- Independent mental health service
Cygnet Maple House
Assessment report published 15 June 2026
Contents
Ratings - Long stay or rehabilitation mental health wards for working age adults
Our view of the service
We completed an assessment of Cygnet Maple House with a site visit on 13, 14 and 20 January 2026. We undertook the assessment as this service had not been rated since opening in September 2023.
Cygnet Maple House a 16-bed specialist high support inpatient rehabilitation (level 2) service for women who may be informal or detained under the Mental Health Act 1983 (MHA).
At this assessment, we rated the service as Inadequate. We identified four breaches of regulations relating to safe care and treatment, good governance, dignity and respect and failure to notify CQC of all incidents that affect the health, safety and welfare of people who use services.
Staff did not always assess risks to patients’ health and safety or take action to reduce those risks, which meant patients were not always protected from avoidable harm. Staff did not always conduct observations of patients when required to do so. The providers systems for monitoring and improving the quality and safety of the service were not always effective, and leaders did not consistently identify or address issues. Staff did not always respect patients preferred pronouns or respect their sexual orientation. Staff did not support patients to maintain their food storage in the patient’s kitchen which increased the risk of infection. The provider failed to act on its duty to notify CQC of all incidents that affected the health, safety and welfare of patients using the service.
However, the service did have a full complement in their multi-disciplinary team and had enough staff to meet patient’s needs. The service had strong links with commissioners and the local community.
We have asked the provider for an action plan in response to the concerns found at this assessment.
Mental Health Act and Mental Capacity Act Compliance Summary
Staff were trained in and had a good understanding of the Mental Health Act 1983, the Code of Practice and the guiding principles.
Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act 1983 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.
We saw evidence that patients had been informed of their rights under the Mental Health Act and the service provided appropriate access to advocacy.
Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this had been granted.
People's experience of this service
During our assessment, we spoke with 8 patients. Five patients did not feel safe at the service due to the amount of risk items available.
Most patients felt staff were kind and supportive. Patients told us that they felt One patient most staff care but not all understood them. Another patient told us that they felt staff team seem to get on well and that most work hard, another told us that they felt that’s its 50/50 that some staff care and that other staff don’t really care. Patients were complimentary of the multi-disciplinary team. One patient told us that they felt that the doctors and staff try to listen to their views.
Patients had experienced staff sleeping during the night shifts. Patients felt there was enough staff during the day but during the night there was not enough staff. Patients told us that they felt they were used and asked to ensure other patients are safe and to help calm other patients down.
Some patients felt disrespected by staff not using their correct pronouns and other patients told us they felt affected by some staff projecting their religious beliefs onto them.
Most of the patients were fearful of speaking up with concerns over their care. One patient told us that they didn’t trust anyone on this team, and they felt they would just tell everyone else.
Patients enjoyed the food offered at the service and how they got advice on healthy eating and healthy sleep.
Patients were complimentary of the environment and felt it was clean. One patient told us that the cleaners were very good at Cygnet Maple House.
Staff supported patients to access their Section 17 leave. Section 17 of the Mental Health Act (MHA) allows a patient’s Responsible Clinician (RC) to authorise a leave of absence from the ward for a specific occasion or occasions and/or specific period. The patient’s RC may also place other conditions on a patient’s leave of absence, including whether they need to be accompanied by staff. They described how staff helped them prepare for visits to the local area and put safety measures in place for times when they might feel unsafe away from the hospital.