CQC - Care Quality Commission

07/09/2021 | Press release | Distributed by Public on 07/10/2021 02:13

CQC publishes report on Cygnet Hospital Hexham

The Care Quality Commission (CQC) has published a report following a focused responsive inspection of the Franklin ward at Cygnet Hospital Hexham in Northumberland.

The inspection took place in April, due to information received in relation to patient safety. There had been several self-harm incidents where patients had required hospital treatment and there were concerns that the risks were not being managed appropriately.

During the inspection we found that staff had learnt from these incidents and had made changes in relation to assessing and managing patient risks. This involved removing high risk items from patients and increasing observation levels.

As this was only a focused inspection, Cygnet Hospital Hexham was not re-rated as the service type had changed since our previous comprehensive inspection in May 2019. Their previous rating of inadequate remains.

At that inspection, enforcement action was taken, and the service was rated inadequate and placed in special measures. The hospital closed in September 2019 and re-opened in October 2020 instead providing acute admission and psychiatric intensive care wards.

Brian Cranna, CQC's head of hospital inspection for mental health, said:

'When we visited Cygnet Hospital Hexham in April, we were pleased to find that staff had learnt from incidents which had taken place and made improvements to keep patients safe.

'The seclusion room allowed clear observation and two-way communication. However, we found that it was also very small, and patients had limited space to move around the room when the mattress was on the floor. When staff needed to enter the room, patients had to stand in the toilet area for staff to be able to enter safely, which is not appropriate.

'We were pleased to see that staff knew about any potential ligature risks. Issues with curtain rails had been identified, as well as the tables having square corners, these had been reported to get them changed to ensure patient safety.

'Staff made every attempt to avoid using restraint by using de-escalation techniques. Patients were only restrained when these techniques failed to keep people safe.

'The leadership team are aware of the actions they need to take, and we will continue to monitor the service to ensure the required improvements are made and embedded.'

Inspectors found:

  • The ward did not have sufficient space for patients to provide a safe and therapeutic environment. The dining and lounge areas were small and would not accommodate all patients at the same time if required to do so. Patients could not access the dining area without support from staff as it was accessed via a locked corridor
  • The seclusion room was small and provided patients with very limited space to move around when the mattress was on the floor. It was located in a corridor that was the main thoroughfare for patients and staff to access the staff room, patient dining room, treatment room and laundry.


  • The ward environments were clean and well maintained. The ward had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices and followed good practice with respect to safeguarding
  • The service was well led, and the governance processes ensured that ward procedures ran smoothly. New managers in the service were supported by regional managers and by a registered manager from another psychiatric intensive care unit in the region.

Full details of the inspection are given in the report published on our website.

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