We do not currently rate independent standalone doctor services.

We found the following areas of good practice:

• Patients received a range of treatments which were not available in other settings, including repetitive transcranial magnetic stimulation and external trigeminal nerve stimulation for anxiety and depression, and eye movement desensitisation and reprocessing for trauma. Patients spoke highly of the impact of these treatments following unsuccessful previous treatments with medicines.

• Patients physical health was monitored, including screening for heart disease due to known links between cardiac disease and depression.

• Staff carried out audits of the efficacy of their treatments, and these were subject to external scrutiny contributing to innovation in mental health treatments within the UK. There were regular clinical governance meetings to discuss management andclinical issues and update staff. Clinicians attended peer review supervision sessions and all staff were appraised each year.

• The centre was clean and well maintained, and infection control audits were undertaken. There was an incident and accident reporting system in place, and a lone working policy for staff.

• Staff had a good understanding of the individual needs of patients and we saw that they made a great effort to reflect their needs and wishes in how they delivered care. The service carried out a survey of patients’ experiences, with overwhelmingly positive feedback. There was a clear system in place for patients to make a complaint, and these were investigated appropriately.

• The centre had no waiting lists for patients, and was open throughout the year, including bank holidays, and Saturdays and some evenings for appointments. Staff spoke a wide range of languages, which patients might speak as a first language.

However, we found the following issues that the service provider needs to improve:

• There were some gaps in safety systems at the centre. Not all staff had up to date mandatory first aid and safeguarding training, and we found insufficiently safe systems for recruitment of staff. First aid provisions were not monitored to ensure that they were complete and within expiry dates, and there was no blood spillage kit available at the time of the inspection. Emergency medicines were not stored safely. The provider took action to address these issues immediately after the inspection visit.

• Although clinicians were assessing risks, these were not documented in explicit risk assessment or crisis plans when relevant, to ensure patients’ safety. Patients’ treatment records were difficult to navigate, which might mean that important information could be missed. There were no audits of the quality of patient records.

• Psychotherapists did not have up to date training relating to the Mental Capacity Act (2005). Nurses received supervision through their employing agency. However, they did not receive formal management or clinical supervision at the centre.

We spoke to one person who used the service and we also looked at recently completed feedback questionnaires and letters of thanks. People were positive about the staff and described them as “extremely efficient and caring” and “having real expertise.”

People received care that ensured their safety and welfare from staff that were supported to deliver care to the appropriate standard. People were assessed by a psychiatrist to determine their treatment options. Both the assessment and treatments provided were based on recommended guidelines and evidence based research.

Clinical staff kept up to date with their continuing professional development. They were appraised annually by people independent of the Centre and were responsible for arranging their own clinical supervision.

People were given sufficient information. This was sent to them before their first appointment and they received written follow up after consultations.

The provider had arrangements for monitoring the quality of service provided to people.