Cognacity

Updated 20 September 2021

The service is provided by Cognacity Wellbeing LLP. It provides specialised mental health assessment, treatment, and psychotherapy on an out-patient basis for adults and children over the age of 13. The provider contracts with 17 consultant psychiatrists (one of whom is a child and adolescent consultant psychiatrist), 18 psychologists, three psychotherapists, a dietician, and a registered mental health nurse. The service is led by four partners, three of whom are consultant psychiatrists within the service. One of the partners is also the service director. The service also has a clinical governance lead and quality assurance lead, a practice manager and five administrative staff. The service is open 8am to 8pm Monday to Friday, and 9:30am to 1:30pm on Saturday, and sees patients face to face and remotely via online appointements and sessions.

Referrals are received from several sources including GPs, other consultant psychiatrists and psychologists, and patients can self-refer. Patients are responsible for funding their treatment either directly or through health insurance.

The provider operates another service, Cognacity at Leon House Health and Wellbeing, which is based in Manchester. That service was not visited as part of this inspection.

How we inspected this service

We used CQC’s interim methodology for monitoring services during the COVID-19 pandemic including on site and remote interactions.

During the inspection visit to the service, the inspection team:

• checked the safety, maintenance and cleanliness of the premises
• spoke with seven patients who were using the service
• reviewed 17 feedback forms and emails from patients who were using the service
• spoke with the registered manager, the service director, the clinical governance lead, the quality assurance lead, two consultant psychiatrists and a clinical psychologist
• reviewed 13 patient care and treatment records
• checked how prescription pads were managed and stored
• reviewed three staff records
• reviewed information and documents relating to the operation and management of the service.

You can find further information about how we carry out our inspections on our website: www.cqc.org.uk/what-we-do/how-we-do-our-job/what-we-do-inspection.

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 20 September 2021

This service is rated as Good overall.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an unannounced comprehensive inspection at Cognacity on the 22 June 2021 as part of our inspection programme. This was the first inspection of this service.

Cognacity provides a consultant led outpatient service to assess and treat adults and children aged 13 and above with mental health needs. This includes private consultations, physical examinations, health assessments and prescribing of medicines for mental health needs.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. Cognacity provides a range of organisational consulting services, for example executive coaching and athlete performance coaching which are not within CQC scope of registration. Therefore, we did not inspect or report on these services.

The practice manager at the service is also the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We received 13 feedback forms and four emails from patients and spoke to seven patients. All of the comments were positive, describing caring, kind and professional staff. Patients said they had effective treatment in an efficient, professional and non-judgemental service.

Our key findings were:

• The service provided safe care. The service had clear systems to keep people safe and safeguarded from abuse. Staff appropriately assessed and managed risks to patient safety. However, patients’ records were not always updated with their latest risk information and the service had not conducted a recent controlled drugs prescription audit. The service was aware of these issues and action plans were in place to make improvements.
• Staff developed holistic care and treatment plans informed by a comprehensive assessments in collaboration with patients. They provided a range of treatments that were informed by best practice guidance and suitable to the needs of the patients.
• Staff had the skills, knowledge and experience to carry out their roles. Leaders ensured that staff received training and appraisals. Staff worked well together as a multidisciplinary team. However, the service did not always update their training records and did not always update patient information sharing consent records. The service’s training and patient information sharing consent records were fully updated when highlighted to the practice manager.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients in all care decisions.
• The service was easy to access. Patients were able to access care and treatment from the service within an appropriate timescale for their needs. The service took complaints and concerns seriously and responded to them appropriately to improve the quality of care.
• The service was well led and the governance processes ensured that that procedures relating to the work of the service ran smoothly.

The areas where the provider should make improvements are:

• The provider should ensure that staff update patients’ care and treatment records with risk information so that risk information is always fully accessible to all clinicians (Regulation 12).
• The provider should ensure that effective and timely clinical audit processes are in place to consider the quality of care provided and prescribing practice in relation to current best practice guidance (Regulation 12).
• The provider should consider arrangements for recording staff training to ensure staff have the appropriate training to deliver services safely.
• The provider should consider arrangements for recording patient information consent records to ensure the service worked well with other organisations to deliver effective care and treatment.

Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care

Or (delete as appropriate)

Name of signatory

Deputy Chief Inspector of Hospitals (area of responsibility)