Cygnet Maple House

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.

This is the first assessment for this service. This key question has been rated Requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

Staff did not always treat patients with compassion and kindness. They did not always respect patients’ privacy and dignity or always understand the individual needs of patients to be able to support patients to understand and manage their care, treatment or condition. Staff did not always involve patients in care planning and risk assessment and actively sought their feedback on the quality of care provided. However, staff informed and involved families and carers appropriately.

This service is in breach of regulations regarding dignity and respect.

We have not awarded this service a score for Caring.

Find out about when we will not publish a key question score and what we look at when we assess Caring.

The evidence showed some shortfalls. The service did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity. Staff did not always treat colleagues from other organisations with kindness and respect.

Staff attitudes and behaviours when interacting with patients showed that they were not always discreet, respectful, or responsive. Staff did not consistently provide patients with help, emotional support, and advice at the time they needed it. During our assessment, we observed staff sitting in communal areas and interacting with patients. We saw one interaction where staff and patients were enjoying a game of cards. The patient was engaged, and it appeared to be a positive activity. However, as time passed the activity did become loud and unfocused.

Staff told us that they supported patients to understand and manage their care and treatment. However, patients we spoke to did not always understand and were confused about the purpose of the service although did state they could speak to staff if needed. Staff explained that they used ward rounds and one‑to‑one sessions to discuss treatment with patients. The service displayed information about treatment pathways in patient areas.

Staff directed patients to other services when appropriate and supported them to access those services if required. Leaders gave recent examples of patients being referred to other services and explained how they planned and worked with patients to ensure a smooth transition.

Patients felt staff mostly treated them well and behaved appropriately. Leaders shared recent patient surveys and community meeting notes showing that patients felt staff were kind and caring. However, during our assessment, some patients reported that staff expressed personal cultural views that conflicted with their own beliefs, which negatively affected them. Patients also told us that staff did not always knock before entering bedrooms. Some patients reported that staff did not consistently use the correct pronouns. We found evidence of this in the care plans we reviewed. We raised this with service leaders, who informed staff about the importance of using correct pronouns. We saw evidence that this had been implemented, as pronouns were added to the handover documents.

One patient told us that after an incident of self‑harm, a staff member said, “They were disappointed in me and angry and that they needed to tell me how they felt.” This response did not demonstrate compassion or awareness of the patient’s emotional state.

Staff understood the individual needs of patients, including their personal, cultural, social, and religious needs. Staff we spoke with discussed each patient in detail and demonstrated that they knew them well. However, this understanding was not always reflected in the care plans we reviewed.

Staff said they could raise concerns about disrespectful, discriminatory, or abusive behaviour or attitudes toward patients without fear of consequences. Staff felt that managers were supportive when concerns were raised and that Cygnet operated a Freedom to Speak Up system for further reporting options.

Staff maintained the confidentiality of patient information. Systems ensured that patient information remained confidential. Cygnet had a robust information‑management and confidentiality policy. All patient documents were securely stored and password‑protected.

The evidence showed some shortfalls. The service did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service made adjustments for disabled patients, for example by ensuring accessible premises and meeting patients’ specific communication needs. At the time of our assessment, two patients had physical health needs that required the use of a wheelchair. We saw that these patients had bedrooms on the ground floor and that their bedspaces were large enough to allow free movement. However, some corridors on the ground floor were only just wide enough to accommodate a wheelchair. Despite this, we observed patients navigating these areas without difficulty.

Staff ensured that patients could access information about treatments, local services, their rights, and how to complain. Information boards around the hospital displayed a range of materials for patients, and we saw easy‑read formats available. Although no patients at the time required information in another language, leaders assured us that the service had previously provided translated materials and could do so again when needed. In a communal area, staff had created an information folder containing details about local public transport and nearby activities.

At the time of our assessment, some patients identified as transgender. These patients told us that staff did not always fully support their individual needs and that they experienced negative attitudes from some staff, which had a detrimental impact on them. They reported that staff used incorrect pronouns. Leaders told us that the service aimed to celebrate LGBTQ+ identity and had supported patients to attend Pride events. However, patients reported occasions where staff expressed personal religious beliefs that made LGBTQ+ patients feel uncomfortable and unsafe.

