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Cygnet Cedars: The story of an ‘Outstanding’ Hospital Director

Cygnet Cedars is a 24-bed learning disability service based in Birmingham which also has independent living flats. Cygnet Cedars have been rated as being ‘Outstanding’ by the Care Quality Commission. Raf Hamaizia, Cygnet Health Care’s Expert by Experience Lead recently visited the service to meet with patients and staff, including Hospital Director, Dr John Taylor.

View CQC inspection report

Raf was very impressed with what he found and said, “The Cedars is a brilliant example of a learning disability service that has the people being cared for at the heart of all decisions being made. The amount and quality of peer-led and recovery orientated initiatives happening within Cygnet Cedars are simply phenomonal.”

“John Taylor, the Hospital Director is an example of a great leader that really gets and values co-production. I think that sometimes on the topic of staff within health and social care we can sometimes focus on roles and titles as opposed to the people behind them. John Taylor is an exemplary Hospital Director which has a very interesting journey to leading Cygnet Cedars to an Outstanding rating. I thought his story is more than worthy of being shared more widely and John kindly agreed to do a Q&A interview with me.”

Raf conducting his interview with Dr John Taylor

Raf: John, Could you please tell us a bit about your background and qualifications?

John: Sure Raf, I have spent around 21 years working within mental health and learning disability services in a variety of management roles. I have four Masters Degrees and two doctorates ranging from business management and Counselling to Neuro-linguistic Programming and Hypnosis.

Raf: That sure is a lot of qualifications. What would your full title be and why so many?

John: Dr John Taylor PhD, MSc, RMN Dip HE. DCMPT, DHP, APSH, POSH, DASH. As a child, I suffered from a life-threatening head injury which was very debilitating and disruptive to my education. As a result, I was always behind on my education. When I became better I decided to work really hard to prove to myself that I can do it. A mixture of hard work, ambition and genuine interest in the subjects led me to pursue the qualifications.

Raf: Wow! When did you start working at Cygnet Cedars?

John: I first became the Hospital Director of Cygnet Cedars in late 2015 after setting up a number of Learning Disability services nationally.

Raf: What was the first thing you did as a Hospital Director?

John: There were a number of environmental issues which I felt needed improving as both the CQC and commissioners also shared my disapproval of the services environment. The first thing I did as Hospital Director was spending time with patients and staff asking what their experiences were here. As a result, a coproduced action plan was created and a number of meetings, targets and strategies were put into place. Five months after being Hospital Director, the Care Quality Commission inspected us and rated us as being ‘Outstanding’.

Raf: What do you think makes Cygnet Cedars an ‘Outstanding’ service?

John: I think here at Cygnet Cedars we have embraced positive risk taking. I will do things for the right reasons and I am willing to be held accountable for what I do. We try to be balanced when it comes risk but we try to take a sensible approach as opposed to a paternalistic one. We are about empowering people and giving people the opportunity to do the things that are meaningful to them. We are not static, we are developing all the time and the world is changing, people change, staff and patients change so the service has to change with it. Sometimes people do not like change but everyone has to leave their egos at home and do what is best for the people we care for.

Here at Cygnet Cedars everything is centred around the person, around what they want to do and what they feel is best for them and not necessarily always what WE feel is best for them. For example there is a lot of talk in the industry about language and we wondered what we are supposed to call people here at Cygnet Cedars; residents? service users? We decided to actually ask the people who are using the service and they WANT to be called patients so that’s exactly what we do.

Raf and John with a patient painting the corridor of the service as part of the Cedars apprenticeship scheme.

Here at Cygnet Cedars we have the people in our care literally involved in the running of the service whether it be painting the service with the maintenance or working within the kitchen alongside catering. I feel it gives people confidence, skills and hope.

As a manager, sometimes you have to do things to make that difference for people, an example is a former patient who had selective mutism and he did not speak to hardly anybody for nearly 15 years, but we noticed that he really liked dogs. As a result I bought a dog and have brought it to work everyday ever since. As a result the patient volunteered to start taking the dogs for walks with me everyday and eventually by himself. He would then come to my office and speak to me for hours all the time. He has now been discharged and is living in the community. This is the heart of it really, for 15 years at all those other services he was at, nobody could take the time out to realise having a pet might help with this gentleman’s communication.

Raf: What advice would you give to other services or managers who are trying to improve a service?

John: I would say take a step back, if you there are challenges within your service, look at what’s going on and speak to people in their own environments. Speak to the catering staff in the kitchen and patients wherever they are. If there is something wrong or if there is something going on, it is worth challenging things on the spot. When challenging, it has to be two way instead of one-way, we need to understand why people are doing things otherwise it is really difficult to make changes. It’s not only about challenging but about complimenting, giving people a pat on the back is really important for morale, its really about finding a balance.

Whatever happens, I always have my meals with the patients, there are no barriers at meal times, I am no longer a manager, we are eating the same food on the same table and we can have real conversations. Little things like eating together and spending time speaking to people can make a really big difference. My office door is always open to all and to anyone who wants to have chat but actually, I really prefer being out of the office engaging with people because in the office it can be a bit too formal. I would recommend all managers to spend as much time as possible with the people they are there for, being behind a computer screen all day kind of defeats the purpose.

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