Cygnet Hospital Hexham

Updated 20 May 2022

Cygnet Hospital Hexham is a 27-bed mental health facility for women with complex mental health needs. Cygnet Hospital Hexham is an independent mental health hospital based on the outskirts of Hexham. The service has two wards, Fisher ward (17 bed acute ward), and Franklin ward (10 bed psychiatric intensive care unit) for females of 18 years and over.

Cygnet Hospital Hexham 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 1983
• Treatment of disease, disorder or injury

The hospital had a registered manager in place at the time of the inspection.

We conducted a focused responsive inspection in April 2021 in response to whistleblowing concerns in relation to patient safety. We did not review all domains; we conducted a focused review of practice relating to these concerns within the safe and well led domains. We did not re-rate Cygnet Hospital Hexham following this focused inspection.

During this inspection we found that the ward did not have enough space for patients to provide a safe and therapeutic environment. The dining and lounge areas were small and would not accommodate all patients at the same time if required to do so. Patients could not access the dining area without support from staff as it was accessed via a locked corridor. The seclusion room was small and provided patients with very limited space to move around when the mattress was on the floor. It was in a corridor that was the main thoroughfare for patients and staff to access the staff room, patient dining room, treatment room and laundry.

Following an inspection in May 2019, when the service provided wards for adults with a learning disability and/or autism (named Cygnet Chesterholme) enforcement action was taken and the service was rated inadequate and placed in special measures. The hospital closed in September 2019 and re-opened in October 2020 providing acute admission and psychiatric intensive care wards. 

What people who use the service say

We spoke to four patients while on inspection, reviewed six discharge questionnaires and reviewed the feedback giving during the last Mental Health Act monitoring visits. Patients said they felt safe on the wards and that staff were supportive in meeting their needs. One patient said that she hadn’t had leave which we checked out with staff. Staff had been supporting the patient to go on leave. One patient was concerned about the cleanliness of the communal beverage bay and this was being addressed by nursing staff. Five out of the six discharged patients felt that the hospital had helped them and would recommend the hospital to family or friends.

During the most recent Mental Health Act monitoring visit in August 2021 most of the patients we spoke with told us they felt safe and were treated with respect. Patient feedback about staff was nearly all positive and included that staff listened to them. Comments from patients included; “exceptionally good”, “staff are good, they help you and you can talk to them” and “staff are wonderful”. However, one patient felt staff talked down to them and two others felt they were not always treated fairly when it came to planning outings.

Three patients commented that the ward was “aesthetically pleasing” and had good facilities. One family member told us staff were friendly and helpful.

Updated 20 May 2022

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

• The ward environments were safe and clean and where possible improvements to the environment had been made as identified at the last inspection. 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 and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received training, supervision and appraisal. The ward staff worked well together as a multidisciplinary team 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.
• The service managed admissions well with multi-disciplinary discussions occurring between the providers central admission team and hospital managers.
• The service was well led, and the governance processes ensured that ward procedures ran smoothly.

However:

• The service continued to use high numbers of agency staff to cover shifts in response to increased observation levels. Agency staff did not always follow risk management plans effectively to keep patients safe.
• The service had recently employed a psychologist and so not all patients had a formulation plan in place for use by support staff when managing patient’s needs.
• The service had two patients on the psychiatric intensive care unit who had been there for longer than 12-week pathway. However, staff were trying to address this.
• The service had not adjusted the bright lighting on the ward on an evening after recommendations in a recent Mental Health Act visit.

Updated 25 September 2019

Updated 20 May 2022