Cygnet Fountains

Updated 31 December 2019

Cygnet Fountains hospital is a 32-bed longer term high dependency rehabilitation unit. It provides care and treatment to males aged 18 and over with a primary diagnosis of mental illness. This includes patients with challenging behaviour, forensic histories and substance misuse issues. The service accepts informal patients and those detained under the Mental Health Act. At the time of this inspection, there were 24 patients. All 24 patients were detained under the Mental Health Act.

The unit includes five self-contained flats used to help prepare patients to return to the community.

There is a registered manager and a controlled drugs accountable officer in place.

Cygnet Behavioural Health Limited are currently the registered provider of Cygnet Fountains.

Cygnet Fountains is registered with The Care Quality Commission (CQC) 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 most recent CQC inspection was in September 2017 when a comprehensive announced inspection was carried out. The service was found to be good overall. However, there were two requirement notices associated with this service. Patients were not protected against the risks associated with unsafe or unsuitable premises because of inadequate cleaning of their bedrooms including linen, pillows and mattresses. There was a blanket restriction in place, this had not been individually assessed. These have now been met and the breaches no longer exist.

The Mental Health Act reviewer from the Care Quality Commission last visited in July 2018. All actions except one had been actioned and this was to support patients and develop opportunities to make an advance statement of their wishes and feelings, which could be used when they were unable or unwilling to express their views or participate as fully in decisions about their care and treatment under the Mental Health Act.

Updated 31 December 2019

We rated Cygnet Fountains as Outstanding because;

• The service provided safe care. The ward environments were safe and clean. 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 cared for in a longer-term high dependency 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.
• There was an effective and creative approach to understanding the needs of different groups of people and to deliver care in a way that meets these needs and promoted equality. This included patients with complex needs.
• There was a mix of highly skilled staff who used a wide variety of recognised tools and rating scales to support patients in their recovery. Staff were involved in clinical audits and in quality improvement initiatives to improve their practice and outcomes for patients.
• Managers ensured that staff received training, supervision and appraisal. The continuing development of the staff’s skills, competence and knowledge is recognised as being integral to ensuring high quality care. Staff were proactively supported and encouraged to acquire new skills, use their transferable skills and share best practice.
• Staff were committed to working collaboratively and had found innovative and efficient ways to deliver more joined up care. Staff worked well with external agencies 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 dignity, and understood the individual needs of patients. They actively involved patients and families and carers in care decisions. Patients who used the service were active partners in their own care and the staff team were fully committed to working in partnership with patients. Staff empowered patients to have a voice and to realise their potential in their rehabilitation and recovery pathway.
• The Fountains had employed a peer support worker to work alongside patients to enable patients to share and discuss their issues with someone who has had lived experience. They had developed a people’s council where patients were encouraged and supported by advocates to make decisions about the service and where patients could give feedback about the Fountains. This was then developed into an action plan to make improvements for the patients.
• Patients emotional and social needs were highly valued by the staff team and imbedded in their care and treatment.
• Staff planned and managed discharge well and liaised well with services that would provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason.
• The service worked to a recognised model of mental health rehabilitation. It was well led, and the governance processes ensured that ward procedures ran smoothly.
• There was a systematic and integrated approach to monitoring, reviewing and providing evidence of progress against the strategy and plans. Plans were consistently implemented and had a positive impact on quality and sustainability of services.
• There was a demonstrated commitment to best practice performance and risk management systems and processes. The organisation reviewed how they functioned and ensured that staff at all levels had the skills and knowledge to use those systems and processes effectively. Problems were identified and addressed quickly and openly.

However;

• There were limited rooms available for patients to access that were quiet and provided a therapeutic space. This also included the lack of suitable space to see visitors in.
• Patients we spoke with told us they would prefer more male staff.

Updated 31 December 2019