Cranbrook Medical Practice

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 assessed all quality statements in the well-led key question.

This is the first inspection for this service since its registration with CQC. At this assessment, we rated the key question as Good. Staff were clear on their individual responsibilities and knew who was accountable for each aspect of the service. The practice encouraged candour, openness and honesty. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. Systems and processes supported the safe delivery of care.However, during our assessment, we identified gaps in governance. The practice took immediate action and developed action plans to address these, but the changes had yet to be embedded.

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 practice had a shared vision and culture which drove high quality sustainable care.

The vision and mission statements were displayed on a notice board in the staff room. All staff members could add their views on the notice board. They had meetings to discuss shared vision and values. Staff were supportive of each other with good team working relationships. Staff told us there was an open-door policy where they could access and speak openly to leaders. The leaders encouraged the staff to keep their knowledge and skills up to date in line with continued professional development to support the practice.Staff were informed of changes in the practice through staff meetings, emails and notices on their computer system.

The leaders were visible and approachable and responded to any concerns raised. We received positive comments from staff regarding the support provided by team leaders.Leaders were aware of the challenges of delivering good quality care and were striving for improvements. We received many examples of how the practice implemented changes in response to staff feedback.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff felt confident to raise any concerns with their managers and leaders. The practice had a whistleblowing policy which clearly laid out the process of raising concerns within the practice and externally, including the name and contact details of the freedom to speak up guardian (FTSUG). The policy was accessible to all staff on their computer system. Most staff were aware of the FTSUG role and how to access their support.

The service valued diversity in their workforce.

All staff had completed training in equality and diversity. The practice had policies on equality and diversity and anti-bullying and harassment. Staff we spoke with told us they had not experienced discrimination or discriminatory behaviour whilst working at the practice. Staff gave examples of reasonable adjustments on their work environment the service had made, to support them at work.

Staff and leaders were clear on their individual roles and responsibilities. Staff took patient confidentiality and information security seriously. The practice provided an example of a data breach, how it was investigated, the actions taken and how learning was shared. Managers met with staff regularly to complete appraisals and performance reviews. Staff could access all required policies and procedures on their computer system. The practice had a business continuity plan which provided guidance and information for staff to follow in the event of systematic failures. The provider had oversight of contracts with external providers. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. However, we observed not all minutes were documented or could be easily retrieved. The practice developed an action plan to systematically document the minutes on their computer system which would improve the accessibility for staff. We identified shortfalls in the oversight of mandatory training completion, fire risk assessment, monitoring the overall themes or trends of complaints and significant events, and summarising patient’s clinical notes. The practice was responsive to our findings and developed action plans to address these issues. The fire risk assessment was completed, and the practice had followed up on the recommendations. We also found some gaps and areas for improvement in the quality of medicine reviews and monitoring of people prescribed certain medicines from the clinical searches. Following issues being identified, the practice acted swiftly and implemented new processes to ensure people were not at immediate or future risk. However, these processes had to be embedded and sustained to ensure people were not exposed to the identified risks in the future.

Staff and leaders had established working relationships with community stakeholders sharing their specialist knowledge, skills and experiences.

Leaders worked in partnership with the PPG to gain their feedback. Various PPG representatives provided positive feedback regarding the practice’s engagement with the PPG and provided examples of how service improvement was made based on the patient’s feedback. We received positive feedback from a community partner who said the practice was “proactive, community-minded, and visibly committed to improving health outcomes in our area”. Another community partner said the practice “actively engages in community involvement by attending local events and offering valuable health-related support… the team demonstrates a strong commitment to supporting and connecting with the community in both practical and compassionate ways”. The practice provided teaching and support to medical students through placement. The medical students gave positive feedback of the learning experience and the level of care they observed. The practice worked closely with their local running club to promote physical activity. The practice nurse had also helped to set up and run a community group to support families with children who had additional needs.

There was a focus on continuous learning and improvement.Staff were encouraged to develop their skill set to enable them to take on new roles, responsibilities and further their career. Leaders encouraged staff to speak up with ideas for improvement. We saw examples of improvements following staff feedback. For example, the appointment and triage system were modified following feedback from both clinical and administrative staff. After the change, there were more appointments available with a shorter waiting time. The practice used a clinical data tool for managing patients with diabetes. The tool helped to code the patients into different priorities and flagged those who required urgent attention. Our clinical search findings showed a high standard of diabetic care. The practice was proactive in making improvements to deliver a safe and effective service. A project aiming to reduce the unnecessary use of antimicrobials for patients presenting with a sore throat was ongoing. The early outcome showed reduced antimicrobial use as a result of the on-site rapid testing machine. This identified whether a bacterial infection, which would require antimicrobials, was present. Another quality improvement project was the introduction of an annual review for patients with coeliac disease (a condition where the immune system attacks patient’s own tissues when they eat gluten). The project aimed at improving patient care and experience and was ongoing.