Psychiatric And Psychological Consultant Services Limited

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

People were involved in assessments of their needs. Staff reviewed assessments taking account of people’s communication, personal and health needs. Care was based on the latest evidence and good practice. There was an experienced staff group with access to regular supervision and appraisals. Staff worked with other agencies involved in people’s care for the best outcomes and smooth transitions. Staff made sure people understood their care and treatment to enable them to give informed consent.

We have not awarded this service a score for Effective.

Find out about when we will not publish a key question score and what we look at when we assess Effective.

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

Clinicians completed a comprehensive assessment of patients’ needs on referral to the service, including where relevant a developmental history, and observations and interactions online.

Feedback from people using the service was positive about the assessment process. Patients told us that they felt confident that staff understood their individual needs. Staff checked people’s health, care, and wellbeing needs.

The service planned and delivered people’s assessments and any treatment with them, including psychosocial needs, and what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Systems were in place to ensure staff were up to date with evidence-based guidance and legislation. Clinical records we saw demonstrated care was provided in line with current guidance.

Staff provided a range of care and treatment interventions suitable for the patient group. There were clear suitability criteria for the service, which had changed to an online remote service since the previous inspection, following changes introducing during the Covid pandemic. Interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence (NICE). This included medication, psychoeducation and therapies.

There were clear requirements for staff working for the service. Staff required a clinical qualification and at least 4-5 years working in the private sector. There were periodic continuing professional development sessions for staff.

Staff had the skills, knowledge and experience to carry out their roles. The service worked well across different clinicians to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between clinicians. Staff had access to the information they needed to appropriately assess, plan, and deliver people’s care, treatment, and support.

Managers checked that staff were meeting key performance indicators, such as recording notes within 24 hours of an assessment and sending a letter to patients’ GPs within 72 hours.

Every clinician had regular clinical supervision and psychologists also had peer mentoring. In the last year 100% of staff appraisals were completed. The service kept up to date records of staff skills, qualifications and training including information from staff on the training they had undertaken whilst working elsewhere. The service was in the process of introducing 3 professional development groups for psychiatrists and psychologists.

Staff referred to and communicated effectively with other services when appropriate. Patient records included letters to the patients’ GP to explain the treatment offered. Clinical psychologists working in the service told us they could ask their consultant psychiatrist colleagues for advice and refer patients to them if appropriate. Before providing treatment, doctors at the service ensured they had adequate knowledge of the patient’s health, any relevant test results and their medicines history. It was the service’s policy to obtain the consent of the patient to contact their GP and obtain relevant background information. When appropriate, the service signposted patients to more suitable sources of treatment. For example, some patients were referred to a private in-patient mental health hospital.

The service supported people to manage their own health and wellbeing to maximise their independence, choice and control.

Psychoeducation was part of the service offer, and the service worked collaboratively with family members of adults who gave consent, and children over the age of 15, their family, and school staff to develop personalised strategies that enabled them to engage within education.

Risk factors were identified and highlighted to patients. For example, patients told us that consultant psychiatrists discussed the possible side effects of medicines with them.

Where patients needs could not be met by the service, staff redirected them to the appropriate service for their needs.

The service monitored people’s care and treatment to improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

There were standard operating procedures in place for all parts of the service’s activities. Medicines prescribers used strict protocols of physical health checks prior to prescribing.

From the clinical notes we reviewed, we found that people who used the service experienced positive outcomes as set out in evidence-based clinical guidance. A comprehensive clinical patient record audit report had been completed covering patient care and treatment. At the previous inspection we noted that the provider did not have effective oversight of clinical practice decision making and prescribing practice and lacked assurance that this was in line with national guidance. More recently the provider had ensured that prompt action was taken in relation to audit findings.

Staff used approved monitoring tools to measure patient outcomes, including GAD 7 (General Anxiety Disorder) on registration and at every sixth appointment and PHQ9 (Patient Health Questionnaire).

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

Staff had an understanding of the Mental Capacity Act (MCA) and the five statutory principles. They also understood the principles of Gillick competence for patients under 16. The service had a policy on the MCA, which was available to staff.

Staff confirmed patients’ consent in writing and verbally prior to assessment or treatment. Consent was confirmed at the point of registration and then again at treatment. Prior to any assessment, patients needed to consent to the service requesting and sharing information with their GP.

Patient records included notes of discussions between patients and consultant psychiatrists which showed that patients were given the appropriate information to give informed consent. Staff supported patients to make decisions. Patients told us that staff included them in decision making. For example, consultant psychiatrists explained different treatment options to them and supported them to make choices about their care and treatment.