Lawrence Hill Health Centre

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• 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 requires improvement. At this assessment, the rating has changed to good.

The service was in breach of legal regulation in relation to good governance.

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.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

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.

The service had clearer responsibilities, roles and systems of accountability. They now acted on the best information about risk to minimise risks to people. For example, another infection prevention and control (IPC) audit had taken place since the last inspection and identified action to take to reduce risks to people.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The service did not always have clear responsibilities, roles, systems of accountability or good governance. However, they acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

The service had made improvements in their governance processes since the last inspection. For example, now, blank prescription stationery was stored securely, areas of health and safety had been risk assessed and, emergency medicines were kept in stock in line with the risk assessment.

New processes had been implemented to ensure delegated tasks were being completed. However, we found some shortfalls in the oversight of these systems and process to ensure they were effective and in line with national legislation. For example, learning events and complaints were not always investigated thoroughly to ensure lessons were identified and appropriate actions implemented. There were also gaps in evidencing pre-employment checks to confirm staff suitability, and measures to minimise the risk of infection prevention and control issues were not consistently followed.

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

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.