Fir Tree Medical Centre

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment in January 2023, we rated this key question as requires improvement. At this assessment the rating has changed to good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a shared vision, strategy and culture. Leaders ensured there was a shared vision and mission statement that staff in all areas knew, understood and supported. Leaders demonstrated a positive, compassionate and listening culture and staff told us that equality and diversity were actively promoted, and if concerns were raised, action was taken to address these.

The service had a practice manager however, they also worked across another service owned by the provider so were unable to be in day-to-day management of this service. Staff told us managers and partners were visible, and open-door policies were in place for when staff needed support. The provider was knowledgeable about issues and priorities for the quality of services and staff told us there was a compassionate management team.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard. Staff and leaders acted with openness, honesty and transparency. Leaders encouraged staff to raise concerns and promoted the value of doing so. Staff fed back to us there was a culture of speaking up, where staff actively raised concerns, and those who did were supported without fear of detriment. When concerns were raised, leaders investigated them sensitively and confidentially, and any lessons learnt were shared and acted on. We received a number of completed staff feedback forms and all staff felt supported and confident to raise concerns.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Leaders acted to remove bias from practices to ensure equality of opportunity and experience for staff. Leaders supported staff who had protected equality characteristics, or those from excluded and marginalised groups. Policies were in place to prevent and address bullying and harassment.

The provider had made governance improvements since the service’s last inspection. This included; clearer responsibilities, changes in management and centralised roles and systems of accountability. The provider and team acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. Staff we spoke with understood their lead role and responsibilities, for example lead clinical roles. Performance issues were escalated appropriately through structures and processes. Staff appraisals were used to manage staff performance.

Systems to manage current and future performance and risks were established and monitored. However, some of the management systems for significant event analysis and complaints management required improvements. The management team used data to monitor and improve performance. For example, practice meetings were held, and discussions took place about performance and operational pressures. Any audit results were discussed in daily and weekly clinical meetings. Staff were aware of data or notifications that needed to be submitted to external organisations as required.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. Staff and leaders we spoke with were open and transparent, and they collaborated with all relevant external stakeholders and agencies.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. Clinical meetings encouraged reflection and collective problem-solving, and there were processes to ensure that learning happened when things went wrong, and from examples of good practice. Leaders encouraged staff to speak up with ideas for improvement during regular clinical and non-clinical meetings.