Living Mind

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, provided advice and support, regularly reviewed their 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.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Clinicians completed holistic assessments of presenting concerns, medical history, current circumstances, communication needs, preferences and treatment goals. The service offered a range of mental health assessments and treatment options for adults experiencing mental health conditions, including depression, anxiety disorders, obsessive compulsive disorder and attention deficit hyperactivity disorder. Treatment approaches included psychiatric assessment, medication management, psychological therapy referrals and repetitive Transcranial Magnetic Stimulation (rTMS). Repetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive treatment that uses magnetic pulses to stimulate specific areas of the brain and may be used for some people whose symptoms have not improved with other treatments. Clinicians assessed whether treatments were appropriate for each person based on their clinical needs, preferences and treatment history. Information from GPs, insurers and other professionals was considered where available. Records supported clinicians to identify adjustments and decide whether the service could safely meet each person's needs.

Patients were supported to share information about their needs before their appointment through a registration and consent process. This enabled people to request reasonable adjustments, identify communication needs, request a chaperone, nominate individuals involved in their care and indicate any preferences regarding the sharing of information. This approach helped ensure clinicians had relevant information available at the outset and could adapt care to meet individual circumstances.

The service promoted informed and person-centred care through the information available to patients before and during their treatment journey. Patients had access to clear information regarding confidentiality, consent, communication preferences, data protection and treatment processes, supporting them to make informed choices about their care and participate actively in decision-making.

Clinicians used information from a range of sources to support comprehensive assessments. The service encouraged patients to provide referral information from GPs, insurers and other healthcare professionals where available, helping clinicians develop a fuller understanding of patients' needs and previous care. Where specialist expertise or additional interventions were required, clinicians worked with patients to facilitate referrals to appropriate services.

The service recognised and responded to individual accessibility and communication needs. Professional interpreters could be arranged where required, and consultations took place in premises that supported access for people with disabilities. An electronic patient record system enabled clinicians to record and review patients' needs, preferences, communication requirements and reasonable adjustments, helping to ensure these were recognised throughout their care.

Clinicians used audits of prescribing, shared-care arrangements, lithium monitoring and rTMS outcomes to evaluate clinical effectiveness and identify improvements.

The service planned and delivered people's care and treatment in line with current evidence-based guidance and individual clinical need. Clinicians considered presenting symptoms, medical history, previous treatments, treatment response and patient preferences when developing treatment plans.

Treatment options included medication management, psychological therapy referrals and rTMS, where appropriate. Clinicians considered the benefits, risks and suitability of treatment options and provided people with information to support informed decision-making.

The service worked with GPs and other healthcare professionals to support prescribing, physical health monitoring and continuity of care. Where additional specialist support was required, people were referred to appropriate services.

Treatment was reviewed as part of ongoing care. Clinical review, outcome measures and prescribing audits were used to monitor effectiveness and ensure care remained appropriate to people's needs.

The service had effective working relationships with GPs, NHS services and other healthcare professionals to support coordinated care and physical health monitoring. This included liaison with NHS and private GPs, psychologists, counsellors, therapists, consultants from other medical specialties and insurers where appropriate.

Staff had access to the information they needed to assess, plan and deliver people’s care, treatment and support.

Clinicians supported patients to consider healthy activities and choices. This included advice on sleep, physical activity, stress management and self-care, alongside support to access psychological therapies, community resources and other services where appropriate. The consultant psychiatrists took a holistic approach, recognising the impact of physical, psychological and social factors on mental health. This helped people develop strategies to improve their wellbeing and support recovery.

The service used recognised outcome measures to monitor progress and treatment effectiveness. Depending on presenting needs and goals, these included the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and Yale-Brown Obsessive Compulsive Scale. Clinicians reviewed results during treatment to inform clinical decisions.

Patients reported improvements in symptoms, wellbeing and quality of life. Clinicians used outcome data, clinical reviews and audits to monitor treatment and identify improvements. When the service could not provide a required specialist intervention, staff referred the person to an appropriate external service.

Clinical staff had completed Mental Capacity Act training. Records showed that staff understood their responsibilities, assessed and documented capacity and consent, and took practical steps to support people to make their own decisions.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood and applied legislation relating to consent. Patients received clear information about proposed treatments and were given opportunities to ask questions before consenting to care and treatment. Staff recognised that consent was an ongoing process and ensured people understood they could review or withdraw consent at any stage. Records demonstrated that consent was routinely discussed, and capacity and consent were clearly documented.