Bracknell Urgent Care 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 - 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, we rated this key question Requires Improvement. At this assessment, the rating has changed to Good.

During our assessment of this key question, we found systems and processes of accountability were clearly set out, understood and effective. Senior leaders promoted a positive staff culture. Staff reported they felt supported in their roles and could raise concerns openly and transparently. Patients were triaged and assessed within target timeframes which were audited and reviewed with the local commissioners, which illustrated consistent and efficient service provision. Risks were identified and assessed for business continuity; clinical performance; recruitment and information governance. However, service processes had not always identified actions required to ensure the health and safety of people relating to the premises and lone working arrangements.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. This was based on equity, equality and diversity, engagement and understanding the needs of people in the community. All staff had contributed to the development of the practice vision and strategy, which was kept under review.

The service was aware of the projected increase in the local demand for walk-in minor injury patients and was working with stakeholder organisations to address future challenges such as reviewing referral pathways, ways to increase patient feedback submissions and improvements to the waiting area within the ‘Health space’. A service improvement plan was reviewed regularly and leaders shared updates weekly which ensured staff on all levels were actively participating in achieving the short-term and long-term goals required to meet the provider’s strategy.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. The provider told us there was a proactive culture across the local team and within the wider group, with the recognised ethos of 'people first, working together and a healthier future'. Leaders had the skills, knowledge, experience and credibility to lead effectively. This was demonstrated through regular documented staff support as well as working with the One Medicare leadership team to share key service updates and improvements. Staff told us leaders in the service was approachable and responded to any concerns raised. We saw the leadership team worked with other external stakeholders in the local area and were engaged in the development of the urgent care centre through initiatives and education for people and services.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. The service had established Freedom to Speak up arrangements within the wider One Medicare organisation. Staff were aware of how to raise concerns, and we saw an example where staff had used this arrangement to positive effect.

Staff told us that they were actively encouraged to speak up and the service had a ‘no blame’ approach to incidents and complaints that supported them to raise concerns. Staff felt involved with service improvements and gave examples of how their feedback had led to improvements. They felt communication was excellent and they were kept updated when processes had changed and improved. We received staff feedback forms as part of our assessment which showed they felt the provider had a positive caring attitude towards both staff and patients.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them. Policies and procedures to promote diversity and equality were in place.

We collated 8 staff feedback forms as part of the assessment process. Staff told us that there were opportunities to develop their skills and learning through Continuing Professional Development (CPD) and supervision sessions, sharing clinical best practice and guidelines.

Staff were supported in their roles to suit their individual needs such as through workforce benefits, organisation wide wellbeing amenities, mental health first aiders and an employee assistance program. Leaders had also demonstrated reasonable adjustments for staff who required flexible working patterns.

Staff told us that their feedback was sought and acted upon and resulted in service improvements. Staff felt respected, supported and valued. The service focused on the needs of patients.

The service did not always have embedded systems and processes to maintain good governance. They did not always act on the information about risk and outcomes following risk assessments or follow this up with other key stakeholders when appropriate.

Service processes had not always effectively identified where actions were required to ensure the health and safety of people relating to the premises. Actions had not always been taken to ensure the premises was compliant with the latest legionnaire risk assessment. The service had also not ensured the premises owners had carried out remedial actions to the emergency lighting and fire alarm system as required. After the assessment, the service provided evidence to demonstrate remedial actions to address the shortfalls in relation to the legionnaires risk assessment however, actions from the fire risk assessment including the emergency lighting remained outstanding and without a clear action plan.

The service provided daily home visiting appointments as part of the minor illness provision. The service had a lone working policy in place and senior leaders were available on-site should visiting staff required support. There was a risk assessment in place for home visiting staff which considered equipment and guidance for escalating urgent concerns. However, we identified that governance arrangements had not identified processes to ensure the service had access to lone working devices such as tracking devices or communications devices for the health and safety of staff carrying out this role.

We found clinical service performance was regularly reviewed and leaders were working to improve methods of obtaining and responding to patient feedback. We found information was used to identify and deliver service improvements. We saw evidence of actions taken in relation to the risk register, which were reviewed during quality and governance meetings.

Patient data and information was stored securely in line with digital security standards with relevant information was made available for patients to access in line with privacy, consent notices and general data protection regulations. Information was available for patients on how their data was used, choices regarding consent and how to protect their data through notices within the premises, registration forms or online via the service website.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners for improvement.

The provider worked with other services such as local primary care networks to provide minor illness pre-bookable appointments to reduce the demand placed on local GP practices in the area. Arrangements were in place to monitor performance and updates to service provision with the primary care networks. The service provided feedback to ensure patients received the information they needed to access appointments and ensured safety netting advice was given for patients’ care and treatment. Staff had made adjustments to improve coordination of their service with other healthcare services, including the care of those at higher risk of onward referral to emergency departments.

The service focused on continuous learning and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people.

The service had developed a patient service’s guide in easy read format to assist patients in understanding how the service worked across the local care system and what treatment pathways were available.

The service had plans to work with patient focus groups to review areas of patient feedback and how the service could support patients in the community. The service was in the development of implementing ‘Talk to Us’ days, with designated time for informal conversations with patients about their experiences for further service improvements.