The Sloane Court Clinic

On this page

• 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

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff regularly reviewed people’s care and worked with other services to achieve this.

This is the first inspection for this service where a rating has been applied. This key question has been rated as good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff completed a comprehensive assessment of patients’ needs following their referral into the service. Following their assessment, patients were offered treatment options, which included medicines and psychological therapies. All ADHD assessments took 3 hours to complete.

Feedback from people using the service was positive. People felt involved in their assessments and felt confident that staff understood their individual needs.

The service planned and delivered people’s treatment with them.

Staff told us they kept up to date with current best practice by attending external conferences and reviewing research. Within the service, clinicians provided training on specialist areas for other staff members. For example, the consultant pharmacist did a presentation on prescribing ADHD medicines to pregnant people. Clinical records demonstrated that treatment was provided in line with current guidance.

Staff provided a range of care and treatment interventions suitable for the patient group. The interventions were those recommended by, and were delivered in line with, guidance from the National Institute for Health and Care Excellence (NICE). These included medication and psychological therapies, as well as referrals to external specialists when needed.

The clinical team offered treatment in a range of specialist areas, such as older adults, eating disorders, and supporting and assessing neurodivergent people. Clinicians attended clinical case discussions, where they were able to present a case, and receive support and advice from their colleagues on treatment options.

When clinicians joined the team, they had regular meetings with the registered manager and the general manager, to offer support and guidance where needed.

Clinicians provided training to team members, as and when needed. For example, operations staff had recent training around medication withdrawal. This was to support them in the communication and management of patients who were calling about repeat prescriptions, in distress.

The service had a number of quality improvement projects, for example, streamlining their prescription requests system, ensuring the request went directly to the treating clinician. The service found this change reduced the number of prescribing errors.

The service worked well across teams to support people. Staff told us there were good working relationships between operations staff and clinicians.

Operations staff told us they felt supported by their team members and managers. These teams had twice weekly meetings to discuss their work and any concerns.

Monthly clinical governance meetings were open to all staff members; however due to external commitments, a small group of 6 out of the 60 clinical staff had attended the 3 most recent meetings. Minutes from these meetings were shared with all staff following the meetings, along with bullet point summaries.

All staff were able to access keep in touch meetings with managers within the service. Staff were able to discuss clinical or personal matters in these meetings. Minutes were not kept to document what was discussed in these meetings.

The service had effective working relationships with teams outside the organisation. For example, patient’s GPs, local authority safeguarding leads, and providers of private inpatient beds.

One clinician had delivered a presentation to a local GP practice on pre-natal mental health. The presentation included symptoms doctors could be looking out for, as well as what can be safely managed through a private clinic, compared to an NHS service.

The service offered a number of online appointments. The service ensured IT equipment, facilities and technology supported the delivery of care. However, some staff said the records system used by the service did not always support the delivery of service. This was because doctor’s records and psychologist’s records were held separately. Neither profession could view the others documentation. This had the potential for clinicians to miss information when their patient was working with different professionals.

Managers were aware of this concern and had been looking into other clinical record systems. They had not yet found a system that met their needs. In the meantime, managers told us staff could send their clinic letters to all those involved with a patient’s care. Clinicians told us they would have meetings together as a treating team to discuss the best plan for their patient, however these discussions were not documented.

Some clinicians we spoke with told us they thought peer supervision sessions would be useful. They told us the service was aware of this request and was looking into it.

The service supported people to live healthier lives. They offered advice and guidance, as well as referrals to external services. For example, staff told us they had referred their patients to dietitians and found them substance misuse support sessions when needed.

We saw evidence in patient records of staff providing employment advice, sleep hygiene advice and being signposted to self help guidance.

Staff used recognised rating scales to assess and record severity and outcomes. For example, those being assessed for ADHD completed the Barkley Adult ADHD Rating Scale (BAARS-IV). Patients who presented with anxiety and depression were asked to complete the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder-(GAD-7).

When higher risk medicines were prescribed, there were protocols in place to ensure physical heath checks were carried out at regular intervals. The service kept an audit to show when reviews were completed for patients taking certain medicines. When patients were accessing the service remotely, patients were asked to provide blood pressure readings prior to medicines being prescribed. The service said they were looking into ways to verify patient readings, such as asking for a photo of the reading.

The service offered ADHD assessments and treatments. All ADHD assessments were carried out by psychiatrists. The service did not keep data on how many assessments led to a diagnosis. However, managers told us they screen their patients with outcome measure questionnaires before they accept an ADHD assessment referral, to ensure the patient is likely to benefit from this appointment.

Patient’s signed agreements with the service before they started treatment. These included consent to start treatment and an understanding of the missed appointment policy. The service collected consent to share information with GPs, other services and family members at the point of initial referral

Clinic letters were often reviewed by patients before being sent to external service, such as GPs. This was to ensure the patient consented to the information being shared.

The records we reviewed did not document discussions around consent to treatments involving medicines. Staff told us these discussions did happen with patients, however, were not always documented.

Staff were aware of when and how to consider and review capacity for patients to consent to treatment or make other, specific decisions. The service had completed 3 capacity assessments for patients in the last 12 months and we saw these were recorded in detail in the patient notes.