We rated Cygnet Views as good because:.

• There were sufficient numbers of staff to deliver care and treatment. Staff were well supported by managers and supervised regularly; 90% of staff were up to date with their supervision. Staff compliance with mandatory training was high at 94%.
• Patients had up to date detailed risk assessments. Staff knew and understood patient risk and met to discuss these. Care plans were holistic, individualised and recovery focused and staff updated these regularly. Patients were involved in care planning and risk management and were invited to meetings to discuss their care.
• We observed staff were kind, respectful and responsive when they interacted with patients. Staff understood the individual needs of patients and ensured their care was individualised. Staff assessed patients’ communication needs and met these individual needs; each patient had a communication file to support this.
• Staff ensured patients received good physical health care. Staff monitored physical health and patients had access to annual health screening and specialists as required. There was good practice in relation to medicines management. Medicines were organised well, stored safely and recorded correctly. Medicines management processes were overseen by a commissioned pharmacist.
• Staff were involved in local audits and there was a robust audit cycle that provided the service with assurance about how care and treatment was delivered. There was a clear hospital dashboard to monitor and manage hospital performance and this was accessible to all staff.
• Managers understood the hospital well; they were visible and engaged in improving care. There was a healthy and supportive culture within the team and staff supported each other well.
• Staff demonstrated that they were committed to reducing restrictive practice, listened to patients’ feedback and gave examples of where they had made changes. Staff were involved in quality improvement projects relating to patient admissions and discharges.
• Staff reported incidents and learning from incidents and complaints and incidents was shared. Changes were made following learning and when required both patients and staff received debriefs after incidents.
• Care and treatment was in line with National Institute of Health and Care Excellence guidance for patients with learning disabilities. There was a range of interventions to aid patients’ psychological interventions, activities and a group programme.

However:

• We saw that some staff wore nail varnish and gel nails. This was not in line with policy as it was a potential infection control risk and a potential safety risk for staff carrying out restraints as it could potentially cause patient harm.
•  At the time of our inspection staff were not offered sepsis training, this meant that they were not trained to notice signs of sepsis in patients. The organisation did not have a sepsis policy for staff to access for guidance. The hospital manager immediately responded to our concerns regarding this, after our inspection posters about sepsis were displayed on the ward, a policy was developed and there was a plan for local staff training. 
• Patients gave us mixed feedback about staff. Some feedback related to a safeguarding concern that patients raised about a member of staff but there was also negative feedback that concerned staff attitudes towards patients.