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This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Updated 26 July 2017

We do not currently rate independent health community based mental health services for older adults.

We found the following areas of good practice:

  • Patients and carers gave positive feedback about the service. They said that it was supportive of their needs. When giving feedback, eighty one percent of clients or their families who had completed a feedback survey rated the service as either nine or ten out of ten. Professionals fed back that both they and their clients were pleased with the service that had been received.

  • The service was person centred. Staff provided appointments at the patient’s home or in a convenient location. Staff wrote assessment letters following initial patient appointments. These were detailed and holistic. The service gave a personal approach to patients, which addressed their individual needs. Staff we spoke with felt that the service was developing and provided a good level of care.

  • The service had set target times for patients to be seen following an initial referral. These were target of 24 hours for an urgent referral and seven days for a non-urgent referral. Following an assessment the service had a target time of seven days for staff to send the assessment letter to the referrer. The service was meeting these targets.

  • The service regularly audited the patient files to ensure that the assessment letter contained a risk assessment, mental capacity assessment and a physical health care assessment. Learning from these audits was fed back to all staff via email and through the weekly multidisciplinary meetings by the medical director.

  • The service had been through significant changes throughout the last year. Despite these changes the morale of both the permanent staff and contracted staff was positive.

However:

  • Whilst the provider had appropriate systems in place to monitor whether sessional staff had completed the necessary appraisals and training, for a couple of staff these documents were not in their staff record.

  • The service had not ensured that all non-clinical staff who had contact with patients and carers had access to regular formal supervision.
Inspection areas

Safe

Updated 26 July 2017

We do not currently rate independent health community based mental health services for older adults.

We found the following areas of good practice:

  • There were sufficient and flexible staffing numbers to ensure that urgent new referrals or urgent requests for appointments from existing patients were seen within 24 hours.

  • There was a clear incident procedure in place so that staff knew how to report incidents. There had been no incidents within the 12 months prior to our inspection

Effective

Updated 26 July 2017

We do not currently rate independent health community based mental health services for older adults.

We found the following areas which needed improvement:

  • The service had not ensured that permanent staff members, who were not clinically trained, but who were taking referrals and having regular telephone conversations with patients and carers, had received regular formal supervision or an appraisal.

  • Whilst the provider had appropriate systems in place to monitor whether sessional staff had completed the necessary appraisals and training, for a couple of staff these documents were not in their staff record.

However:

  • Care records were accurate, comprehensive and up to date. Contracted staff reported that the electronic recording system was easy to use and could be accessed remotely.

  • Clinicians wrote thorough and detailed assessment letters.

  • The provider carried out regular clinical audits to assess the quality of the service. These audits monitored risk assessments, mental capacity assessments and assessments of physical health.

Caring

Updated 26 July 2017

We do not currently rate independent health community based mental health services for older adults.

We found the following areas of good practice:

  • Patients and carers gave good feedback regarding the service that they had received.

  • The service undertook a personalised approach to patients which addressed their individual needs.

  • The service offered support to family and carers if needed.

  • During our inspection we observed staff interacting positively with carers on the telephone.

Responsive

Updated 26 July 2017

We do not currently rate independent health community based mental health services for older adults.

We found the following areas of good practice:

  • The service had clear target times for responding to referrals and sending out the assessment letter after the initial assessment. These response times were regularly audited.Audits showed that the target times were generally being met.

  • The service had a clear complaints process. There had only been one complaint within the last year. Staff had responded to the complaint quickly and thoroughly. There was a clear audit trail to show what actions staff had taken.

  • Consultations were held in a convenient location for the patient.

Well-led

Updated 26 July 2017

We do not currently rate independent health community based mental health services for older adults.

We found the following areas of good practice:

  • The service had gone through a great deal of change over the last year; however staff morale was good. All staff felt supported within their role.

  • The service had a good structure in place to ensure that learning took place throughout the service as a result of both audits and complaints.

  • The service was looking at trialling a new outcomes measuring tool which had been developed in partnership with the Institute of Psychiatry.

Checks on specific services

Community-based mental health services for older people

Updated 26 July 2017