Chiltern Business Centre

Updated 30 May 2023

The service is provided by Chiltern Mind Limited. The service is run by an individual psychiatrist who provides outpatient psychiatric care which includes occasional prescribing of medicines. They also provide Intensive Short-Term Dynamic Psychotherapy.

The service is based at unit 23, Chiltern Business Centre, 63-65 Woodside Road, Amersham, HP6 6AA. This is a large building with many different businesses located within it. The office is located on the first floor and there is no lift available, so any patients with mobility issues would be seen at a GP surgery instead. We only visited the main business location during this inspection.

The service has been registered with CQC to provide treatment of disease, disorder or injury since 27 August 2020. The service only treats adults over the age of 18.

Referrals are received directly from patients or other healthcare professionals.

How we inspected this service

• During the inspection visit, the team:
• Checked the safety, maintenance and cleanliness of the premises
• Spoke with 8 patients who were currently using the service
• Interviewed the sole staff member
• Reviewed 9 care records, including 6 for current patients and 3 for recently discharged patients
• Reviewed medicines processes and prescription pad storage and management
• Spoke with 3 external professionals who work closely with the service
• Reviewed information and documents relating to the 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 30 May 2023

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 announced comprehensive inspection of Chiltern Business Centre on 19 April 2023 as part of our routine inspection programme. This was our first inspection of the service.

Chiltern Business Centre is run by an individual psychiatrist who provides outpatient psychiatric care. They also provide Intensive Short-Term Dynamic Psychotherapy (ISTDP) to patients. ISTDP uses a set of interventions to alleviate symptoms of emotional distress and to promote mental health in a rapid way. The focus is on the unconscious emotional processes that underlie many psychological as well as somatic difficulties. No other staff work for the service. At the time of the inspection 25 patients were receiving care from the service.

The psychiatrist 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.

We spoke with 8 patients during the inspection. They all told us that the clinician treated them with dignity and respect at all times. They told us they felt safe and secure during their sessions and that they felt appropriately challenged.

Our key findings were:

• The service provided safe care. The premises where patients were seen were suitable and clean. The service had clear systems to keep people safe and safeguarded from abuse.
• The clinician developed holistic care and treatment plans informed by a comprehensive assessment in collaboration with patients. Care and treatment were planned and delivered in line with current legislation and best practice guidance produced by the National Institute for Health and Care Excellence (NICE) and met the needs of the patients. The service evaluated and reflected on the quality of care provided to ensure it was delivered to a high standard.
• The clinician treated patients with compassion and kindness, and understood the individual needs of patients.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs. The clinician had alternative pathways for people whose needs they could not meet.
• The service was well-led and had a clear goal in place for what it wanted to achieve. The clinician was experienced and passionate about the therapy offered.

However:

• The service had not ensured a legionella assessment had been carried out in the building patients were seen in.
• The service had not calibrated their blood pressure machine and weighing scales.
• Risk management processes were not always followed.
• There were no documented risk management plans in place for patients with previously identified risks.
• The service did not always document outcome measures for patients.

The areas where the provider should make improvements are:

• The service should ensure that all appropriate environmental checks have been conducted [Regulation 15 (1) (e) Premises and equipment].
• The service should ensure that physical health monitoring equipment is correctly calibrated [Regulation 15 (1) (e) Premises and equipment].
• The service should consider documenting risk management plans for patients with previously identified risks.
• The service should consider following their own risk management procedures.
• The service should consider more routine collection of outcome measures.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

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