CQC review raises “serious concerns” over private provider running 113 mental health facilitiesBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m148 (Published 14 January 2020) Cite this as: BMJ 2020;368:m148
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Thank you for the opportunity to respond to the article (CQC review raises “serious concerns” over private provider running 113 mental health facilities).
Firstly I want to say that Cygnet is committed to working openly and transparently to deliver safe, effective and quality care across all our services. The Well Led report recognises that Cygnet’s vision and values support a person-centred approach to providing services, and that we have a stable and approachable senior executive and leadership team who work together to support the delivery of care.
The board take any concerns raised very seriously and as a leadership team we promote honesty and transparency. The report cites a culture of openness and initiatives to encourage reporting of issues, including a whistleblowing line. It acknowledges most staff feel able to report incidents and raise any concerns, which demonstrates our lines of accountability are clearly understood. We are also appointing a freedom to speak up guardian.
We deliver 140 services across the UK and the CQC recognise most of our services that they inspect have been rated as good and some outstanding. Many have maintained these ratings following multiple inspections, over many years, which shows sustainability and quality in our provision.
However, we are not complacent and where there are recommendations for improvement, we take these on board. Indeed, we are implementing recommendations made by the CQC which have already resulted in improvements, including conditions being less restrictive and ratings being upgraded in some areas. The CQC acknowledge that where concerns have been identified, our senior leaders have taken steps to improve quality, through the provision of additional resource and support.
At Cygnet, we treat some of the most acute patients that other providers may not be able or willing to support. The report recognises it does not take into account the level of need or acuity of individual patients admitted to these wards. We always aim to de-escalate and advocate least restrictive practices in line with current good practice guidelines.
As part of our transparent culture, we encourage all incidents to be reported to ensure we have visibility across our services and we have joined the NHS Benchmarking programme.
At the time of the inspection in July 2019 we were in the process of integrating Danshell policies and systems into the Cygnet portfolio and we have a robust plan to ensure our processes are properly reviewed, safely implemented and continue to be aligned. We deliver a range of services that require different policies but every site has the appropriate policy in place for the service they provide.
As part of the integration plans and our ongoing commitment to continuous learning we are delivering training for intermediate life support and safeguarding. We also incorporate safeguarding into all supervisions.
Prior to the publication of this report, Cygnet had already appointed external advisors to review the Group’s governance structures and identify opportunities for these to be strengthened.
You note that the CQC reports comes in response to Whorlton Hall and we cannot stress enough that we were horrified and shocked by the footage shown in the Panorama programme. We have a zero tolerance approach to abusive behaviour and took immediate steps to minimise any risk across our portfolio well in advance of this review, including transferring residents to appropriate alternative placements, closing the facility and cooperating fully with external agencies, which we continue to do.
Finally, due to the inspection happening at short notice we were not able to immediately show the CQC all the relevant documents they required to fully evidence our executive meet ‘fit and proper persons’ requirements. Since the inspection, the appropriate actions and checks have been verified by external lawyers. We are satisfied we are fully compliant and there are no issues around directors’ capability, experience, or qualifications. We will be submitting this information to the CQC as part of our action plan.
We take on board the report’s findings and our management team will continue to work closely with the CQC and other stakeholders to ensure that all recommendations are fully implemented and that the CQC is informed of the progress and continual improvements being made.
Dr Tony Romero
Cygnet Health Care
Competing interests: No competing interests