Herstmonceux Integrative Health 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

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

This is the first inspection for this service since its registration with CQC under a new provider in December 2022. This key question has been rated as requires improvement.

The service was in breach of legal regulation 17 in relation to Good Governance. This was because leaders lacked oversight of some systems and processes. Policies and procedures were not always in place or sufficient.

This service scored 62 (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 an overall vision and mission based on providing responsive, safe, high-quality care and transforming people’s lives across all services it managed. However, staff told us they had not been involved in its development and were unclear how it applied specifically to their local service. It was also unclear what analysis the provider had undertaken of the health needs of the local population of this service so that the specific needs and challenges of local people and their communities could be understood and addressed.

The practice had leaders with the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. However, feedback from staff and patients highlighted that as a relatively new provider of primary care to the area, there was a need to ensure that leaders at all levels thoroughly understood the context of general practice in this specific locality.

Staff told us that leaders in the practice was approachable and responded to concerns raised. We saw the leadership team worked with other practices in the primary care network and were engaged in the development of primary care services in the local area.

The service fostered a positive culture where staff felt they could speak up. The practice had established Freedom to Speak up arrangements within the wider organisation. Staff were aware of how to raise concerns. However, some staff reported they felt unsure they had been heard and understood, particularly in relation to staffing pressures. After the inspection the practice told us that as a result of a 'listening event' they had added the practice to rota management system that would enable IC24 GP colleagues in Sussex to cover any staffing gaps at the practice, up to three months in advance. Along with successful recruitment to permanent posts this would help ease staffing pressures.

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. Adjustments had been made to ensure all staff were valued. We saw adjustments to support staff were in place.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. We saw that there were regular meetings for clinical staff during which they discussed clinical concerns and emerging risks. These meetings were recorded and shared and included any actions arising. However, we saw that meetings for other groups of staff were less regular and for nursing staff in particular there were no team meetings. This meant there were limited opportunities to discuss patient issues, share best practices, ensure all team members were informed about key issues such as significant events and other developments withing the practice.

Whilst staff could access all required policies and procedures, governance processes were not always appropriate for the service. For example, there was no formal policy for assessing and prioritising appointments so that staff could safely and consistently direct patients to the appropriate clinician. Whilst the provider’s policy for clinical supervision contained information about the structure, frequency and recording arrangements for clinical supervision, evidence from staff feedback and practice records indicated that the policy was not consistently implemented.

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

The service worked with other practices in their primary care network to offer extended access, and flu and covid vaccination programmes. Staff worked in partnership with community providers to ensure care for the frail, vulnerable and those at the end of life was co-ordinated.

There was evidence of continuous learning, innovation and improvement across the organisation.

The service had plans for improving services, for example, the introduction of a digital triage system for appointments in August 2025. All staff were encouraged to put forward and test out new ways of working, and we saw examples of this.