Cygnet Oaks

Updated 27 April 2022

Cygnet Oaks is an independent mental health hospital situated in Barnsley, South Yorkshire. Since May 2018, Cygnet Behavioural Health Limited has been the registered provider of this service. The hospital has previously been owned and operated by other independent providers since it was first registered with CQC on 17 August 2011.

Cygnet Oaks is a 35-bed high dependency rehabilitation service for male patients with a primary diagnosis of mental illness. It accepts both informal patients, who voluntarily consent to stay and receive treatment, and patients detained under the Mental Health Act 1983. The hospital consists of two wards – the Lodge, which is the admissions ward and has 20 beds and the House, which has 15 beds for patients who have progressed on the rehabilitation pathway, including a four bed ‘step-through’ unit for patients nearing the point of discharge. At the time of our inspection, 34 patients were staying at the hospital. One room was being refurbished as part of an ongoing programme of environmental improvements.

The hospital had a registered manager in position and an accountable controlled drugs officer. Cygnet Oaks is registered to provide the regulated activities: Assessment or medical treatment of persons detained under the Mental Health Act 1983 and Treatment of disease, disorder or injury.

We have inspected Cygnet Oaks eight times previously. The last inspection was a comprehensive inspection carried out in October 2018. At that inspection we rated the service as ‘requires improvement’ overall. We rated the service as ‘requires improvement’ under the safe and effective key questions and as ‘good’ under the caring, responsive and well led key questions. We identified breaches of the following Regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014:

• Regulation 12 Safe care and treatment: in relation to how quickly a doctor could attend the hospital in an emergency and concerns about medicines management
• Regulation 13 Safeguarding service users from abuse and improper treatment: in relation to prompt intervention following incidents to safeguard people from abuse.
• Regulation 18 Staffing: in relation to staff keeping up to date with mandatory training requirements.

We found that the hospital had made improvements in relation to the concerns we identified at our previous inspection and that the regulatory breaches had been resolved.

What people who use the service say

We spoke with seven patients and eight relatives.

Most of the patients we spoke with said they were happy with their care at the hospital. They felt it was promoting their recovery and equipping them with tools to manage their mental health and live more independently when they moved on. They said that staff were respectful and supportive.

Patients told us that they felt safe on the ward and incidents were managed well. Most patients told us the food was good and they were being supported to lead healthier lives. Most patients said that the wards were always well staffed, and the staff were mostly permanent employees rather than agency or bank staff. However, some patients told us that there was not always enough staff to support all their escorted section 17 leave.

Two patients raised specific complaints about their care which were fed back to the manager, who told us that action would be taken to work with the individuals to try and resolve their concerns.

Relatives told us that their family member felt safe at the hospital. They spoke highly of the staff, who they said were respectful and supportive to their family member. Those relatives who had been on the ward said it was clean and senior staff were visible. Some relatives told us they had been involved in reviews of their family member’s care and they were invited to meetings, but some said they had not been as involved as they would like. They told us they were able to keep in contact with their family member, using video technology if they did not live close to the hospital. Several relatives told us that they had not been involved in the development of their family member’s care plans.

Updated 27 April 2022

Cygnet Oaks is a 35-bed high dependency rehabilitation service for male patients with a primary diagnosis of mental illness.

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

• The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors to meet the needs of patients. Staff assessed and managed both environmental and individual risks well. They minimised the use of restrictive practices, managed medicines safely and followed good practice with respect to safeguarding.
• Staff developed individual care plans for patients informed by a comprehensive assessment of their needs. They provided a range of treatments suitable to the needs of the patients cared for in a mental health rehabilitation ward in line with national guidance and best practice. Staff engaged in clinical audit to evaluate the quality of care they provided and made improvements to practice as a result of their findings.
• The ward teams included the full range of specialists required to meet the needs of patients. Managers ensured that these staff usually received regular training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who had 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 involved patients and families and carers in care decisions.
• Staff planned and managed patients’ discharge well and liaised well with services that would provide aftercare. As a result, patients rarely experienced a delay to their discharge other than for a clinical reason.
• The service worked to a recognised model of mental health rehabilitation.
• Leaders were experienced and qualified for their roles, they were accessible and approachable to staff. The service had a positive culture where staff felt able to speak up and felt respected and valued.
• Leaders were aware of the risks associated with the running of the service and had taken action to mitigate risks and make improvements.
• People using the service told us that they felt safe, they had access to the rehabilitation support they needed, the wards were usually well staffed and staff treated them with respect.

However:

• Staff had not fully complied with the duty of candour following a notifiable safety incident because the person had not received a written apology.
• The service did not have defined local procedures in place for searching patients on their return from leave. Care plans did not always clearly outline the amount of leave a patient could have that could be facilitated by staff when an escort was needed. Staff did not always record the reason why leave was cancelled.
• Care plans were not always recovery-oriented, some were not up to date with the person’s current needs and best interests assessments were not always recorded. Staff did not always record when patients had been given a copy of their care plan. The provider’s records audits had not picked up these shortfalls.

Updated 27 April 2022