Hattersley Group 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

Following our last inspection changes to the provider management structure had taken place. This had resulted in gaps to support the practice and a restructure was in progress at the time of our assessment to address this.

Not all staff felt supported to give feedback and roles and responsibilities were not always clear. Managers worked with the local community to deliver the best possible care and were receptive to new ideas.

This service scored 57 (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 and strategy. 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 felt they had not contributed to the development of the practice vision and strategy. The practice was aware of the projected increase in the local population however they were not working with partner agencies to address future challenges. For example, the primary care network and provider had conflicting priorities.

Not all leaders understood the context in which the service delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively.

The leadership structure had changed since our last inspection and a practice manager was in post 3 days prior to our assessment. An operations manager had overseen the practice team with support from the leadership academy of the provider. The provider recognised the practice manager role was needed to ensure the knowledge and leadership skills for the practice was in place. There was no medical lead or specialist nurse for diabetes for the practice and it was unclear how these gaps were managed at the time of the assessment. The provider had plans to address this going forward.

People did not always feel they could speak up and that their voice would be heard.

The practice had Freedom to Speak up arrangements and staff were aware of how to raise concerns. Staff gave examples of raising concerns to leaders and managers and no action was taken to address them.

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.

Policies and procedures to promote diversity and equality were in place. We saw some staff were working above and beyond their working hours to ensure the service was maintained. This had not been acknowledged or addressed by the provider.

The service did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes. Leaders and managers did not always support staff. Staff we spoke with told us they were not clear on systems and processes for patient recall since changes were made. The provider had introduced another restructure to support the practice which included the appointment of a practice manager. Some risks had not been identified and added to the risk register. For example, increase in list size and staffing. We saw staff were working unpaid hours to complete administration tasks to ensure they had the information needed to assess patients. Staff could access policies and procedures. There was no regular practice meeting with all staff, but clinical meetings were held with no set agenda.

The service had challenges to collaborate and work in partnership, so services work seamlessly for people. They did not always share information and learning with partners or collaborate for improvement. Other supporting services had issues with IT systems and processes that had impacted obtaining blood results for patients. This had been escalated to the ICB and Local Medical Committees (LMC) for resolution.

The service did focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people.

The provider had not ensured staff had completed the required training due to staff vacancies. Staff felt their ideas for improvement were not listened to.

The provider had plans for improvement and innovation with the wider organisation and these were in progress at the time of the assessment.