Updated 30 December 2022
LANCuk (Learning Assessment and Neurocare Centre) provides assessment and treatment for both children and adults for attention deficit hyperactivity disorder and autism. Most of the staff working for LANCuk were self-employed on a sessional basis. The majority of staff had other substantive roles, mostly within NHS trusts.
LANCuk employed the director, one psychological wellbeing practitioner, one mental health nurse, one general nurse and health visitor, the clinical lead, the interim service manager, administration service manager, office manager and six administrators full time. LANCuk has been registered with CQC since 19 October 2017 to provide the following regulated activities:
- Diagnostic and screening procedures
- Treatment of disease, disorder or injury.
The service accepts private referrals for children and adults and is commissioned by the NHS to provide assessments and diagnostics for adults living in Oldham, Rochdale and Bury.
The service had the following additional NHS funded contracts:
- Assessments for autism for children in Stockport.
- Assessments for attention deficit hyperactivity disorder for children in Tameside and Glossop.
The base in Heywood is where all the NHS patients are seen. LANCuk rent facilities in Wilmslow and London for their private patients. All administration takes place from the Heywood base.
The registered manager had been absent from work and the interim service manager had been covering for the registered manager responsibilities whilst applying to be the registered manager.
We last inspected the service in March 2022. The service was rated inadequate overall with ratings of inadequate for safe and well led. Following the inspection, we took urgent action and served a Notice of Decision which placed conditions on the providers registration. The Notice of Decision prevented them from accepting any new or repeat patients to the medicine prescribing service without the prior written agreement of the Care Quality Commission. We also instructed the provider to:
- implement an effective system for recording all future reviews of patients’ prescription needs including details of clinical observations and decision making and minutes of prescription meetings by 26 April 2022
- review all treatment plans for all patients currently prescribed medicines and any patients who have been accepted for prescription service and awaiting their treatment to commence by 12 May 2022
- develop and implement an effective system for the oversight of dispensing prescriptions to ensure medicines are provided to patients securely and within the time period specified within treatment plans and complete an audit of the system on a monthly basis by 11 May 2022.
This service was placed in special measures in October 2021. Following a further inspection in March 2022 where we found insufficient improvements we took action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. In this third inspection we found that insufficient improvements have been made such that there remains a rating of inadequate for a core service, key question or overall. Following concerns we served a Notice of Proposal, followed by a Notice of Decision to cancel the provider’s registration. The service was deregistered on 13 February 2023.
What people who use the service say
Since the last inspection in March 2022, we received information of concern from 19 patients about the service. Fourteen were in relation to the medicine prescribing process, three were in relation to waiting times, one was in relation to records and one in relation to staff attitude.
We spoke with a parent who was supporting their child to an appointment, we observed the clinician come into the waiting room to collect the patient. They did not introduce themselves or explain the process, they told the parent that they had to wait in the waiting room and could go and get a coffee, but did not say where or how long the appointment would be. This experience was the same as feedback we received from another parent regarding their experience. We raised this with the manager to address.
During the inspection process, we received feedback from a patient and a family member regarding the prescribing process and the impact this had on their mood and ability to function, one patient felt so unwell that they may need to be admitted to hospital.