Cambridge Clear Ear

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

This means we looked for evidence the practice was led effectively and in a way that was inclusive, supported improvement and innovation and made sure patients received care that was safe and effective.

At our last inspection, we rated this key question good. At this inspection, the rating remains good.

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders 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. However, we found that governance processes were not always formally embedded, transparent or accessible.

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 service had a shared vision, strategy and culture, underpinned by principles of transparency, equity, equality and human rights, diversity and inclusion and meaningful engagement. Staff demonstrated a strong awareness of how care, treatment and support were delivered in line with the service’s values. The service had a positive and compassionate, listening culture that promoted trust and understanding between staff and people using the service. The provider had plans for the future development of the service.

The service had inclusive leaders who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Staff told us leaders had the skills, knowledge, experience and credibility to lead effectively. They always did so with integrity, openness and honesty. Staff told us leaders were approachable and responded to any concerns raised in a compassionate, inclusive and timely manner.

The service had an equality and diversity policy and promoted equity to all people – including staff, patients and visitors to the practice. Leaders demonstrated a clear understanding and embedded commitment to equality, diversity and inclusion. Leaders created a culture where individuality was valued and differences were seen as a source of strength.
 

We found that there was a positive culture where people and staff felt they could speak up and their voice would be heard. There was a whistleblowing policy in place. Not all staff were aware of who the Freedom to Speak up Guardian was. Staff we spoke with told us that this was because they did not feel the need to contact them, as they felt they could speak with leaders if they had any concerns and would be listened to.

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. There were systems in place to support workforce equality, diversity and inclusion, with an emphasis on the safety and well-being of staff. All staff were aware of how to support people with protected characteristics such as age, gender, sexual orientation, religion and disability.

The service had governance systems in place; however, these were not operating effectively to provide sufficient assurance. For example, there were gaps in the records of staff recruitment processes and checks, and staff training. These issues were identified during our assessment and had not been recognised through the provider’s own governance and oversight processes.

Governance processes were not always formally embedded. Many governance arrangements relied on the provider’s knowledge rather than clear, documented systems. This meant governance processes were not always transparent or accessible to others, and there was limited shared understanding or oversight. Although the provider demonstrated a commitment to governance, the dual responsibility of managing governance while delivering clinical care created an excessive workload, limiting the capacity to maintain effective oversight and assurance on an ongoing basis.

The provider understood the need to strengthen their governance processes and were taking steps to improve their systems.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for patients. They shared information and learning with partners and collaborated for improvement. The service worked with other organisations, such as a major retailer with the aim of improving service provision in the community.

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. The service had a quality improvement plan to help drive improvements in services.