Psychiatric And Psychological Consultant Services Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The service had a clear learning culture and people could raise concerns. Managers investigated incidents thoroughly and took appropriate action to safeguard people. Staff understood and managed risks, and staff had the right skills, qualifications and experience to meet patients’ needs. Managers made sure staff received training and regular supervision and appraisals to maintain high-quality care.

However, there were some gaps in safeguarding, Prevent (radicalisation), and information governance training. Managers were working with clinicians to improve training compliance.

We have not awarded this service a score for Safe.

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

The service had appropriate incident reporting policies and procedures in place. Staff we spoke with were aware of the procedures and said that they had discussed the learning

from incidents to improve the quality of the service.

Lessons were learnt to continually identify and embed good practice. Staff and managers could provide examples of learning from incidents and actions being put in place to prevent recurrence.

Staff knew which incidents to report and how to report them. Incidents were discussed in team meetings and supervision sessions.

Duty of candour is a legal requirement, which means providers must be open and transparent with patients about their care and treatment. This includes a duty to be honest with patients when something goes wrong. Staff were aware of the need to be open and transparent, including after an incident.

The provider had established and maintained safe systems, ensuring continuity of care, including when people moved between different clinicians within the service. There was a clear referral process, after which patient’s needs were assessed, and they were allocated to an appropriate clinician. There were clear systems in place for processing information relating to patients promptly at different stages of their journey through the service. Patients were not accepted on the service’s caseload unless they had a local GP.

There were some gaps in safeguarding training. Training in safeguarding adults at level 3 was at 68% for clinicians (8/12 psychiatrists and 7/10 psychologists). Training in safeguarding children at level 3 was at 59% (8/12 psychiatrists, and 5/10 psychologists). Only 1 of 7 administrative staff were up to date with their safeguarding training, with 3 needing refresher training, and 3 not yet completing this. Training in Prevent (radicalisation) was at 50%. Managers were aware of staff needing to complete this training, and working to achieve compliance.

Staff knew how to make a safeguarding alert and said that they did so when it was appropriate. Staff discussed safeguarding concerns in supervision sessions when relevant.

The service kept a patient risk register which included safeguarding issues. This ensured that staff reported incidents in line with safeguarding multi-agency safeguarding procedures and there was appropriate follow up to keep patients safe.

Current safeguarding children and adults’ policies were available to staff. Staff knew how to identify adults and children at risk of, or suffering, significant harm. They could give examples of safeguarding alerts they had made. If a patient was assessed to be at immediate risk, they would discuss this with the safeguarding lead, and make an appropriate referral, seeking consent from the patient/parents, but going ahead without consent when appropriate. The team would follow up concerns with the patient’s GP following any referral.

Staff had the appropriate safeguarding training level for their role, with all clinicians trained to level 3 for children and adults. We reviewed two safeguarding cases and found that they detailed appropriate interventions.

The provider carried out appropriate staff checks at the time of recruitment, including interviews, references and proof of qualifications. Disclosure and Barring Service (DBS) checks were undertaken. DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable.

There were systems to assess, monitor and manage risks to patient safety. The service worked with people to understand and manage risks and provided care to meet people’s needs safely.

As recommended at the previous inspection in 2019, managers had made improvements to the service’s risk assessment documentation and procedures. Staff assessed patients’ risks on referral, and initial appointments, and reviewed these at each appointment. Risk assessments included details of protective factors to keep people safe, and crisis plans when this was deemed necessary.

If patient risks increased, clinicians would escalate their concerns within the team so that appropriate action could be taken swiftly. Staff would also contact a patient’s GP to ensure the patient was seen face to face if needed. Staff told us that support and advice was always available

from their peers or the medical director if they had concerns about the safety of a patient. Patient records showed that staff took appropriate action to address any emerging risks in relation to the health and well-being of patients including follow up of physical health issues.

Patients were advised on risks related to their conditions or diagnoses and actions to take if their condition deteriorated. There was a patient risk register to ensure that there was appropriate follow up of risks. For example, staff followed up when patients did not attend appointments.

The service had a flow chart in place for managing risks from when patients were in contact by telephone, including action to take in high risks cases including contact with patients’ GPs or accident and emergency services.

As this service took place remotely, both for staff and patients, there were no concerns about potential risks within the provider’s environment. On rare occasions when face to face appointments were arranged, this was in a rented consultation room/the patient’s own accommodation, and the situations were risk assessed individually. The provider made sure IT equipment, facilities and technology supported the delivery of safe care. The service had appropriate indemnity insurance for its activities.

Patient verification checks took place on calls, sessions and assessments. Proof of identity and address were also undertaken with all clients.

Mandatory training compliance was monitored for all staff. There were some gaps in training including only 32% of clinicians trained in complaints, 59% in information governance, and 68% in equalities, diversity and human rights. Managers were working with clinicians to improve training compliance.

The service made sure there were enough qualified, skilled and experienced staff, who received support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Managers noted that there had been some turnover of staff in the last year, with many clinicians leaving the service. The service was actively recruiting to new posts. In the 6 months prior to the inspection staff sickness was at 2.6%, one clinician had left and two new clinicians had started work at the service.

There were rigorous recruitment practices, with all potential staff asked to fill out detailed forms, and provide disclosure and barring screens, identity documents, proof of qualifications, written references, and proof of right to work. These steps were checked before being signed off as appropriate to proceed. All prospective new clinicians attended a clinical interview and an administrative interview as part of the selection procedure. Although there were regular audits of staff members recruitment documentation, there was room for improvement in the way this was documented. All clinicians were expected to have worked for 4-5 years in private practice prior to joining the service.

All new staff undertook induction training specific to their role, and had time to complete their mandatory training, and for shadowing other staff. There were annual checks to make sure staff were registered with their appropriate body, which were more frequent if there were conditions of registration.

The service was not providing face-to-face consultations in their own environment in which to control infection.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Staff involved people in reviews of their medicines and helped them understand how to manage their medicines safely. People knew what to do and who to contact if their condition did not improve or they experienced any unexpected symptoms.

Staff followed protocols to ensure they prescribed all medicines safely, and ensured people received all recommended medicines reviews and monitoring. There was a policy on prescribing, with a clear system for recording each prescription on the patient record system before generating an electronic prescription.

Prescribers liaised with the patients’ GPs to ensure that appropriate blood tests were carried out when patients were prescribed particular medicines.

The service was in the process of reviewing medicines prescribing systems and had set up a Medicines Management Advisory Group meeting in November 2025.