Archived: Keats House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

At our last assessment we rated this key question Good. At this assessment the rating has remained Good. This meant people were safe and protected from avoidable harm.

• All premises where clients received care were safe, clean, well equipped, well furnished, well maintained and fit for purpose.
• Risks were assessed and managed well. The service had a very clear scope of practice and ensured it referred people to alternative services if it could not safely meet their needs.
• Staff kept up-to-date records of clients’ care and treatment and stored these in line with privacy and confidentiality requirements.

We have not awarded this service a score for Safe.

Find out about when we will not publish a key question score and what we look at when we assess Safe.

The service had a proactive and positive culture of safety based on openness and honesty. Any concerns about safety are listened to, safety events are investigated, and lessons learned to continually identify and embed good practices.

There had been one serious incident in the service over the last 12 months surrounding medication. The consultant psychiatrist had investigated this incident and shared lessons learned with the whole team. The registered manager could also investigate incidents and identify learning to improve the service. There was evidence that changes had been made as a result of feedback.

Staff understood the duty of candour and had policies and procedures in place. Staff understood the importance of being were open and transparent and would give patients and families a full explanation if things went wrong.

The service was easy to access. The service had a clear scope of practice and only accepted referrals for patients whose needs it could meet safely. This was made clear in documentation shared with anyone accessing the service.

The service admission process included a pre-assessment of the patient to ensure that the patients’ needs could be safely met. This included reviewing any mental and physical health.

Staff understood how to protect patients from abuse and the service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, and they knew how to apply it.

Staff kept up to date with their level 3 safeguarding training.

The consultant psychiatrist assessed and managed risks to patients and themselves well. Staff followed good personal safety protocols.

Patients’ risks were assessed at point of referral. If patients presented with risks that were outside the scope of practice, the consultant psychiatrist would signpost or refer them to other services based on their individual needs. If members of the public rang the service in crisis, staff knew when to direct them to emergency services to ensure their safety.

Where referrals were accepted, the consultant psychiatrist completed a detailed assessment of risk with every patient. This included the completion of a risk assessment tool the service had developed internally. All care records we reviewed included detailed assessments of risk that had been completed with each patient and reviewed regularly.

Records we reviewed showed that the service shared clear information with patients about what to do in crisis, as emergency and crisis care was not offered by the service.

Staff communicated with patients so that they understood their care and treatment. Staff enabled patients to give feedback on the service they received.

The premises where patients would usually be seen were safe and clean. The main reception area, administration offices, waiting room and consultant psychiatrist’s office were well maintained, well-furnished and fit for purpose.

There were no clinic rooms onsite, the consultant psychiatrist ensured physical health examinations were conducted by patient’s GPs when needed.

Staff followed infection control guidelines, including handwashing. Cleaning was provided by the building landlord and staff checked this was done as part of the service infection prevention and control procedures.

Staff had completed risk assessments to ensure the onsite office base and home working environment for staff were safe and any potential risks were managed during this time. For example, display screen equipment guidance for working from home had been shared with staff and risks assessments completed.

The team was made up of the consultant psychiatrist, practice manager and medical secretary. At the time of the inspection the service was in the process of recruiting another medical secretary.

The number of patients on the consultant psychiatrist’s caseload was well managed to allow enough time to treat each patient.

All staff received and kept up to date with mandatory training that met the needs of patients.

Staff received appropriate appraisals, supervision and opportunities to update and further develop their skills.

The consultant psychiatrist took steps to ensure they remained clinically effective. They completed an annual appraisal through an independent body every year and followed guidance on revalidation set out by the General Medical Council. (GMC). They also attended a quarterly peer review with other clinical professionals to reflect on their own practice. In addition, the consultant psychiatrist was also part of multiple multi-disciplinary team forums, some consisting of pharmacist, nurses, occupational therapists, doctors, and commissioners who met to discuss complex issues and review policy issues. The consultant worked 20 days a year in NHS services.

The registered manager made sure non-medical staff had the right skills, qualifications and experience to carry out their roles. Leaders identified any training needs their staff had and gave them the time and opportunity to develop their skills and knowledge.

Any poor performance was identified and managed

Staff followed infection control guidelines, including handwashing.

Cleaning was provided by the building landlord and staff checked this was done as part of the service infection prevention and control procedures.

The service used systems and processes to safely prescribe medicines. The consultant psychiatrist ensured the effects of medication on each patient’s mental and physical health were reviewed. The service did not administer medicine directly to patients or store any medication on site.

We reviewed the prescriptions for patients and found the consultant psychiatrist followed current national practice when prescribing patients’ medicines.

Staff stored prescribing documents in line with the provider’s policy and national guidance.

The consultant psychiatrist worked closely with other healthcare professionals to ensure the effects of medication on patients’ physical health were regularly reviewed and monitored. The consultant psychiatrist provided specific advice and information to patients about their medicines in a way they could understand. For example, we found in records clear communication provided to patients’ advice on their medication.

The provider followed the overarching principles set by the General Medical Guidance (GMC) around prescribing medication where treatment was delivered online. No other staff beside the consultant psychiatrist had access to the authorised signature needed to complete patient prescriptions.

Patients could select a pharmacy of their choice for a prescription to be dispensed