Cygnet Hospital Ealing

Updated 26 August 2022

Cygnet Hospital Ealing is made of up two wards.

Sunrise Ward is a ward for women over 18 requiring treatment for complex eating disorders. The service offers psychological therapies as well as support and care relating to physical and mental health. The ward can accommodate up to 14 patients.

New Dawn Ward is a specialist service for women over 18 with personality disorders. It has nine beds and predominantly offers a dialectic behaviour therapy treatment model.

The service is registered to undertake the following regulated activities:

Care and treatment for persons detained under the Mental Health Act 1983

Treatment for disease, disorder or injury

There was a registered manager in post at the time of the inspection.

We have inspected Cygnet Hospital Ealing four times since 2015. At our last comprehensive inspection in January 2020 we rated the specialist eating disorder service and personality disorder services as requires improvement in safe and well-led. We rated effective, caring and responsive as good. At that inspection we rated the hospital as requires improvement overall.

We found breaches in relation to:

Regulation 12 (safe care and treatment)

Regulation 17 (good governance)

At our comprehensive inspection in June 2019, the service was rated as inadequate overall, with an inadequate rating for the specialist eating disorder service provided on Sunrise ward, and a rating of requires improvement for the personality disorder service provided on New Dawn ward. The service was placed in special measures following the inspection as they had not addressed the requirements in the previous warning notices.

In November 2018 we carried out a focused inspection in response to concerns raised. At that inspection we took enforcement action and issued the provider with warning notices.

What people who use the service say

We spoke to twelve patients and overall feedback we received was positive. Patients said they were treated with kindness, were supported in their recovery and there were some very caring staff. Patients told us they were involved in their care and treatment and staff were responsive to requests for support. Patients on New Dawn ward said the consultant psychiatrist was excellent, that they listened to them, involved them in their care and provided clear information.

However, on New Dawn ward patients reported that some staff were not as engaged with them as other staff. For example, they would not engage in conversation or would not always speak kindly or caringly. On Sunrise ward, patients told us that agency staff needed further training to understand eating disorders and better communication at mealtimes.

Patients told us they enjoyed the variety of activities including the recreational activities such swimming and personal training. Patients were able to give feedback on the service so that improvements could be made, through community meetings and feedback questionnaires.

All patients told us they were supported to maintain contact with family and carers.

We received feedback from three carers we spoke with. All carers told us that they were involved in their family members’ care and staff were kind and caring. Carers told us they valued the carers group and the psychoeducation provided. Two carers on Sunrise ward told us that communication between them and the ward staff could be improved.

Updated 26 August 2022

Our rating of this location improved. We rated it as good overall, with requires improvement in safe because:

Patients told us they felt safe. The ward environments were safe and clean. Since our last inspection, a nurse call system had been installed throughout the hospital. Sunrise ward had been refurbished and all bedrooms were now single and en-suite.

The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices, managed medicines safely 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 ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward 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.

Most 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 said they felt respected, supported and valued. They could raise any concerns without fear.

However:

Staff did not always record observations of patients in line with the provider’s policy. Intermittent observations were recorded at regular and predictable intervals. There was a risk that the patients would know when observations would take place and they could plan any actions around this.

On New Dawn ward some of the staff did not engage with the patients or show a caring attitude towards them. Staff at times would be using their mobile phones when they were observing the patients.

Staff were not always able to take their break when escorting patients to the emergency department.

The provider had made significant improvements since our last inspection. Overall, governance processes operated effectively, and arrangements were in place for the management of performance and risk. However, issues identified with the recording of patient observations required improvement.

Updated 26 August 2022

Our rating of this service improved. We rated it as good because:

See the summary above for details.

Updated 26 August 2022

Our rating of this service improved. We rated it as good.

See the summary above for details.