Cognacity

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 means we looked for evidence that people's care, treatment and support achieved good outcomes and promoted a good quality of life based on the best available evidence.

At our previous inspection, we rated this key question as requires improvement. At this assessment, the rating has changed to good.

This meant people's care and treatment achieved good outcomes and reflected current evidence-based guidance. Staff assessed people's needs, delivered appropriate treatment and worked effectively with other healthcare professionals to support people's health and wellbeing.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service assessed and reviewed people's health, care, wellbeing and communication needs to support effective care and treatment.

We reviewed 15 care and treatment records. Staff completed comprehensive mental health assessments promptly following referral. Patients receiving ADHD assessments underwent a structured two-stage assessment process.

Staff developed care plans that reflected people's identified needs and recorded progress following appointments, including agreed treatment goals and next steps. We saw examples of detailed assessment letters that were shared with patients and, where appropriate, their GP.

At our inspection in October 2025, we identified concerns that care and treatment did not always reflect legislation, national guidance or best practice. At this assessment, we found the provider had made improvements and was delivering care in line with evidence-based guidance.

Staff provided a range of interventions appropriate to the needs of the patient group. Treatments were delivered in line with guidance from the National Institute for Health and Care Excellence (NICE).

Staff followed best practice guidance when assessing and managing patients with complex risks associated with opioid substitution treatment (OST). Where people's needs could not be safely met by the service, staff referred or signposted them to specialist substance misuse services. At the time of the assessment, the provider was not accepting new referrals for patients requiring OST while governance and clinical arrangements continued to be strengthened.

Staff followed best practice guidance when prescribing controlled drugs and other dependence-forming medicines. Prescribers used a structured prescribing framework that supported safe assessment, monitoring and review. Regular prescribing audits and reviews helped identify risks associated with dependence, misuse and diversion.

Staff followed NICE guidance when assessing and treating ADHD. This included completing baseline physical health checks and reviewing existing medication with patients' GPs before prescribing.

Staff provided evidence-based treatment for a range of mental health conditions, including depression, anxiety and obsessive-compulsive disorder. The therapy team offered a range of interventions, including cognitive behavioural therapy, dialectical behaviour therapy, psychodynamic therapy and group therapy.

The service had access to an appropriate range of professionals, including consultant psychiatrists and clinical psychologists. Staff referred patients to GPs or local healthcare services when physical health assessments or interventions were required.

Managers audited treatment records, including those completed by consultant psychiatrists and therapy staff. Staff attended clinical governance meetings to discuss incidents, clinical risks and service developments.

Staff received specialist training relevant to their role. However, only 42% of staff had completed the second part of the Oliver McGowan training programme, and this remained an area for improvement.

Managers addressed poor performance appropriately and provided staff with opportunities for supervision and support.

The service worked effectively across teams and with external organisations to support people and promote continuity of care.

Staff attended weekly clinical risk meetings and monthly team meetings where complex cases, risks and incidents were discussed.

Information was shared appropriately between medical and therapy teams to ensure coordinated care. Staff worked collaboratively when patients required input from more than one discipline.

Staff maintained effective relationships with external organisations, including GPs. We saw evidence that relevant information, including prescribing decisions and treatment updates, was shared to support safe and coordinated care.

The service supported people to manage their health and wellbeing and encouraged healthier lifestyles.

Staff provided advice and support relating to smoking cessation, exercise, nutrition, sleep hygiene and mindfulness. Care records demonstrated that staff considered people's wider health and wellbeing as part of treatment planning.

At our inspection in October 2025, we identified concerns regarding how the service monitored and evaluated patient outcomes. While some improvements had been made, further work was required to ensure outcomes were routinely collected and used to improve care.

Staff used recognised outcome measures, including the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Scale (GAD-7) and ADHD assessment tools to support clinical assessment and treatment.

However, the service did not routinely collect, collate or analyse outcome data across the service. This limited leaders' ability to evaluate the effectiveness of treatment, identify trends and use outcome information to drive service improvement.

The manager recognised this gap and had plans to introduce a system for routinely collecting and analysing patient outcome measures.

At our inspection in October 2025, we found staff did not always assess people's capacity to consent on a decision-specific basis. At this assessment, we found improvements had been made.

Staff received training in the Mental Capacity Act and understood the principles of capacity assessment. Staff knew how to access the provider's Mental Capacity Act policy and sought support from senior clinicians when required.

Records showed staff appropriately assessed and documented capacity where concerns were identified. We also reviewed evidence of a Gillick competence assessment for a young person, which had been completed and recorded appropriately. This demonstrated staff were applying legal requirements and best practice when supporting people to make decisions about their care and treatment.