Dartmouth Health & Wellbeing 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.

At our last assessment in April 2016, we rated this key question as Good. At this assessment, the rating remains unchanged.

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders and the management team detailed a clear vision and values for the service. This was shared with staff. Staff were aware of and understood the vision, values and strategy and their role in achieving them.There was a clear vision and set of values, which the service acted on. The service had a realistic strategy and supporting business plans to achieve priorities. The strategy was in line with health and social priorities across the region. The provider planned the service to meet the needs of the local population. The provider monitored progress against delivery of the strategy.

Staff interviewed expressed enjoyment in their roles and valued the collaborative environment. Regular team meetings were held to share updates and promote open communication across the service. Records of meeting minutes and actions were stored and accessible to all staff on the service’s electronic system.

Staff described a friendly and supportive culture, with strong teamwork and a positive working environment. Staff were supported in their professional development and encouraged to keep their skills up to date. The service promoted openness and used staff surveys to drive improvements. There were clear procedures to address behaviour inconsistent with the service values.

The service was aware of health inequalities. For example, digital exclusion, armed forces veterans and people affected by poor transport links to access care and treatment.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment, support and embodied the culture and values of their workforce, practice and the wider organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Staff told us that managers were visible and approachable and that they worked closely with staff and others to make sure they prioritised compassionate and inclusive management leadership.

There were clear lines of responsibility to support capable leadership. The service had job descriptions for all staff and had ensured staff were aware of their roles and responsibilities.

Leaders were responsive to both local and national challenges, and decisions were informed by data and multidisciplinary collaboration. The leadership team worked with other practices in the primary care network (PCN) and were engaged in the development of primary care services within the local area.

Staff consistently fed back that they felt leaders treated them with care and compassion. Support for staff was provided through regular appraisals, check ins and open communication via meetings, emails, and the services intranet (a private, secure computer network used by an organisation to share information).

Staff described a strong team culture, feeling respected, valued, and inspired by the leadership team. Staff wellbeing was supported through a “you said-we did” culture.

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

The practice had established Freedom to Speak up arrangements with other practices in the PCN, and this was promoted within the building. Staff were aware of how to raise concerns and told us they felt confident to do so. The service had a Whistleblowing Policy which was accessible to staff. The policy outlined the process for raising concerns internally and externally.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

There were policies and procedures to promote diversity and equality. We saw senior leaders had addressed concerns related to discrimination. Adjustments had been made to ensure all staff were valued. For example, we saw adjustments to support staff working flexibly.

The service promoted a fair, inclusive, and supportive working environment. Leaders demonstrated a clear commitment to equity and diversity, underpinned by policies and systems that ensured equal access to development opportunities for all staff. Staff reported feeling treated fairly, with zero tolerance for discrimination.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver high-quality, sustainable care, treatment and support. They always 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. Managers met with staff regularly to complete appraisals, competency and performance reviews.

GP partners and managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. Managers recorded any actions arising from these meetings and ensured they shared these with staff. Staff took patient confidentiality and information security seriously.

The service had established governance frameworks and systems of accountability which were appropriate for their service. Service leaders had established effective policies, procedures and activities to ensure safety and to assure themselves that they were operating as intended. For example, the service conducted ongoing clinical audits which it used to monitor consistency and systems to identify where action should be taken. Quality and governance were discussed in relevant meetings, and all staff had access to this information as appropriate to their respective roles.

Clinicians were available to support enquires from staff and met regularly with specialists to discuss vulnerable patients, complex cases and share expertise. This approach reinforced a strong culture of openness, learning and improvement. Staff told us they felt supported and empowered, and that leaders were approachable and responsive.

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 patient participation group (PPG) was active and met regularly with the practice. Feedback from the PPG indicated that there was a desire to promote its activities more within people who used the service. They also highlighted initiatives in reaching a broader demographic, particularly the involvement of younger patients. For example, attending local schools to gain feedback

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

Staff were supported to develop in their roles and take on new responsibilities. Learning needs were discussed in team meetings, and identified in annual appraisals. The service encouraged professional development and career progression. Staff had completed training such as moving from receptionist to manager and gaining independent prescriber qualifications. The practice offered placements to GP trainees.

The service was innovative and encouraged contemporary thinking supporting new ways of working. The provider had effective systems and processes to develop and support their teams, enabling safe working practices. They supported and developed their staff to help fulfil their potential and to meet the challenges of providing health care to a local population.