Check your clinic against the problems CQC inspectors raise most often at ADHD and autism clinics, and get a score and a list of what to fix. Each check shows how often the problem comes up and what inspectors wrote, from over 1,500 CQC reports.
A good score is not a Good rating. The check covers the problems inspectors raise most often at ADHD and autism clinics, not everything CQC looks at. Inspectors also speak to staff and patients and read records. The findings behind it: what CQC inspectors find at ADHD and autism clinics.
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0 of 23 checks in place, 23 still to check.
Your answer: Not answered
Do you assess and record each patient's risks (such as self-harm, suicide, safeguarding and driving) with a recognised tool, and update it when things change?
“In 5 of the 15 records reviewed, risks had either not been documented promptly following assessment, or evidence of risk management was recorded across email correspondence and informal case notes rather than within a clear, structured risk assessment.”
“In 4 of the 13 records risk levels were noted without any explanation of how these levels were determined.”
“The provider did not consistently use a recognised risk assessment tool in line with guidance.”
What good looked like
“The service operated a 24-hour crisis support line staffed by consultant psychiatrists on a rota basis.”
Your answer: Not answered
Do you keep an incident log, record every incident and near miss, investigate them, and share what you learned with the team?
“Learning from incidents was not always shared consistently across the service and not all staff were aware of learning arising from serious incidents.”
“Many were unaware of the formal procedures for reporting incidents and complaints, and some could not explain how learning from incidents was shared or led to service-wide changes.”
“However, there was no incident log in place to record such occurrences.”
What good looked like
“The service had a proactive and open safety culture, and staff consistently reported incidents using the provider’s electronic system.”
Your answer: Not answered
Are blank prescription forms locked away, with each serial number logged from delivery to use, and is access limited to named people?
“Prescriptions forms were not always stored in the same location and staff did not consistently monitor their use.”
“The service did not have a qualified prescriber onsite every day and prescribers pre-signed prescriptions for clients based on the standard titration pathway.”
“There were no records to indicate how many prescriptions there should have been.”
What good looked like
“Prescription stationery was stored securely, and auditable records were maintained detailing when prescriptions were issued to prescribers.”
Your answer: Not answered
Do you check and record blood pressure, pulse, weight and height before starting ADHD medication and at each review, and act on the results?
“The provider had not yet fully standardised how treatment outcomes and medicine side effects were monitored.”
“In four records, there was not evidence that an initial physical health check had been completed.”
“For example, the service was not routinely asking female patients if they were pregnant or were attempting to get pregnant.”
What good looked like
“Where medicines for attention deficit hyperactivity disorder (ADHD) were prescribed, staff obtained and reviewed appropriate physical health information, including electrocardiograms (ECGs) where required, before treatment commenced.”
Your answer: Not answered
Does each prescribing decision follow NICE guidance and your own medicines policy, with the reason recorded when it does not?
“However, we found it was not always clearly documented whether the choice of preparation, dosage and follow-up arrangements had been discussed and agreed.”
“We also saw instances where prescriptions were not signed or dated, this is a legal requirement.”
“There was no documentation within the notes which stated why this medicine was prescribed in the first instance.”
What good looked like
“Young peoples' initial assessments were structured according to NICE guidance.”
Your answer: Not answered
Has every clinician safeguarding training at the right level for their role (level 3 for anyone assessing children), and does your policy name local contacts?
“One administrative staff member had not received safeguarding training; this was raised during the inspection, and the registered manager immediately ensured the member of staff completed the required training.”
“The safeguarding policies were out of date, and there was no clear definition when safeguarding concerns met the threshold for a safeguarding referral to be made to the local authority.”
“The service did not have an effective system to follow up or act upon known safeguarding risks when patients disengaged and did not respond to contact.”
What good looked like
“The provider and registered manager had both undertaken level three safeguarding training for children and adults.”
Your answer: Not answered
Is each patient's record kept in one place, complete, and readable by every clinician involved in their care?
“A small number of staff were not using the electronic system and kept their notes in a separate place.”
“However, minutes for Multi-Disciplinary Team meetings were not always detailed.”
“We saw examples when consultation records had been completed in advance.”
Your answer: Not answered
If patients visit your premises, are fire and health and safety risk assessments current, and is any emergency equipment checked on a schedule?
