Carlisle Central Practice

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

Well-led – this means 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 assessment for this newly registered service. This key question has been rated Good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

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 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.

The provider 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 feedback was mostly positive about leadership, with 14 of the 21 staff members we spoke to saying they felt supported by leaders, compared to 5 who said they did not and 1 who said they sometimes did.

People did not always feel they could speak up and that their voice would be heard. Feedback from staff was mixed on this matter, with 10 staff members saying they felt listened to while 7 said they did not and 2 said they sometimes felt that their views were being heard. We saw there was a Freedom to Speak Up Guardian in place and mechanisms for staff to raise concerns.

The provider 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. We saw senior leaders had addressed concerns related to discrimination.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. However, some staff were not always aware of who held certain roles or responsibilities. Communication was the second most frequently highlighted area for improvement by staff we spoke with (after the need to recruit more staff) and this was demonstrated as an issue by the number of people who were unaware who performed the role of Infection and Prevention Control (IPC) lead. Of the 21 staff we spoke with, 9 people said they did not know who the IPC lead was, and of the 12 who said that they did, many did not give the correct answer. Over half of the staff we spoke with said they did not attend any staff meetings, and we were informed that there was no meeting for all staff to attend outside of time set aside for practice learning time, and this had not happened in the 4 months prior to inspection.

The provider understood their duty to collaborate and work in partnership, so services mostly worked seamlessly for people. We saw they often shared information and learning with partners and collaborated for improvement. We were made aware of an occasion where other services had asked repeatedly for information to be shared with them in order for a patient to receive a vital social care placement, however the provider gave us evidence of the processes that can be used to collaborate with partners, such as a dedicated phone line which bypasses the need to contact reception.

The provider 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. They actively contributed to safe, effective practice and research. We were given a number of examples of new initiatives the provider was bringing in to make improvements, such as a planned call centre to improve telephone access. The provider had already started this with other practices they operated, and were planning to extend it to include Carlisle Central Practice soon. They had also recently installed a new system which merged tasks across multiple platforms to allow staff to find patient information more easily.