Cygnet Nield 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

We reviewed all 5 quality statements in the caring key question. This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last inspection we rated this key question as Good. At this assessment the rating has remained Good.

Staff treated patients with dignity, respect, compassion and kindness. They respected their privacy and followed appropriate policies to maintain confidentiality.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Patients we spoke with told us that staff treated them with kindness, compassion, dignity and respect. Patients stated that staff would preserve their privacy and were caring.

Staff treated patients with compassion and dignity. Staff we spoke with discussed patients in a respectful and caring manner. They were able to describe individual patients and discuss their care and treatment.

We did not receive any concerns from stakeholders.

Staff treated patients with compassion and kindness. Staff and patient interactions we observed during the assessment were respectful and conducted in a caring manner. Staff were discreet, respectful, and responsive when caring for patients. They respected patients’ privacy and dignity. Staff protected patient confidentiality and followed relevant policies and procedures.

Patients we spoke with were positive about staff and felt they were treated with dignity and respect. Patients attended community meeting on the wards and were able to provide feedback and ideas for activities for the ward.

Staff understood patients individual needs and preferences. Staff were able to access interpreters for patient’s whose first language was not English. Staff informed us that they had links with a local church for patients.

Staff and patient interactions we witnessed demonstrated that staff understood and respected the individual needs of each patient. Multidisciplinary patient reviews we observed were person centred and holistic. We observed holistic and person-centred interventions between staff and patients.

The service had a regular independent mental health advocate (IMHA) who visited the ward and was involved in MDT meetings and best interest decisions.

Feedback forms for patients where available in easy read formats.

Patients we spoke with were generally positive about their care and their involvement.

Staff invited patients to attend ward rounds and supported them to do so. Where patients did not wish to attend they could submit information for consideration.

Staff were able to help facilitate patient involvement and choice by providing information in different formats as appropriate including translation services, easy read and large print. Staff were aware of Independent Mental Health Advocacy services that visited the ward and how to refer patients to them.

Patients were supported to maintain relationships and networks that were important to them. There was access to visiting facilities including a family room for patients relatives. We observed staff supporting section 17 community leave and helping patients to visit shops and cafes.

We observed patients taking part in a range of activities including art groups. Patients were involved in choosing activities during community meetings.

Patients had access to Independent Mental Health Advocacy services to support their involvement in decisions about their care and treatment. The service held weekly community meetings where patients had the opportunity to feedback and make suggestions or a choice around planned activities.

Patients we spoke with told us that they were able to access staff when they required them. They told us that staff were responsive to their needs.

Staff demonstrated a good knowledge of the patient group and were able to describe individual risks and how they would respond to immediate need. Individual information and updates were also shared at shift handovers to ensure staff understood potential needs and the most appropriate and effective responses to them.

We observed staff providing care and responding to patient’s needs appropriately. Staff were responsive to requests for support We observed staff proactively engaging with patients to address their needs, for example by asking about their mood or offering drinks and snacks. Care records demonstrated staff were responsive to physical health needs.

There were appropriate systems and guidance in place to support staff in responding to immediate needs. There were nurse call alarms in bedrooms and staff carried personal alarms to summon help when required. Staff had access to emergency medical kits and a defibrillator if required.

We received mixed feedback from staff around the culture of the ward and hospital. Some staff were very positive about the culture and the hospital management. However, some staff raised concerns regarding the lack of management support for the ward, due to long term absence in the leadership team on the ward. The hospital manager informed us that the leadership team at the hospital, as well as the Clarion ward manager had been offering support to the ward.

The staff were aware of their freedom to speak up guardians and felt they could raise and had raised concerns.

The hospital manager informed us that they are aware of the cultural issues as they had been raised in the staff survey. They had spoken to staff and developed an action plan.

There were processes for staff to feedback, raise concerns and suggest ways to improve the service. This included through supervision, team meetings and staff surveys.