planning. Staff were not all engaging with patients in a positive and proactive way, for example staff were mainly chatting among themselves during lunchtime rather than engaging with patients.

We found examples where staff were not always familiar with patients’ individual needs, for example physical healthcare, mobility impairments, dietary needs, or vulnerability/risk to others.

However, staff within the service placed patient care around individual needs and preferences. They involved patients in planning of their section 17 MHA leave and preferences to visit. They involved patients by having informal leave questions before and after their leave away from the hospital.

Patients had access to the people’s council and community meetings. The people’s council worked in partnership with patients to respond to any changes needed during their stay. Activity timetables were collaborated with patients’ involvement. They corroborated with patients during their stay and involved families where the patient has consented to this, they also completed interest checklists with patients on admission.

Staff empowered patients to make their own decisions about their care and treatment and involved them in their multidisciplinary meetings if the patients wanted to attend and participate. They used various tools to seek feedback from patients, an example of this was when the patient was accessing occupation therapy the patient would complete a document identifying their own needs. Patients were encouraged to complete their own relapse prevention plans, and we saw copies of these.

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity.

When appropriate, staff ensured that patients had access to education and work opportunities. Patients had taken on therapeutic roles within the unit. An example of this was where patients managed the tuck box stall.

Staff supported patients to maintain contact with their families and carers.

Staff supported patients to access their chosen place of worship within the community if this was what the patient wanted. We saw care plans had been produced with the patients to support their cultural and spiritual needs as well as s17 MHA leave documents addressed access to community places of worship for one individual.

Health and care needs were addressed individually, and screening programmes had been discussed with the GPs so that patients had access to these.

We provide appropriate, accurate and up-to-date information in formats that we tailor to individual needs.

Staff made notifications to external bodies as needed including safeguarding and to commissioners. CQC received appropriate notifications where necessary from the service. Staff ensured carers, families and commissioners were regularly updated about the patient’s progress. There was a carers link worker, and they organised up to 3 carers events per year. There are no restrictions on visiting and they had a visiting room. The psychiatrist made time in their diaries for carers to book in for a video or telephone call to discuss any concerns about their family or friends who were living at the unit. Carers, families, and friends had completed surveys about the service and these were positive.

Information governance systems included confidentiality of patient records. The service complied with the Accessible Information Standard producing easy read information some of which were pictorial.

Staff ensured that patients could obtain information, for example on treatments, local services, patients’ rights and how to complain. This information was available throughout the hospital on notice boards. Patients had access to a patient information pack describing the unit and this was accessible online as well as an easy read booklet.

Staff made information leaflets available in languages spoken by patients and access to translation and interpretation was provided if patients’ needs identified this.

We make it easy for people to share feedback and ideas or raise complaints about their care, treatment, and support. We involve them in decisions about their care and tell them what’s changed as a result.

Complaints were captured monthly and reported through their clinical governance structure. Complaints were captured formally or by patients raising issues informally at meetings or with their named nurse and via the advocate.

Patients knew how to complain or raise concerns. Quick response (QR) codes could be used via smart phone or tablets to leave complaints and complements about the service. When patients complained or raised concerns, they received feedback. Staff protected patients who raised concerns or complaints from discrimination and harassment. Staff knew how to handle complaints appropriately. Staff received feedback on the outcome of investigation of complaints and acted on the findings.

The unit had a notice board to capture what staff and patients had said and what actions had been taken. Easy read posters were displayed informing patients how to make a complaint.

We mostly make sure that everyone can access the care, support, and treatment they need when they need it.

Staff mostly ensured the needs of patients with mobility issues were met, for example, people who used wheelchairs were placed in bedrooms at ground level. The lift was not in use at the time of our assessment however arrangements had been made to fix the lift after our visit. Staff made reasonable adjustments for patients – for example, people with mobility issues were provided with walking aids, shower chairs.

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, s117 aftercare. This meant that some people who have been kept in hospital under the Mental Health Act can get free help and support after they leave hospital. They also ensured access to post treatment support was available.

Staff planned for patients’ discharge, including good liaison with care managers/co-ordinators to facilitate discharge.

The manager told us discharge was sometimes delayed, and this was mostly down to finding appropriate accommodation and support packages that were suitable for patients being discharged into the community. However, on reviewing discharge data this did not identify there were any delayed discharges in the last 12 months.

We actively seek out and listen to information about people who are most likely to experience inequality in experience or outcomes. We tailor the 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. There was a coproduction strategy in place so that patients were involved in decisions and consulted with during their stay at the unit.

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. They had a disability discrimination policy in place to ensure suitable arrangements were in place so that disabled people had access to facilities and services.

Staff were aware of their roles and responsibilities in relation to disability discrimination and ensured that reasonable adjustments had been made where possible to enable access. The lift was broken and not accessible to patients with limited mobility and people who used a wheelchair. Staff were trained in equality, diversity, inclusion, and human rights; at the time of our assessment 90% of staff had been trained.

We support people to plan for important life changes, so they can have enough time to make informed decisions about their future, including at the end of their life.

Staff supported patients to make decisions about their care and treatment and their future. Staff create personalised care plans to account for the patient’s needs, wishes and feelings. The manager told us there were no patients with a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision recorded. They had an Advanced Decision policy in place, but no patients had created one.

There was a policy and procedure for end of life and dignity in care.

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