Hope House Surgery

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – This means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

This is the first inspection for this service since its registration with CQC. This key question has been rated as Outstanding.

People are truly respected and valued as individuals and are empowered as partners in their care, practically and emotionally, by an exceptional and distinctive service.

This service scored 90 (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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect. Arrangements were in place to promote patients’ privacy.

The National GP Patient Survey (GPPS) 2025 results reflected people felt listened to as well as the healthcare professional they saw or spoke to was good at listening to them and treated them with care and concern.

Staff we spoke with understood guidelines on how to judge people’s capacity to consent to medical treatment and there was a process to ensure young adults had control over their own privacy and the amount of parental involvement in managing their care and support.

Feedback from people who used the service and those who are close to them, including stakeholders was continually positive about the way staff treat people.

Feedback gathered during the inspection and through the service’s internal staff survey results showed staff were highly motivated to offer care that is kind and promoted people’s dignity. Relationships between people who used the service and staff were caring, respectful and supportive. These relationships were highly valued by staff and promoted by leaders. During the onsite visit, we were shown examples of how the service worked compassionately with people in the local community, such as involving local artists to present their work across the premises as a project to promote positive mental health and wellbeing.

The service treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The service took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Staff recognised people’s needs to have access to, and links with, their advocacy and support networks in the community and they supported people to do this. People’s communication needs were met to enable them to be fully involved in their care. For example, the service had established an autism working group through a project to understand how they could best meet their needs as a population group. The service developed a survey and received feedback from 68 people with lived experience of Autism Spectrum Disorder (ASD) and learning disabilities. We saw evidence of actions from the survey during our onsite visit such as the use of a ‘health passport’, to document reasonable adjustments that were accessible to clinicians. This included preference for a named clinician for continuity of care. We observed there was a large box full of resources available in the service, including a ‘sensory box’ which had been developed in partnership with people with lived experience. It contained communication identity cards, to assist people in identifying preferences for providing communication in a way which better suited the person; ear defenders to reduce the level of noise experienced in the environment; sensory fidget accessories, emphasising usage to reduce anxiety rather than for recreational purposes. Staff knew where it was and what it was for. Feedback collected by the service from people who used the sensory box demonstrated these tools helped them cope with unfamiliar and stressful environments. Leaders told us this led to more effective consultations due to people being able to communicate more effectively, whilst service users were able to build trust with clinicians. The service received feedback from people with lived experiences of ASD who were part of the working group as a result of the implemented service changes. The service valued and embedded these insights as a vital source of expertise, to support decision-making which led to tangible improvements in accessibility and the quality of care.

There was a specific board in the reception area with information for people with a learning disability and autistic people which had ‘visual cards’ displayed. These were slips of paper people with a range of needs could use to indicating they had a specific need. Once used, this would be added to their patient record for subsequent visits. There were numerous quieter areas throughout the service for people to wait to ease the pressure of feeling overwhelmed in busy areas and avoiding socialisation. The service’s website had also been reviewed to include a link to the local council’s autism services as well as photos of named clinicians and a video walkthrough of the premises. Pictograms of the premises and layout of the building was available at reception on request. The service was in the process of delivering learning disability and autism training to staff, which included hearing from people with lived experiences.

The service had carried out an environment assessment led by a working group to promote dementia friendly services. As a result, dementia friendly clocks were implemented, and seating arrangements were changed in waiting areas. This was to improve comfort to feel more orientated, enhance safety, promote social interaction, and reduce agitation.

We carried out a remote review of the service’s clinical records system and noted people with learning disabilities were assessed and treated in line with national guidelines. A sample of 5 records reviewed showed all 5 people had received a comprehensive learning disability review in the past 12 months. We noted all contained appropriate information addressing physical, mental, social and health issues with action plans issued to the person and retained on the clinical record to improve future care planning.

