The Care Quality Commission
  • Doctor
  • Independent doctor

Halcyon Doctors Limited

Overall: Good read more about inspection ratings

Unit 1, Cam Centre, Wilbury Way, Hitchin, SG4 0TW

Provided and run by:
Halcyon Doctors Limited

Important: This service was previously registered at a different address - see old profile

All Inspections

11 March 2022

During a routine inspection

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 Halcyon Doctors Limited on 11 March 2022 as part of our inspection programme.

Halcyon Doctors Limited 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.

The operations manager 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.

Halcyon Doctors Limited provides medico-legal services which are not within the scope of registration, therefore we did not inspect or report on this.

We reviewed the provider’s feedback log that contained several comments from 2019 to 2021. We also reviewed three separate feedback letters and spoke with three family members or carers. Comments and feedback were mostly positive and described the service as being professional, efficient and compassionate. Family members told us that clinicians were supportive and provided them with enough information to make an informed choice.

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.
  • The service employed staff that had the right skills, knowledge and experience to carry out their roles effectively. Contracted clinical staff were required to show proof that they had undertaken an annual appraisal externally to Halcyon Doctors Limited.
  • Staff treated patients with compassion and respect and helped them to be involved in decisions about their care and treatment. Families and carers told us that their clinician supported them to understand a diagnosis and treatment options available to them.
  • 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, prior to our inspection the service had already identified gaps in care through the quarterly clinical record audits. Plans were put in place to address the issues.

However,

  • Permanent staff were not appraised on a regular basis. We identified four out of six members of staff who had not received an annual appraisal. At the time of our inspection, the provider was organising the appraisals for April and May 2022. The provider recognised that this was an area for improvement. The lack of annual appraisals meant that staff performance was not formally evaluated and therefore did not provide individual staff members with an opportunity to reflect and develop.
  • The provider needed to strengthen the governance systems in place to ensure that service leads were aware of which doctors have been issued with blank prescription pads so that their usage can be monitored. The lack of monitoring increased the risk of prescriptions being mishandled or abused. The provider told us that whilst the service waits to transfer from paper prescriptions to an electronic system, the service will request doctors to log their prescribing and share the record with service leads.

The areas where the provider should make improvements are:

  • The provider should ensure that service leads have oversight of which doctors have been issued with prescription pads so that their usage can be monitored.
  • The provider should ensure that staff receive an annual appraisal.

Jemima Burnage

Interim Deputy Chief Inspector Hospitals (Mental Health)

22nd & 23rd March 2017

During a routine inspection

We do not currently rate independent health community based mental health services for older adults.

We found the following areas of good practice:

  • Patients and carers gave positive feedback about the service. They said that it was supportive of their needs. When giving feedback, eighty one percent of clients or their families who had completed a feedback survey rated the service as either nine or ten out of ten. Professionals fed back that both they and their clients were pleased with the service that had been received.

  • The service was person centred. Staff provided appointments at the patient’s home or in a convenient location. Staff wrote assessment letters following initial patient appointments. These were detailed and holistic. The service gave a personal approach to patients, which addressed their individual needs. Staff we spoke with felt that the service was developing and provided a good level of care.

  • The service had set target times for patients to be seen following an initial referral. These were target of 24 hours for an urgent referral and seven days for a non-urgent referral. Following an assessment the service had a target time of seven days for staff to send the assessment letter to the referrer. The service was meeting these targets.

  • The service regularly audited the patient files to ensure that the assessment letter contained a risk assessment, mental capacity assessment and a physical health care assessment. Learning from these audits was fed back to all staff via email and through the weekly multidisciplinary meetings by the medical director.

  • The service had been through significant changes throughout the last year. Despite these changes the morale of both the permanent staff and contracted staff was positive.

However:

  • Whilst the provider had appropriate systems in place to monitor whether sessional staff had completed the necessary appraisals and training, for a couple of staff these documents were not in their staff record.
  • The service had not ensured that all non-clinical staff who had contact with patients and carers had access to regular formal supervision.