Balance Street Practice

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 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 service had a shared vision, strategy and culture. This was based on transparency, equity, equality, human rights, diversity, inclusion and engagement. Staff and leaders understood the challenges and the needs of people and their communities.

The service had a clear vision and strategy, which was kept under review. Their mission statement was to deliver high-quality, compassionate, and patient-centred healthcare to the community. To work collaboratively as a multidisciplinary team, guided by professionalism, respect, and continuous learning, to provide safe, effective, and accessible services that supported the health and wellbeing of every patient.

Leaders monitored and reviewed progress against the delivery of their strategy. The service was aware of local challenges which affected their service, such as access to secondary care services. Staff and leaders actively promoted equality and diversity and worked to identify the causes of any workforce inequalities. They demonstrated a positive and compassionate listening culture that focused on learning and development. Staff were extremely positive about the culture within the practice and told us it was open, transparent, and they felt supported to raise concerns which they knew would be listened to and acted on.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

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 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.

The provider told us the practice’s strength lay in a distributed leadership structure that acted as their eyes and ears on the ground to ensure that community voices directly influenced their clinical governance and that vulnerable patients did not fall through the gaps. For example, the practice employed a care home and safeguarding care co-ordinator who had established direct lines of communication with the care homes to significantly reduce misunderstandings and improved the quality and safety of patient care. Their community co-ordinator provided a vital link to the wider community and social prescribing networks co-ordinating care for people with complex needs, vulnerable people and those recently discharged from hospital.

All staff we spoke with were clear on their individual roles and responsibilities. Leaders proactively supported staff and regularly met with them to complete appraisals and performance reviews. Staff feedback from the recent Partners and Manager Survey showed a positive and supportive culture. Most staff expressed high satisfaction with the leadership structure and reported clear communication, strong advocacy and accessible managers. Staff felt encouraged to develop professionally, with leaders promoting training and innovation. The survey also demonstrated a psychologically safe environment, with the majority of staff stating they felt comfortable raising ideas directly with leaders.

The practice’s CQC registration was not up to date at the time of our assessment, 3 partners had not registered with the CQC. The practice acted immediately when this was brought to their attention and applied for the required checks and forms.

The provider had established governance processes in relation to the quality statements we reviewed during this assessment. Whilst risk assessments and audits were completed, an overarching risk log was not in place. Following our assessment the provider sent us the risk log they had developed. Staff could access all required policies and procedures, which were kept up to date and reflected latest guidance. Leaders held regular meetings with staff, during which they discussed emerging risks and potential improvements to the service. Leaders clearly recorded any actions that arose from these meetings and shared these with staff.

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.