The service provided a focused review to address factors which contributed to avoidable health inequalities. The service audited outcomes on people with learning disabilities which demonstrated positive impact of these checks for the diagnosis and management of diagnosis and wider health issues that would otherwise not have presented or would have had a delayed presentation, when there is a risk of further harm having occurred. The service completed a total of 115 learning disability health checks on 90 people. A random sample of 30 health checks were audited. As a result of the health checks, 3 patients (10%) were newly diagnosed as having type 2 diabetes, two of these patients are under 40 years of age. They were all offered appropriate and accessible information regarding their diagnosis and appropriate ongoing treatment with appropriate follow up. Early diagnosis and management of diabetes improves long-term health outcomes for people. A further type 2 diabetic person and a type 1 diabetic person were followed up as a result of their learning disabilities check which led to improvements in their management of diabetes and reported positive benefits of their wellbeing. The health checks also facilitated the diagnosis and management of unknown high cholesterol, B12 deficiency and new Chronic Kidney Disease (CKD) in 4 separate people. In total, 7 (23%) people had diagnosis of a new chronic disease/condition that required ongoing management and medicines initiated by the service to prevent further harm.16 (53%) received a change in care and treatment because of attending their learning disabilities check. 10 (33%) patients were referred on to one or more additional services for further support and assessment to improve their health and wellbeing. A total of 15 referrals were made which included alcohol and smoking cessation support, renal support, social care, dietetics and audiology as well as a safeguarding referral made for a person due to self-neglect. Of the 30 reviews audited, 22 (73%) resulted in further action or review being arranged and 8 (27%) did not identify anew diagnosis or further interventions being currently required. People who were included in the audit provided direct feedback to the service which showed they felt an improved rapport and trust with clinicians and their needs were met.

The service was exceptional at promoting people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing. Staff helped patients and their carers to access advocacy and community-based services.

People were supported to access a wide range of meaningful activities and community opportunities that promoted independence, health, and overall wellbeing. The service demonstrated an innovative and proactive approach to community engagement by partnering with a local school and Scout group to build a community garden at the service site. This initiative not only fostered social inclusion but also provided educational opportunities, including habitat and ecology awareness sessions and hands-on gardening programmes. These activities formed part of a multidisciplinary approach to improving childhood health, nutrition, and environmental understanding as a result of the service proactively identifying an increasing prevalence of childhood obesity and emerging nutritional concerns locally. This reflected the service’s commitment to empowering individuals and enhancing quality of life beyond the scope of traditional care. The community garden was also used as a tool to support people’s mental health whilst reducing social isolation, through the usage of local bereavement services and recommended to people by the social prescriber. For example, the service demonstrated how the community garden project integrated community stakeholders to positively benefit people. We received feedback from a local charity formed of a collective of artists who managed creative studios in the area of Bath and North East Somerset which focused on funded activities for adults facing challenges to accessing resources, due to low income, mental health, career gaps and other stigmatisation. The charity worked with a group of local residents on developing multiple artworks and structures to facilitate improvement in their mental health. The service noted improvements on a reduction in frequency of people’s further mental health support, co-ordinated through the social prescriber as a result of the project.

The service had enabled a provision of a dedicated wellbeing space within the premises. People and organisations were able to utilise the space to enhance the mental and physical health of the local community. This included local children's services based within the health centre. GP partners had worked collaboratively with the local children's services to identify and provide additional educational weight management programmes to families.

The service also worked in collaboration with Age UK to provide skills and confidence using mobile phones, tablets and laptops on a monthly basis for people aged 55 and over in the local community. This included how to access health services and the NHS app. As well as one-to-one advice, people were offered free loan devices for those who do not have access to online services to assist them in seeking the support for their care. The service demonstrated how this positively impacted people in accessing the care they needed via improved usage in online appointment access and health literature, as well as a reduction in service requests to support people in accessing their results.

