We carried out an announced comprehensive inspection on 13 November 2018 to ask the service the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this service was providing safe care in accordance with the relevant regulations

Are services effective?

We found that this service was providing effective care.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

The service provides private psychiatric and psychological treatments for mental health problems and specialises in the assessment and treatment of stress, anxiety and depression.

Dr Kishore Chandiramani is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service is registered with the Care Quality Commission (CQC) under the Health and Social Care Act 2008.

Our key findings were:

• Care was highly person centred. Care records evidenced a collaborative approach to setting treatment goals. Staff listened to patients and adjusted treatment to suit a patient's personal experiences and needs.
• Patients were able to give feedback to the service. The registered manager valued this information and included it in planning future service development.
• The service was responsive to patient need. Patients were offered appointments out of hours and at weekends to improve access.
• Regular clinical reflection supported the operation of the service and gave assurance that the quality of care was monitored effectively.
• All staff received supervision and support in developing their knowledge and skills and there was a strong emphasis on continued professional development.
• The manager encouraged staff feedback and participation in making decisions about the service. All staff felt their voice was listened to.
• The provider did not always completely document or regularly review risk assessments for all patients. This meant that patient records did not have up to date information on patient risk and was not available to other professionals.

There were areas where the provider could make improvements and should:

• Always record their risk assessments, fully demonstrating the identification, management and mitigation of risk.
• Regularly update risk assessments when a patient’s situation changes.
• Review and update its clinical and human resource (HR) policies and procedures
• Review and develop its quality improvement programme
• Complete a full environmental risk assessment to include a ligature risk assessment

Dr Paul Lelliott

Deputy Chief Inspector of Hospitals (Hospitals- Mental Health)

We spoke with two people, who both told us that they would recommend the clinic to other people. They both told us that all the staff were approachable and understanding. One person said, "The clinic is my little sanctuary."

People were fully involved in making decisions about their treatment. One person said, “The doctor and the nurse listened, explained and then it was over to me.”

People’s needs were assessed before any course of treatment or recovery plan was discussed and agreed. The management plan put in place was informed by people’s own choices and preferences. People were provided with ongoing support and access to resources as part of their treatment and recovery plans. One person told us, "I feel I owe them a lot."

Information was regularly shared with people’s GPs to ensure that when care from the GP was needed, they had a full picture of their needs and current medication.

Everyone attending the clinic was asked for feedback on their experience of the clinic and what they had achieved. There was an ongoing process of monitoring and audit in place, supporting the doctor and nurse working in the clinic to assess the quality of care and identify any areas for improvement.

We found that background checks for all staff had been completed to check their suitability to work with vulnerable people.