Dr Todd Mitchell, Consultant Psychiatrist

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

We looked for evidence that people were protected from abuse and avoidable harm.At our last assessment, we rated this key question as good. At this assessment, the rating remains good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety based on openness and honesty. Staff understood how to raise concerns and report incidents, and there were systems to investigate safety events and support learning.

There had been no reported incidents in the 12 months before the assessment. The consultant psychiatrist and administrative staff understood what constituted an incident, adverse incident or near miss and knew how to report concerns.

A sample of the Service User Incident / Adverse Incident / Near Miss Report Form and procedures were reviewed. This confirmed that the service had structured processes in place to document, report, and monitor incidents should they occur. The consultant psychiatrist attended monthly meetings with Harley Therapy senior management, where incidents could be shared and discussed. The consultant psychiatrist understood the duty of candour and had a policy in place.

The service worked with people and external partners to establish and maintain safe systems of care. It supported continuity when people moved between services.

The service had clear operational boundaries and accepted people whose needs could be safely met in a non-acute outpatient setting. It did not provide emergency or crisis care. Exclusion criteria included acute or crisis presentations, active substance use, court-ordered treatment and people requiring immediate intervention.

Referrals included self-referrals and referrals from professional colleagues and psychotherapists. The service did not accept walk-in (drop-in) patients or referrals from medical services. People whose needs were outside the scope of the service were signposted or referred to appropriate specialist services.

The service worked with people and healthcare partners to understand and manage safeguarding risks. It protected people’s right to live in safety, free from abuse, discrimination, avoidable harm and neglect.

The service had systems to safeguard adults and children from abuse. The safeguarding policy had been updated in February 2026. The consultant psychiatrist and administrative staff had completed relevant safeguarding training and knew how to identify and report concerns. The service only assessed and treated adults aged 18 and over.

The service worked with people to understand and manage risks holistically so that care was safe, supportive and met their needs.

Care records showed that patients’ risks were assessed at referral and reviewed during treatment. The consultant psychiatrist gathered relevant information to determine whether the service could safely meet each person’s needs. There were clear processes in place to assess whether patients could be safely managed within the service and what their risks were. People were given clear information about what to do in a crisis as the service did not provide emergency or crisis care.

The service detected and controlled potential risks in the care environment and made sure facilities and equipment supported safe care.

The shared reception areas, waiting rooms and consultant psychiatrist’s office were clean, well maintained and fit for purpose. The office was on the third floor and the building had a lift for people with restricted mobility.

The provider conducted safety risk assessments. There were appropriate safety policies, which were regularly reviewed. They outlined clearly who to go to for further guidance. There were no clinical examination rooms. Where a physical examination was needed, people were directed to their GP. The landlord completed premises risk assessments, maintained fire safety arrangements and serviced equipment. Fire exits were clearly marked and an automated external defibrillator was available in the main reception area.

The service made sure there were qualified, skilled and experienced people who received effective professional support and development.

The service was clinically led and delivered by the consultant psychiatrist. Administrative support was provided through Harley Therapy rather than directly employed by the service.

The consultant psychiatrist was registered with the General Medical Council, held a current licence to practise and met appraisal and revalidation requirements. The consultant psychiatrist completed annual appraisals through the Independent Doctors Federation. The most recent appraisal was completed in January 2026, and revalidation was undertaken every five years in line with GMC requirements. Evidence of appraisal and revalidation was available for review.

The consultant psychiatrist maintained professional competence through ongoing Continuing Professional Development including participation in the American Board of Psychiatry and Neurology's Continuous Maintenance of Certification programme and regular review of professional journals. They were also fully licensed and board-certified by the American Board of Psychiatry. The consultant psychiatrist attended monthly peer review meetings with other psychiatrists to discuss clinical cases, share learning and promote reflective practice.

Mandatory training was up to date and included safeguarding adults and children and adult and paediatric resuscitation.

The service assessed and managed the risk of infection. Staff followed infection control guidelines, including handwashing. Cleaning records were up to date, and we observed that all areas were clean, tidy and well maintained. Cleaning was provided by the building landlord, including infection prevention and control procedures. The infection prevention and control policy had been updated to support the safe delivery of services. Audits were reviewed annually.

The service made sure medicines and treatments were safe and met people’s needs, capacities and preferences. People were involved when treatment changed.

The service did not administer medicines or store medicines onsite. It had systems for safe prescribing and secure management of prescription stationery. The consultant psychiatrist was the only authorised signatory for prescriptions.

Care records showed prescribing followed relevant national guidance. The consultant psychiatrist reviewed the effects of medicines on people’s mental and physical health, discussed side effects and alternatives, and worked with GPs and other professionals to arrange monitoring. We saw letters sent to GPs with patients’ consent, including for people prescribed antipsychotic medicines.

The consultant psychiatrist followed General Medical Council principles for prescribing when treatment was delivered online.