The service had implemented regular ‘pain café’ sessions, a project in supporting people with reducing symptoms of pain in relation to their chronic conditions. There were 15 sessions between February 2024 and July 2025. Volunteers and service users were supported by practice staff members such as the social prescriber. The project was specifically to support people with diagnosed fibromyalgia (a total of 185 people recognised by the service), which excluded patients with cancer pain. People were asked to complete feedback forms at every session to monitor progress. This assessed their level of pain, knowledge and confidence on managing symptoms. The service identified sleep, pain relief and movement were the highest priority objectives recorded by people. People were advised on different types of therapies and treatment of chronic pain, which showed sustained improvements in pain and function. After 6 months, a comparison of feedback data demonstrated scores either improved or stayed the same with notable increases in a few categories, in particular with emotional and confidence. The service offered referral pathways into their first contact physiotherapy service. The service also supported the provision of bi-monthly Living Well With Pain (LWWP) education courses. The service provided additional training for staff to support people in accessing well-being resources and links to the ‘pain café. The service demonstrated they were able to reduce or stop unsuitable medicines prescribed to people and ensured treatments were right for each person to improve pain management via cycles of audits of outcomes for people involved in the project during these timeframes. The project also showed a reduction in the level of pain scores recorded by people over time. The service carried out an audit which demonstrated how people involved in the project improved their symptoms of pain which allowed them to benefit from greater independence and control of their health and wellbeing. For example, out of 23 people who attended all ‘pain café’ sessions, 12 were able to attend additional health and wellbeing services such as chair dance classes and 6 people completed further pain education sessions hosted by the social prescriber. The service demonstrated people who attended the ‘pain café’ had a 9% reduction in face to face (594 appointments in September 2024 to 497 appointments in January 2025) and 20% reduction in telephone consultations with clinicians (234 telephone consultations in September 2024 to 187 telephone consultations in January 2025). Medicine changes between prescriptions between these periods also demonstrated a reduction in regular opiate prescribing or amounts prescribed. For example, of the 9 people prescribed opiate medicines (used to treat severe pain), 2 people stopped taking this completely and at least 2 people reduced their prescription amounts. Of the 5 people prescribed pregabalin or gabapentin (used to treat nerve pain), 2 people reduced the dosage amounts prescribed.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. There was a system for appointment triage to ensure people with immediate needs had access to services. Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams.

The service demonstrated how people were able to access care for their immediate needs, including reasonable adjustments to assist them in this process. For example, vulnerable people always had appointments offered at the same time on the same day of the week, with the same clinician for continuity of care and to ensure their complex health needs would be addressed. All information on people’s immediate needs is recorded on the person’s clinical records so they do not need to be asked or requested on each occasion.

The service promoted the wellbeing of their staff and we saw evidence they supported and enabled staff to always deliver person-centred care. Staff told us they were valued by leaders. Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as regular breaks and rest areas. Staff reported being supported if they were struggling at work.

The service demonstrated examples of initiatives which aimed at improving staff wellbeing, connecting staff who may not otherwise interact. Initiatives included, a staff forum and book club, where the service provided a free book and met regularly. From a review of the service’s internal staff feedback surveys, we saw a positive and open culture. The service showed prioritised on creating a caring and supportive culture by placing wellbeing at the centre of its improvement plan. Through regular events and team-building activities, staff felt valued and connected, enabling them to provide consistently compassionate care. Staff we spoke with reflected positively about the focus on wellbeing and found to break down barriers across the whole team as activities were free or low cost. This worked to provide a positive working environment for all staff. Records highlighted 76% of staff had taken up at least one of these sessions offered in the last 12 months. Staff told us they contributed to and positively supported the service’s wellbeing initiatives. For those who had not taken up these sessions, all staff had access to dedicated wellbeing spaces inviting staff areas encouraging social interaction and resources to mindfulness and mental health support. As a result, survey results had improved from 2023 which highlighted 79% of staff agreed or strongly agreed the service had taken positive action on health and wellbeing to 95% in 2024. Feedback responses also had demonstrated improved staff morale, engagement and improved team cohesion. For example, in November 2024, the service hosted a nutrition and mental health wellbeing event, which was attended by 24 staff members. The service received a survey response rate of 42% following the event to evaluate the benefits. The survey results showed 80% felt that the session benefited their own wellbeing and recommend this session to other practices. Survey results showed 50% of staff reported it was extremely useful to attend a ‘whole team’ event and a further 30% reported it was useful.

Staff told us there were monthly all colleague meetings which included health and wellbeing as a standing agenda item. Staff were offered an employee assistance program (EAP) through the practice’s occupational health service partner and had access to mental health first aiders.

The service was accredited with the ‘Living Wage Foundation’ employer scheme, which committed to fair pay and responsible employment based on the cost of living.

Staff had regular opportunities to provide feedback, raise concerns and suggest ways to improve the service or staff experiences. Leaders provided a timely and considered response. The service carried out annual staff feedback surveys. From the previous survey in December 2024, there were 21 responses (84% of all staff). The service identified themes of high level of satisfaction with improved results from previous surveys which included ‘general attitude to work’, ‘involvement in decision making’, ‘culture and workload, ‘patient care’ and ‘staff health and wellbeing’. We received staff feedback as part of the assessment process which highlighted positive themes, such as staffing teams who had a focus on providing positive outcomes for people who used the service and leaders who welcomed feedback for service improvements.