Sidley Medical Practice Also known as Dr Lawton & Partners

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

At a previous assessment, we rated this key question as inadequate. At this assessment, the rating remains as inadequate. We identified breaches of the regulations.

The provider was not visible or effective as a leader. We found instability in the management team and a lack of established and effective systems in place to ensure safe care.

There were not defined and effective systems established to ensure staff understood their roles and responsibilities and were held accountable. Staff and patients told us they were not listened to and did not feel their experiences were valued. Risks had not been identified, recorded, investigated and mitigated. There was no culture of learning or improvement.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff did not have access to management support or leadership from the partners. Staff told us the partners were not present in the practice with staff unaware of when they would be in the practice or where they would be. There was no registered manager in post and the practice manager position was vacant. Staff retention was poor and high sickness levels reported by staff were witnessed during our inspection.

We spoke to staff who were unclear on what was expected of them in their role and how this directly contributed to the wider organisation’s objectives. Staff told us they did not feel listened to or trusted to work with autonomy. Their achievements were not acknowledged or celebrated.

The provider and management team failed to demonstrate they had the experience, capacity, capability and integrity to ensure that people were safe. The provider had failed to comply with previous enforcement notices issued by the Care Quality Commission (CQC) identifying improvements were required to provide safe care and treatment, appropriate staffing and well led practices. We found the provider had not implemented measures to mitigate risks to people as detailed in their action plan submitted to CQC.

Staff did not know if there were Speak Up Champions for them to approach if they felt unable to directly raise concerns with the management team. Staff told us they were told only to report issues directly to the partners, who were described as absent or unapproachable. Staff did not have confidence the provider would listen to them, record their concerns, investigate them and improve the service.

The provider did not promote equality, diversity and inclusion. Some staff described working in silos, isolated from the rest of the practice team and subjected to inappropriate behaviour from the provider.

We found no evidence of staff meetings or similar opportunities being provided to staff for them to support one another, share learning and diversify their knowledge and skills base.

Staff were not encouraged, supported, or involved in contributing to governance systems, or overseeing and establishing safe practices. We found no established and effective governance, management and accountability arrangements in place at the service. The provider did not meet with staff individually or collectively to assess and review performance. Staff with leads roles including clinicians, did not demonstrate they had the skills, knowledge and/or experience to perform the roles effectively. Staff were not held accountable for their responsibilities. There was no registered manager or practice manager in post responsible for the day-to-day operation of the business and ensuring the practice was running efficiently and effectively. A member of the management team told us they had not discussed, agreed or recorded plans or priorities for their workstreams with the partners prior to their implementation. Staff did not know what was intended to happen to patient services or staff when the branch surgery lease was due to end in 2025.

There were no established and effective systems in place to ensure staff and leaders operated with openness and transparency. Staff told us they did not engage with people, communities and partners to share learning with each other that resulted in continuous improvements to the service. The provider did not actively engage with local networks to identify new or innovative ideas that could lead to better outcomes for people.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.