Gladstone 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 71 (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 mission statement was reviewed annually and discussed with staff.

Staff feedback was very positive about the culture within the practice. Staff told us there was an open and transparent culture and they were encouraged and supported to raise any issues. They told us the culture was supportive, caring and friendly and they felt valued and motivated.

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.

Staff told us leaders in the practice were approachable and responded to any concerns raised. Staff also told us leaders 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 service fostered a positive culture where people felt they could speak up and their voice would be heard.

The practice had established Freedom to Speak up arrangements with other practices in the primary care network. Staff were aware of how to raise concerns, and we saw examples where staff had used the arrangements in place to positive effect. Staff felt that they could speak up and were confident their voice would be heard and acted upon.

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.

Policies and procedures to promote diversity and equality were in place. We saw senior leaders had addressed concerns related to discrimination. Adjustments had been made to ensure all staff were valued, for example we saw adjustments to support staff were in place.

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.

However, effective systems needed to be implemented to ensure the effective management of prescription stationery from receipt to destruction within the service. Following our assessment, the provider sent us an updated prescription policy, outlining the process for safe receipt, storage, destruction and tracking of prescription stationery throughout the practice.

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. The provider had established governance processes that were appropriate for their service. Staff could access all required policies and procedures although a number required reviewing to include additional information or 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. Staff took patient confidentiality and information security seriously.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The provider worked with other practices within their primary care network (PCN) and within the local GP federation. Staff were encouraged and supported to attend meetings and local forums which provided networking opportunities with other services within the locality. The practice manager attended monthly meetings, where they networked with staff from other local practices.

The service worked in close partnership with the Patient Participation Group (PPG). A representative from the group told us they met every 3 months and were supported at the meetings by the practice manager. The lead GP aimed to attend at least annually. The representative explained the working relationship between the practice and the PPG was very good, leaders were supportive, and the views of the PPG were listened to and acted on. The practice manager commented positively on the support from the PPG, especially around the feedback from surveys carried out on their behalf.

We received positive feedback from 4 care homes where the practice provided care and treatment. They told us that staff were professional, approachable and they addressed any problems or concerns raised.

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 used learning from significant events and complaints to continually improve the service they provided.

The service had completed several single cycle audits, which had resulted in changes to practice. For example, the introduction of 3 monthly monitoring for people prescribed a specific medicine to simplify the process and ensure the required blood tests are completed. The service had also aligned long term condition reviews to reduce the number of times people needed to attend for appointments. Audits were also completed by the primary care network pharmacist aligned to the service.