Adam House Medical Centre

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 good-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

The provider had made improvements in the following areas: there was a settled management team at the service and systems to monitor risk and ensure quality and sustainability were in place.

At our last assessment, we rated this key question as requires improvement. At this assessment, the rating has changed to good.

This service scored 68 (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. The aims and objectives were outlined in the statement of purpose. The majority of staff were positive about the culture of the practice.

The service had leaders at all levels who understood the context in which they delivered care, treatment and support. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. The provider had considered succession planning and strengthened the clinical team with the appointment of two salaried GPs. Staff told us leaders in the practice was approachable and mostly responded to any concerns raised. We saw the leadership team worked with other practices in the primary care network.

The service aimed to foster a positive culture where people felt they could speak up and their voice would be heard. There were systems in place to support staff to whistle blow or to speak with a Freedom to Speak Up Guardian if they had any concerns. Staff were aware of how to whistle blow and who the internal Freedom to Speak Up Guardian was and what their role was in supporting staff. Most staff felt that they could speak up and most felt that their voice would be heard and acted upon.

However staff were not aware of who they could raise concerns with outside the service as links had not been established with an external Freedom to Speak Up Guardian. The day after our assessment, the provider informed us they had updated their policy to include the details of the external Freedom to Speak Up Guardian.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them. The service valued diversity in their workforce. Policies and procedures to promote diversity and equality were in place. Staff had received appropriate training.

The service had identified clear responsibilities, roles, systems of accountability and governance following the changes to the partnership. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on information about risk, performance and outcomes. However, action was required to complete the actions required as outlined in the legionella risk assessment, ensure appropriate emergency equipment was available at both sites and the system for prescription tracking was effective.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews. Staff could access all required policies and procedures, although a number required updating to ensure the information was up to date and accurate. 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 they shared these with staff.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. The practice had a Patient Participation Group (PPG). A representative from the PPG told us that their views were acted on whenever possible and they worked closely with the practice to improve services for example, repeat prescriptions. The PPG had supported the service to set up a Facebook page and was developing a working relationship with Sandiacre Hub to increase the level of information and support for patients and the local community. The PPG also shared details of support groups listed in the newsletter of Joined Up Care Derbyshire.

There were processes in place to work in partnership with key organisations and agencies to support the provision of care and joined up working.The service worked in partnership with other services to meet the needs of its patient population. For example, the frailty team and the local Primary Care Network (PCN). The PCN provided a range of appointments in addition to the ‘on day’ service including home visiting service, NHS health checks, mental health practitioner, social prescriber and blood tests.

The service focused on continuous learning and improvement across the organisation. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. The service had a quality improvement plan in place to help drive improvements in services. There was an annual audit plan in place. Completed audits demonstrated improvements, for example steroid emergency cards.