“The service had not been completing fire evacuation drills, which they should have done in line with fire safety requirements.”
“The service did not have a first aid kit on site or an appointed person to take charge of first aid arrangements.”
“There were 7 actions identified following the assessment.”
What good looked like
“The fire system and fire extinguishers were inspected regularly; with comprehensive records maintained for all fire alarm checks.”
Your answer: Not answered
Does every staff file show DBS, references, professional registration and right to work, all checked before the person started?
“Staff recruitment files did not contain all the information required.”
“However, on our review the personnel files for 2 staff members were missing their employment history and proof of ID.”
“Our review of a sample of staff records identified that some documentation was incomplete.”
What good looked like
“Managers made sure all staff had completed appropriate recruitment checks, such as having a clear enhanced Disclosure and Barring Service (DBS) certificate, had indemnity insurance and were registered with the relevant professional body, such as the Nursing and Midwifery Council (NMC).”
Your answer: Not answered
Do your ADHD and autism assessments follow NICE guidance, use recognised tools, and explain in the report how the conclusion was reached?
“One record involving a young person diagnosed with generalised anxiety disorder and panic attacks did not contain evidence that a recognised diagnostic assessment tool or rating scale had been used.”
“In several ASD assessments, there was no evidence of input from educational settings, which is a key component of a holistic developmental assessment.”
“However, the assistant psychologists had not received specific training on the assessment of neurodiversity and autism, especially in relation to children and young people.”
What good looked like
“The service used a range of specialist assessment tools to assess a patient.”
Your answer: Not answered
Has every clinician had training specific to ADHD and autism work, and has all staff completed the Oliver McGowan training on learning disability and autism?
“However, only 42% of staff had completed the second part of the Oliver McGowan training programme, and this remained an area for improvement.”
“However, the service did not offer specific learning disability training in line with guidance.”
“However, staff had not received specialist training relevant to their role.”
What good looked like
“All of the services autism assessing clinicians were Autism Diagnostic Observation Schedule (ADOS)and Autism Diagnostic Interview - Revised (ADiR) trained.”
Your answer: Not answered
Do you keep a training matrix showing each person's mandatory training, when it was done and when it is due?
“The service did not monitor the training status of their associate clinical staff members.”
“The service did not complete competency assessments for this role to help assure the quality and safety of the assessment process.”
“It was raised at the time of inspection that staff had not completed refresher courses in over a year.”
What good looked like
“Mandatory training compliance was reviewed regularly by the administrative team and operations manager.”
Your answer: Not answered
Does every clinician, including sessional and remote clinicians, get regular clinical supervision and an annual appraisal, and are both recorded?
“However, was no formal process in place to ensure non-medical staff received adequate support, such as through regular supervision.”
“Regular formal one-to-one meetings were not consistently taking place across all staff groups.”
“The service did not have a policy on how they would receive or record assurance of these taking place and did not hold information about this for their clinicians, at the time of inspection.”
What good looked like
“Supervision completion rates were 100% at the time of our inspection.”
Your answer: Not answered
For children and young people, do you record consent, Gillick competence where it applies, and who holds parental responsibility?
“However, although parental consent was recorded in the care records reviewed, there was limited evidence that Gillick competence had been consistently assessed, discussed or documented for children and young people under the age of 16 where this was applicable.”
“We also found that the child and adolescent consent form did not have an option for over 16's to provide consent.”
“However, at the time of the inspection the service’s policy did not include reference to Gillick competence.”
What good looked like
“Where appropriate, they assessed and recorded a young person’s competence to make a decision.”
Your answer: Not answered
Do you collect feedback from patients and families as a routine, and can you show what you changed because of it?
“However, patients told us they were unsure how to provide feedback on their care.”
“Patients could give feedback on the service, via the provider website, however there was no formal and regular mechanism to obtain feedback consistently to help improve the service.”
“The service did not however have a service specific process or method for formally gathering patient feedback on the service or their experiences of the care and treatment provided.”
What good looked like
“Changes were made as a result of patient feedback.”
Your answer: Not answered
Do you ask about and record each person's communication needs and reasonable adjustments, and offer information in easy read and other formats?
“However, information leaflets were limited to the English language, but staff said they arranged interpreters when required.”
“However, the service did not offer patient information leaflets in a range of languages or accessible formats, for example, in easy-read form.”
