Care Quality Commission (CQC) inspectors found Cygnet Health Care has made progress but still has work to do following a review of the private healthcare provider.
The regulator revealed it had carried out a review of the mental health services provider, which operates over 150 centres with more than 2,500 beds across the UK, following up on areas identified as needing improvement during a previous inspection in 2019.
The review, conducted between 27 January and 4 March 2021, considered additional concerns which had arisen at 13 Cygnet services following previsous inspections and assessments and feedback from stakeholders.
This included ongoing serious incidents, whistleblowing contact from Cygnet staff to the CQC and safeguarding concerns across a number of the provider’s locations.
Overall, inspectors found although improvements have been made at some services, including improvements over checks being carried out to ensure executive directors were fit and proper persons, some were still not providing safe care.
Although Cygnet had made progress towards meeting the requirements from the previous review, further work was required across the organisation to ensure sustainable improvements and the safety of services.
This includes working on recruitment and retention of staff to improve patient safety, the forming of a long term strategic plan, better use of data to identify areas of improvement and improving confidence among staff to report concerns.
CQC head of hospital inspection Jane Ray said: “We carried out this review to check Cygnet was making sufficient progress with the improvements required, following our well-led review in 2019.
“We found a number of areas where progress had been made and where Cygnet was performing well. This review took place when Cygnet was dealing with the implications of the Covid-19 pandemic, and we found that it had largely managed the risks associated with this well.”
Ray noted that appointments of independent advisory board members had been made to provide independent challenge to the executive team and effective arrangements were now in place to identify and escalate risks from services to the leadership team.
However, while work was underway to address issues at a leadership level, several areas were found that required significantly more work including development of a longer-term strategic plan to reduce repurposing of services at short notice, leading to a breakdown of people’s placements and care arrangements.
“Additionally, action is needed to improve patient safety and working culture, ensuring proper engagement and transparency across the wider healthcare system that Cygnet is a part of,” Ray coninued.
“People should be able to expect high-quality and safe care in all Cygnet services and staff should be supported to raise concerns. While most Cygnet services are providing good care there are some that still need to improve.
“While we are seeing progress in some services, we are concerned that some others are not providing safe care and are struggling to meet the needs of patients.”
Reports from CQC inspections of Cygnet Beckton and Cygnet Acer Clinic were also published this week.
Acer and Beckton clinics
Cygnet Acer Clinic in Chesterfield is now rated as good overall and good for being safe, effective, caring, responsive and well-led and will now exit special measures following the CQC’s inspection.
However, the CQC told Cygnet Hospital Beckton in London that it must make rapid improvements to ensure people’s safety.
The CQC revealed inspectors made an unannounced, focused inspection of the hospital’s psychiatric intensive care unit and the ward for patients with learning disabilities, in March.
The inspection followed the report of four incidents of alleged abuse of patients by staff, which Cygnet Hospital Beckton told CQC about.
Following the inspection, conditions were imposed on Cygnet’s registration stopping it from admitting people into the hospital without CQC’s permission.
The inspection resulted in the overall rating for Cygnet Hospital Beckton moving from good to inadequate, and the service placed into special measures.
Individual ratings of whether the service is caring or well-led were cut from good to inadequate, and the safety rating of the service dropped from requires improvement to inadequate.
Although two wards for patients with a personality disorder were not visited by CQC inspectors in March, due to the overarching concerns about the hospital, the good rating for this service has been suspended until CQC is assured this is still reflective of the care being delivered.
Cygnet response
In response to the CQC announcements about the company, a spokesperson for Cygnet Health Care said the safety and wellbeing of its service users was an “absolute priority” and 80% of Cygnet Health Care services across the UK were rated good or outstanding.
“In a small minority of services where we have not met the expected standards, we are committed to continuous improvement by investing in our staff, resources and facilities to ensure those we look after receive the care they deserve,” the firm said.
“Since the CQC inspection at Cygnet Hospital Beckton in March, we have made major improvements and have been able to demonstrate these to the regulator. These include additional resources to further safeguard our patients, enhanced training for staff and a renewed focus on consulting with patients and their relatives about improvements and planning their care.
“While we faced staffing challenges during the pandemic, we have also been able to reduce the number of agency staff and recruit new registered nurses and multi-disciplinary team professionals.”
The provider added that it took its responsibilities to identify and improve services very seriously.
“Since the last well led inspection in August 2019, 61 Cygnet services have had their CQC rating either upgraded or retained following inspection, including Cygnet Acer Clinic, which has been upgraded today to good overall and in all domains by the CQC,” it continued.
“We are pleased that CQC well led review recognises the positive progress Cygnet has made, including that our services have managed the risks associated with the pandemic well.”
