Living Mind

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

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.

The provider had a clear vision and values for the service, centred on person-centred care, equality, inclusion and understanding the needs of the people using the service. These were reflected in the way the consultant psychiatrists and practice staff worked together and delivered care.

The 2 consultant psychiatrists, practice director and practice manager understood the service's aims and their respective roles in delivering them.

The service was led by an experienced consultant psychiatrist with the skills, knowledge and expertise to provide effective clinical leadership. They promoted a person-centred culture focused on delivering high-quality, compassionate care and treatment tailored to individual needs.The consultant psychiatrist maintained their professional competence through continuing professional development, peer review, appraisal and revalidation. They remained engaged with professional bodies and specialist clinical networks, supporting the delivery of care in line with current evidence and best practice. Patients consistently described the consultant psychiatrist as approachable, respectful and clear in their communication. They told us they felt listened to, involved in decisions about their care and confident in the treatment and support they received.

The service promoted a positive and collaborative culture within its small team. The consultant psychiatrists worked closely with the practice director and practice manager to coordinate clinical, operational and administrative arrangements.

The consultant psychiatrists and practice staff described positive working relationships and direct communication. Team members said they could raise concerns, discuss issues openly and contribute to improvements.

The service valued equality, diversity and inclusion and sought to ensure people were treated fairly, with dignity and respect.The consultant psychiatrist understood the importance of equitable care and of responding to protected characteristics and individual circumstances. Patients said they felt respected and valued as individuals.

Appropriate governance arrangements were in place. The consultant psychiatrist had clinical oversight of the service and systems to identify, monitor and manage risks. Governance meetings reviewed clinical activity, outcomes, incidents, complaints, risks, patient feedback, audit findings and service performance. Actions arising from meetings were recorded, monitored and reviewed.

Governance meetings were also used to review operational issues, prescribing practices, training, appointment availability and service improvement actions. This helped ensure that quality, safety and the day-to-day running of the service were regularly monitored.

Policies and procedures supported consistent practice and compliance with relevant standards. Audit, supervision, appraisal, continuing professional development and peer engagement provided additional assurance. The provider used audits to review systems and identify improvements. These included audits of appraisal, revalidation and governance processes. For example, a review of patients who did not attend appointments led to the introduction of text message reminders one week before appointments.

Information governance arrangements supported secure record keeping and confidentiality. Policies relating to information governance, data protection and Caldicott principles provided guidance on the management of patient information.

The consultant psychiatrists maintained their professional standards through appraisal, revalidation, continuing professional development, peer support and clinical supervision. These arrangements supported reflective practice, professional accountability and the delivery of safe and effective care.

The service worked with GPs, NHS services and other healthcare professionals to support coordinated care and physical health monitoring. This included communication with NHS and private GPs, psychologists, counsellors, therapists, consultants from other medical specialties and insurers where appropriate. Care records demonstrated information sharing with relevant professionals to support continuity, treatment planning and patient safety. The service sought patients' consent before sharing information and used communication across services to coordinate care.

The provider demonstrated a commitment to continuous improvement. Audit findings, governance reviews and changes in guidance were used to strengthen practice. Improvements included enhanced identity verification procedures, prescription logging, revised consent forms and clinical templates, additional crisis information in clinical correspondence, and seizure-risk documentation within rTMS records.

The consultant psychiatrists participated in professional networks, peer support groups and continuing professional development activities to maintain awareness of developments in mental health care and emerging practice. Outcome data, professional learning and relevant guidance were reviewed to support ongoing service development and improvements in care.