Shakespeare Walk in 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. We found that staff understood their roles and responsibilities and those of other members of the team, and lines of accountability were clear. Staff felt well supported in their role, and had been provided with information about speaking up when they had concerns. Leaders and managers demonstrated that they understood the challenges to quality, sustainability, and increases in demand. We saw they were working closely with others to develop the walk in centre into an urgent treatment centre which could deal with a wider range of patient needs. Information was used effectively to monitor and improve the quality of care and treatment provided.

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 we spoke with knew the ethos of the provider’s shared direction and culture. The walk in service was in the process of becoming an urgent treatment centre, and we saw the detailed planning that had been undertaken to achieve this. This included regular engagement with commissioners and NHS 111, as well as the development of pathways to support patients. The provider had kept staff aware of this activity, and had developed additional training and support plans for staff when the walk in centre becomes an urgent treatment centre. Staff we spoke with and received feedback from informed us that the walk in centre had a positive culture, and that they would recommend this to others as a place to work. We saw that communication had improved across the organisation since the last assessment. The provider used a variety of methods such as a staff engagement platform, daily huddles, and more formal meetings.

The service was seen to have 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 we spoke with had the skills, knowledge, experience and credibility to lead effectively. Staff told us leaders in the service were accessible and approachable. They said that they felt free to raise with managers any concerns they had, and had confidence that these would be responded to. Clinical staff were able to receive advice and support when required via duty clinical leads during service operating hours. We saw that leaders and managers had sought to develop the service to better meet needs, and had increased capacity by successfully recruiting substantive staff members. This had reduced the need to utilise locum or agency staff.

The service fostered a positive culture where people felt they could speak up and their voice would be heard without recrimination. The provider had established Freedom to Speak up arrangements which included a supporting policy, and the appointment of a senior staff member to oversee concerns. Staff we received feedback from knew how to access the policy and how to raise any issues they had.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them. The provider had policies, procedures and training in place to support the workforce, and equality and diversity outcomes. There was a strong emphasis on supporting the wellbeing of staff. For example, we heard how the provider had supported staff through challenging periods such as illness, and made reasonable adjustments to accommodate the specific needs of staff for issues such as provision of specialist seating.

The service had established governance and reporting lines, and had developed clear responsibilities, roles, and systems of accountability. They used these to manage and deliver good quality, sustainable care, treatment and support. We saw that managers supported and advised staff, and all staff we spoke with, or received feedback from told us that they were clear on their individual roles and responsibilities within the organisation. Staff told us they had access to policies and standard operating procedures to support them within their respective roles. We saw that practices were in place to monitor and mitigate risks and oversee performance. For example, they had recognised that their handling of complaints often exceeded their targets for timely resolution, and had put in new processes to improve this. There were communication structures in place, such as via a staff engagement platform, daily huddles, and more formal meetings. Staff told us that they felt well informed and were kept updated on key learning from complaints, significant events and clinical concerns. There was a business continuity plan and this detailed arrangements in place in the event of certain incidents. The provider met regularly with the service commissioner to discuss contract performance. Feedback from the commissioner informed us that engagement with the provider was effective and relationships were positive. We saw that the organisation took patient confidentiality and data and information security seriously.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information with commissioners and key partners to improve services for patients. For example, they worked closely with the commissioner, local integrated commissioning board and others on the proposed change from being a walk-in centre to an urgent treatment centre. Such work included the development of a radiology pathway to ensure that these services were delivered effectively for patients at other locations.

The service had a focus on continuous learning, innovation and improvement across the organisation. Clinical audit was used to monitor and drive improvement. Two-cycle audits to review areas of activity, including operational prescribing and safeguarding had been undertaken. On review of these we saw that these audits had shown improved performance over time. To support staff supervision, learning and development the provider had established a practice educator role. Staff we spoke with told us that they felt the provider actively supported their learning and development. We saw examples, whereby staff had been, or were being, supported to develop their careers within the organisation.