The Care Quality Commission (CQC) has rated Cygnet Appletree in Durham, good following an inspection carried out in October.
The service was last inspected in April and May 2021, and due to significant concerns found at that inspection, the ratings were suspended, and enforcement action was taken, which prevented people from being admitted to the hospital. Prior to this latest inspection in October, the restrictions had already been removed and there were no restrictions on admissions at this time.
Cygnet Appletree, run by Cygnet Behavioural Health Limited is an independent mental health hospital split over two floors and has two wards - Bramley ward, which is a 15-bed acute ward, and Pippin ward, which is a 10-bed psychiatric intensive care unit. Both of these are for females aged 18 and over.
Following this inspection, the ratings are no longer suspended, and the service is rated good overall. It is also rated good for being safe, effective, caring, responsive to people’s needs and well-led.
Sarah Dronsfield, CQC deputy director of operations, said:
“When we inspected Cygnet Appletree, we were pleased to find that the service had made significant improvements since our last visit in 2021.
“We found leaders had the skills, knowledge and experience to perform their roles. They also had a good understanding of the service and were visible and approachable for people and staff.
“The service was providing safe care and the ward environments were clean and well maintained. We also found, the wards usually had enough staff who assessed and managed risk well. Staff minimised the use of restrictive practices, managed medicines safely and followed good practice with regards to safeguarding people.
“Staff were also treating people with compassion and kindness. They respected people’s privacy and dignity and understood their individual needs. They also actively involved people and their families or carers in care decisions which is really important.
“Cygnet Appletree should be proud of the progress they have made since our last inspection to ensure people are receiving safe care. We will continue to monitor it and will re-inspect to ensure improvements continue to be sustained and embedded.”
Inspectors found:
- Staff developed care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the people and in line with national guidance about best practice
- The ward teams included or had access to the full range of specialists required to meet the needs of people on the wards. Managers ensured that these 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
- The service managed beds well so that a bed was always available to a person who would benefit from admission and people were discharged promptly once their condition warranted this
- The service was well-led, and the governance processes ensured that ward procedures ran smoothly.
However:
- The design and layout of Pippin ward meant that there were areas accessible to people that were out of sight of the nurse’s station
- The hospital had some nurse vacancies which meant that not all shifts on Pippin ward had the required two qualified nurses
- Care plans were repetitive and sometimes difficult to follow due to the amount of information in them.