We do not currently rate independent health community based mental health services for older adults.

We found the following areas of good practice:

• Patients and carers gave positive feedback about the service. They said that it was supportive of their needs. When giving feedback, eighty one percent of clients or their families who had completed a feedback survey rated the service as either nine or ten out of ten. Professionals fed back that both they and their clients were pleased with the service that had been received.

• The service was person centred. Staff provided appointments at the patient’s home or in a convenient location. Staff wrote assessment letters following initial patient appointments. These were detailed and holistic. The service gave a personal approach to patients, which addressed their individual needs. Staff we spoke with felt that the service was developing and provided a good level of care.

• The service had set target times for patients to be seen following an initial referral. These were target of 24 hours for an urgent referral and seven days for a non-urgent referral. Following an assessment the service had a target time of seven days for staff to send the assessment letter to the referrer. The service was meeting these targets.

• The service regularly audited the patient files to ensure that the assessment letter contained a risk assessment, mental capacity assessment and a physical health care assessment. Learning from these audits was fed back to all staff via email and through the weekly multidisciplinary meetings by the medical director.

• The service had been through significant changes throughout the last year. Despite these changes the morale of both the permanent staff and contracted staff was positive.

However:

• Whilst the provider had appropriate systems in place to monitor whether sessional staff had completed the necessary appraisals and training, for a couple of staff these documents were not in their staff record.

• The service had not ensured that all non-clinical staff who had contact with patients and carers had access to regular formal supervision.