Cygnet Storthfield House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Systems were in place to manage safeguarding incidents and staff were trained in safeguarding people from abuse. Staff demonstrated good knowledge and understanding of safeguarding, all staff we spoke to were able to describe what actions to take to keep people safe. Patients told us they felt safe at the hospital and if they felt unsafe staff would support them. Patients told us searches happened when staff thought they were needed to keep people safe. The service had processes in place to identify risks and communicate this to staff effectively. The provider care plan policy promoted patient involvement in the development and updating of care plans. Care plans were person centred; they were detailed in individual patients risks. We found staff recorded patients voice in their plans. Staff acted quickly and brought up concerns to the attention of the multi-disciplinary team and had written this within the care plan under potential risk. We found examples to show that changing risks in patients were updated in their care plans, written up in daily risk assessments and documented on handover sheets. This showed a proactive approach to prevent patients from living in an unsafe environment.

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.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

Staff had completed and kept up to date with their safeguarding individuals at risk training. Staff training compliance rate was at 100% overall. The service had a system in place to log all safeguarding incidents showing clearly what actions had been taken. Each incident logged showed who the incident had been reported to and what actions had been taken to safeguarding patients. Storthfield House had received 42 potential safeguarding incidents between December 2023 and February 2024. One of these incidents was still open and under safeguarding investigation and others had been concluded, with appropriate actions being completed where required. The provider had a detailed safeguarding policy in place. The policy gave guidance around how to identify and raise safeguarding concerns. This policy was reviewed annually.

Patients told us that they felt safe at the hospital and if they felt unsafe the staff would support them. Patients told us searches happened when staff thought they were needed to keep people safe.

Notice boards situated around the ward displayed information relating to well-being and living well, mindfulness, anxiety and stress management, advocacy services, the Mental Health Act and CQC information including contact details and feedback on care. Patients were comfortable and relaxed, patients were spending time with peers watching television and listening to music. Staff were engaging with patients and spent time watching television with them and discussing the programme being watched and appeared to have good therapeutic relationships with the patients.

Staff demonstrated good knowledge and understanding of safeguarding. They were able to describe what actions to take to keep people safe, knew the organisations safeguarding policy, protocols and procedures, were confident in identifying different forms of abuse and the reporting of these to the local authority via the safeguarding team. They had completed organisational safeguarding training and had annual refresher training. Staff said that patients felt comfortable to approach them to report any concerns and this did happen on occasion. They always supported patients to raise concerns and any concerns raised were always documented and acted upon. Leaders of the service had clear operational procedures on how to report safeguarding and worked closely with other agencies to protect patients. Leaders understood their roles in safeguarding and how to report and feedback to staff and patients.

All patients told us they were involved in their care planning and clinical reviews. However, one person felt their needs were not fully met. On review of their care plans and review meeting documentation we saw appropriate clinical reviews and decisions had been made and explained to them. Care plans and multi-disciplinary meetings notes which the patients attended showed that individual risk and needs were identified. Patients’ daily notes also showed how individual needs and risks were being met. One patient told us that even though they felt they don’t have any specific needs the staff look after ‘everything the way that I want it’.

Allocation sheets in place showed patients with a risk of ligature were allocated a staff member to check their room daily. This was linked to the risk assessment in patient care plans. Staff recorded when items of risk were found after room searches. However, completion of room searches was not recorded on staff handover sheets. This was raised to the head of care and hospital manager, and they agreed this would be followed up with staff and records would be checked to confirm this. Care plans were person centred; they were detailed in individual patients risks and recorded in the patient's voice. These were reviewed daily and any new or changing information would be shared at handovers so that staff were aware. We found examples where staff had observed potential risks for a patient who may become a victim of harassment or bullying. Staff had acted quickly and brought it up to the attention of the multi-disciplinary team and had written this within the care plan under potential risk. We found examples to show that changing risks in patients were updated in their care plans, written up in daily risk assessments and documented on handover sheets. This showed a proactive approach to prevent patients from living in an unsafe environment. Information was available in a specific language for a patient whose first language was not English. We found their legal paperwork and activity timetables in their language. The provider had a number of policies in place to ensure patients were involved in managing risks. The provider care plan policy promoted patient involvement in the development and updating of care plans. The service had a clear contraband list in place, which was on display in the communal area. The provider had a detailed search policy in place. This policy stated the different types of searches that staff could carry out and when these would be considered.

Staff said patients were made aware of any risks on the ward when required. Patients risk assessments were dynamic, and person centred with risk assessments being reviewed regularly and updated to reflect current risks. Staff demonstrated good knowledge around restrictive practice and said certain items were only restricted based on current risk levels. Patients were consulted regarding restricted items and had input into the assessments which determined which items were to be restricted and why. Staff had good knowledge of least restrictive practice and were able to explain different provider policies, procedures and techniques used when faced with incidents of verbal hostility, violence and aggression. Staff told us that by following the providers policies, procedures and treatment plans, physical intervention was rarely used. Leaders told us that patients were involved in managing their risk by being part of care planning. Key individual risks were monitored and shared at daily risk meetings with staff and at handovers. Staff were supported to raise concerns about changes to behaviour as soon as possible to raise awareness of future risk for patients.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe and effective staffing during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.