Archived: Schoen Clinic Chelsea

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• 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

This means 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.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care. Leaders had the skills, knowledge and experience to perform their roles. Staff knew and understood the provider’s vision and values and how they applied to the work of their team. Staff said they felt respected, supported and valued. Governance processes operated effectively. Performance and risk were managed well. Teams had access to the information they needed to provide safe and effective care. Staff collected and analysed data about outcomes and performance. They used this to identify improvements.

We have not awarded this service a score for Well-led.

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

We scored the service as 3. The evidence showed a good standard. The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff felt respected, supported and valued. They told us the leadership was focused on providing safe, multi-disciplinary, high quality person-centred care which was evidence based.

Staff reported they felt positive about their jobs and that staff morale and communication between team members and the leadership team had improved.

Staff knew and understood the provider’s vision and values and how they were applied in the work of their team.

The provider’s senior leadership team had successfully communicated the provider’s vision and values to the frontline staff in the service.

Staff had the opportunity to contribute to discussions about the strategy for their service, especially where the service was changing. For example, staff were involved in planning for a new 28-day addictions programme and a new weight management service.

We scored the service as 3. The evidence showed a good standard. The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The leadership team prioritised safe, high‑quality, compassionate care. Staff told us they felt well supported and described morale as very good. Leaders were visible and approachable, and staff said teamwork was effective. The senior leadership team maintained an open‑door policy, being accessible, enabling staff to raise concerns openly and transparently. Staff were encouraged to share their views.

Leaders had the skills, knowledge and experience to perform their roles. They had a good understanding of the services they managed and could explain how the team was working hard to deliver high quality care. The registered manager and medical director had extensive experience of working in mental health settings. They could explain clearly how the teams were working to provide high quality care.

Leaders we spoke with demonstrated that they had the experience, capability and understanding to deliver the service’s vision, and manage risks. They were aware of the key challenges, priorities and risks and were open in sharing them. Leaders reported that they could access appropriate support and development in their role.

We scored the service as 3. The evidence showed a good standard. The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff told us the service had a culture where they were able to speak up without fear of retribution. They were able to raise concerns with the leadership team and knew the process to do this. The service had a whistleblowing policy and a Freedom to Speak up Guardian.

Managers and staff had access to patient, carer and staff feedback and used it to drive improvements. Recent reviews (49) gave the service an average rating of 4.9 out of 5, helping leaders to understand and enhance patient experience. Patients told us the service responded well to feedback. For example, reception music was changed from pop to calmer, more soothing options to improve the waiting experience.

We scored the service as 3. The evidence showed a good standard. The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff were able to apply to work flexibly. Flexible working agreements were considered, to account for personal circumstances such as caring responsibilities and health issues.

Managers put reasonable adjustments in place for staff members to help them carry out their role.

The provider carried out equality monitoring of staff within the service to ensure it was diverse in its make-up and representative of the patient group.

We scored the service as 3. The evidence showed a good standard. The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

There was a clear framework of what must be discussed at a service level in team meetings to ensure that essential information, such as learning from incidents and complaints, was shared and discussed. The service held monthly team meetings to ensure essential information was shared amongst the staff.

Staff had implemented recommendations from reviews of deaths, incidents, complaints and safeguarding alerts at the service level. For example, updating its standard operating procedure for shared care prescribing of ADHD medicines following a Prevention of Future Deaths report published by the coroner in response the death of a patient with another provider. This included ensuring pre-titration baseline assessments which included a full cardiovascular history.

Staff completed audits to provide assurance on the performance of the service. Staff acted on the results when needed.

Staff understood the arrangements for working with other teams, both within the provider and external, to meet the needs of the patients.

Governance and performance monitoring arrangements were in place to support the delivery of the service, identified risk and monitored the quality and safety of service provision. There were systems and procedures to ensure that the service was clean and safe. There were sufficient staff to meet the assessed needs of patients safely. Staff were trained, supervised and appraised appropriately.

The registered manager and senior leadership team were aware of areas where improvements could be made and were committed to improving care and treatment for patients. There was a site action plan in place which covered how improvements could be made to the operation of the service.

The service maintained a risk register containing 14 documented risks. The register was reviewed regularly as part of the monthly clinical governance meeting. The service also had plans for emergencies such as adverse weather.

The service collected reliable information and analysed it to understand performance and to enable staff to make decisions and improvements. The service had a dashboard that held key data about the service. This included key information such as incident reporting, staffing, complaints and training. The dashboard was being further developed so that they could track BMI for eating disorder patients, physical health observations for people with ADHD and Eating Disorder Examination Questionnaire (EDE -Q) scores.

Staff had access to the equipment and information technology needed to do their work. The information technology infrastructure, including the telephone system, worked well and helped to improve the quality of care. Staff were using artificial intelligence transcription tools at each consultation with the consent of the patient.

Information governance systems ensured patient confidentiality, with access to patient records restricted to authorised staff. The service operated within the Medical Practitioners Assurance Framework (MPAF), enabling proactive two‑way information sharing between private providers and NHS colleagues.

The manager had access to information to support them with their management role. This included information on the performance of the service, staffing and patient care.

We scored the service as 3. The evidence showed a good standard. The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborate for improvement.

The service manager and medical director engaged with external stakeholders such as commissioners. Plans had been agreed to offer ADHD assessments to NHS patients.

The service worked closely with other private providers and NHS crisis and emergency departments to ensure safe care.

We scored the service as 3. The evidence showed a good standard. The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

The service was committed to continuous learning, innovation and improvement in order to be more efficient and improve outcomes for patients. For example, one of the psychotherapists had been trained in Dialectical Behavioral Therapy skills to support patients with specific addiction needs.

Staff described a culture of learning and of opportunities to develop their knowledge and skills. The service had adopted and implemented the Patient Safety Incident Response Framework (PSIRF) to ensure the response to patient safety incidents was focused on compassionate involvement and learning.

Service leaders had a clear plan to grow the service so it could meet the rising demand from neurodivergent patients.