- SERVICE PROVIDER
Alder Hey Children's NHS Foundation Trust
This is an organisation that runs the health and social care services we inspect
Assessment report published 6 August 2025
Contents
Ratings - Specialist community mental health services for children and young people
Our view of the service
This inspection took place on the 25 to 27 March 2025.
The inspection covered specialist community mental health services, ASD ADHD Services for children and young people.
We inspected the service following a major incident. Although we did not have specific information of concern regarding the specialist community mental health services for children and young people we visited the service to ensure they were operating safely and to enable the Trust to provide assurance about the quality of care being provided
Alder Hey Children’s NHS Foundation Trust provides specialist community mental health services, ASD ADHD Services for children and young people up to the age of 18. The service covers the populations of both Liverpool and Sefton. The service provision included Children young people community mental health services, ADHD and ASD services, Mental Health Support Teams, Eating Disorder community team and a Crisis Care service. Services worked with each other but were primarily structured by locality to reflect previous commissioning arrangements. The Crisis Care service was based in Liverpool but provides a service across both Liverpool and Sefton.
The ADHD and ASD service provide assessment and diagnosis for Attention Deficit Hyperactivity Disorder and Autism. They commence treatment and prescribing for ADHD. During this inspection we visited the ADHD and ASD service in both Liverpool and Sefton localities. We also visited the ADHD and ASD post-diagnosis support team that was only commissioned in the Sefton area. The service supported children or young people and their parents and family to understand the diagnosis and the needs of the child or young person and helped develop personalised strategies areas such as behaviour management.
Child and Adolescent Mental Health Teams provide support and treatment for children and young people experiencing emotional, behavioural or mental health difficulties. They offer a range of services including assessment, therapy, prescribing and support for families. They work with individuals up to the age of 18. During this inspection we visited the CAMHS service in both Liverpool and Sefton.
ADHD and ASD teams provide assessment and diagnosis for Attention Deficit Hyperactivity Disorder and Autism. They commence treatment and prescribing for ADHD. During this inspection we visited the ADHD and ASD services in both Liverpool and Sefton. We also visited the ADHD and ASD post-diagnosis support team that was only commissioned in the Sefton area. The service supported children or young people and their parents and family to understand the diagnosis and the needs of the child or young person and helped develop personalised strategies areas such as behaviour management.
Mental Health Support Teams (MHST) are part of a national programme to reduce inequalities and increase access to mental health support for children and young people. They work with schools to engage with children and young people. They provide low level psychosocial interventions to people with low to moderate needs and offer a pathway into CAMHS services for those who require it. MHSTs do not provide a regulated activity under the Health and Social Care Act 2012. However, we visited the teams in both the Liverpool and Sefton localities to understand how services engaged with local schools.
We did not visit the community Eating Disorder service as part of this inspection.
At our last inspection of this service, in 2020, we rated the service as good and did not identify any regulatory breaches. At this inspection we rated the service as outstanding. We did not identify any regulatory breaches.
Mental Health Act and Mental Capacity Act Compliance
Mental Health Act
The Trust had a Service Level Agreement in place with a local mental health trust to provide Mental Health Act and Mental Capacity Act management services.
Staff were trained in and had a good understanding of the Mental Health Act, the Code of Practice and the guiding principles. Staff completed training on the Mental Health Act as part of their mandatory training programme. At the time of our inspection compliance with the training was 98%.
The provider had relevant policies and procedures that reflected the most recent guidance. Staff had easy access to local and specialist Mental Health Act policies and procedures, these included a policy covering the legal aspects of assessment and treatment of children and young people with a mental health disorder. Staff had access to the Mental Health Act Code of Practice.
Staff had access to administrative support and legal advice on implementation of the Mental Health Act and its Code of Practice. Staff knew how to contact Mental Health Act administrators. Managers made sure that the service applied the Mental Health Act correctly by completing audits and discussing the findings. The Community and Mental Health Division produced an annual use of the Mental Health Act report for the Trust board.
Mental Capacity Act
The Trust had a Service Level Agreement in place with a local mental health trust to provide Mental Health Act and Mental Capacity Act management services.
Staff had a good understanding of the Mental Capacity Act, in particular the five statutory principles. Staff completed training on the Mental Capacity Act, including the use of Gillick competence as part of the mandatory Safeguarding Level 1 training. Compliance with the training was 96%.
The provider had a policy on the Mental Capacity Act. Staff were aware of the policy and had access to it. Staff knew where to get advice from regarding the Mental Capacity Act and Gillick competency.
Staff recorded capacity to consent. Consent and capacity were captured on the electronic records system. However, it was not always reflected on the electronic records system as to how capacity had been assessed. Staff took all practical steps to enable children and young people to make their own decisions. Staff understood how to follow best interest policies and ensure that decisions recognised the importance of the person’s wishes, feelings, culture and history.
Managers made sure that the service applied the Mental Health Act correctly by completing audits and discussing the findings.
People's experience of this service
We spoke with 3 children or young people during our inspection and held a focus group with 8 members of the Camhelions service user group. The Camhelions was a participation and service user forum for children and young people who were using or had used CAMHS services.
Feedback from children and young people was positive. They considered staff to be kind, caring and empathetic. They felt that staff treated them as individuals and were invested in their care and wellbeing. Children and young people were positive about their involvement in their care and treatment and felt empowered to give their opinions and views.
Our observations during our inspection supported this. We saw that staff had a positive, caring attitude towards people using the services. During appointments, staff involved children and young people, listened carefully to what they said and acted in a respectful, inclusive and compassionate manner.
Children and young people were actively involved in decision making within the service. They told us they were consulted on changes to the service and were involved in quality improvement projects.
In addition to speaking to children and young people we also spoke with 12 parents or carers of children and young people using the service. Parents and carers we spoke with were also positive about the service, staff and the care and treatment their child was receiving. They felt that staff involved them in decisions about the child’s care and took the time to answer any queries or questions that they had.