Stirling Road Medical 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, we rated this key question as requires improvement. At this assessment, the rating has changed to good.
 

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.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.
Staff said changes were communicated through email, newsletters, meetings, training days, supervision, online systems, and they had opportunities to attend relevant meetings. The service understood projected growth in the local population and worked with partner organisations to plan for future challenges.
 

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.
Staff told us leaders in the service were approachable and responded to any concerns raised. Staff told us they felt supported by team leaders, managers and senior management. Most described leaders and managers as visible and approachable, with access to senior clinical and managerial decision makers when support or guidance was required.
 

The service fostered a positive culture where people felt they could speak up and their voice would be heard.
Staff understood the whistleblowing arrangements and knew that a Freedom to Speak Up Guardian was available. The service promoted this through staff newsletters. However, while some staff told us in their feedback that they believe patient safety concerns would be welcomed by the service there were a minority of staff that did not feel fully confident raising concerns or speaking up. The service acknowledged this feedback and planned to promote this in team meetings and during new or temporary staff induction.
 

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.
The service had equality and diversity and bullying and harassment policies to support an inclusive and fair working culture. These set expectations for respectful behaviour, equality of opportunity and routes for staff to raise concerns about discrimination, bullying or harassment.
 

The service did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.
The service demonstrated that environmental, cleaning and premises concerns had been identified through governance processes and escalated prior to the assessment. However, despite these actions, concerns relating to environmental standards, infection prevention and control and medicines storage were still found at this assessment. This showed that governance systems identified and escalated risks but did not secure timely and sustained operational resolution.

The service had established an implemented an assurance framework to oversee quality, compliance and risk across all areas of the service, which required time to be fully embedded. The framework mapped activity to the CQC quality statements and key questions and brought together information about complaints, incidents, risks, audits and action plans.

Leaders used integrated governance systems to communicate concerns across sites, monitor service performance, identify areas for improvement and track actions through to completion. Staff had access to policies, procedures and guidance through a centralised system and understood their roles and responsibilities. Development plans supported service improvement and estates development. Staff also described arrangements to maintain service delivery during operational pressures, including locum and overtime cover, cross-site working and business continuity planning.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.
Leaders demonstrated a commitment to wider improvement activity through participation in organisational and system level initiatives. Including the development of Smart Voice and Smart Navigation, the use of an organisation wide assurance framework, and involvement in programmes designed to improve access, quality and service sustainability across the wider provider group.
The service worked with community and voluntary sector organisations to respond to local population needs and support specific population groups. This included social prescribing services, community workers supporting the PL5 project and digital inclusion initiatives delivered within the local community. These arrangements supported people to access healthcare services, community resources and wider support, while helping to reduce barriers associated with digital exclusion.
The service is a veteran-friendly practice and worked with veteran support networks, including a veterans hub, to improve access to support and community resources for veterans

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.
The service demonstrated a systematic approach to innovation through the development of smart voice and care navigation systems in response to concerns about telephone access, appointment availability, administrative workload and care navigation. The systems were designed to improve access, direct people to the most appropriate service and release staff capacity for more complex and proactive care.

The smart voice system gathered basic information and routed telephone calls appropriately, while the smart navigation system used information about a person’s needs to help staff direct them to the most appropriate clinician or service.

People and staff were actively involved in developing and refining the systems through regular feedback, which informed changes to call and access options. Learning from people’s adverse experiences and significant events was also used to inform ongoing development.
Innovation was embedded within the service’s approach to quality improvement. Leaders used data from the smart navigation system to evaluate effectiveness, understand the volume and nature of demand, identify emerging trends and determine the clinical skills required. This informed workforce, capacity and service planning at service and provider group level.
Leaders reported increased call handling and same day appointment capacity, reduced waiting times and improved use of staff resources following implementation. They monitored performance and outcomes through established governance arrangements and used this information to continuously refine service delivery.
Leaders described adoption of their smart navigation system beyond the service and plans for further development, demonstrating wider system learning and improvement.
The service used its assurance framework to bring together learning from incidents, complaints, risks, access, audits and improvement activity. This enabled leaders to identify themes and monitor improvement actions across the service.
We saw evidence that learning from incidents, complaints, audits and clinical searches resulted in improvements to systems and practice. Examples included introducing a lead GP role following concerns about patient record management, strengthening prescribing verification processes and developing a test management standard operating procedure to improve clinical oversight.
Quality improvement activity included repeat cycle clinical, prescribing, infection prevention and control, clinical record and carers register audits. Leaders used findings to monitor improvement and evaluate outcomes. For example, the carers register audit demonstrated sustained improvement in identifying and supporting carers.