We carried out this short notice announced, focused inspection in line with our inspection methodology. As this was a focussed inspection, we have not rated the service.
At our last inspection visit in 2016 we rated the Portman clinic overall as good and requires improvement in safe. This inspection included a follow up on our last inspection to see if improvements had been made.
During this inspection we looked at three key lines of enquiry. We looked at safe, responsive, and well led.
The Tavistock and Portman NHS Foundation Trust provides specialist psychological therapy services. The Portman clinic provides outpatient assessment and treatment to both adults and children. The Portman clinic provides assessment and treatment for patients primarily presenting with difficulties relating to violence and sexual compulsions. Using psychoanalytically informed psychotherapeutic help to provide services for people who may be excluded from other services due to their past or present behaviours.
The clinic offers individual therapy, group therapy and occasionally couples therapy. They also offer a mentalisation-based treatment programme for men with a diagnosis of antisocial personality disorder which comprises of group and individual sessions.
The staff are trained as psychoanalysts, psychoanalytic / psychodynamic psychotherapists, child and / or adolescent psychotherapists with backgrounds in nursing, psychiatry, psychology, probation and social work.
Five months before our inspection, the trust had experienced a malware attack effecting the trust’s electronic patient record system. We took this into account during our inspection and assessed how the service had managed this. This issue had affected several NHS and independent health providers.
We did not rate this service at this inspection. The previous rating of good remains. We found:
- The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. The service managed infection risk well. Staff assessed risks to patients and acted on them. The service managed safety incidents well and learned lessons from them.
- Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their care and treatment. They provided emotional support to patients, families, and carers.
- The service took account of patients’ individual needs and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.
- Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. At a service level, staff felt respected, supported, and valued. They were focused on the needs of patients receiving care. Staff were clear about their roles and accountabilities.
- Although there were overall improvements since our last inspection, adult case records sometimes lacked consistency in case recording and completion of risk documentation.
- Staff survey results indicated there was significant work needed to address staff morale and wellbeing as scores were lower than the trust average in several key areas.
How we carried out the inspection
Before the inspection visit, we reviewed information that we held about the location.
As part of the inspection, the inspection team:
- Visited the clinic and looked at the quality of the environment
- Spoke with 7 people who were using the service
- Spoke with 16 staff including the service manager, clinical lead, administration, and therapy staff
- Looked at 25 care and treatment records
- Looked at a range of policies, procedures and other documents relating to the service.
You can find further information about how we carry out our inspections on our website: https://www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.
What people who use the service say
We spoke with patients during our inspection and the feedback was overwhelmingly positive. Patients said that the treatment had changed their lives for the better and helped them understand themselves better.
Patients told us all the staff treated them with kindness, compassion, and respect. They told us the treatment had enabled them to feel safe whilst exploring the issues that had impacted their lives in some cases for decades.
Patients told us staff were always available by phone if they needed them and that they asked about their physical as well as mental health. For example, some patients told us accessing support at the Portman for the psychological wellbeing had given them the confidence to access services for their physical health.
Patients said they felt supported and safe.