Cygnet Wast Hills

Updated 28 October 2022

Cygnet Wast Hills is an independent hospital providing assessment, treatment, and care to people with a learning disability and autistic people. It is managed by Cygnet (OE) Limited.

The site has three units, Main House, Annexe, and Lodge. The hospital is in a rural area close to the outskirts of Birmingham. However, it is not within easy reach of the local community.

There are 25 beds: 15 in the Main House, six in the Annexe and four at the Lodge. However, at the time of our inspection there were only 10 people admitted. All 10 people were detained under the Mental Health Act.

There were four people residing in the Main House (which included two people in flatlets in the courtyard), four people in the Annexe and two people in the Lodge.

Since our previous inspection, the service had undergone a significant programme of environmental work and the Annexe had been refurbished to provide individual flats for four people as well as a communal dining room, kitchen, laundry and bathroom. Two individual flats had been built in the courtyard area attached to the Main House. There were building works ongoing in the Main House due to be completed by December 2022. The service then plans to commence refurbishment of the Lodge to create three individual flats. At the time of our inspection the provider had paused admissions to allow for people who had recently been admitted to settle in and for staff get to know them.

Cygnet Wast Hills is registered with the Care Quality Commission for the following regulated activities:

Assessment or medical treatment for persons detained under the Mental Health Act 1983

Treatment of disease, disorder, or injury

Both the Main House and The Lodge are period properties, and the Annexe is a single-storey building of more recent construction. The buildings, location and layout were not suited to modern day psychiatric care as the hospital is a mile away from the nearest pub and local community. The hospital is set in six acres of ground. The hospital admitted people from throughout the United Kingdom.

The service is commissioned through clinical commissioning groups. The hospital director was the registered manager and had been in position since August 2021.

We last inspected this service in November 2021. At that inspection we identified areas of concern, and for the second time rated the service inadequate and placed the service under special measures.

We carried out this inspection due to concerns we identified at our previous inspection when we rated the service inadequate. At this inspection we looked at all the key lines of enquiry and checked whether the service had made improvements following concerns identified at our previous inspection.

How we carried out this inspection:

Three CQC inspectors, the CQC National Professional Advisor for people with a learning disability and autistic people, a medicines inspector and a specialist advisor who is a nurse working with people who have a learning disability visited the service.

We spoke with two people using the service using a communication tool called Talking Mats. We observed activities including a visit from a pet therapy organisation and observed the evening mealtime on the first day of inspection. We spoke with an advocate who was visiting.

We observed the morning meeting on the second day and the handover from day to night staff on the first day. We looked at all areas of the buildings and all clinic rooms.

We spoke with 27 staff members including day and night nurses and support workers, doctor, speech and language therapists, occupational therapists, and psychologists. We also spoke with the registered manager and operations manager.

We looked at six records of people who use the service and six prescription charts.

You can find information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.

Updated 28 October 2022

Our rating of this hospital improved. Our previous inadequate ratings at key question level improved, and we have removed it from special measures.

We rated the hospital as good overall because:

• The hospital had improved in a sustainable way those issues that led to it being placed in special measures.

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.

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

Right Support:

The hospital was located on the outskirts of Birmingham. However, it is in a rural location, a mile from the nearest pub and local community. This meant that staff needed to accompany people to access the local community.

The hospital was undergoing extensive refurbishment which provided people with self-contained flats with their own bedroom, living area, ensuite shower and toilet and small garden. They also had access to communal areas where they could meet with others if they wanted to. People showed us they had personalised their flats and staff had supported them with this.

Staff supported people to be independent. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life.

People were supported by staff to pursue their interests and people said they had tried out new activities they wanted to do.

Staff 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.

Staff enabled people to access specialist health and social care support in the community. They supported people to attend dental, optician, and health screening appointments.

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. People and their relatives said that staff looked after them well and treated them with respect. Staff were able to tell us about people’s individual needs and how they wished to be supported.

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 told us they felt safe.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People who had individual ways of communicating, could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.

People’s care, treatment and support plans reflected their range of needs, and this promoted their wellbeing and enjoyment of life.

Right Culture:

People received good quality care, support, and treatment because trained staff and specialists could meet their needs and wishes.

Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. People and their relatives knew what their goals were and where they planned to move to.

Staff placed people’s wishes, needs, and rights at the heart of everything they did.

People and those important to them, including advocates, were involved in planning their care. Relatives told us they were invited to meetings via video calls or in person and were kept updated at least weekly by the family liaison officer who worked at Wast Hills.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect, and inclusivity. Staff were welcoming and open and eager to show us and commissioners the improvements they had made since our previous inspection.

Updated 28 October 2022