Patients had access to food that met dietary requirements related to religion, ethnicity, allergies, and intolerances. The service had recently appointed a new head cook, who had made significant improvements to the food provision. We saw that they had introduced new documentation to support additional dietary requirements, including detailed allergy information that staff could access easily.

Staff ensured that patients could access appropriate spiritual support. However, during our tour of the service, we found the multi‑faith room to be sparse and not particularly inviting. It did contain items for spiritual and religious use, including religious texts, a compass, and a prayer mat. Staff told us that the room was available for both staff and patients when required.

The evidence showed some shortfalls. The service did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

Leaders highlighted that the service aimed to promote independence, choice and control through its rehabilitation model. Least restrictive practice was central to their approach. The service did not restrict patients from having items that could present a risk, such as razors, lighters or wires, to help prepare them for returning to community environments. However, this approach resulted in some patients feeling unsafe because they had access to these items and during our assessment, we reviewed incidents where patient where harmed due using risk items that were available to them due to the open environment.

During our assessment, we observed patients accessing various areas of the hospital that supported their recovery. Patients could make their own hot drinks and prepare meals and snacks in the ‘ADL kitchen’ on the ground floor. They also had access to laundry facilities and were supported to clean their own bedrooms. Patients told us that cleaning their rooms promoted their independence. One patient told us they did their own cooking, laundry and cleaned their own room.

The service provided opportunities for patients to discuss their treatment options with doctors and staff during ward rounds and through one‑to‑one nursing sessions. Patients said that they could speak to their doctor.

Information was available for informal patients, so they understood their rights. Clear notices about leave status were displayed at the entrance and exit of the service.

The evidence showed some shortfalls. The service did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

Staff were aware of specific risk issues, such as falls or pressure ulcers, and planned care accordingly. Staff identified patients’ physical health needs, and when patients required external support, such as speech and language therapy, the service arranged this. During our assessment, a patient told us they required a pressure mattress that had not been provided. We spoke with leaders and reviewed the patient’s care plan, which showed that staff had made appropriate referrals and had repeatedly tried to meet the patient’s needs. Staff had explained this to the patient.

Staff identified and responded to changing risks posed to, or by, patients. The service used a system called “pink notes,” which enabled staff to record information relevant to each patient. During our review of individual pink notes, we saw that staff had documented a patient showing signs of low mood and that the patient had sought support. We could see how staff shared this risk information through pink notes and face‑to‑face handovers. We reviewed handover documents where risks were discussed. However, we were not assured that the methods used were effective for this patient, as the patient continued to self‑harm even after clearly telling staff they intended to do so.

Staff used de‑escalation techniques to reduce the need for physical interventions when patients became distressed and presented a risk to themselves. The service had low levels of restraint. Leaders shared their most recent clinical governance document, which recorded 6 restraint incidents in December 2025. None of these incidents lasted longer than 20 minutes. This was an increase from 3 incidents recorded in November 2025. Leaders identified that all incidents involved the same patient and had referred the patient for transfer to a more suitable placement that could meet their needs.

The evidence showed a good standard. The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff felt respected, supported, and valued. Staff said there had been a recent change in management, and they felt the transition had gone well. They felt supported by leaders and felt listened to, although they acknowledged that the change was new and staff were still adjusting.

Staff felt positive and proud about working for the provider and their team. They told us they enjoyed working at the service and were proud to be part of it. Staff felt valued what the service offered patients and believed they were making a positive difference in patients’ lives.

Staff had access to support for their physical and emotional health needs through the occupational health service. Cygnet offered a range of options to support staff wellbeing, and staff told us that the care package provided by Cygnet was good.

Leaders shared their most recent report from the human resources department with us. At the time of our assessment, sickness levels were recorded at 1.1%.

The provider recognised staff achievements within the service, for example through staff awards. The service operated an “Employee of the Month” scheme; however, this had not been updated at the time of our assessment.