Cygnet Hospital Derby

Updated 29 June 2022

Cygnet Hospital Derby is a purpose-built facility run by Cygnet Health Care Limited. It registered with the CQC in 2010 and provides 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 provides services to adults aged over 18 years of age across three wards:

• Alvaston ward is a 14-bed low secure ward for females with a primary diagnosis of emotionally unstable personality disorder or mental illness.
• Litchurch ward is a 15-bed low secure ward for males with mental illness, sometimes with dual or multiple diagnoses.
• Wyvern ward is 16 bed locked rehabilitation ward for males who no longer require care in a low secure environment. Wyvern Court is attached to the ward and provides an additional three beds in a self-contained apartment for male patients who cannot easily access the ward.

At the time of inspection, Alvaston ward had 12 patients, Litchurch ward had 14 patients and Wyvern ward, including Wyvern Court, had 19 patients. All patients on Alvaston and Litchurch wards were detained under the Mental Health Act. There was one informal patient on Wyvern ward.

Cygnet Hospital Derby has had five inspections since registering with CQC. It was last inspected in April 2018, when it was rated good overall and good in all five domains, with no requirement notices. The report was published in June 2018.

What people who use the service say

We spoke with 14 patients across all three wards. Patients said that staff supported them well, were understanding, kind and always polite. Staff made time for them and listened to them and helped them feel safe.

Patients said they had paid job roles which helped to prepare them for their rehabilitation or aided their recovery. Patients across all wards said there were a lot of activities on the wards, including bowling, going out for walks, for lunch, to shops, karaoke and a music therapist visited in the evenings a few times a week, including at weekends.

On Wyvern ward, patients told us they had pool tournaments and film nights and played cricket in the courtyard. They could access the kitchen when needed to make hot drinks and snacks and did their own laundry. Patients said they knew how to contact the advocate and they visited regularly. They attended morning meetings at 9am each day where they decided what activities and groups, they would be attending that day. Patients had monthly community meetings with staff which a patient chaired and minutes of these were kept.

We spoke with eight carers. They said staff were polite and kind and kept patients safe. Many commented on the number of activities offered to their relatives, although some said there was less to do at weekends and their relative often got bored. Three carers said the medical staff were caring, engaging and had a good understanding of their relative and that they were involved in care planning. However, three carers said communications could be more frequent and that they were not always informed about care planning. Another said high numbers of agency staff meant they had to tell their story all over again.

Updated 29 June 2022

Cygnet Hospital Derby provides one male and one female low secure wards and a locked rehabilitation ward for male patients who no longer require secure care.

Our rating of this service stayed the same. We rated it as good because:

• The service provided safe care. The ward environments were safe and clean.
• The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices and followed good practice with respect to safeguarding.
• Patients had an opportunity to manage their own medicines as part of their rehabilitation or recovery.
• 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 ward, which included substance misuse workers and social workers.
• Managers ensured that 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 their families and carers in care decisions. This included carers' days and there was an allocated staff member on each ward to communicate with carers.
• Staff planned and managed discharge well and liaised with services that would provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason.
• The service was well led, and the governance processes ensured that ward procedures ran smoothly.

However:

• The wards looked tired and in need of redecoration particularly on Alvaston and Wyvern wards. There was a programme of planned refurbishment and we saw this had started in the corridors leading to the wards.
• There was a blind spot in the toilets of the seclusion rooms on Litchurch and Alvaston wards. Seclusion on Litchurch ward was not always in line with the Mental Health Act Code of Practice and one of the seclusion records was incomplete. Documentation was messy and handwritten and not always easy to understand.
• On Alvaston ward, staff had administered prescribed intramuscular injections to a patient but had not always documented what physical health observations had taken place. One patient did not have a T2 attached to their medicine record on Wyvern ward, but staff ensured this was done during our inspection.
• Although staff mostly managed medicines safely and where appropriate, patients had an opportunity to manage their own medicines as part of their rehabilitation or recovery, there were some gaps in the recording of monitoring the self-administration of medicines on Wyvern and Litchurch wards, so it was not always clear that patients were managing these safely.
• Staff did not always make reasonable adjustments in multidisciplinary team meetings to ensure patients could fully participate.

Updated 29 June 2022

The service consisted of two wards:

• Alvaston ward is a 14-bed low secure ward for females with a primary diagnosis of emotionally unstable personality disorder or mental illness.
• Litchurch ward is a 15-bed low secure ward for males with mental illness, sometimes with dual or multiple diagnoses.

Updated 29 June 2022

The rehabilitation service consists of the following:

• Wyvern ward, a 16 bed locked rehabilitation ward for males who no longer require care in a low secure environment.
• Wyvern Court, which is attached to the ward and provides an additional three beds in a self-contained apartment for male patients who cannot easily access the ward.