The Care Quality Commission
  • Mental Health
  • Independent mental health service

Archived: Referral, Utilisation and Intensive Case Management

Overall: Requires improvement read more about inspection ratings

1 Printing House Street, Birmingham, West Midlands, B4 6DF 0300 300 0099

Provided and run by:
Operose Health Limited

Important: The provider of this service changed. See old profile

All Inspections

14th January 2020

During a routine inspection

Referral, Utilisation and Intensive Case Management are known as The Access Centre and are a community-based services for people with mental health needs for single point of access activity for children and young people aged 0–25 living in the Birmingham area.

We rated Referral, Utilisation and Case Management as requires improvement:

Our rating of this service went down. We rated it as requires improvement because:

This service was previously rated outstanding overall because it offered the Utilisation and Intensive Case Management part of the service which sought innovative ways to project a continuous cycle of improvement. The Access Centre is no longer contracted to provide this part of the service. The service has dropped two ratings to requires improvement as the safe, responsive and well led domains during this inspection have been rated requires improvement.

  • The service did not always have sufficient staff to manage the number of patient referrals on the services caseload, patients referrals were clinically screened within four hours.  However, the queue to be triaged for patients screened as requiring routine care were not always triaged in a timely manner.  At the time of the last inspection 87% of non-crisis referrals were triaged within 72 hours, but the year to date figures running up to this inspection 47% of non-crisis referrals were triaged within 72 hours. However, data provided by the service for January 2020 highlighted 70% of routine referrals were triaged within 72 hours.
  • The caseload volume caused delay in routine triage and delayed referral on to further treatment. However, the service was easy to access.
  • Staff did not routinely receive mandatory training in the Mental Health Act and the Mental Health Code of Practice.
  • The provider did not have a clear strategy to ensure robust local management levels.
  • Staff we interviewed did not have a clear understanding of the providers vision and values.

However:

  • Staff assessed and managed risk well and followed good practice with respect to safeguarding.
  • Staff referred to a range of treatments suitable to the needs of the patient, Staff assessed and referred patients on who required urgent care promptly.
  • The teams included or had access to the range of specialists required to meet the needs of the patients. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation.
  • Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients.

15-16 May 2018

During a routine inspection

We rated Referral, Utilisation and Intensive Case Management as outstanding because:

  • The morale among all staff we spoke with at the service was excellent. Senior staff and leaders within the organisation were described as visible and accessible, driving improvements and leading by example, demonstrating commitment, enthusiasm and innovation in their roles.Staff and managers demonstrated an open and transparent culture that ensured learning from complaints and incidents was embedded in practice. Staff were encouraged to share concerns and enable change. Staff were supportive of each other.
  • Care records reflected holistic and recovery focussed interventions. Staff completed person-centred assessments with young people to ensure they would receive the right referral pathway that was the least restrictive for them. Staff had built good working relationships with partners and external agencies and were embedded in the multidisciplinary teams on inpatient wards where young people they supported were receiving treatment.
  • Staff were qualified, skilled and experienced and ensured young people were safe. They provided a high quality service that was accessible to everyone in need of the service. The service did not use bank or agency staff, to ensure consistency of service delivery.
  • There was a person-centred culture within the service at every level from senior managers to front-line staff. Staff showed commitment to working in partnership with people who used their service, and their families and carers. Feedback from young people and their families was positive.
  • The service had reduced the average length of stay for young people on inpatient wards and developed new, accessible pathways for young people to access services to support engagement of vulnerable young people into services that might have otherwise been missed. The service had a ‘no wrong door’ policy. This meant that anyone who contacted the service would receive referral onwards to a suitable support service.
  • The service had low numbers of incidents and complaints. There was an imbedded culture of learning lessons and improving safety following incidents that had affected the service and those that had occurred outside the service. Governance structures were clear and provided assurance that the service was safe and effective and achieving a high standard of care.
  • Staff were aware of their responsibilities in relation to the Mental Health Act and Mental Capacity Act and their guiding principles, including Gillick competence. Staff ensured children and young people made informed choices following assessment and routinely sought their consent to access treatment.
  • Staff looked outside their own organisation for quality improvement and research methodologies. The service and managers sought innovative ways to project a continuous cycle of improvement. The service was involved in multiple projects and worked in innovative ways to inform future practice. They routinely shared learning with partner agencies to improve outcomes for young people.