Wargrave House 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 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 practice 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 promoted a positive and compassionate culture that supported trust and understanding between staff and patients using the service. Learning and development were supported. Staff reported a positive experience of working at the practice. They felt there was a supportive environment and expressed strong teamwork and a shared commitment to delivering high-quality, patient-centred care.

The practice 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, responded to all concerns raised and modelled the values of the practice. 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 partners schedule included protected administrative and leadership time, time to support strategic focus and quality improvement.

The practice fostered a positive culture where staff felt they could speak up and their voice would be heard. Staff reported that there was an open-door policy with their line managers and felt they were always approachable. Staff felt their concerns would be dealt with appropriately. The practice had a Freedom to Speak up policy. The practice had established Freedom to Speak up arrangements with other practices in the primary care network. Staff were aware who the Freedom to Speak up guardian was. The guardian came into the practice on a weekly basis.

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. There were policies and procedures to promote equality and diversity. We reviewed staff training and found that not all staff were up to date with their equality and diversity training. Staff feedback about the culture of the practice in the context of workforce equality was positive. Leaders made reasonable adjustments to support staff to carry out their roles well.

Staff told us they were clear about their responsibilities, roles, systems of accountability. The provider had established governance processes that were appropriate for their service to deliver good quality, sustainable care, treatment and support. Leaders were in the process of improving their policy schedule to make it more streamlined and planned to store them in the same place to make them more accessible to staff. Clinical concerns and emerging risks were discussed during team meetings, and the minutes were shared with staff to ensure the relevant information and actions were acknowledged and addressed. Staff took patient confidentiality and information security seriously. The practice had introduced a legitimate access audit that provided oversight as to the reason why staff were opening a patient record.

The practice understood their duty to collaborate and work in partnership to support care provision enabling services to work seamlessly for patients. Staff and leaders engaged with people, communities and partners to share learning with each other and to promote continuous improvement. The practice actively sought and recruited a paramedic partner to broaden their skill mix and bring a new perspective to the partnership. The partners held monthly clinical and multidisciplinary (MDT) team meetings with community advanced clinical practitioners, palliative care nurses, the wellbeing team and primary care network safeguarding lead. The practice actively engaged with the PCN and also held MDT meetings for learning disability, care homes team and frailty. One of the practice nurses also attended diabetic and leg ulcer MDT meetings. Working alongside practices in the primary care network, enabled the practice to identify new or innovative ideas that could lead to better outcomes for people.

The practice focused on continuous learning, innovation and improvement across the organisation. As a training practice, they recognised the importance of developing future clinicians. Staff learned from significant events and complaints to continually improve the service they provided. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research. For example, the pharmacy team created an informative video that highlighted information about cholesterol and ways to reduce this, including a guide to statins (a medication that lowers cholesterol levels). The video featured a staff member within the primary care network with the aim to engage patients. This video was sent out to patients to raise awareness and improve health. The practice intended to create more videos on other topics to improve and promote patient health.