Potters Bar Clinic

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• 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 best available evidence.

At our last assessment we rated this key question as good. At this assessment the rating has remained good.

Staff ensured young people had risk assessments completed on admission. Risk assessments were reviewed following an incident. Staff monitored young people’s physical health. The wards had access to a range of specialists to meet the needs of young people. Staff provided evidence-based care and used clinical tools. Staff understood their roles and responsibilities under the Mental Health Act 1983. This meant young 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 3. The evidence showed a good standard. The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff ensured that risk was assessed on admission to the wards. In the 3 care records we reviewed, risk assessments were completed on the day of admission. Risk assessments were regularly reviewed and were updated following an incident.

Staff ensured care plans were effective and met young people’s needs. Care plans referenced young people’s preferences and were personalised. For example, in 1 care plan we found a plan in place to support a young person with an autism diagnosis. Young people had crisis plans or positive behavioural support plans in place.

Staff assessed young people’s physical health on admission. In all care records we found evidence of physical health monitoring taking place.

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 understood their roles and responsibilities under the Mental Health Act 1983 and the Mental Health Act Code of Practice and discharged these well.

Staff ensured patients received evidence-based care. There was a psychology team that delivered interventions recommended by National Institute of Health and Care Excellence (NICE). For example, there were groups sessions, such as weekly coping skills groups based on dialectical behavioural therapy (DBT), acceptance and commitment therapy (ACT) and compassionate focussed therapy (CFT) to support young people to manage risks and improve their quality of life.

Staff told us individual therapy sessions were offered to young people. This included cognitive behavioural therapy (CBT), eye movement desensitisation and reprocessing (EMDR), psychodynamic and art therapy. This meant that there was therapy available to meet young people’s needs.

The psychology team were also able to support with interventions, such as behavioural support plans, sleep hygiene, meal support and care, education and treatment reviews (CETR). This meant that treatment was provided to meet young people’s needs.

There was an activity timetable in place, which included activities such as a cooking group, psychesoma (an exercise programme for mental health patients) and art therapy groups. Some young people felt that groups could be repetitive.

There was a parent and carers support group available.

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.

Staff had regular multi-disciplinary meetings. We reviewed the last 3 meeting minutes and found that essential information about risk was discussed. For example, patient observations, incidents and actions were discussed.

Staff had effective handover meetings. We reviewed handover meeting minutes and found essential information about each young person was discussed. For example, a summary of each young person’s presentation was discussed. This meant that staff were effectively sharing information between shifts to keep young people safe.

Staff worked alongside external agencies and services where required to support young people. For example, staff liaised with the local authority where appropriate. Young people were taken to external healthcare appointments, such as diabetic eye screenings. We also found that multi-disciplinary teams were supporting young people. For example, where a young person had reduced food intake, they were receiving support from the dietician.

We scored the service as 3. The evidence showed a good standard. 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, reduce their future needs for care and support.

Staff supported young people to live healthier lives. Ward activities promoted a healthy lifestyle. For example, there were psychesoma exercise sessions available, which were provided by an external company. This consisted of low intensity exercise in the morning to improve alertness. Afternoon sessions involved higher intensity exercise, such as circuits or sports.

Young people were supported to attend external appointments, for example with the optician or dentist. The service also arranged for mobile opticians and dentists to attend the service.

Young people were encouraged to establish healthy routines. Staff told us that young people were supported with healthy eating. Menus were reviewed by a dietician to ensure they were nutritionally balanced.

We scored the service as 3. The evidence showed a good standard. 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 clinical tools to support patients and monitor progress and outcomes. For example, Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) was used to track mental health and social functioning. HoNOSCA was completed in all care records that we reviewed. Staff also used Young Persons’ Clinical Outcomes in Routine Evaluation (YP-CORE) to measure psychopathology in young people. Children’s Global Assessment Scale (CGAS) was used to measure quality of life. This was present in all care records we reviewed.

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.

Staff supported young people to make their own decisions. There was evidence of consent to treatment in care records we reviewed. Young people were read their rights under the Mental Health Act. Staff understood Gillick competence and were able to give examples of when they would use it. Gillick competence is a legal principle to determine if a child under 16 can consent to treatment. This meant that young people consented to and understood the treatment they were receiving.

Staff supported young people with understanding their rights. There was information available on how to access an Independent Mental Health Advocate (IMHA) and young people knew how to access them.

Capacity assessments were completed in all care records we reviewed.