Cygnet Views has recruited a new hospital manager after the Care Quality Commission rated the Derbyshire independent hospital inadequate overall and placed it in special measures.
The CQC carried out an unannounced inspection in June at Cygnet Views in Matlock which provides care for up to 10 women with learning disabilities, behaviour that could challenge and complex mental health needs.
Following the inspection, the hospital’s rating was moved down from ‘requires improvement’ to ‘inadequate’ overall. It was rated ‘good’ for being responsive, ‘requires improvement’ for being caring, and ‘inadequate’ for being safe, effective and well-led.
The CQC warned as the service is in special measures, it will be inspected again within six months and if there insufficient improvement, it will use its enforcement powers further to protect patients from the risk of harm and hold service leaders to account.
What inspectors found
The hospital was ordered to make a number of improvements including to ensure all areas of the hospital are assessed for ligature risks, that physical healthcare risks are monitored and mitigated against, that staff receive adequate training, that patients receive appropriate treatment, that patient records are complete and fit for purpose and that staff support patients to understand the care or treatment choices available to them.
However, inspectors also found that hospital staff planned and managed discharge of patients well, that they followed infection control policy well, that they worked well together and that they had access to the full range of specialists required to meet the needs of patients.
Safety and risk assessment concerns
Commenting on the CQC’s action, Jenny Wilkes, CQC head of inspection for mental health and community services, said: “When we inspected Cygnet Views, we were not assured all reasonable steps were being taken to protect women from avoidable harm.
“We were concerned that safety incidents were not well-managed at the hospital. Staff were trained in how to use restraint, but many were not confident about using these techniques which often resulted in the police being called to assist.
“Police have contacted us with their concerns about the safety and management of patients following several call outs to the hospital.
“Liaison meetings were set up with the local safeguarding authority to monitor police involvement at the hospital and are ongoing.
“In addition, risk assessments failed to identify significant ligature points across the hospital meaning vulnerable patients were at an increased risk of causing harm to themselves. Assessments inspectors looked at had missed several ligature points in bedrooms. This was despite similar risks being identified and actioned for improvement as part of Cygnet’s national review of ligature risks inside their hospitals.
“We did, however, see some examples of positive care for patients. For example, staff always treated people with kindness and respect and met the needs of all patients including those with a protected characteristic. Staff helped patients with communication, cultural and spiritual support.
“We spoke with Cygnet about addressing our findings as a priority and making the necessary improvements. We will continue to closely monitor the service and will return shortly to check on progress.”
Disappointment at rating
In response, a spokesperson for Cygnet Views said: “We are naturally very disappointed by the rating, although the report does highlight a number of positive areas of practice, including the compassion and kindness our staff showed to patients and that patients said they felt safe. The report also acknowledges that we employ a full range of specialists required to meet patients’ needs and involve patients and their families in decisions about their care, which contributed to the service being rated as good in the responsive domain.
“We do not take the concerns that have been raised lightly, however, and since the inspection, we have made significant improvements that include appointing an experienced hospital manager to give full-time management support to the service, providing additional training to staff and putting in new processes to ensure good practice is applied consistently across the hospital.
“The police calls related to one patient and our staff are working with her to manage and reduce distressing behaviour to keep her, as well as other patients and staff, safe. As a result, there have been no further incidents involving the police.
“We are committed to working closely with the CQC, and our commissioners and other stakeholders, and look forward to demonstrating the improvements that have been made at the next inspection.”