The Weobley and Staunton-On-Wye Surgeries

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 outstanding. At this assessment, the rating has changed to good.

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. 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 practice 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. Leaders had the skills, knowledge, experience and credibility to lead effectively. Most staff told us that leaders in the practice were visible and approachable. Leaders were alert to any examples of poor culture and addressed concerns.

Leaders encouraged staff to raise concerns and promoted the value of doing so. We received a high number of completed CQC staff feedback forms and feedback from staff was mixed in relation to staff feeling able to raise concerns in confidence. The practice had established freedom to speak up arrangements with a primary care network manager that was independent of the organisation. This was a recent change within the practice and their policy had not been updated so not all staff knew who the speak up guardian was. The practice was responsive and keen to address this.

The practice 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. Leaders made reasonable adjustments to support staff to carry out their roles well.

The practice had clear and effective governance, management and accountability arrangements. They used these to manage and deliver good quality, sustainable care, treatment and support. The practice had established governance processes that were appropriate for their service. Staff knew how to access all required policies and procedures. Leaders supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff to complete appraisals to manage staff performance and address any concerns. 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 ensured this information was shared with the relevant staff.

The practice understood their duty to collaborate and work in partnership to support care provision, service development and continuous care. Staff and leaders engaged with people, communities and partners to share learning with each other and to promote continuous improvement to services. For example, leaders created templates, protocols and alerts within the practice that were shared within the primary care network. The practice adopted good working relationships with district nurses, frailty team, safeguarding team and palliative care team. Staff members such as the pharmacist, paramedic and wellbeing co-ordinator were shared amongst the primary care network and utilised by the practice. The practice offered space for extended access clinics once a week and were involved in practice nurse forums. The lead nurse also attended monthly diabetic team meetings with social care consultants.

The practice focused on continuous learning and improvement at all levels across the service. For example, the service was a GP trainee practice and there were regular clinical meetings to discuss cases and best practice. Staff were supported to prioritise time to develop their skills around improvement and innovation. There were processes to ensure that learning happened when things went wrong, and when there was good practice. The service actively contributed to safe and effective practice and research. Staff and leaders engaged with external partners, including research, and embedded evidence-based practice in their service that supported improvement and innovation. For example,the practice co-hosted educational evenings for local GP practices, was part of a successful dermatology project and one of the GP's was a diabetes clinical lead for the Hereford and Worcester Integrated Care Board that set up multi-disciplinary team meetings, leading to a 50% reduction in referrals to secondary care.