Redgate 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 assessed all quality statements in the well-led key question.

Our rating for this key question remains good. We found that the provider had clear and effective governance processes, which supported the safe delivery of care. Staff were clear on their individual responsibilities and knew who was accountable for each aspect of the service. The service encouraged candour, openness and honesty.

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 and culture which drove high quality sustainable care.

The mission statement was displayed on a notice board in the staff room. Staff described the culture as friendly and supportive with a good atmosphere. There was good teamwork and the staff enjoyed working at the service. Staff told us there was an open-door policy where they could access and speak openly to leaders. There was an emphasis on the safety and wellbeing of staff. Staff were informed of changes in the service through regular meetings, emails and on the staff notice board.

The leaders were visible and approachable and responded to any concerns raised. We received positive comments from staff regarding the support provided by team leaders. The leaders cared about the staff’s wellbeing during periods of absence due to personal or family circumstances and coordinated flexible working arrangements to support their return to work. Leaders were aware of the challenges of delivering good quality care and were striving for improvements.We received different examples of how the service implemented changes in response to staff feedback. For example, during the initial phase of the new triage system, some staff were not happy with the changes. The service collated the views from all staff and reviewed them in a staff meeting to review the feedback and come up with suggestions for improvement.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff felt confident to raise any concerns with their managers and leaders. The service had a whistleblowing policy which clearly laid out the process of raising concerns within the service and externally, including the name and contact details of the freedom to speak up guardian (FTSUG - a person who supports workers to speak upwhen they feel that they are unable to do so by other routes). The policy was accessible to all staff on their computer system. Most staff were aware of the FTSUG role and how to access their support. The FTSUG information was also displayed on the staff notice board.

The service valued diversity in its workforce. The service had policies on equality and diversity and bullying and harassment. Staff we spoke to told us they had not experienced discrimination or discriminatory behaviour whilst working at the service. Staff gave examples of how the service made reasonable adjustments to support their family circumstances and health needs.

The service had clear responsibilities, roles, systems of accountability and good governance. Staff took patient confidentiality and information security seriously. During the evidence-gathering process of our assessment, we identified an incident of data breach by the service. The service took immediate remedial actions and managed it according to their policies and procedures. Managers met with staff regularly to complete appraisals and performance reviews. Staff could access all required policies and procedures on their computer system. The service had a business continuity plan which provided guidance and information for staff to follow in the event of systematic failures. The provider had oversight of contracts with external providers and liaised with them regarding any issues raised. 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. We identified shortfalls in safe recruitment practice as described under the ‘safe effective staffing’ of the ‘Safe’ key question. The service was responsive to our findings and developed action plans to address the issue. The service had a succession planning process to ensure smooth transition.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. The service worked collaboratively with their local PCN to provide care home service and engage in health promotion campaigns. The provider worked with other practices within their PCN to offer extended hours of patient appointments. The service worked with the local ICB and was responsive in their communication. There was mixed feedback from PPG representatives regarding their relationship with the service. One member said the service is “always open to suggestions to go forward for consideration,” while another felt the PPG is not valued. The current PPG was small with around 6 members. The service was looking into recruiting new members to increase the representativeness of patient demographics. The service was also establishing a new virtual PPG to promote patient participation. Representative of the care home that the service worked with was thankful to the service “for assisting our residents and doing their best in supporting” the care home. However, they commented that the service was sometimes not responsive to their requests. Since the launch of the new triage system, requests from the care home have gone through the same triage process as other patients’ requests based on clinical needs. If it were triaged as non-urgent, the requests would be managed by a designated clinician for consistency.

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. The service was a teaching practice for GP registrars and nursing students. Leaders encouraged staff to speak up with ideas for improvement. We saw examples of improvements following staff feedback. For example, the new triage system was modified following feedback from both clinical and administrative staff. The service conducted an audit on the excessive use of rescue inhalers in asthma people and identified measures to reduce their use. The service worked jointly with the local PCN in a quality improvement project to identify people with undiagnosed hypertension through more widespread blood pressure monitoring. The identified people were kept in the hypertension register and were followed up and managed with lifestyle support.