Cygnet Maple House

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• 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. At the previous inspection, this key question was rated requires improvement. At this assessment, there was insufficient evidence to rate.

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 service is generally caring and respectful, but there are some shortfalls that mean not all patients have a consistently positive experience.

The service did not always treat people with kindness, empathy and compassion. While many patients spoke positively about staff and described them as caring, compassionate and supportive in their day-to-day interactions, this experience was not consistent. Several patients told us they felt dismissed when raising concerns about their safety and welfare. Some patients described feeling unheard and not believed when reporting concerns. This undermined their confidence that staff would listen, respond appropriately and take action when concerns were raised. Although staff demonstrated compassion in some aspects of care, particularly following the death of a patient when additional support was provided, the service did not consistently ensure people felt respected, listened to and supported when they were most vulnerable.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

Evidence showed some shortfalls for Responding to People's Immediate Needs

Following the death of a patient, all patients were offered individual support from nursing staff and psychology services. Additional observation arrangements were implemented, and inspectors attended a psychology-led support session attended by four patients. Patients told us they valued the opportunity to discuss the incident and generally felt supported by staff during this period.

One patient who experienced a deterioration in their mental health following the bereavement was placed on continuous observations and received increased multidisciplinary support. Their presentation and risks were reviewed regularly throughout the day, demonstrating that staff could respond appropriately when increased needs were identified.

However, this was not consistent across the service. We found evidence that staff did not always carry out observations of patients in line with care plans and risk management arrangements. Staff did not consistently recognise or escalate concerns when risks were identified, meaning opportunities to respond promptly to changes in patients' needs were sometimes missed. This placed patients at risk of not receiving timely support or intervention when required.

While there were examples of staff providing compassionate and responsive support during periods of heightened need, the service could not demonstrate that people's immediate needs and risks were consistently recognised, monitored and responded to appropriately. As a result, people were not always assured of receiving timely and effective support when their circumstances changed

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.