- Independent mental health service
Cygnet Hospital Harrow
Report from 29 May 2024 assessment
Contents
Ratings - Wards for people with learning disabilities or autism
Our view of the service
Date of assessment: 3 February to 29 May 2024. Springs Centre is a specialist ward for up to 14 male patients with a diagnosis of autism spectrum disorder and who also present with mental health needs. The ward opened in January 2018 and is part of Cygnet Hospital Harrow. We conducted this assessment to review all breaches identified in the previous inspection which took place in May 2023. We assessed 15 quality statements across the safe, effective, caring, responsive and well-led key questions and have combined the scores for these areas with key question ratings from the last inspection. At this assessment we found the ward had implemented sufficient improvements to comply with the requirement notices we issued at the last inspection. Incidents were reported and investigated appropriately. Restrictive practices were reviewed and reduced appropriately. Staff had received training in learning disabilities and autism. Patient’s physical health observations were checked appropriately and recorded following rapid tranquilisation. Staff were kind and compassionate and the ward culture had improved. Leaders were visible, compassionate and capable to drive improvement throughout the ward. There were effective governance and management systems to ensure risks and performance were monitored and improved. However, activity provision did not include many rehabilitation or sensory activities. The sensory room was not being used for its purpose, but this was resolved during the assessment. Though the assessment of these quality statements indicated areas of good practice since the last inspection, our overall rating remains inadequate. The ratings for the key questions of safe and well-led, have improved from inadequate, to requires improvement.
People's experience of this service
Patients we spoke to felt safe on the ward and said staff were proactive to ensure their safety. Patients were involved in their care and treatment and discussed this with staff on the ward and during multi-disciplinary team (MDT) meetings. Patient’s medication was reviewed regularly, and PRN medication was used as a last resort. Staff attitudes and behaviours when interacting with patients showed they were kind, compassionate and responsive in their day-to-day care and support. People’s individual needs and preferences were understood, and these were reflected in their care, treatment and support. People’s communication needs are mostly met to enable them to engage in their care, treatment and support.
However, patients did not have access to a functional sensory room due to it being used as a storage room. Patients also told us they needed a quiet space, like their living room to access during the night if they couldn’t sleep. ‘Talking mats’, a visual communication aid, was not always used on the ward between patients and staff to support conversations, although patient's communication passports recommended it. Patients felt the evening snacks available were limited and could be improved in quality and quantity available.