Cygnet Nield House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We reviewed all 6 quality statements in the effective key question. This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on the best available evidence. At our last inspection we rated this key question as Good. At this assessment the rating has remained Good.

The teams included or had access to the full range of specialists required to meet the needs of patients. Managers ensured staff received training, supervision and appraisal. Care was delivered in line with national guidance and best practice. Staff worked well together as a multidisciplinary team. Staff worked collaboratively with stakeholders to deliver joined-up care to patients.

Patients had up to date and comprehensive assessments in place. These were reviewed regularly. Patients’ physical health was assessed and monitored.

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 had a clear understanding of their care and treatment and were confident in who to approach for information. Carers we spoke with had been involved in their relative’s care and treatment including attending multidisciplinary team meetings.

Staff we spoke with were able to describe the assessment process and their involvement in it. They were able to describe how they were informed of the outcomes of assessments and how associated care and risk management plans were shared with them.

Staff were aware of how they could access specialist assessments, for example occupational therapy, speech and language therapy or psychology.

The psychologist at the service had begun undertaking autism assessments where indicated, this had helped with the care and treatment of the patients.

We reviewed 6 care records and found each had a comprehensive assessment in place which captured all relevant information and evidenced involvement from the patient and relevant stakeholders such as family members, loved ones and other services involved in the patients care.

We observed morning handover meetings and ward rounds meetings, we found staff were knowledgeable about the patients on the ward and their needs.

Patients we spoke with felt informed about their care and treatment, they were confident they could speak with their named nurse or the doctor if they required additional information.

Staff delivered care and treatment in line with best practice. Staff we spoke with were able to describe the range of professional input, treatment and care options available to patients in line with national guidance.

Staff told us there had been limited psychology and occupational therapy available for patients due to vacancies, but these posts had now been filled.

Provider policies were written in line with national guidance. There were governance structures to review and disseminate new guidance. The ward completed clinical audits to ensure compliance with relevant standards and guidance.

Patients we spoke with felt informed about their care and treatment, they were confident they could speak with their named nurse or the doctor if they required additional information.

Staff we spoke with described a supportive multi-disciplinary team and told us that they worked well together. They were able to describe links with other services and organisations and explain how they worked together.

Staff had access to the information they required to appropriately assess, plan and deliver people’s care and treatment. Staff were able to describe the processes and guidelines for sharing information within the multidisciplinary team and with external services. They were able to discuss examples where they had worked collaboratively with relevant staff, teams and services to deliver care and treatment and support patient’s pathways.

Staff attended daily morning meetings, we observed morning meeting which covered updates on patient presentation, required actions and lessons learnt from any incidents.

We observed a ward round meeting that included the patient and their advocate. This meeting was attended by a multidisciplinary team with staff both internal and external to the organisation.

There were processes and systems in place to support admissions, discharges and transfers of care.

Referrals to the service came through the bed bureau for the organisations who commission beds at the service. There were clear pathways and referral procedures into the service. Staff had access to policies and procedures to support transitions and pathways into and out of the service.

Patients we spoke with felt informed about their care and treatment, they were confident they could speak with their named nurse or the Doctor if they required additional information.

Staff made sure patients had support for their physical health needs and access to interventions and activities that promoted healthier living. These included access to smoking cessation programmes and physical exercise.

Staff completed regular physical health checks. They had received training to support those interventions as utilised the National Early Warning Score system to flag any concerns. Staff discussed physical health with patients as part of those checks and in ongoing care reviews.

There were processes to monitor physical health and identify possible healthy living interventions. These included physical health assessment on admission and ongoing physical health care. There were pathways to provide services such as smoking cessation.

Patients we spoke with felt informed about their care and treatment, they were confident they could speak with their named nurse or the doctor if they required additional information.

Staff used recognised rating scales to assess and record the severity of patient conditions and care and treatment outcomes. The service completed Health of the Nation Outcome Scales (HoNOS) for patients.

Staff took part in clinical audit and benchmarking initiatives. They were supported by audit, assurance and performance monitoring teams within the wider organisation. Results from audits and quality assurance processes were used to generate improvements.

Staff used recognised rating scales to assess and record the severity of patients’ conditions and care and treatment outcomes. The occupational therapists used a range of tools including interest checklists and the model of human occupation screening tool.

Patients we spoke with felt informed about their care and treatment, they were confident they could speak with their named nurse or the doctor if they required additional information. Patients we spoke with were aware of independent mental health advocacy services that visited the ward.

Staff we spoke with had completed training around the Mental Health Act and Mental Capacity Act.

We reviewed 6 care records and found evidence of capacity being assessed and considered. We saw an example of a best interest process that met required standards. Family members had been involved and the process gave due consideration to the patients interests and wishes.

Staff received training on the Mental Capacity Act. At the time of our assessment compliance with the training was 96%. The service audits Mental Capacity act compliance on the ward quarterly.