- Independent mental health service
Cygnet Hospital Maidstone
Report from 24 April 2025 assessment
Contents
Ratings - Long stay or rehabilitation mental health wards for working age adults
Our view of the service
We assessed this service on 4 and 5 June 2025. At this inspection we assessed all 33 quality statements across the Safe, Effective, Caring, Responsive and Well-led key questions.
We rated the assessment service group as good. The service had made improvements and is no longer in breach of regulations.
The service now ensured that the emergency bag checklist was kept up to date and included the full contents requiring checking. The service now ensured that the emergency bag seal was one that could be broken with ease to enable timely access to the bag. The service now ensured adequate record keeping and thorough checks on medicines. The service now ensured that there were cleaning records available which were audited to ensure staff maintained and cleaned clinic room equipment.
The service now ensured that ligature risk assessment audits were completed appropriately to identify the risks accurately and ensured suitable mitigations were in place. All staff had completed their ligature rescue training, and there was always a member of staff with this completed training on shift.
The service now has meaningful activities suitable for a long stay rehabilitation service and met the needs of the patient group. Leaders now have appropriate oversight of the recovery-orientated activities suitable for patients’ care and treatment on this ward and ensured appropriate action was taken to address shortfalls with this.
The service now appropriately identified and recorded restrictive interventions. Managers had oversight of these. Patients and staff actively reviewed these to ensure least restrictive practice.
The service now held regular team meetings to ensure appropriate and consistent information sharing.
The service now ensured all patients had a clear plan for discharge and that they, and where possible, their relatives, were involved and kept informed of recovery progress.
Patient choice and views were evident throughout care plans. Patients told us they understood their care plans and what they needed to do to meet their goals.
The service now ensured that the correct weekly food menu was displayed clearly for patients.
Mental Health Act and Mental Capacity Act Compliance
Mental Health Act
All staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles.
Staff had easy access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew who their Mental Health Act administrators were.
The provider had relevant policies and procedures that reflected the most recent guidance. Staff had easy access to local Mental Health Act policies and procedures and to the Code of Practice.
Patients had easy access to information about independent mental health advocacy.
Staff explained to patients their rights under the Mental Health Act in a way that they could understand, repeated it as required and recorded that they had done it.
Staff ensured that patients were able to take Section 17 leave (permission for patients to leave hospital) when this had been granted.
Staff requested an opinion from a second opinion appointed doctor when necessary.
Staff stored copies of patients' detention papers and associated records, such as section 17 leave forms, correctly and so that they were available to all staff that needed access to them. We reviewed section 17 leave forms, and they were in good order. These were also regularly audited.
The service audited adherence to the Mental Health Act every 6months. This was to ensure the Mental Health Act had been applied correctly.
Mental Capacity Act
Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles. Staff had received training in the Mental Capacity Act and Deprivation of Liberty Safeguards, and the ward was 100% compliant.
The provider had a policy on the Mental Capacity Act, including Deprivation of Liberty Safeguards. Staff were aware of the policy and had access to it.
Staff knew where to get internal advice from regarding the Mental Capacity Act, including Deprivation of Liberty Safeguards.
Staff took all practical steps to enable patients to make their own decisions. For patients who might have impaired mental capacity, staff assessed and recorded capacity to consent appropriately. They did this on a decision-specific basis with regard to significant decisions.
When patients lacked capacity, staff made decisions in their best interests, recognising the importance of the person’s wishes, feelings, culture and history. We saw evidence of best interest decisions recorded in patient records.
The service had arrangements to monitor adherence to the Mental Capacity Act and staff audited these every 3 months. The service took action when learning had been identified as a result of Mental Health Act visits and audits.
People's experience of this service
During this assessment, we spoke with 4 patients and 1 family member. Patients told us that staff were friendly, respectful and polite. Patients felt that staff cared about their wellbeing. Patients knew the staff who worked on the ward which meant that staff could get to know patients better. The ward had a display board at the entrance, with photos of all the staff and topics of interest, so that patients could get to know them better.
Patients felt safe on the ward. Patients told us that staff were always around if they needed support. Patients felt supported by the psychology team. A patient told us, “I will talk to staff if something is worrying me.”
Patients were aware of their care and treatment plans and what they needed to do to be discharged. One patient told us he was happy with his discharge plan as “it had been worked on and planned”.
Patients could have visits from friends and family members.
Patients understood how to complain if they needed to raise concerns.
Patients told us that food was good but sometimes there was a lack of choice.