Larksfield Surgery Medical Partnership

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

This means we looked for evidence the service involved people in their care and treatment, and treated them with compassion, kindness, dignity and respect.

At our last inspection we did not look at this key question. The rating of Good had been carried over from the previous inspection.

At this inspection, the rating has changed to Requires Improvement.

This is because:

• Not everyone felt staff treated them with kindness, empathy and compassion.

• Some people using the service felt staff did not involve them in decisions about their care and treatment.

• Not all staff had completed training to help them further support autistic people and people with a learning disability, and it was not clear what arrangements were in place to support veterans.

• Staff did not always feel leaders cared about and promoted the wellbeing of staff, and staff were not always supported to deliver high-quality care.

However, the provider had taken steps to help respect people’s privacy and dignity and was usually able to respond to people’s immediate needs.

Feedback from care homes the practice supported was mostly positive about the attitude of clinical staff.
 

This service scored 55 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice had taken some steps to help make sure consultations with patients, telephone calls and discussions with other staff could not be overheard. For example, at the branch site, a radio played in the waiting area to help maintain people’s privacy and safety.

At the main site, there was a quiet room away from reception that could be used if a patient needed privacy, for example for a discussion or to breastfeed.

Staff from care homes the practice supported described most clinical staff from the practice were approachable, kind, warm, patient, professional, knowledgeable, and genuine. They described most staff took the time to listen to residents and their families and understand their wishes. Care home staff reported feeling well supported and involved in decisions about the residents’ care and treatment.

Of the people who responded to the 2025 national GP Patient Survey about the practice, 80% said during their last appointment the healthcare professional was very good or fairly good at treating them with care and concern. This was in line with local and national averages.

However, other people who had used the service and provided feedback online or to CQC were negative about the attitude of clinical and non-clinical staff at the practice. People described staff as rude, unhelpful, feeling staff made them feel they were wasting the clinician’s time, and staff had not done all they could to reduce and respond to discomfort during procedures.
 

The practice was an accredited ‘Veteran Friendly’ practice, meaning the practice had a dedicated clinician who has specialist knowledge of military-related health conditions and veteran specific health services, to help support serving members of the Armed Forces, ex-service personnel, and their immediate family and carers to access the best possible care and treatment.

However, although the practice asked patients newly registering with the practice if they had served in the Armed Forces, practice staff did not know what other support was available or which clinicians in the practice had this specialist knowledge.

Since July 2022, there has been a legal requirement for providers to make sure their staff receive training to help them support autistic people and people with a learning disability. Training records showed 6 of the 31 non-clinical members of staff employed by the practice had started the required training and 1 non-clinical member of staff had completed the training. However, there was no record any clinical staff had started or completed the training.
 

The findings of the 2025 GP Patient Survey showed 81% of the people who responded to the survey said during their last appointment they were involved as much as they wanted to be in decisions about their care and treatment. This was below the national average of 90%.

Staff told us they could also use the quiet room away from reception at the main site if a patient needed a quiet space to wait or if someone became agitated.

The branch site was less busy than the main site. Staff would respond to people’s needs using the limited space available.

At both sites, reception staff could easily see people in the waiting area and could therefore notice and respond if someone became very unwell or distressed. However, the practice had not identified and addressed risks relating to the upstairs waiting area at the main site, which was isolated and not visible. Practice leaders responded to our feedback.

All non-clinical staff had completed training in Sepsis Awareness. Sepsis, sometimes called blood poisoning, happens when your body overreacts to an infection and starts to damage itself. Symptoms can be difficult to spot, and sepsis can be life-threatening. Therefore, it is important that staff can recognise and act on symptoms.
 

The practice displayed posters advising patients about the practice ‘zero tolerance’ approach in the reception areas and the Zero Tolerance Policy was available on the practice’s website.

Some staff described a poor culture within some teams, and we observed tension between some members of staff.

Leaders told us about steps they had taken to help improve working relationships, including a ‘whole practice away day’. Leaders told us about plans they had for further team building days.

The practice had signed up to an employee assistance programme that staff could access if they needed.

Leaders had not carried out a specific risk assessment for an individual staff member when this could have been appropriate.

Some staff told us the actions taken to help improve their working environment were not always effective. For example, some staff told us the building would get very hot in the summer and very cold in the winter.

We also saw that treatment plinths in clinical rooms were not moveable nor adjustable, which sometimes made it difficult for staff to assess or treat patients easily, and reduce the risk of injury.

Some staff told us practice leaders had discretely supported them with personal matters, such as making adjustments to help their return-to-work following illness or injury.

There were some arrangements for staff to seek assistance if needed, however these needed strengthening. For example, to help promote the safety for staff who worked alone at the practice's main site, and to support staff when working from the branch site.

The practice offered home visits to patients who could not attend the practice. However, arrangements to help reduce risks to staff did not work effectively. For example, the processes in place for staff in the practice to know if a member of staff had visited a patient at home, where they were expected to be and when they were expected back at the practice did not work effectively. There was no system for identifying if a member of staff had completed the home visit safely or to ‘check-in’ with the member of staff. We were told that staff out on a home visit could contact the practice by telephone if they needed assistance. However, staff also told us this phone line was not always answered or in a timely way. Staff told us about safety incidents and risks they had encountered whilst on home visits, for example aggressive pets.

Although some staff told us they felt support was available when they needed it, other staff told us they were not always sure who to ask if they had a query, were unsure about something or needed peer support. Staff gave examples of when they felt they had not been supported by others with a caring approach and in line with the practice’s policies and procedures.