Cygnet Churchill

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We rated caring as good. We assessed 1 quality statement from the caring key question and found areas of concern. The scores for these areas of concern have been combined with the scores for the other quality statements which are based on the key question ratings from the last inspection. Though the assessment of this quality statement indicated areas of concern since the last inspection, our overall rating of caring for this service remains good. We found 1 breach of Regulation 10 in relation to findings that staff did not always treat people with kindness, empathy and compassion. We observed 2 interactions between staff and patients that did not demonstrate compassion. Some patients we spoke with said not all staff treated them with kindness. However, leaders proactively with investigated allegations of inappropriate staff behaviour towards patients and took disciplinary action where appropriate. Staff from partner organisations spoke very positively about staff on the ward, and staff and leaders we spoke with described a patient-led ward where patient views were taken seriously. The ward had systems in place to support patients to be involved in their care and treatment, and staff actively sought feedback from patients about their experiences on the ward. Patients had easy and regular access to independent advocates.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not always feel they were treated with kindness, compassion and dignity in their day-to-day care and support. We spoke with 7 patients. Five patients we spoke with did not feel that all staff treated them with dignity, respect, and compassion. Two patients felt staff were rough at times. 5 patients we spoke with said they had to wait a long time for a nurse to address their requests on the ward, 4 of these commented that staff were in the office a lot. We spoke with 5 carers who provided mixed feedback about staff. Three out of 5 carers said not all staff respected the rights or wishes of their relative. Two of these carers said a couple of staff seemed caring, but that others just stood around not interacting with patients or just opened doors. One carer said patients had to wait so long when they asked staff for anything. Three out of 5 carers stated that communication from staff was poor and found getting information challenging. However, the patient survey from October to December 2023 which was answered by 8 patients showed patients were very positive about staff being caring and supportive. Where patients fed back about improvements they would like to see, leaders added these to an action plan and communicated with patients about plans to make improvements in response to their feedback. Staff gained feedback from patients during weekly community meetings and were responsive to suggested improvements from patients. Patients reported they felt safe, but 1 patient said night staff did not speak to them in a respectful way, just telling them “no” to requests without an explanation.

Staff described a positive culture on the ward and good working relationships between staff and external agencies. Staff and leaders described the ward as patient-led where views, complaints and safety of patients were taken seriously. Some staff said the ward felt more like a rehabilitation ward in ethos than an acute ward. Leaders acknowledged issues the ward had faced with staff attitudes and said this was what had led to the cultural assessment and disciplinary action taking place. Following the onsite assessment, leaders conducted development days for staff which included training on delivering compassionate care. Two members of staff we spoke with said they would like nurses to have fewer office-based tasks so they could spend more time on the ward with patients.

There was a culture of kindness and respect between colleagues from other organisations. The independent advocate reported that the ward seemed “positive and engaging,” and said staff engaged well with advocates, made referrals on behalf of patients, and informed patients of their rights. They said clients approached them and staff, and their wishes were heard and acted upon proactively. The clinician from SLAM described the ward staffing team as conscientious, thorough and compassionate.

During our onsite assessment, we observed 2 interactions between staff members and patients that we did not feel demonstrated kindness or compassion. On one occasion, a patient knocked on the nursing office door and a staff member responded by saying, “what do you want, what is your problem?” During our other day onsite, we observed a patient repeatedly ask a staff member in the office for support, but the patient was ignored. The patient continued to speak loudly from the hallway to get attention from staff, but was then assaulted by another patient allegedly due to the disturbance the shouting had caused. Staff in the hallway responded to the altercation and removed both patients from the area.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Independence, choice and control during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.