Archived: ADHD 360 - admin centre

Updated 22 January 2021

ADHD360 admin centre was registered with the CQC in April 2019. It is an independent clinic which diagnoses and treats children and adults with ADHD.

How we inspected this service

This was an unannounced comprehensive inspection looking at key lines of enquiry in the safe, effective, caring, responsive and well led domains.

Before the inspection visit, we reviewed information that we held about the location. During the inspection visit, which was compliant with all Covid 19 government and Care Quality Commission guidelines, the team:

• visited the admin hub where we spoke to staff and reviewed care records.
• spoke with four patients and four carers of patients over the telephone.
• spoke with three other members of staff over the telephone: including a doctor and two nurses.
• spoke with the registered manager.
• looked at nine care and treatment records.
• looked at a range of policies, procedures and other documents r of patients.s elating to the running of the service.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 22 January 2021

This service is rated as Requires improvement overall. Choose a rating

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

ADHD360 admin centre is an independent diagnostic and treatment service for children and adults with attention deficit attention disorder. Clinics are held in various locations across England.

Why we did this inspection

ADHD360 admin centre was registered with the CQC in April 2019. The service has never been inspected and therefore does not have a rating. We received intelligence from several sources which raised concerns about the running and prescribing practices at ADHD360.

What we found

Managers did not have a specific incident reporting system. We found examples of incidents that had not been reported. Although clinical staff recognised incidents and reported them to the registered manager by e mail.

Managers did not have records of staff compliance with mandatory training. Staff reported they were up to date with mandatory training. Managers did not have a specific emergency planning policy or procedure in place.

Managers did not manage complaints effectively. Whilst a complaints log was in place it did not provide a detailed description of the complaint, the investigating officer, how a resolution had been reached, how learning had been shared or how duty of candour requirements had been met.

However:

Staff assessed the mental health needs of all patients. They worked with patients and families and carers to develop individual care plans and updated them when needed. Care plans reflected the assessed needs, were personalised holistic and recovery oriented.

Staff treated patients with compassion and kindness. They understood the individual needs of patients and supported patients to understand and manage their care and treatment.

The service was easy to access and used technology to ensure patients were seen in a timely manner. Its referral criteria did not exclude patients who would have benefitted from care. Staff assessed and treated patients promptly. Staff followed up patients who missed appointments.

What people told us

Patients told us they were very well informed about the possible side effects of their medication and that staff were very kind and helpful. Two patients told us that they were unhappy that they had been assured there would be a shared care arrangement in place, however this was not the case. One patient said that staff had been rude to them.

Carers told us the service was very responsive and called them back very quickly if they had a problem and that the service was a “lifeline”.

Staff told us they were very proud and loved their job, they were particularly impressed with the amount of development and training opportunities.

Our key findings were:

We rated ADHD360 admin centre as requires improvement because:

Managers did not have a specific incident reporting system. We found examples of incidents that had not been reported, although clinical staff recognised incidents and reported them to the registered manager by e mail.

During the inspection, managers did not have records of staff’s compliance with mandatory training. Managers told us that the online system used for staff records had crashed and the data was not available, and they did not hold local records.

Managers did not have a specific emergency planning policy or procedure in place.

Managers did not manage complaints effectively. Whilst a complaints log was in place it did not provide a detailed description of the complaint, the investigating officer, how a resolution had been reached, how learning had been shared or how duty of candour requirements had been met.

However:

Staff assessed the mental health needs of all patients. They worked with patients and families and carers to develop individual care plans and updated them when needed. Care plans reflected the assessed needs, were personalised holistic and recovery oriented.

Staff treated patients with compassion and kindness. They understood the individual needs of patients and supported patients to understand and manage their care and treatment.

The service was easy to access and used technology to ensure patients were seen in a timely manner. Its referral criteria did not exclude patients who would have benefitted from care. Staff assessed and treated patients promptly. Staff followed up patients who missed appointments.

Action the provider MUST take is necessary to comply with its legal obligations

• The provider must ensure they are in receipt of accurate physical health measurement prior to prescribing medication. The provider must ensure ligature assessments are undertaken in locations where patients are seen. Reg 12 – (2) (f) Physical Health Monitoring. (2) (a) (b) Assessing and mitigating risks to the health and safety of people using the services.

• The provider must ensure there are robust governance systems in place including, complaints procedure and oversight,duty of candour requirements, incident reporting, recording of clinical supervision, actions from audits and data breaches. Reg 17 (1) (2) (a) (b)(c)(e)(f)– Governance

The provider should take action to avoid breaching a regulation in future

• The provider should consider how they have up to date records of mandatory training compliance.
• The provider should consider clinicians recording their rationale for deviating from national prescribing guidance in care records.
• The provider should consider if and how the parents of children referred to the service have a mental health assessment as per national guidance.

Dr Kevin Cleary
Deputy Chief Inspector, Hospitals Director, mental health lead