The Cliffs Chiropractic Clinic

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 scored the service as 1. The evidence showed significant shortfalls. The service did not have a shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not understand the challenges and the needs of people and their communities.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

The evidence showed some shortfalls. The service did not always understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

A vision or strategy for the service had not been established. The service lead stated that the direction of the clinic was shared transparently with all staff, although no formal strategy existed.

The service had a clinic policy outlining expected values and behaviours. Staff expressed confidence in the function and purpose of the service.

Staff said they were respected, supported and valued. Focus was placed on the needs of patients receiving care. An open culture was evident, in which patients, their families and staff were able to raise concerns without fear.

Staff reported they worked as a family. Team members spoke highly of one another. Confidence in and approachability of the service lead were expressed, and staff reported feeling empowered to make changes and offer suggestions.

The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The evidence showed a good standard. 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. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Leaders told us they supported independent learning. Staff told us that radiological research was being undertaken and support was provided by the clinic lead. External learning undertaken by radiographers was partially funded by the service lead.

The manager was visible and approachable to patients and staff. They made themselves available to staff outside of working hours. We spoke to 2 members of staff, who reported they felt supported by leaders, for example they were supported to develop their skills and to take on more senior roles.

Leaders were described as having the skills and abilities required to run the service. Leaders told us they actively and openly engaged with patients and staff to plan and manage services.

Leaders offered reduced cost or free access to clinic services to staff to support their health. Staff meetings frequently included wellbeing sessions such as meditation, yoga and general wellbeing advice.

Patient engagement influenced service delivery, including whether patients preferred to wear their own clothing or gowns, which resulted in changes to accommodate preferences.

The evidence showed some shortfalls. The service did not always understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

Staff and leaders told us the service does not have a Freedom to Speak Up champion or relevant policy. However, staff we spoke to reported they felt confident in raising concerns and they felt their views would be listened to.

The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Staff and leaders were committed to continuous learning and service improvement. Staff had a good understanding of quality improvement methods and the skills to use them were evident. Staff told us innovation and participation in research were encouraged. Staff represented diverse and minority backgrounds.

The evidence showed significant shortfalls. The service did not have a shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not understand the challenges and the needs of people and their communities.

The service did not have a risk register, and leaders had not formally identified, recorded, or escalated risks. We did not see evidence of mitigation plans or formal oversight of risks, which meant actions to reduce their impact were not structured. Governance oversight was limited, particularly in relation to policy management and review processes. Many policies had not been reviewed for several years, creating a risk that the service was not operating in line with current national guidance. Although a clinical governance policy was in place and in date, it lacked sufficient detail, including clear escalation processes and a defined governance structure.

Staff reported access to policies, procedures and training; however, these were not always up to date or aligned with national guidance. Additionally, the clinic lead confirmed that some documents were stored on a drive at home rather than on-site, which posed further governance and access risks. These concerns were raised with the clinic lead, who stated they would review documentation promptly.

Although leaders held governance meetings and recorded discussions, oversight of key governance functions remained insufficient. Meeting minutes were available, including those from January 2026, and historical minutes from 2025 showed discussions about staffing. However, these records did not demonstrate robust risk management systems or formal processes for recording and monitoring patient outcomes, and we were not assured that such systems were in place.

On the day of inspection, we did not see a business continuity policy to manage major incidents; however, a plan dated February 2026 was provided after the inspection as assurance.

Despite these concerns, there were systems in place to manage data securely. Staff collected and analysed data and reported having access to information to support performance monitoring and decision-making. Information systems were secure and integrated. The service held a current registration with the Information Commissioner’s Office (ICO), and staff had received GDPR training. Electronic systems were password-protected, and patient information, including diagnostic images, was stored securely. Correspondence was appropriately managed and documented unless patients opted out.

Staff described a recent incident involving patient overexposure. While full investigation records were not available on the day, evidence provided after inspection confirmed that a complete investigation had taken place, and processes were reviewed to prevent recurrence. The service reported no IR(ME)R reportable incidents in the 12 months prior to inspection.

Staff understood their responsibilities under the duty of candour and demonstrated openness and transparency when things went wrong. They were able to explain when the duty applied, and no notifications had been required in the 12 months prior to inspection.

The service had previously been invited to contribute to parliamentary reviews in 2015 and 2019 in recognition of good practice within the private healthcare sector; however, we did not see evidence of outcomes from this involvement.

The evidence showed some shortfalls. The service did not always understand their duty to collaborate and work in partnership, so services work seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

The clinic lead led weekly meetings with staff to discuss capacity, staffing and recent or anticipated incidents. These meetings were informal and not minuted.

Staff said they shared learning with colleagues on best practice or learning from recent research journals. We did not see evidence of this in team meeting minutes on the day of the inspection.

Leaders told us they communicated with local GP surgeries, this communication was normally by email or phone call. We did not see evidence of this during the inspection.

The evidence showed a good standard. The service made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The clinic lead held monthly team meetings, covering training, clinic procedures and team morale. Minutes showed discussions relating to service improvement and innovation. IRMER-related audits were shared and discussed at these meetings. However, not all minutes were found on the day of the inspection.

The lead radiographer was actively involved in external research and was supported by the clinic lead to use this learning to enhance radiological practice.