Cygnet Grange

Updated 27 June 2019

Cygnet Grange is part of Cygnet Learning Disabilities Midlands Limited. Cygnet Learning Disabilities Midlands Limited is the registered provider. Cygnet Grange, located in Sutton in Ashfield, Nottinghamshire, provides eight rehabilitation beds for adult males with an acquired brain injury. At the time of inspection, there were eight patients, six detained under the Mental Health Act 1983 and authorisations for two patients to be subject to Deprivation of Liberty Safeguards had been made.

The hospital has two floors, communal areas and offices on the ground floor and patient bedrooms and a nursing station on the first floor. A registered manager and nominated individual were in post during this inspection.

Cygnet Grange is registered with the Care Quality Commission to provide the following regulated activities:

• assessment or medical treatment for persons detained under the Mental Health Act
• treatment of disease, disorder or injury.

Patients admitted to this hospital have a diagnosis of established or suspected acquired brain injury, alcohol-related brain injury, Korsakoff’s Syndrome, Huntington’s disease or early onset dementia with rehabilitation potential. Patients might be detained under the Mental Health Act, the Mental Capacity Act Deprivation of Liberty Safeguards, or admitted on an informal basis.

Patients might also present with mental health disorders, cognitive impairment, organic psychiatric disorder or organic personality change, dysphagia or other communication problems and abnormal movements or restricted mobility.

Cygnet Grange was last inspected on 21 August 2017. The service was rated GOOD overall and there were no identified Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 breaches. This inspection was part of the CQC’s ongoing comprehensive mental health inspection programme.

A Mental Health Act monitoring visit occurred on 19 March 2019. When we inspected the hospital manager had not yet received written feedback from this monitoring visit.

Updated 27 June 2019

Our rating of this service stayed the same. We rated Cygnet Grange as Good because:

• The service provided safe care. The hospital environment was safe and clean. The hospital had enough nurses, doctors and senior multidisciplinary staff. Staff assessed 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 mental health rehabilitation hospital and in line with national guidance about best practice.
• The hospital team included or had access to the full range of specialists required to meet the needs of patients. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with those outside the hospital 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 involved patients and families and carers in care decisions.
• 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 hospital used a person-centred model of mental health rehabilitation that met the individual needs of patients.

However;

• Staff practice to monitor and record patients’ physical health was not always good. This included not always effectively monitoring patients’ physical health with the use of tools to assess and respond to clinical changes in patients. We also saw examples of staff omissions in recording the outcomes of routine physical health observations. For example; staff failing to record dates, times and signatures, records written unclearly or without necessary corrections.

• The provider’s physical health audit had not identified shortfalls in the completeness and quality of recording by staff when completing the ongoing monitoring of patients’ physical health.

Updated 26 October 2017

Updated 27 June 2019