Minehead 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. This is the first inspection for this service since its registration with CQC. This key question has been rated as good. Staff told us the onsite leadership team 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 drive to improve the service.

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 provider told us they had worked hard to change the culture of the service. The service had a quality improvement plan to continue to progress their commitment to people. Staff told us there was an open-door policy where they could access and speak openly to onsite leaders. Feedback from staff was positive about the change in culture at the service since the new provider took over. However, some staff told us they felt there was a divide between staff that worked onsite at the service and senior staff who were based at the head office of the provider. Staff were encouraged to keep their knowledge and skills up-to-date in line with continued professional development to support the service. Daily huddle meetings and regular team meetings kept staff informed of any changes or progress the service had made.

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 onsite at the service were approachable and responded to any concerns raised. Staff also told us onsite leaders modelled the values of the service. However, some staff also told us senior leaders based offsite were not always visible or approachable. We saw the leadership team worked with other practices in the primary care network and were engaging in the development of primary care services within the local area.

The service fostered a culture where most staff felt they could speak up and their voice would be heard. There were policies and processes to support speaking up and these were accessible to all staff online.The service had a formal freedom to speak up guardian (FTSUG) although not all staff knew what their role was or who it was. The FTSUGs were not external to the provider but were named people not associated with the immediate service. Staff were aware of how to raise concerns.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them. Policies and procedures to promote diversity and equality were in place. Staff were able to explain their understanding of equality, diversity and inclusion and had completed training in this area. Staff gave examples of reasonable adjustments the service had made to support them both at work and in personal circumstances.

The service had responsibilities, roles, systems of accountability and good governance however, these were not always effective. The service had not had a consistent clinical lead which had impacted on the governance, oversight and implementation of new processes. The extensive use of locum GPs had presented challenges, as their lack of permanence created inconsistencies and limited their ability to support new processes.

Our clinical searches found some areas of patient risk that the service had not identified themselves. New systems and processes had been established and were still in the early stages of being embedded. We saw evidence some of these new systems were in use. For example, a safeguarding audit had been carried out to review staff compliance with systems and processes. This audit identified improvements were needed in key record-keeping areas and feedback was given to those involved. This process had been introduced at the beginning of this year and had so far been carried out twice.

The service mostly acted on the information about risk, performance and outcomes, and shared this securely with others when appropriate. Leaders and managers supported staff, and staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly but had not yet completed appraisals. The service had a planned schedule to implement annual appraisals.

Staff could access all required policies and procedures. Managers held regular meetings with staff, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. Staff took patient confidentiality and information security seriously

Staff and leaders worked to establish and maintain working relationships with community stakeholders sharing specialist knowledge, skills and experiences.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement. Partner organisations told us how collaborative working had improved since the provider took over this service. The service worked with other practices within their primary care network. Staff had made adjustments to improve coordination of their service with community healthcare services. For example, the service frequently liaised with external organisations such as schools, community mental health services, village agents and complex care nurses.

The service focused on continuous improvement across the organisation and local system. They actively contributed to a safe, effective practice. The service had a quality improvement plan to drive positive changes to improve the health and wellbeing of the patient population. This focussed on recruiting permanent GPs to support the service delivery and the future development of a new appointment triage process. Staff told us they had been encouraged to develop their skillset to enable them to take on new roles, responsibilities and further their careers.