“There was a lift for disabled access but not for wheelchair access, however treatment rooms were available on the ground floor.”
What good looked like
“The service had ground floor rooms available if clients had mobility issues and used video calling for clients who could not attend in person.”
Your answer: Not answered
Do you tell people how long they will wait, keep in touch while they wait, and check on anyone whose risk may change?
“The volume of NHS assessments had meant this assessment pathway took longer to complete.”
“The volume of NHS assessments had meant this assessment pathway took longer to complete.”
“However, there was still a long waiting time from referral to first assessment with a practitioner.”
Your answer: Not answered
Do you have a planned audit programme (records, prescribing, consent and assessments) with actions and repeat audits?
“Although a range of clinical audits were undertaken, these were not always completed with sufficient frequency or structure to maximise their effectiveness.”
“However, more could be done to carry out clinical audits particularly with monitoring outcomes for young people and for attention deficit hyperactivity disorder (ADHD) assessments.”
“However, leaders had identified opportunities to strengthen prescribing monitoring arrangements and had begun improvement work in these areas at the time of the assessment.”
What good looked like
“Staff completed and monitored outcomes of audits for records, ID checks, prescribing medicines, anti-psychotic drugs, ECGs and ADHD assessments.”
Your answer: Not answered
Do you measure outcomes and quality (such as time to diagnosis, follow-up and patient-reported outcomes) and use them to improve the service?
“At the time of the assessment, staff were not actively participating in any formal quality improvement initiatives.”
“However, staff did not routinely collect outcomes for young people.”
“The provider's audit programme identified outcome measures, waiting times and elements of prescribing oversight as areas where methodologies, reporting functions or benchmark standards were still being refined.”
What good looked like
“Outcome data was shared publicly on the service’s website to promote transparency.”
Your answer: Not answered
Is every policy in place, written for your service, dated, and reviewed on schedule?
“However, the provider's induction policy had not been updated to specify expected completion timescales, which limited assurance that the process would be applied consistently.”
“The service had not notified CQC when their patient was referred to the local authority safeguarding team.”
“Despite our request, the provider failed to supply an adequate policy for managing safety incidents.”
Your answer: Not answered
Do you hold regular governance meetings with minutes, and keep a risk register that leaders review?
“Although staff described an open reporting culture and duty of candour processes, the minutes from the July and September 2025 clinical governance meetings did not record the actions taken or learning shared.”
“The service did not have a risk register in place at the time of the inspection.”
“However, the risks identified on the risk register were not dated, and there was no indication that the risks had been reviewed.”
What good looked like
“The service held monthly governance meetings where incidents, staffing, complaints and performance were reviewed and shared with staff.”
Your answer: Not answered
Can staff raise concerns safely, and do you send CQC the notifications it requires and follow the duty of candour?
“The service did not have a Speak Up champion, but the manager aimed to appoint one in the future.”
“The service failed to notify the CQC of two safeguarding concerns, that were reported to the local authority.”
“However, due to the small size of the service, there was no one above the registered manager staff could report to if the concerns related to the registered manager.”
What good looked like
“All staff knew what incidents to report and how to report them using the electronic incident reporting system.”
From over 1,500 CQC inspection reports and assessments for independent clinics in England, published from 2017 to 2026. 66 of the clinics do ADHD or autism work; the rest are similar independent clinics such as private doctors, online prescribing services and independent mental health services. Every quote shown was checked word for word against the report.
No. The check covers the problems inspectors raise most often at ADHD and autism clinics, not everything CQC looks at. Inspectors also speak to staff and patients and read records, and they rate on what they find on the day.
Not yet. The law does not let CQC regulate a service that only diagnoses. On 9 October 2026 the Department of Health and Social Care asked CQC to regulate all ADHD and autism diagnostic assessments once new regulations are in place, with no date set. Until then, the checks show what inspectors look for at clinics that diagnose and treat. Answer "No, we only diagnose" and the prescribing checks drop out.
Yes. Our article What CQC inspectors find at ADHD and autism clinics covers how ADHD and autism clinics are rated compared with similar clinics, which key questions they fall down on, and what inspectors wrote, with charts.
Yes, and you don't need an account. Your answers save in your browser, so you can come back and finish later.
Cerebric holds each patient's screening, assessment, report and titration in one place, and every report cites the evidence for each finding.