Orri Wimpole Street

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

This was the first inspection of the registered Wimpole Street location following the relocation of the service from its previous premises in Hallam Street. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

We scored the service as 4. The evidence showed an exceptional standard. The service always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

All patients we spoke with told us they worked in collaboration with staff on their plan of care. Feedback about the service included “My care plan is very clear and is reviewed every 6 weeks. You speak through it together as a team and I am always clear about my goals of treatment. You are very involved and it’s a collaborative process”.

We reviewed 9 care records. The records we reviewed demonstrated a consistent, high‑quality approach to assessing and reviewing each patient’s physical health, mental health, wellbeing, communication needs, and overall care requirements. Staff completed comprehensive, person‑centred mental health, physical health and dietetic assessments. All patients confirmed they had regular reviews of their care with their case managers and that all care was delivered in partnership.

For patients attending face‑to‑face day care or outpatient services, the service carried out all required physical health monitoring directly. This included weight monitoring, BMI (body mass index), height, electrocardiogram (ECG) monitoring, the sit up, squat and stand up (SUSS) test of muscle function in anorexia nervosa, plus dietetic and occupational therapy assessments, which were reviewed regularly.

For patients receiving online day care or outpatient support, the service worked closely with the patient and individual GPs to ensure that regular blood tests, electrocardiograms (ECG), and any other necessary physical health checks were completed. For example, patients could provide self‑reported weights via email, video, or photograph. Where necessary, weights could also be verified by the patient’s GP or during a video consultation with an Eating Disorder Associate.

Dieticians, therapists, eating disorder associates, nurses, occupational therapists and psychiatrists worked together to plan and deliver care and treatment in conjunction with patients and reviewed this in the weekly multi-disciplinary meeting. This approach ensured that all patients regardless of how they accessed the service, received consistent, safe, and proactive monitoring of their physical health needs.

Care plans were reflective of patients’ assessed needs, embodied the voice of the patient and their family members and were recovery-orientated in considering how patients could work towards achieving their goals. Care plans were collaborative and staff worked with families to create a shared understanding of individual needs, for example the service developed bespoke care plans for diabetic patients.

The service demonstrated a strong commitment to delivering effective, personalised care for neurodivergent patients. Assessments were thorough and explored each individual’s sensory profile, including sensitivities to noise, light, textures, and environmental triggers, ensuring that treatment plans incorporated appropriate reasonable adjustments. For example, for a patient the service agreed flexible arrival arrangements and alternative one to one sessions rather than attending groups to manage sensory overload. Clinicians also used co-produced communication passports and other personalised communication tools such as co-produced traffic light communication cards to understand how patients preferred to receive, process, and express information. This approach supported effective engagement, reduced barriers to participation, and ensured that interventions were adapted to meet diverse cognitive and sensory needs. The service was committed to identifying and supporting neurodiversity. As part of the assessment process the service carried out screening for attention deficit hyperactivity disorder (ADHD), autistic spectrum condition (ASC) and Avoidant/Restrictive Food Intake Disorder (ARFID). Given the number of patients with neurodiverse needs, the service had developed a dedicated dedicated neurodevelopmental pathway to ensure assessments, interventions and adaptations were consistently applied. This enabled staff to provide tailored, inclusive care that recognised and responded to the specific needs of neurodiverse patients.

We scored the service as 3. The evidence showed a good standard. The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff provided an extensive range of care and treatment for patients which went beyond national guidance and best practice. Staff used evidenced based approaches to support the delivery of high-quality care and treatment.

The service model of care was based on a biopsychosocial approach which considered the holistic needs of each patient. Staff viewed each patient as a unique individual. The service provided a stepped model of care that offered different programmes which were tailored to the individual. For example, some patients had a blended approach whereby they attended in person and then online. The intensity of each programme varied dependent on the needs of the patient.

Patients were offered a comprehensive programme of group and individual therapies. This included cognitive behavioural therapy, dialectical behavioural therapy, interpersonal psychotherapy, psychodynamic psychotherapy, creative arts therapies, eye movement desensitisation and reprocessing (EMDR), psycho drama therapy, trauma-based therapy and MANTRA (Maudsley Anorexia Nervosa Treatment for Adults). The service followed a stepped approach so that treatment evolved with each individual patient as they progressed in their recovery. This enabled staff to provide personalised, responsive interventions that supported patients at every stage of their recovery journey.

