Oak Tree 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 remained the same.
Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers worked with the local community to deliver the best possible care and were receptive to new ideas. There was a culture of continuous improvement with staff given time and resources to try new ideas. For example, the service sought ideas from staff about how to maximise space within the building.
 

This service scored 75 (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 strategy was available on the practices’ website. Upon speaking to staff we found that some staff were aware of practices’ strategy and vision and some were not aware.
The service worked as part of a PCN to increase services to their patient population.
Leaders were aware of their local challenges including a recent increase to patient population and was actively recruiting more GP’s to ensure people could access services. Staff could describe how communication through meetings and emails kept them up to date about practice changes.

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.
During our site visit, we found leaders of the service to be engaging, honest and strived to continually improve. Leaders were aware of the challenges they faced and the areas they needed to improve. We were given mixed feedback about whether leaders were supportive, visible and approachable within the practice.
 

The service fostered a positive culture where people felt they could speak up and their voice would be heard.
The service had a formal freedom to speak to guardian (FTSUG) and this was promoted within the building. However, staff could not always tell us who the FTSUG was. Staff were aware of how to raise concerns and told us they felt confident to do so. The service had a Whistleblowing Policy which was accessible to staff. The policy outlined the process for raising concerns internally and externally.

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.
The service had policies and procedures to support equality and diversity and staff had completed appropriate training. There was a policy and procedure to protect staff from bullying and harassment.
The various staff teams within the service held regular meetings to be able to communicate changes and minutes were recorded.
The service used digital technology within the service as a method of communication across both sites. The leaders of the service took steps to promote wellbeing within the staff group. To support staff wellbeing the practice had developed a wellbeing resources page, held teams days and social events.
 

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 acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.
At the last inspection, we recommended the provider review and standardise governance systems across the organisation to ensure accurate records are kept in respect of recruitment checks, training records and meetings held.
At this inspection, we found the service had taken steps to improve its governance and developed additional electronic systems to allow standardised governance arrangements. Staff and leaders we spoke with were clear on their individual roles and responsibilities. There were protocols for decision making within the partnership and a scheme of delegation for financial decisions. During the assessment process leaders were responsive to our feedback and provided additional assurances to ensure people were not at risk.
The service utilised an external resource to support the service with remote consultations and the appropriate data security requirements were in place.
Staff could access all required policies and procedures that were held digitally.
The service held regular meetings in various operational areas to communicate changes and share learning. Meetings were recorded with clear actions and could be shared across appropriate staff teams.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.
The service was part of a Primary Care Network The service benefitted from the roles and services delivered by the PCN and the service had taken steps to ensure that staff employed by the PCN were integrated into the service team.
The service worked in an integrated way with health and social care colleagues and this was evidenced through Multidisciplinary Team (MDT) meetings. (An MDT meeting, is a gathering of healthcare professionals from different specialties who collaborate to discuss and make decisions about a patient's care plan). The service enhanced the way it worked with others by allowing the sharing of their system access to a community district nursing team to support collaborative working.
We received positive feedback from a community partner who said the service “always responds to our anxieties promptly, always visits when we ask them to and also does a very thorough 6-month review of medications and ailments’’.
 

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. The service was actively contributing to research and had a research team. The team had a variety of research studies taking place such as, Kardia a study on hypertension and Victorian, a study looking at the effects of a new treatment for coronary artery disease. Additionally new studies relating to obesity and acne were about to start. The service kept people informed about research on the website.
There was a focus on continuous learning and improvement. Staff were encouraged to develop their skill set to enable them to take on new roles, responsibilities and further their career. Staff told us they could access training through a training hub and that they were supported by the service to do so.
Leaders encouraged staff to speak up with ideas for improvement and we saw an example of this when staff were asked for their feedback about maximising space within the practice.
Where significant events had occurred the service had taken steps to ensure learning took place and we saw evidence of this. Where the service had conducted a GP Family and Friends survey we saw the service communicate its findings and an improvement plan to its patients.