Stonecot Surgery

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 remains the same.

This service scored 82 (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 very clear shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an exceptional understanding of the challenges and the needs of people and their communities.
The service had 3 linked priorities: continuous service improvement, preventing ill-health and improving long-term condition management, and strengthening community partnerships. We saw how innovations and changes were used to drive improvements in these areas.
The service was exceptionally patient-focused and responsive in its direction and culture. This was reflected in feedback from staff and patients and how improvement work was framed. Initiatives and improvements were patient-centred, for example online communication had been added as an additional choice for people rather than as a default option, with other software used to streamline administrative tasks and have extra contact with people who needed it.
The service was changing how care was delivered for people with long-term conditions. The rationale for this included efficiencies and benefits for the practice but the point of view of people receiving care was very clearly articulated.
All staff were invited to a recent Business Development Dinner when the team discussed current operational processes informally, explored ways to improve clinical services, and initiatives for staff wellbeing and team cohesion.

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 approachable and responded to concerns raised. We saw the leadership team worked with other practices in the primary care network and were engaged in the development of primary care services within the local area.

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 with other practices in the primary care network. Staff were aware of how to raise concerns.
The service had a Learning Safety Culture Strategy, which included formal success measures. One area of focus was to ensure staff felt fully confident and encouraged to report incidents, errors, and near misses. This was being monitored by reviewing incidents reported and through staff survey feedback.

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. Arrangements in were in place to make adjustments for staff who needed them.
The service was very responsive and tried to ensure that anyone who felt they needed one received an appointment. At times this meant staff felt under pressure. Service leaders showed us evidence that demand was monitored and that changes they had made had reduced clinical workload. Additional clinical staff had been recruited and were due to start in the service soon. There were further actions in progress designed to reduce the pressure on clinical staff while maintaining good access and quality care.

The service 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 act on the best information about risk, performance and outcomes, and share this securely with others when appropriate.
All staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews. The provider had established governance processes that were appropriate for their service. Staff could access all required policies and procedures. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions arising from these meetings and shared these with staff. Staff took patient confidentiality and information security seriously.
The practice had a demonstrable commitment to becoming a ‘greener’ practice. Solar panels meant the practice used renewable energy and systems had been put in place to maximise recycling and minimise resources used. There were plans in place for other environmental improvements, for example a secure bike rack to encourage cycling and reviewing sustainability in prescribing.

The service clearly understood and carried out their duty to collaborate and work in partnership, and services worked seamlessly for people. They always share information and learning with partners and collaborate for improvement.
The service worked with local charities to reduce health inequalities and provide people with more information about support available. There were plans to develop space outside the surgery into a community garden in partnership with two other local charities.
The service worked with other practices in their primary care network on the delivery of standard GP services and led on innovative projects to improve how care is delivered.
Staff worked collaboratively with social care providers and actively sought feedback as to how to improve care for the people who lived in social care locations.
The service worked with consultants from 3 hospital teams to develop better ways to collect and share information to identify people who need their care planned more carefully, and to ensure patients received care that was optimised before an outpatient appointment and then received more joined up care after consultant input.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They always encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research.
All staff were encouraged to put forward and test out new ways of working. There was a staff suggestion box and other opportunities for staff to suggest and develop ideas. We heard about ideas that had come from staff, that had been tested and found to work well, for example the daily administration appointment list.
Innovation and improvement work was driven by knowledge of the needs of the people registered as patients at the practice. This included practice-led projects as well as wider initiatives that the service chose to participate in. Innovation and improvement work was evidence-led and was planned and documented well. Data was collected before changes were made, so that improvement could be measured and resources targeted.
Technology was used effectively to support creative ways of delivering equality of experience, outcome and quality of life for people.
The service worked with other practices in the primary care network to make larger projects possible, including by sharing initiatives developed within the service. Specialist support had been sought to make sure these larger projects were delivered in line with best practice for health improvement.
After changes had been made, performance was monitored to make sure the expected improvements were made and sustained. Where changes were successful the service built on these to improve further, and there was transparency and action where changes were unsuccessful. Following work to improve patient experience of contacting the practice by phone, there was ongoing quantitative and qualitative monitoring of call handling. The use of software to code information from hospital letters was discontinued because staff found that it did not reduce the time taken to accurately input the information onto patient records.
Innovation and change resulted in measurable improvements in patient access, care and outcomes.
The service shared what they had learned locally and nationally.