Cygnet Hospital Kewstoke

Updated 21 November 2022

Cygnet Hospital Kewstoke is an independent mental health hospital near Weston super-mare in Somerset, providing a range of specialist mental health services. This can include people detained under the Mental Health Act, those who use behaviours to communicate their frustrations and anxiety, and those with long-term mental illness.

There are five wards within the hospital at the time of inspection. Nash ward is a male psychiatric intensive care inpatient ward with 12 beds. Sandford ward is a female acute inpatient ward with 16 beds. Milton ward is a female low secure inpatient ward with 16 beds. Knightstone ward is for females with a diagnosis of personality disorder and has 15 beds. The Lodge is a high dependency inpatient rehabilitation service situated in a separate building on the grounds and has a 12 bed capacity.

At the time of this inspection the hospital had a registered manager in post. The hospital is registered to provide two regulated activities; treatment of disease, disorder or injury and assessment or medical treatment of persons detained under the Mental Health Act 1983.

The service was last inspected in May 2019 and was awarded a rating of good across all wards and had no outstanding recommendations or requirements.

This was an unannounced focused inspection. We considered information from notifications submitted by the provider as well as information received from stakeholders and people who use the service. There have been specific concerns around staffing and the impact this was having on care provided. A recent tragic incident in which a patient died on Sandford ward has resulted in a range of interventions and investigations from external agencies and stakeholders; these are ongoing. Our inspection activity focused on provisions in place to keep people who use the service safe. This was an unannounced focused inspection on our key question of safe.

A follow up visit was undertaken on 3rd October by a CQC pharmacist specialist to review initial concerns around the management and use of medications. At this time there was no registered manager in post. However, an application has now been submitted to fulfil this position by the current acting manager.

Updated 21 November 2022

Cygnet Hospital Kewstoke is an independent mental health hospital near Weston-super-Mare in Somerset. It provides a range of specialist mental health services. This can include people detained under the Mental Health Act, those who use their behaviours to communicate their frustrations and anxiety, and those with long-term mental illness.

This was an unannounced focused inspection following a tragic incident in which a patient died on Sandford ward that has resulted in a range of interventions and investigations from external agencies and stakeholders; these are ongoing.

Our inspection focused on whether patient were safe and so we only looked at the key question ‘are services safe’.

Our rating of the Safe key question went down. We rated it as requires improvement because:

• Risk management plans were not person centred and contained generic statements.
• The service did not always have enough nursing and medical staff who knew the patients. Staffing levels and skill-mix were not always appropriate to meet patient’s needs.
• Patients were routinely missing out on section 17 leave. Poor staffing levels meant patients sometimes had their leave cancelled or postponed.
• The service had complicated internal processes when escalating safeguarding concerns. Internal processes meant there were delays making referrals to external organisations.

However:

• All wards environments were safe, well equipped, well furnished, and fit for purpose.
• Staff received basic training to keep people safe from avoidable harm.
• Staff had easy access to clinical information whether paper-based or electronic.

Updated 14 May 2019

Our rating of this core service remained the same as the previous comprehensive inspection.

We rated safe, effective, caring, responsive and well led as good.

During this inspection we found that patient records were person centred, detailed and up to date. Staff knew their patients well.

Staff were suitably trained and were up to date with mandatory training.

Patients were actively involved in decisions about their cae and care planning including involvement in decsions about medication and psychological treatment.

Updated 14 May 2019

Our rating of this core service remained the same as the previous comprehensive inspection.

We rated safe, effective, caring, responsive and well led as good.

During this inspection we found that patient records were person centred, detailed and up to date. Staff knew their patients well. Physical health monitoring and care were well managed.

Staff were suitably trained and were up to date with mandatory training.

Patients were actively involved in shared decision-making and supported in self-management and there was a recovery focus.

Updated 21 November 2022

Cygnet Hospital Kewstoke is an independent mental health hospital near Weston-super-Mare in Somerset. It provides a range of specialist mental health services. This can include people detained under the Mental Health Act, those who use their behaviours to communicate their frustrations and anxiety, and those with long-term mental illness.This was an unannounced focused inspection following a tragic incident in which a patient died on Sandford ward that has resulted in a range of interventions and investigations from external agencies and stakeholders; these are ongoing.

Our inspection focused on whether patient were safe and so we only looked at the key question ‘are services safe’.

Our rating of the Safe key question went down. We rated it as requires improvement because:

• Risk management plans were not person centred and contained generic statements.
• The service did not always have enough nursing and medical staff who knew the patients. Staffing levels and skill-mix were not always appropriate to meet patient’s needs.
• Patients were routinely missing out on section 17 leave. Poor staffing levels meant patients sometimes had their leave cancelled or postponed.
• The service had complicated internal processes when escalating safeguarding concerns. Internal processes meant there were delays making referrals to external organisations.

However:

• All wards environments were safe, well equipped, well furnished, and fit for purpose.
• Staff received basic training to keep people safe from avoidable harm.
• Staff had easy access to clinical information whether paper-based or electronic.

Updated 14 May 2019

Our rating of this service remained the same as the previous comprehensive inspection.

We rated safe, effective, caring, responsive and well led as good.

During this inspection we found that patient records were person centred, detailed and up to date. Staff knew their patients well. Physical health monitoring and care were well managed.

However we found that there was not a detailed plan for discharge in any of the care records we looked at.

We also found that patient records did not always reflect actions taken as a result of physical observations.