Cygnet Hospital Harrow

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

We looked for evidence on how the service provided was caring. At the last inspection in 2023, we rated this key question as requires improvement. At that inspection, the service was in breach of regulation 10 (dignity and respect): the provider must ensure all patients are given access to personal hygiene products. At this inspection, this had been addressed, and the rating has changed to good. We observed good, caring interactions between staff and patients. We found no breaches of regulations in relation to this key question.

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.

The service treated people with kindness, empathy and compassion and we respected their privacy and dignity.

Staff were discreet, respectful, and responsive when caring for patients. Staff commented that there was a strong culture of compassion within the staff team. Throughout the inspection, we saw good interaction between staff and patients. We observed staff responding to patients calmly and sensitively. Staff were observed to be kind when dealing with a patient that was very agitated. Every time a patient knocked on the office door staff responded promptly.

Staff supported patients to understand and manage their own care, treatment or condition. Staff said that encouraging patients to understand their condition and their treatment was a fundamental part of their work. Patients said that they spoke to their doctor if they had any questions about their medication.

Most patients said staff treated them well and behaved kindly. Some patients said that staff were very good. They said staff listened to their concerns and were supportive.

Staff understood and respected the individual needs of each patient. Of the four patients we interviewed, three gave very positive feedback about the service. One patient said they did not feel listened to.

Staff followed policy to keep patient information confidential. Information held on electronic systems was protected. Staff entered a personal username and password to access this information. Patient information recorded on paper was held in locked filing cabinets.

The service treated people as individuals and make sure their care, support and treatment met their needs and preferences, taking account of their strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff within the service had a very good understanding of each patient’s mental health, their risk history and their social circumstances outside hospital. Occupational therapists and activity co-ordinators supported patients to pursue their interests and hobbies. For example, some patients attended the gym each day. Staff were also aware of patients’ specific vulnerabilities. For example, they were aware that one patient was vulnerable to exploitation. In response to this, they regularly spoke to this person about their relationship with other patients.

Patients came from diverse cultural backgrounds. Staff recognised this and provided facilities to meet patients cultural and religious needs.

The service promoted people’s independence, so they know their rights and have choice and control over their own care, treatment and wellbeing.

Staff made sure patients could access information on their rights and how to complain. Information about the Mental Health Act and making complaints was displayed on a notice board.

Patients could make phone calls in private. Staff did not restrict patients’ access to their mobile telephones unless there was a clinical reason to do so. When patients did not have access to their own telephone, staff arranged access to telephones that could be used in a private space.

Patients could make their own hot drinks and snacks and were not dependent on staff. Patients had access to drinks at all times. Patients kept their own food in a fridge. However, food in the fridge was not labelled to show who it belonged to and when it was opened, which was not best practice.

The service offered a variety of good quality food. None of the patients raised any concerns about the food. During an inspection in May 2023, the provider had the following breach: the provider must ensure it supports patients to eat meals off the ward where risk allows. Where meals must be eaten in patients’ bedrooms, they must be delivered from the kitchen to the ward via a method in line with the provider’s policy so that the meals are the correct temperature. During this inspection, we saw this had been addressed.

The service listened to and understood people’s needs, views and wishes. We respond to these and acted to minimise any discomfort, concern or distress.

Staff introduced patients to the ward and the services as part of their admission. Health care assistants said they provide patients with an introduction and orientation to the ward.

Staff involved patients and gave them access to their care planning and risk assessments. Staff said they met with patients once a week for key working sessions. During these sessions they reviewed the patient’s care plans together. Records showed that patients and their carers attended multidisciplinary team meetings and were actively involved in decisions about care, treatment and discharge. However, of the four patients we spoke with, only one said they had been given a copy of their care plan.

Staff involved patients in decisions about the service, when appropriate. The ward held a daily planning meeting. This enabled staff and patients to plan leave and activities collaboratively. The service employed an expert by experience who had previously used inpatient services. They had facilitated patients’ involvement in the redesign of the hospital. For example, they engaged patients in choosing colour themes for the ward to create a more therapeutic, less clinical environment. Patients were keen to have double beds installed so they could sleep more comfortably.

Patients could give feedback on the service and their treatment and staff supported them to do this. The service held a weekly community meeting. Recent meetings had been attended by two patients. During these meetings, patients had said that the washing machine had been broken. They also suggested that the ward hold a gaming competition. These comments and suggestions had been passed to the ward manager. When patients were discharged from the service, staff encouraged them to complete a feedback questionnaire that asked for their views on their stay at the hospital.

Staff made sure patients could access advocacy services. Information on how to contact the independent mental health advocacy service was displayed on a notice board.

The service cared about and promoted the wellbeing of staff, and supported and enabled them to deliver person centred care.

Staff told us that morale across the hospital had been very low after the service received an inadequate rating following the inspection in 2023. However, this had improved significantly following investment and support. Staff said the hospital director was approachable, supportive and engaged with staff on the wards.

The service had introduced well-being clinics for staff, including a clinic for staff working on night shifts. Information about these clinics was displayed in the nurses’ office. An employee assistance programme was available to staff.

Staff and managers said they found senior managers at the hospital to be very supportive.