Nurify Medical Also known as London TMS Centre

Updated 16 September 2022

• The service is provided by Dyad Medical Limited. Dyad Medical Limited is registered at the following address, which is the location where our inspection was carried out:

100 Harley Street, London W1G 7JA

• Service website - www.dyad-medical.com
• Dyad Medical Limited is registered to provide the following regulated activity:

Treatment of disease, disorder or injury.

• Dyad Medical Limited is a consultant-led outpatient service providing clinical psychiatric assessment, treatment and diagnosis for adults who are experiencing mental illness, cognitive impairments and other long-term conditions in the community. Patients may be referred via their GP or consultant or self refer. The service has been registered with CQC since 11 February 2021.
• In addition to the above location, the provider also delivers regulated activities at:

10 Harley Street, London W1G 9PF (we did not visit this location as part of the inspection).

• This was the first CQC inspection of this service.
• The service includes five consultants with experience in psychiatry, neurology and pain management; a clinical pharmacist and five registered nurses. The medical director leads the service with support from the service manager, and administrative staff. Clinic hours are between 9am and 5pm, Monday to Friday. However, appointments can be scheduled outside of core working hours as well as at weekends. Clinicians assessed patients in person at the service, as well as by video calling.
• Amongst services provided are a private clinic, Transcranial Magnetic Stimulation (TMS) Centre and Esketamine Clinic to treat treatment resistant depression, and an Alzheimer’s Clinic providing Transcranial Pulse Stimulation (TPS).

Updated 16 September 2022

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 a short-notice announced comprehensive inspection at Dyad Medical on 22 July as part of our inspection programme.

Dyad Medical provides a consultant led outpatient service to assess, treat and diagnose adults aged 18 and above who are experiencing mental illness, cognitive impairments and other long-term conditions. Amongst services provided are a private clinic, Transcranial Magnetic Stimulation (TMS) Centre and Esketamine Clinic to treat treatment resistant depression, and an Alzheimer’s Clinic providing Transcranial Pulse Stimulation (TPS).

The medical director 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.

This was the first inspection of this service.

Our key findings were:

• The service provided safe care and treatment. The provider had appropriate systems and processes in place to keep people safe and safeguard them from abuse.
• Clinicians carried out comprehensive assessments and developed treatment plans in partnership with patients. They recommended or prescribed a range of treatments that were informed by best practice guidelines and met the needs of the patients.
• There were rigorous governance systems in place to monitor the use of prescription pads by all doctors and non-medical prescribers within the service.
• The service employed staff that had the right skills, knowledge and experience to carry out their roles effectively and provided them with appropriate training, supervision and appraisals.
• Staff treated patients with compassion and respect and helped them to make informed decisions about their care and treatment. Patients told us that their clinician supported them to understand the diagnosis and treatment options available to them.
• The service provided a range of treatments which were not easily available to patients on the NHS or elsewhere. The medical director ensured that the service had a focus on continuous learning and improvement.
• The service used a wide range of outcome measures to evaluate the effectiveness of treatments for patients at the service.
• Patients could easily access the service. Staff ensured that care and treatment from the service was delivered within an appropriate timescale for their needs.
• The service responded promptly to feedback and was keen to make improvements when required.
• The service had effective governance systems in place that monitored the quality and safety of the service and highlighted when an improvement was required. For example, improvements had been made to the quality of patient records kept.

However:

• Staff had not completed an infection control audit to ensure that there were appropriate infection control measures within the service.
• Doctors did not always record the justification for prescribing medicines to patients who were unable to, or chose not to have information shared with their general practitioner.
• Staff were not recording the room temperature at which medicines were stored, to ensure they were stored in line with the manufacturer’s guidelines.

Jemima Burnage

Interim Director of Mental Health

Updated 16 September 2022