London Autism Clinic

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this.

This is the first inspection for this service since its registration with CQC. This key question has been rated as good.

People were involved in assessments of their needs. Staff carried out assessments taking account of people’s communication, personal and health needs. Care was based on latest evidence and good practice. Staff worked with all agencies involved in people’s care for the best outcomes. Staff made sure people understood their care and treatment to enable them to give informed consent.

This service scored 83 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

The service carried out Autism Spectrum Disorder (ASD) assessments for children aged 2 to 14.

The service ensured these assessments were always effective by gathering information from a range of sources, such as the parents, the child and schools. They also carried out physical health examinations to rule out any physical health interactions or concerns.

The service made recommendations at the end of each assessment for further support and guidance for the child and family. This included informational websites or videos for parents, and recommendations for the NHS trust to refer the patient to specific supportive services.

Feedback from carers about the assessments was very positive. All carers told us these assessments were carried out by kind staff, who made the carer and child feel comfortable. All carers told us clinicians explained the assessment in detail, that they felt part of their child’s assessment and they felt listened to.

We observed part of an assessment and saw staff were friendly and warm in their interactions. The clinician explained the process well to both the child and the carer, speaking with the child in a child-friendly, kind manner.

When a report had been completed, administrative staff reviewed the report to ensure there were no gaps and the correct formatting was used. Senior managers then reviewed all reports to ensure the context was accurate and the recommendations were realistic and appropriate.

All carers told us they received a written report, which was also explained to them in their final session. Carers were able to ask questions or request changes to these reports where appropriate. We saw evidence of these discussions with carers within the service records.

The service always planned and delivered people’s care with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

The service carried out autism assessments in line with the current guidance, such as from the National Institute for Health and Care Excellence (NICE).

Their assessments consisted of an Autism Diagnostic Observational Schedule (ADOS), which is an observational assessment of the child. A physical examination carried out by a doctor, including a developmental assessment, the Schedule of Growing Skills (SOGS-2) if the child is under 5 years old. Followed by an Autism Diagnostic Interview Revised (ADI-R) which is an interview with the carers, as well as observations of the child. A psychologist also gathered information from the child’s educational setting for a more holistic assessment. Following the assessment, feedback on the outcome is provided to the carers, along with the service’s recommendations for further support.

This process was clearly highlighted on the service’s website, and discussed in the pre-assessment meeting with self-funding patients. All carers told us the assessment process was clearly explained, which helped to manage their expectations and anxieties. The service booked all parts of the assessment at the time of the initial booking, ensuring there was a clear set out plan for the full assessment.

Managers ensured they kept up to date on the latest research and recommendations in this field and updated their practice as needed. For example, the National Autistic Society (NAS) had recently published recommendations on how to talk and write about autism, with a focus on using neuroaffirmative language. The clinic was in the process of carrying out an audit on their written reports to ensure they followed these recent recommendations.

Managers shared the latest research with their staff in meetings and through messaging. Staff we spoke with told us about the service’s focus on neuroaffirmative language and told us they had been involved in these discussions.

The service had a number of quality improvement projects, for example, redeveloping their website to improve accessibility and ensuring their content was child friendly. The service was also in the process of uploading a number of videos to support patients and carers on a range of topics, such as sleep and diet, as well as what the assessment processes looks like.

The service had offered a range of free parent workshops, open to all parents, on areas such as language development, understanding sensory processing and a parenting workshop. The service planned to offer more of these free workshops in the summer, after they had finished recording and uploading their supportive video content.

The service worked well across teams and services to support people. They completed and shared assessments of people’s needs to support their patients.

The service worked well together to support people. Staff told us there were good working relationships between staff within the service. Carers told us the staff working with them worked well together, and all information was passed between clinicians for the final feedback session.

All staff told us they felt supported within the team and by managers. They told us there was good communication through team messages and a range of team meetings. Some clinicians were unable to attend the clinical meeting due to external commitments, however, minutes were taken and shared from these meetings.

The service had effective working relationships with teams outside the organisation. For example, patient’s local safeguarding leads, children’s educational settings, and the NHS trusts this service has contracts with.

One carer told us they were having difficulties with their child’s school after their assessment at the service. A senior clinician was able to call the school promptly to explain their findings and recommendations on how the school could best support the child.

A staff member told us they wrote a supportive housing letter for a patient a while after they had been discharged.

The service supported people to manage their health and wellbeing. They supported people to live healthier lives.

The service provided advice and guidance on healthy lifestyles at the end of each assessment. This service did not make external referrals themselves, however they made a number of recommendations for referrals and advice, such as support with sleep, healthy eating and advice on tooth brushing. The service also recommended support for carers in the form of recommended books, videos and groups.

The service filmed and uploaded videos to their social media accounts to support all parents and children on areas such as visiting the dentist, developing motor skills and sleep.

The service used outcome measures to assess their patients. They ensured that outcomes met both clinical expectations and the expectations of people themselves.

The service provided autism assessments for their patients. Clinicians used outcome measures to assess their patients, such as the Autism Diagnostic Observational Schedule (ADOS), the Schedule of Growing Skills (SOGS-2) if the child was under 5 years old and the Autism Diagnostic Interview Revised (ADI-R)

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Consent for assessments was sought from carers prior to the assessments taking place. The service assessed children aged 2 to 14 years of age. The majority of their patients were under 7 years old, affecting their ability to consent for themselves.

Private self-funding patients had a call with a doctor before consenting to the full assessment where they discussed the assessment process and ensured this was the most useful route for them. Consent was taken once they had agreed with the assessment process, and this included information on the service’s missed appointment policy.

For those patients on the NHS pathway, the NHS trust gained consent from carers for the assessment, and consent for the assessment to be carried out by this service on the NHS’s behalf.