Roller Mill

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 assessment for this service. This key question was rated Good.

Staff conducted comprehensive mental health assessments and delivered evidence-based care in line with national guidance. Care plans were highly personalised and recovery-oriented and staff used recognised rating scales to monitor outcomes. Clinicians were qualified, well-supported through regular supervision and worked with internal physical healthcare teams and external agencies. Clear processes were in place to manage patient consent and identify when a person's needs fell outside the service's remote remit. However, the monitoring of patients' physical health conditions within care records was inconsistently recorded.

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.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The patient care records we viewed showed that clinicians completed and recorded a comprehensive mental health assessment after every appointment. Care plans were clearly personalised, recovery oriented and focused on individual wellbeing.

Clinicians routinely checked that people understood their care plans and support mechanisms during appointments. However, staff did not always record patients’ physical health conditions within the care records, which limited the holistic overview of patient needs.

The service planned and delivered people’s care and treatment with them, including what was important to them. Staff understood when the Mental Health Act safeguards may need to be used.

Clinicians provided a range of interventions suitable for the patient group, including medicines management, psychological therapies, lifestyle advice and external referrals. These interventions aligned with national standards and guidance.

Staff were experienced, qualified and possessed the skills required to meet patient needs. Managers identified learning needs and provided staff with regular team meetings, annual performance appraisals and structured supervision. These supervision sessions allowed staff to discuss case management, reflect on practice and focus on professional development.

Mental Health Act

All clinicians received training as part of their professional qualifications about the Mental Health Act 1983 and the guiding principles.

Roller Mill did not provide care and treatment to patients who needed to be detained under the Mental health Act 1983. If a patient’s mental state deteriorated and their needs could no longer be met by the service, they would be referred to an alternative service.

The provider 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 had effective ways to share information with patients' GPs is they wish, at the end of their care. People could also get support from the physical healthcare side of the provider business. Staff coordinated well with external agencies. They completed urgent referrals to NHS crisis services and reported safeguarding concerns to local authorities or employers promptly when required.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduced their future needs for care and support.

Clinicians helped people to live healthier lives by offering lifestyle health advice and utilising other resources available through the parent provider. While alcohol and drug addictions were excluded from the scope of the service, clinicians could provide guidance if substance misuse was not the main reason for referral. Staff would identify wider healthcare needs and make referrals to external specialists, such as cardiologists. Clinicians did not carry out formal fitness-for-work assessments but they would draft letters for patients to share with GPs or employers to inform and help support workplace adjustments.

The service routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent and that they met both clinical expectations and the expectations of people themselves.

Staff used recognised clinical rating scales to assess and record the severity of mental health conditions and to track treatment outcomes. Treatment continued until it reached a natural conclusion or funding ceased, with most patients receiving 6 appointments, at intervals according to their needs. These measures ensured that short-term interventions were monitored for effectiveness throughout the care delivery period.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

People received an electronic leaflet at the start of treatment explaining consent and the exceptional circumstances where confidentiality may be breached. Clinicians verified and recorded consent at the start of every appointment. Staff followed people’s wishes and rarely needed to share information without consent.

Clinicians had all received training on the Mental Health Act and its guiding principles. If a patient might require these safeguards, care was stopped and a referral made to other services.

Staff correctly operated under the assumption that patients have capacity to make decisions. If an impairment of capacity was suspected, the person was excluded from the service as remote care was not suitable for them. Care records we viewed showed that mental capacity was assessed, was present and had been fully recorded.