The Sloane Court Clinic

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture

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

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

The service was in breach of legal regulation in relation to Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 17, good governance. The service did not carry out audits in all areas, such as a review of the content of clinical records. Clear action plans were not always made following audits.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff were aware of the service’s visions and values and how they applied to the work of their team.

Managers communicated the service’s vision and values to the staff in their keep in touch meetings, team meetings and governance meetings. In the most recent staff survey, staff said leaders had kept them informed of any updates and changes within the service.

Staff had the opportunity to contribute to discussions about changes within the service. For example, staff were encouraged to attend the clinical interest groups which aimed to improve the overall service and treatment offered to their patients.

Staff appraisals included conversations about career progression where relevant and how they could support staff development. Staff spoke positively about opportunities for professional development. For example, some staff had been given more responsibility in areas they expressed interests in.

Managers had the skills, knowledge and experience to perform their roles. They had a good understanding of the service they managed.

Staff told us managers were supportive and approachable.

There were fortnightly manager team meetings, where managers were able to discuss any operational concerns and updates. Managers communicated with staff through monthly governance meetings, keep in touch meetings, and whole team emails. Managers arranged team away days and social meet ups for staff.

Leadership development opportunities were available for staff, and staff we spoke with described their progression within the organisation.

When managers were on leave there was a handover system, where formal cover was arranged for different areas, such as someone to cover the safeguarding lead, someone to lead on triage and someone to cover managerial duties.

The service fostered a positive culture where people said they could speak up and their voice would be heard. We heard examples where staff had spoken up to managers with positive effect.

Staff told us they felt supported by their colleagues and managers.

Staff were aware of the whistleblowing procedure and how to use it.

Managers ensured staff were supported following serious incidents. A psychologist ran meetings where staff were able to come together and discuss any concerns, such as how to manage working in this field and coping strategies.

Staff were able to apply to work flexibly, such as, flexible working agreements. One staff member had reduced their hours to be able to complete further training.

The service actively recruited clinicians from different specialties and backgrounds to ensure they were able to provide diverse treatment to patients, such as having staff from a range of cultures and speaking a number of different languages.

We found some governance process that needed improvement. This included what audits were carried out, how some identified actions from audits were being followed up, clear documentation of supervision, and clear oversight on what training different staff groups needed.

Whilst the service participated in some clinical audit and quality improvement initiatives, audits were not carried out in all areas. For example, the service was not regularly auditing the content of clinical letters, and they were not keeping track of clinical staff’s documentation and training records. The service had not completed an audit looking in detail at clinical records since 2021. This audit found a number of areas of concern. For example, handwritten notes were found to be 'poor' which meant some records were illegible. They also found 'poor' record of prescriptions. The service made changes following this audit, such as moving to typed records and an electronic prescription process. However, the service had not re-audited these areas and had not audited the content of clinical records such as risk assessments, care planning and discussions on medicines.It was also not clear if there was a plan in place to follow up the recommendation on propranolol from the medicines audit.

Operations staff did not receive regular updates to their mandatory training and there were some areas where staff groups had not received training in line with policy requirements.

The service did not have a policy on how they would receive or record assurance of clinical staff ongoing supervision, training and revalidation.

The service did not have a remote appointment policy for staff to follow. The service did however include some information in patient reminder emails, where they told them that their session needed a private environment with a reliable internet service.

Safe recruitment practices were followed when staff first joined the service. When associate clinicians were onboarded they uploaded information, such as, professional certificates, DBS, and professional registrations.

Staff had access to the equipment and information technology needed to do their work. Staff said these systems worked well, however there were difficulties in accessing other disciplines notes. The service was aware of this system limitation and was actively looking for new providers.

The service had a framework of what should be discussed in governance meetings, managers meetings, and operations team weekly meetings. However, there were no fixed agenda points stating what should be discussed in each meeting, such as learning from incidents, complaints, and audit findings. Following our feedback to the service, managers told us they would be starting monthly system compliance and audit meetings. These meetings would look at ensuring key governance areas such as audits and staff training was formally documented and reviewed.

All staff were invited to attend governance meetings, however due to external commitments many clinical staff were not able to attend. Minutes were taken and shared with all staff following the meeting. Managers highlighted 3 main bullet points from each meeting and shared this with all staff.

The service did not document clinical discussions between staff members. When more than one clinician was working with a patient, staff told us they would have regular meetings to discuss their patients care and treatment plans. However, these discussions were not documented.

Staff maintained and had access to the risk register. All staff were able to escalate their concerns if needed. Their risk register noted areas such as IT failures and financial errors.

The service had a business continuity plan in place for emergencies. This plan covered areas such as power failures and cyber-attacks.

Staff could access all required policies and procedures through the service’s online folders.

Information governance systems included confidentiality of patient records. Staff took patient confidentiality and information security seriously. They had white noise machines and computer privacy screens to ensure information could not be overheard or read.

Managers engaged with external stakeholders, such as insurance companies and local universities.

Staff, patients and carers had the opportunity to give feedback on the service to managers, influencing its future direction.

The service had a positive approach to quality improvement, and we saw a number of improvement projects that had taken place. For example, the service created a clinician directory. This was a database which held information on clinicians, such as gender, languages spoken and specialist services offered. This enabled operations staff to search and direct patients to the appropriate clinicians for assessment and review.

Innovations were taking place in the service. For example, clinicians created videos for the service’s website on a range of topics, such as information about the patient journey and more specific information on different diagnosis.