The service was passionate about treating the whole patient, not just their eating disorder, and this involved treating any underlying issues. For example, staff offered Mentalization-Based Therapy for eating disorders and multi-family therapy. Mentalization-Based Therapy is a specialised, long-term psychotherapy designed help someone understand their own emotions and the mental states of others. Carers told us they were offered family therapy and this had supported them to understand the effects of eating disorder on the family and other siblings.

Staff made sure patients had support for their physical health needs from their GP before they could access this service. Staff helped patients to live healthier lives by supporting them to take part in programmes, giving advice, or referring them to specialist services. One patient told us the service had supported them to access substance misuse services.

Staff assessed and met patients’ needs for food and drink and for specialist nutrition and hydration effectively. Dieticians carried out comprehensive assessments with each patient. Dietitians and the chef worked collaboratively with patients to develop individualised meal plans tailored to their specific eating requirements. They also promoted a positive and normalised food culture, supporting patients to rebuild healthy relationships with food. The service did not use calorie counting, with the goal to reduce anxiety around meals and maintain a therapeutic, recovery‑focused environment.

Staff participated in clinical audit, benchmarking and quality improvement initiatives. The service had an established programme of clinical audit. Managers maintained clear oversight of audit activity and used the findings to drive improvements in practice. Audits covered key areas of quality and safety, including care planning, risk assessment, discharge planning, health and safety, hydration and nutrition, incident management, complaints and duty of candour, staff induction, physical health monitoring, record keeping and consent. Where audits identified shortfalls, managers developed action plans and monitored progress to ensure improvements were implemented and sustained.

All staff were actively engaged in activities to monitor and improve quality and outcomes. The service had a strong and well-established range of quality improvement initiatives that included projects on improving MDT processes, meal service, DEI strategy, education and learning and improving food experience.

Patients were able to provide feedback on the service through a range of channels, including community meetings, the suggestion box, the complaints process, direct feedback to keyworkers and dedicated patient expression sessions. Feedback was reviewed regularly, with themes identified and actions implemented to drive improvements. For example, work was undertaken with group facilitators following feedback about the inconsistent application of boundaries, for example the number of minutes a client was able to join a group once it had commenced.

The service had a full range of specialists to meet the needs of each patient. This included consultant psychiatrists, dieticians, physiotherapists, occupational therapists, nurses, eating disorder associates, psychologists, psychotherapists. Patients could also access additional specialists to meet their needs, such as a drama therapist, art and yoga and body awareness therapists.

Managers ensured staff had the right skills, qualifications, knowledge and experience to meet patients’ needs, including bank and agency staff. Staff spoke with passion about working for the service.

Managers ensured all new staff completed a comprehensive induction, with differentiated levels of training aligned to the competencies and responsibilities of each role.

All staff we spoke with confirmed they had regular clinical and managerial supervision. Managers provided staff with supervision (meetings to discuss case management, to reflect on and learn from practice, and for personal support and professional development) and appraisal of their work performance. Teams had weekly reflective practice sessions.

Managers ensured that staff had access to regular team meetings. All teams within the service had regular team meetings. We reviewed meeting minutes for various teams which evidenced regular updates about the service and team, learning from incidents and problem solving follow up actions.

The service demonstrated an exceptional commitment to workforce development, training and ongoing professional growth. Staff told inspectors that developing their skills, competence and knowledge was viewed as essential to delivering high‑quality care and treatment. In addition to its mandatory training programme, the service had created a comprehensive training framework for all professional disciplines. The service director used various learning methods to embed learning such as Cake and Capacity, game based learning such as role plays, ligature cutter treasure hunts and a hands up hand hygiene dance.

Managers identified individual and team learning needs and ensured staff were provided with opportunities to expand their skills and knowledge. Staff received the specialist training and development required for their roles. Leaders monitored uptake and reviews of what was offered, to ensure training remained current and relevant. The service delivered weekly in-house learning sessions, known as Wise Wednesdays, as part of a structured, modular education programme delivered throughout the year. Sessions were led by a combination of internal staff and external specialists, covering core training topics alongside emerging issues relevant to the service. During our inspection, we observed a Wise Wednesday session focused on Avoidant/Restrictive Food Intake Disorder (ARFID), which provided staff with structured learning and opportunities for reflective discussion.This strong focus on professional development contributed to a confident, skilled and well‑supported workforce.

