The Child and Family Practice

Updated 22 December 2023

The Child and Family Practice is a community-based independent health service that specialises in the psychological wellbeing and mental health of children, young people and adults. The service accepts self-referrals from individuals across the country and internationally. The service

conducts mental health assessments and provides treatment. Most of the patients are children and adolescents, but some adults of working age are accepted.

The service directly employs the lead consultant psychiatrist who is also the registered manager, one practice manager and two part time receptionists.

There are around 30 other clinicians, known as faculty members, who hire rooms to see patients at The Child and Family Practice. This includes psychiatrists, paediatricians, psychologists and psychotherapists. These professionals are responsible for their own clinical practice. The Child and Family Practice provides their accommodation and administrative support for when they access the service.

The organisation is a limited company with a board of directors and 13 shareholders. The registered manager is the chair of the board.

The inspection of The Child and Family Practice focused on the clinical treatment delivered by the lead consultant psychiatrist and the associated administrative support. The inspection did not look at the treatment delivered by the other clinicians as they were either separately registered or had practising privileges with another registered provider.

The service is registered with CQC to undertake the following regulated activities:

• Treatment of Disease, Disorder or Injury

How we inspected this 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.

During the inspection visit, the inspection team:

• Visited the service, checked the safety, maintenance and cleanliness of the premises.
• Spoke with the registered manager, the triage clinician, the practice manager and the receptionist.
• Reviewed six patient care and treatment records.
• Reviewed patient feedback.
• Reviewed three staff records.
• Looked at a range of policies, procedures and other documents relating to the running of the service.

Updated 22 December 2023

This service is rated as Good overall. (Previous inspection 01 2018 – Good)

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? – Requires improvement

We carried out an announced comprehensive inspection at The Child and Family Practice as part of our inspection programme.

The service provides outpatient mental health assessments and treatment for children and adults.

The consultant psychiatrist at the service is 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.

The inspection of The Child and Family Practice focused on the clinical treatment delivered by the consultant psychiatrist and the associated administrative support. The inspection did not look at the treatment delivered by the other clinicians who rented rooms at this location to see patients. They were either separately registered or had practising privileges with another registered provider.

Our key findings were:

• The service met the needs of the individual patients who were assessed and treated.

• Each patient had a comprehensive mental health assessment. The treatments provided were informed by best-practice guidance and suitable to the needs of the patients.

• The service considered the risks for individual patients and understood and acted appropriately to safeguarding concerns.

• Staff worked well together as a team and linked with relevant services outside the organisation such as the patients GP.

• Staff had access to mandatory training and supervision.

• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. The service actively involved patients and their families in care decisions.

• The service was easy to access. Every referral received a telephone response, discussing whether the service could meet their needs or not. The service actively sought patient feedback on care.

• The service promoted a positive, patient centred culture. Leaders were competent, accessible and supportive.

However:

• Staff employment records did not include all the required information.

CQC inspected the service in January 2018 and asked the provider to make improvements regarding access to patient records belonging to other faculty members. This was not identified as a concern at this inspection because faculty members operated as independent healthcare professionals. This means that there is no requirement for them to access each other’s treatment records for the purpose of shared governance processes.

The areas where the provider must make improvements as they are in breach of regulations are:

• The service must ensure governance arrangements identify when areas for improvement are needed. This included ensuring staff pre-employment checks were completed and documented.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

• The service should ensure consent to treatment is formally recorded for all patients in the patient record.
• All staff should receive an annual appraisal.
• The service should ensure policies and procedures are dated and version controlled.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

Updated 23 April 2018