22 - 23 February 2022
During a routine inspection
Cygnet Manor is a high dependency rehabilitation hospital that provides a service for up to 20 men with learning disabilities, people who are expressing emotional distress and mental health needs.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
People were supported by staff to pursue their interests.
Staff supported people to achieve their aspirations and goals.
The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative.
Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced.
People had a choice about their living environment and were able to personalise their rooms.
Staff enabled people to access specialist health and social care support in the community.
Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.
Right Care
Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice.
Right Culture
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.
People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.
People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.
People and those important to them, including advocates, were involved in planning their care.
Our rating of this service stayed the same. We rated it as good because:
People’s care and support was provided in a safe, clean, well equipped, well-furnished and well-maintained environment which met people's sensory and physical needs.
People were protected from abuse and poor care. The service had sufficient, appropriately skilled staff to meet people’s needs and keep them safe.
People received kind and compassionate care from staff who protected and respected their privacy and dignity and understood each person’s individual needs. People had their communication needs met and information was shared in a way that could be understood.
People’s risks were assessed regularly and managed safely. People were involved in managing their own risks whenever possible.
If restrictive practices were used, there was a reporting system in place and there were comprehensive reviews to try and reduce the use of these practices. We reviewed eight incidents on CCTV and saw staff had managed these appropriately.
People made choices and took part in activities which were part of their planned care and support. Staff supported them to achieve their goals.
People received care, support and treatment that met their needs and aspirations. Care focused on people’s quality of life and followed best practice. Staff used clinical and quality audits to evaluate the quality of care. We saw that these audits were reviewed, and actions were acted upon.
The service provided care, support and treatment from trained staff and specialists able to meet people’s needs. Managers ensured that staff had relevant training, regular supervision and appraisal. All staff had received an appraisal at the time of this inspection.
People and those important to them, including advocates, were actively involved in planning their care. A multidisciplinary team worked well together to provide the planned care.
Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005.
People were in hospital to receive active, goal oriented treatment. People had clear plans in place to support them to return home or move to a community setting. Staff worked well with services that provide aftercare to ensure people received the right care and support.
Staff supported people through recognised models of care and treatment for people with a learning disability or autistic people. Leadership was good, and governance processes helped the service to keep people safe, protect their human rights and provide good care, support and treatment.