All inspections: Cygnet Newham House - Care Quality Commission

We inspected Cygnet Newham House on 2 and 3 December 2025. This was a comprehensive inspection. It was unannounced, which means staff were not aware we were coming. The reasons for the inspection were because it formed part of our routine inspection schedule and the service had not been inspected since September 2022.

Our inspection team comprised two Care Quality Commission inspectors and a specialist nurse acting as an advisor to the Care Quality Commission.

Cygnet Newham House is a 20-bed neuropsychiatric service offering care and treatment to women affected by acquired brain injuries and progressive neurological conditions such as Huntington’s Disease.

The hospital has been designed specifically to provide a clinically led, evidence based neuropsychiatric pathway for those individuals presenting with behaviours that challenge.

The service offers a range of activities and facilities to promote independent function. Positive behaviour goals are focussed on discharge planning to support patients to return to the community, either with support or independently.

Mental Health Act and Mental Capacity Act Compliance Summary

At the time of our inspection, 95% of staff had completed their mandatory Mental Capacity Act and Mental Health Act training and were able to evidence their understanding of the Acts.

Capacity assessments were carried out appropriately on a decision-specific basis, and staff took all reasonable steps to support patients in making their own decisions. Where patients lacked capacity, decisions were made in their best interests, with careful consideration of their wishes, feelings, cultural background, and personal history. This reflected good practice and a person-centred approach.

The provider had policies for the Mental Health Act and Mental Capacity Act, the latter of which also included guidance on deprivation of liberty safeguards. Staff were aware of these policies and could access them.

There was a Mental Health Act administrator within the service who conducted audits of Mental Health Act and Mental Capacity Act documentation within the service to ensure staff adhered to the Acts. They also provided advice and guidance to staff when required.

Patients were supported to understand their rights under the Mental Health Act and had access to advocacy. Section 17 leave was facilitated appropriately, and second opinion appointed doctors were sought when necessary.

Detention papers and associated records were stored securely and were accessible to relevant staff, reflecting good governance. Notices were displayed to remind informal patients of their right to leave freely, and care plans included reference to Section 117 aftercare for those detained under section 3 or equivalent powers.

ygnet Newham House was registered with CQC in September 2020 to carry out the following regulated activities:

Assessment or medical treatment for persons detained under the Mental Health Act 1983
Treatment of disease, disorder or injury.

The service had a controlled drugs accountable officer and a registered manager.

We rated the service as good overall. The ratings for the safe, effective, caring and responsive key questions remained as good, and the rating for the well led improved from good to outstanding. There were no breaches of regulation.

We rated this service as good because:

The service provided safe care. The hospital environment was safe and clean. The hospital had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices and followed good practice with respect to safeguarding.
Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
The staff teams included or had access to the full range of specialists required to meet the needs of patients in the hospital. Staff worked well together as a multidisciplinary team and with those outside the hospital who would have a role in providing aftercare.
Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
Staff planned and managed discharge well and liaised well with services that would provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason.
The service was well-led and the governance processes ensured that procedures ran smoothly.

However:

Not all staff had up to date appraisals in place in line with the providers policy.
Staff had not clearly recorded details of one-to-one sessions between the patient and their named nurse.
Staff had not updated all patient’s medicine cards to reflect their current status (e.g. detention, informal of Deprivation of Liberty Safeguard).
Staff did not ensure capacity assessments to treatment, for patients who were informal or on a Deprivation of Liberty Safeguard, contained the proposed treatment they were assessed for.
Staff did not ensure capacity to treatment assessments for patients were easily available in the prescription folder.
Staff had not reported all non-patient incidents such as administration issues which may affect the effective running of the hospital.

Cygnet Newham House

All Inspections

During an assessment of Services for people with acquired brain injury

During an assessment of the hospital overall

31 August 2022 & 1 September 2022

During a routine inspection