Cornerstone Medical 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

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 Good. At this assessment, the rating has changed to requires improvement.
We found breaches of regulation in relation to Good Governance. We have asked the provider for an action plan in response to the concerns found at this assessment.
 

This service scored 62 (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.
All staff at Cornerstone Medical Practice had contributed to the development of the practice vision and strategy. The practice was aware of the projected increase in the local population and was working with partner agencies to address future challenges. There was a commitment to reducing barriers to care for disadvantaged groups, particularly patients with complex social circumstances and communication needs.
 

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 practice were visible, approachable, and supportive. Staff also told us leaders modelled the values of the practice. During feedback discussions, leaders were receptive to inspection findings and acknowledged areas requiring improvement. We saw the leadership team worked with other practices in the PCN and were engaged in the development of primary care services within the local area. The care coordinator role reflected compassionate and inclusive leadership through its focus on supporting vulnerable and underserved populations.
 

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 and staff were aware of whistleblowing arrangements. Staff were aware of how to raise concerns, described clear escalation routes within the practice, and we saw examples where staff had used the arrangements in place to positive effect. There was no evidence from interviews that staff felt unable to challenge concerns or raise issues.
 

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.
Policies and procedures to promote diversity and equality were in place at Cornerstone Medical Practice. Equality, diversity, and inclusion training formed part of mandatory training requirements. Adjustments had been made to ensure all staff were valued, for example we saw adjustments to support flexible working arrangements for staff were in place.
 

The service had set out clear responsibilities, roles, systems of accountability however there were gaps within the governance systems and processes. They did not always act on the best information about risk, performance and outcomes.

Governance systems were not robust and could lead to poor outcomes due to being ineffective. For example, concerns were also identified during the review of clinical records for patients prescribed certain high-risk medicines. Our review found that some patients had not received a documented medication review and there were no systems in place to ensure patients received a documented asthma review following exacerbations. The practice was reviewing governance systems to make the necessary improvements. Governance systems also needed strengthening to ensure effective oversight of patients with DNACPR decisions.

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 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 contribute to safe, effective practice and research.
At this practice, significant events, complaints and incidents were reviewed through established governance processes, with learning shared across teams. Examples were provided where identified issues resulted in changes to practice processes, including strengthening workflows and introducing additional monitoring. Following the clinical search feedback, leaders acknowledged the findings, committed to reviewing affected patients and agreed to provide an action plan. This demonstrated a willingness to learn and improve when concerns were identified.
 

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. They actively contribute to safe, effective practice and research.
At this practice, significant events, complaints and incidents were reviewed through established governance processes, with learning shared across teams. Examples were provided where identified issues resulted in changes to practice processes, including strengthening workflows and introducing additional monitoring. Following the clinical search feedback, leaders acknowledged the findings, committed to reviewing affected patients and agreed to provide an action plan. This demonstrated a willingness to learn and improve when concerns were identified.