Cygnet Aspen Clinic

Updated 26 July 2022

Cygnet Aspen Clinic is a 16-bed locked rehabilitation service providing assessment, treatment and rehabilitation for women with personality disorder and complex needs. At the time of our inspection, there were 16 patients staying in the hospital.

Cygnet Aspen Clinic has been registered with the Care Quality Commission since 17 November 2010 and is registered to provide the following regulated activities;

-Assessment or medical treatment for persons detained under the Mental Health Act 1983

-Treatment of disease, disorder or injury.

The hospital provides care and treatment to informal and detained patients. There was a registered manager in place at the time of inspection.

The last time the Care Quality Commission inspected Cygnet Aspen Clinic was in November 2017 when we rated the service as good overall. We rated the safe domain as requires improvement and all remaining domains as good.

Following this inspection, we told the provider they must take the following actions;

-Staff must ensure they record the current temperature of the medication fridge, not just the maximum and minimum temperatures

-Staff must ensure they practice good infection control precautions when carrying out clinical procedures

-Staff must ensure they store controlled drugs securely prior to disposal

What people who use the service say

During inspection we spoke with six patients and four family members of patients.

Most patients told us staff were caring and appeared interested in their wellbeing. We observed positive interactions between patients and staff and staff were observed to speak respectfully about patients during handover and multidisciplinary team meetings. However, patients told us they often had to wait for staff to be available as they were too busy with other tasks such as patient observations.

Patients told us they could speak to staff if they had any questions and most patients knew what was in their care plan. Patients engaged in daily planning meetings and could make requests for activities of interest but did tell us there were no activities on weekends which could be difficult for patients unable to leave the hospital.

Patients were able to give feedback in several ways and told us they knew how to raise formal complaints. However, family members we spoke with were unclear on how they could give feedback or raise a complaint.

Updated 26 July 2022

Our rating of this service went down. We rated it as requires improvement because:

• The ward environments were not consistently safe and clean. The ligature risk assessment had not been updated following identification of an additional risk following a serious incident, rooms within the ward were cluttered with patient belongings due to a lack of formal storage, and oxygen was not safely and securely stored.
• Prescriptions were not always signed by a doctor in a timely manner as per the provider’s policy.
• Whilst staff received supervision and had access to team meetings, supervision was sometimes on a team rather than one to one basis and meetings were not taking place regularly.
• Due to lack of space and storage within the building, patient’s privacy and dignity was not always maintained when they were given their medications.
• It was not clear whether all patients had their physical health reviewed effectively during their time on the ward.
• Whilst we could see that staff actively involved patients in care decisions, we could not see that families and carers were equally involved, where the patient requested this. Families and carers told us they were unsure how to provide feedback, and felt visiting facilities were not adequate for children visiting the service.
• The governance of the service did not always ensure the delivery of high-quality care and audits did not always identify areas of concern found.

However:

• The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices 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 cared for in a mental health rehabilitation ward 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. 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.
• Staff treated patients with compassion and kindness, respected their privacy, and understood the individual needs of patients.
• Staff planned and managed discharge well and liaised well with services that would provide aftercare.

Updated 26 July 2022