The Care Quality Commission
  • Mental Health
  • Independent mental health service

Archived: Psychiatry-UK LLP

Overall: Good read more about inspection ratings

Lowin House, Truro, Cornwall, TR1 2NA 0330 323 0183

Provided and run by:
Psychiatry-UK LLP

Important: This service is now registered at a different address - see new profile

All Inspections

09 January 2020

During a routine inspection

We rated Psychiatry UK as good because:

  • Patients were respected and valued as individuals and empowered as partners in their care, practically and emotionally, by a distinctive service. Staff worked in partnership with patients and carers to provide the best treatment for them and acted on feedback from them and their carers to adjust their support. The provider created patient forums through which patients could feedback about their care and have access to peer support. We saw examples of how the service had responded to match the requirements of the patient group.
  • Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment and in collaboration with families and carers. They provided a range of treatments that were informed by best-practice guidance and suitable to the needs of the patients. Patients told us that by having a consultation and a diagnosis with this provider, they could resume a fulfilling life due to having the correct medication prescribed. Feedback from commissioners and other services was consistently positive about the way the provider worked together with them to achieve the best outcomes for patients. Staff engaged in clinical audit to evaluate the quality of care they provided. The teams included or had access to the full range of specialists required to meet the needs of the patients. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and with relevant services outside the organisation. Staff understood and discharged their roles and responsibilities under the Mental Health Act 1983 and the Mental Capacity Act 2005.
  • The service provided safe care. The number of patients on the caseload of the teams, and of individual members of staff, was not too high and staff could give each patient the time they needed. Staff managed appointments well to ensure that patients who required urgent care were seen promptly. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
  • The service was easy to access. Patients could choose a preferred psychiatrist by viewing their profile on the provider’s website and could choose a preferred appointment time by viewing their calendar. Staff assessed and treated patients who required urgent care promptly and those who did not require urgent care did not wait too long to start treatment. Patients who had been waiting years for an appointment with other services received an appointment within a week with this provider. The criteria for referral to the service did not exclude patients who would have benefitted from care. The provider saw all patients initially before deciding if they could provide appropriate treatment.
  • The service was well led and the governance processes ensured that procedures relating to the work of the service ran smoothly. The provider reacted quickly when they recognised that systems were not running as effectively as they could be. For example, they had recently appointed a chief technology officer to support improvements with their information technology systems. The provider engaged remote workers effectively and actively sought feedback to improve their service provision.

25 April 2018

During a routine inspection

We rated Psychiatry-UK as requires improvement because:

  • There was insufficient oversight and understanding of safeguarding procedures. Safeguarding policies and procedures lacked information to enable staff to make referrals to the local authority without delay. Staff did not all know how to make safeguarding referrals. Staff had not completed an appropriate level of training in safeguarding.
  • Staff did not verify the identity of the person they were consulting with before starting the appointment and this meant there was a risk staff could prescribe medicines, record and share information about the wrong patient.
  • Staff did not routinely record patients’ consent to treatment or whether or not they had needed to assess the patient’s capacity to consent to their treatment. The provider did not ensure all staff were trained in the Mental Capacity Act.
  • Psychiatrists did not always record patients’ current or historical risks in patients records or in letters to GPs. Staff did not always develop and document crisis plans with patients.
  • There were limited opportunities for staff to discuss their work, service development and learning from incidents and complaints.
  • There were limited ways to monitor psychiatrists’ work, answer questions and provide support as the provider did not offer formal induction, supervision or team meetings to staff. Some staff did not have appraisals that were specific to their work with Psychiatry-UK. There was a lack of oversight and monitoring of the quality of consultations and the provider had not developed systems and processes to enable them to performance manage staff.
  • Although the provider took steps to store care records securely, information such as letters to GPs needed to be stored locally in order for psychiatrists to edit them and this presented a risk to the security of patient information.

However

  • The provider was well staffed and there were no waiting times. Patients could choose which psychiatrist they consulted with and appointments were available at a range of times. Patients said the service was easy to access.
  • Patients gave good feedback and said staff were kind and respectful. Patients said they were involved in decision making about their care. Patients could include their families in their care if they wanted to and carers said they felt supported and involved.
  • Psychiatrists completed a comprehensive assessment during the first appointment with each patient. They used nationally recognised scales to help them make accurate diagnoses. Assessments were personalised, holistic and recovery-oriented.
  • Staff made shared care arrangements with GPs to ensure physical health monitoring was in place.
  • The provider was keen to develop the service and they took part in the development of new approaches. There were opportunities for specialist psychiatrists to develop the service they offered.