Managers dealt with poor staff performance promptly and effectively.

We scored the service as 3. The evidence showed a good standard. The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The service demonstrated good practice in how staff, teams and external partners worked together to deliver holistic, person-centred care. Staff reported that teams worked well together and that there was a shared culture of openness and transparency.

Staff held regular and effective multidisciplinary meetings. Records evidenced shared decision making and the patient voice.

Staff shared information about patients at effective handover meetings. The teams had effective working relationships, including good handovers, with other relevant teams within the service. End of day handovers reviewed any administration or operational challenges that needed review.

We saw evidence of proactive partnership working with external professionals. Commissioners we spoke with described the service as a ‘system leader’, citing excellent communication, responsiveness and focus on achieving the best outcomes for individuals. Other examples included working collaboratively with the London Ambulance Service, local accident and emergency department, schools and universities.

We scored the service as 3. The evidence showed a good standard. The service supported people to manage their health and wellbeing to fully maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service demonstrated an exceptional commitment to supporting patients in achieving long-term health and wellbeing that extended beyond managing eating disorder symptoms. Staff proactively empowered individuals to take ownership of their recovery by providing high quality accessible information.

Staff supported patients with their wider health such as psychoeducation groups on smoking cessation, dental health, bone health and physical activity tailored to recovery.

We scored the service as 4. The evidence showed an exceptional standard. The service monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

The service demonstrated consistently high clinical outcomes. Staff routinely used recognised clinical rating scales to assess and record the severity of patients’ symptoms and functional impairment. These included the Eating Disorder Examination Questionnaire (EDE‑Q), Clinical Impairment Assessment (CIA), Eating Disorder Stage of Change Questionnaire (EDSOCQ), Depression, Anxiety and Stress Scale (DASS), and the Orri Severity of Eating Disorder (OSED). OSED has been developed by the service Director of Research and Development. The consistent use of these validated tools enabled the service to monitor progress effectively, evaluate treatment impact, and ensure that clinical interventions were responsive to individual need.

Patients were provided with information in the patient handbook on these self-reporting tools and how the service used the information to understand any improvements in the patient’s progress, understand eating disorder symptoms, support discharge planning and evaluate the effectiveness of the service.

The service had completed an outcomes report in November 2025 that highlighted the clinical strengths of its clinical pathways. The report highlighted the success of weight restoration and symptom reduction in the day care pathway and psychological recovery and weight restoration for patients using the outpatient’s service, for example the day care programmes achieved statistically significant weight restoration and substantial reductions in eating disorder symptoms. The outpatient pathway facilitated meaningful psychological recovery. Patients demonstrated significant reductions in depression, anxiety, and stress as measured by the DASS‑21. The report also highlighted that there was no statistical difference in outcomes between online services, in person or blended programmes. The report concluded that the online pathway was a viable, clinically equivalent alternative to traditional in-person care.

The Director of Research and Development undertook a comprehensive quarterly review of patient outcomes, drawing on detailed client‑population data to identify trends, monitor progress and evaluate the effectiveness of interventions.

We scored the service as 3. The evidence showed a good standard. The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

The service demonstrated a comprehensive understanding of the legal frameworks surrounding consent. For adults, staff followed the principles of the Mental Capacity Act 2005 and ensuring that staff took all practical steps to enable patients to make their own decisions. Staff regularly reviewed individual patients’ capacity to consent to treatment as they were aware that each individual’s capacity could fluctuate. Managers completed a quarterly audit to evaluate how well staff applied the Mental Capacity Act.

Patients were asked for consent to share information and consent to treatment during registration and assessment. Records confirmed that staff documented which other organisations patients agreed to share information with regarding their care and treatment.

For patients under the age of 16, staff applied Gillick competence principles to assess whether the young person had sufficient maturity and understanding to make informed decisions about their care and treatment. Where a young person was deemed Gillick competent, they could consent to treatment without parental involvement.

Compliance for Mental Capacity training was 100%. Managers had created a Mental Capacity Act song for staff to remember the five principles.