Archived: Big White Wall Head Office

Updated 8 August 2016

The Big White Wall Head Office provides a live therapy service involving one to one online therapy with experienced counsellors and therapists via webcam, audio or instant messaging through a secure digital platform. The service is contracted to provide live therapy to NHS mental health services through contracts with the Improving Access to Psychological Therapies (IAPT) programme.

Services are also provided to universities, NHS England and the Ministry of Defence.

Therapies offered include cognitive behavioural therapy, person-centred and integrative counselling/psychotherapy. The service is provided to adults. People who use the service choose from a directory of approved therapists with different therapeutic approaches.

The Big White Wall Limited also provides a support network (24/7 professionally moderated on line peer support) and guided support (structured online group courses on common mental health issues). This part of the service is not regulated by the CQC.

This was the first inspection of the live therapy service since the service registered with CQC in 2014. At the time of our inspection seventy two patients were receiving live therapy. Big White Wall Limited is registered to provide the regulated activities of treatment of disease, disorder or injury.

Updated 8 August 2016

We rated The Big White Wall Head Office as good because:

• There were sufficient staff to meet people’s needs safely.

• Staff had received and were up to date with appropriate mandatory training. Therapy staff completed a comprehensive induction to prepare them for their role.

• Policies and procedures for managing risk were in place. Staff had a good understanding of these and followed them consistently to protect people.

• Safeguarding arrangements were in place and staff were aware of the procedures to follow so that any safeguarding concerns were raised appropriately.

• People’s needs were assessed and reviewed so that the service ensured people were receiving the treatment they needed. Risk assessments were reflected in the treatment plan. The service worked with other healthcare providers when people were discharged.

• Treatment was planned and delivered in line with current evidence based guidance, standards and best practice.

• Consent to treatment was sought prior to the start of each therapy session. Staff had undertaken training in the Mental Capacity Act 2005 and had completed other mandatory training.

• People were treated with kindness, dignity and respect. People told us the service was professional and live therapy had helped them.

• People were at the centre of their care and treatment and were involved in making decisions about their treatment.

• People could access live therapy in a timely manner. The service operated out of hours and at the weekend, this allowed people to have more flexibility in arranging their therapy sessions and was responsive to individual need.

• People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.

• Staff enjoyed working at the service and were committed to providing good quality care and support to people.

• The service had been nominated for and had won several awards. The Big White Wall was the winner in the 2015 Digital Entrepreneur Awards, technical innovation within the public sector and won the Women in IT awards for Innovator of the year 2016.

• The Big White Wall team had several articles published in journals such as the British Journal of General Practice and Current Psychiatry reports.

However:

• Systems to assess, monitor and improve the quality of the service were not fully developed and embedded within the organisation. This meant there was a risk that areas that required improvement would not be identified.

• Arrangements to share learning from incidents took place during supervision only. There was no system to share meeting minutes where incidents were discussed.

• Supervision records contained brief information about ongoing treatment and risk.

• Regular staff meetings with therapy staff did not take place.

• Arrangements were not in place for the continued professional development (CPD) of therapy staff. Staff were only offered mandatory training.

Updated 8 August 2016

We rated The Big White Wall Head Office as good because:

• There were sufficient staff to meet people’s needs safely.

• Staff had received and were up to date with appropriate mandatory training. Therapy staff completed a comprehensive induction to prepare them for their role.

• Policies and procedures for managing risk were in place. Staff had a good understanding of these and followed them consistently to protect people.

• Safeguarding arrangements were in place and staff were aware of the procedures to follow so that any safeguarding concerns were raised appropriately.

• People’s needs were assessed and reviewed so that the service ensured people were receiving the treatment they needed. Risk assessments were reflected in the treatment plan. The service worked with other healthcare providers when people were discharged.

• Treatment was planned and delivered in line with current evidence based guidance, standards and best practice.

• Consent to treatment was sought prior to the start of each therapy session. Staff had undertaken training in the Mental Capacity Act 2005 and had completed other mandatory training.

• People were treated with kindness, dignity and respect. People told us the service was professional and live therapy had helped them.

• People were at the centre of their care and treatment and were involved in making decisions about their treatment.

• People could access live therapy in a timely manner. The service operated out of hours and at the weekend, this allowed people to have more flexibility in arranging their therapy sessions and was responsive to individual need.

• People’s concerns and complaints were listened to, addressed in a timely manner and used to improve the service.

• Staff enjoyed working at the service and were committed to providing good quality care and support to people.

• The service had been nominated for and had won several awards. The Big White Wall was the winner in the 2015 Digital Entrepreneur Awards, technical innovation within the public sector and won the Women in IT awards for Innovator of the year 2016.

• The Big White Wall team had several articles published in journals such as the British Journal of General Practice and Current Psychiatry reports.

However:

• Systems to assess, monitor and improve the quality of the service were not fully developed and embedded within the organisation. This meant there was a risk that areas that required improvement would not be identified.

• Arrangements to share learning from incidents took place during supervision only. There was no system to share meeting minutes where incidents were discussed.

• Supervision records contained brief information about on-going treatment and risk.

• Regular staff meetings with therapy staff did not take place.

• Arrangements were not in place for the continued professional development (CPD) of therapy staff. Staff were only offered mandatory training.