London Autism Clinic

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

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 decisions about their care. The service provided information people could understand. People were asked for feedback, and the service took it seriously and acted on it. People received fair and equal care and treatment. People were involved in their assessments and further recommended support.

This service scored 86 (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 was exceptional at making sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

All carers told us they were involved in the assessment process, and they were supported to understand the processes and outcomes. These were also explained to the children, in an age appropriate way as needed.

Carers told us the clinicians discussed the outcomes and recommendations following their child’s assessment and sought their approval for each plan made.

Clinicians made recommendations for further support for patients, to support their individual needs. The service ensured they only recommended specific services if these were offered in the patient’s local area by their NHS teams or local authorities. Clinicians recommended services such as, occupational therapy, sleep clinics and physical health follow up. They also recommended a range of online services, such as charity websites and supportive literature.

Staff had recommendations for physical health service to follow up concerns as needed, for example, when a heart murmur was detected, or when a recommendation was made for genetic testing.

The service was able to signpost patients and carers to their own websites and social media accounts. These had videos and information on a range of different topics, as well as occasionally having sessions for parents to attend.

Our review of the clinical records showed carers were involved in discussions on recommendations and the outcome of assessments. We saw examples of questions carers had asked, and where they had agreed for specific referrals and recommendations to be made.

The service had an exceptional understanding of the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff worked together with other services and clinicians to meet the needs of their patients. We saw complex case discussions notes, involving a range of professionals within the service, coming together to think about a patient’s diagnosis and plans. Clinicians spoke with local authority safeguarding teams when they had any concerns for their patient’s safety. Managers worked closely with NHS trusts to ensure their recommendations for patient’s aftercare could be appropriately met by their local services.

We received feedback from a carer that the service was very responsive to their request for support after they had a full assessment. The clinical director and service director were quick to speak with the carer and the child’s school to ensure they received the appropriate reasonable adjustments they required.

A staff member told us they received a request from a family who was discharged some time ago who requested a letter for housing support, which they were happy to provide.

In the past 12 months the service had completed 127 private assessments and 825 assessments on behalf of NHS trusts.
Private self-funded assessments were completed within 4 weeks of their referral. This service did not have control over how long their NHS patients had been waiting to be seen, however once they were referred to this service, assessments were completed within 6 to 8 weeks in line with their local NHS arrangements. The volume of NHS assessments had meant this assessment pathway took longer to complete. The service was in the process of onboarding 2 new doctors to support with the assessment process.

The service offered appointments in the evening and weekends to allow patients and carers to attend appointments outside of school or work times. An administrative staff member also worked at the clinic over the weekend to provide support to the clinicians and families. Carers told us they appreciated the flexibility of appointment times.

The service was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service had thought carefully about how to develop appropriate, accurate and up-to-date information in formats that were tailored to individual needs and their patient group.

The service had developed child friendly leaflets, with families, to help improve understanding. For example, the service had a leaflet on ‘what to expect’ from their appointment, with cartoons.

The service’s website had clear information on what the assessment process looked like and how much the appointments would cost. They had pictures of their clinicians, with some information about them, to allow the children to see who their assessments would be with. The website had a frequently asked questions section, which had links to the complaints process.

Carers received emails before appointments with useful links and information, such as specific information on how to get to the clinic and what to expect from the assessment. The service’s website was due to be updated to include videos of the clinic rooms, as well as more of their clinicians, to help to reduce a child’s anxiety when going to an unfamiliar place.

The service had social media accounts where they provided free information and videos for all carers and patients. The service had also held free parenting workshops, which were open for anyone to attend. These sessions were recorded and uploaded to their channels for anyone to view.

The service had spent time making a number of videos for the re-development of their website. These videos were on topics such as sleeping better, diet and general top tips.

Clinicians at the service were able to speak a number of languages. The service was also able to access interpreters for patients when needed.

The electronic record system was secure. Only those clinicians working with a patient were able to view their notes. The video platform used to have online appointments was secure, and these calls were not recorded.

The service was registered with the information commissioner’s office as appropriate.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Patients and carers were asked for feedback throughout the assessment process. All carers were emailed feedback forms when they were sent their child’s final report. There were also paper copies available in clinic rooms, as well as a QR code for feedback to be completed online.

Four of the carers we spoke with were not aware of the formal complaints process. However, these carers had not had a need to use it. Managers told us the complaints policy was available on their website and in the clinic rooms. Following this feedback the service updated their booking information to refer patients to the section of the website where the complaint procedure was highlighted.

One carer told us the service had not responded to one of their voicemails. Managers told us they did not previously have a dedicated phone line, instead calls went to one of their location’s building receptions. However, in the last few months the service had created their own phone line, held by their administrative staff. This number was displayed on their website. The carer confirmed to us that recently communication had improved.

In the last 12 months the service had not received any formal complaints. They had received a few lower level feedback comments, such as asking for clearer directions to their 1 Kingdom Street location and having more information about clinicians on their website

Changes were made as a result of patient feedback. For example, the service provided more detailed instructions on how to access their clinics, and the website now displayed clinicians’ names, pictures and some information on them.

The service received feedback from some carers that their reports could sometimes be difficult to read. Managers have since redesigned the templates to make them more user friendly, with the use of colour and changes to the report structure. They have also set out their recommendations in an easier to read table format.

The service introduced follow up calls for their self-funded patients following feedback that some carers felt overwhelmed with the diagnosis for their child. Carers we spoke with described how helpful it was to have this call to ask any further questions they had and receive guidance if needed.

The service made sure that people could access the care, support and treatment they needed.

Patients were able to access the service in a way that met their needs, such as in person or virtually. Appointment times were flexible depending on the clinicians and the patients’ availability.

Appointments were only held virtually if the clinician was confident that they could carry out their assessment in full. If there were any concerns, a face to face appointment was booked.

The service’s rooms were accessible for all, with large rooms and lift access.

Patients were directed to local community crisis services or emergency departments if crisis intervention services were needed.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Feedback from carers was very positive. Patients told us staff treated people with respect and without discrimination.

Staff within the service promoted a culture in which the people using the service felt able to give their views. Patients we spoke with said they would speak to the clinician or administrative staff if they had any concerns.

Managers were aware community assessments may not be suitable for all patients. They had a suitability criteria, which was reviewed when NHS patients were referred into the service. Self-funding patients had pre-assessment interviews to determine their suitability. If a patient could not be managed safely by the service, they were given an explanation, as well as recommendations for more suitable services.

Carers told us they appreciated the honesty of staff in the pre-assessment, suggesting other, less costly, routes where possible.

The service offered an international assessment package, which included accommodation for the family to attend their face to face assessments. The service had provided this service to 3 patients in the last 12 months.

The service offered a bursary scheme for lower income families to receive money off of their assessment. Managers reported a large percentage of their self-funded patients used this bursary.

All staff had completed training in equality and diversity.

People were supported through their assessments, and recommendations were made, with families, to support the child’s future.

This service provided assessments for their patients and did not offer longer term treatment. When needed, patients were referred to NHS services where patients were able to receive this longer term support.

Staff ensured relevant information from healthcare professionals and other relevant bodies were involved in the assessment of patients. For example, staff included safeguarding services, schools, and local NHS reports when needed.