Cheriton Bishop & Teign Valley 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 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.

All staff had contributed to the development of the practice vision and strategy, which was kept under review. Staff described the service as supportive with an open culture and a focus on people’s care. Daily short catch-up meetings, regular team meetings and emails kept staff informed of changes in the service and provided an opportunity to discuss concerns.

The leaders were aware of the challenges of delivering good quality care and were striving for improvement. For example, the leaders were conscious of the pressure of insufficient clinical space at times to house various staff members and implemented a plan to extend the premises to future-proof the service. The planned extension would result in 2 additional consulting rooms, an office, a larger dispensary and a new waiting room and reception. Building work was due to commence. Patient participation group (PPG) members and people using the service were well informed of the building work during PPG meetings and on service’s website and social media.

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 service were visible and approachable and responded to any concerns raised. Staff from different roles gave examples on how they were well supported by their leaders at work and flexible work arrangements were made for their individual circumstances. Leaders led effectively and were open to staff feedback. We received different examples of how the service implemented changes in response to staff feedback. For example, the service streamlined the process of urine sample collection by updating the relevant guidance and added an instruction slip for people to reduce the number of samples submitted out of the required courier time.

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

Staff felt confident to raise concerns with their managers and leaders. The service had a whistleblowing policy which clearly laid out the process of raising concerns, including the contact details of the freedom to speak up guardian (FTSUG). Staff were aware of the FTSUG role and how to access their support. (FTSUG is a person who supports workers to speak upwhen they feel that they are unable to do so by other routes.)

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.

There were policies and procedures to promote equality and diversity. All staff were up to date with their equality and diversity training.

The service made adjustments to ensure all staff were valued. For example, staff gave examples of how the service made adjustments to support their health needs, such as during a period of ill-health. Staff feedback demonstrated there was an inclusive culture at the service.

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

The recently implemented processes of structured clinical supervision for all clinical staff, documentation of clinical competency and non-medical prescriber audits had to be further embedded in the service.

Staff could access all required policies and procedures on their electronic system. 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, with learning and development identified.

Managers held regular 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. Staff took patient confidentiality and information security seriously.

There was a system to monitor the completion of mandatory training and evidence showed that staff training was up-to-date.

The service had a business continuity plan which provided guidance and information for staff to follow in the event of systematic failures.

The remote clinical searches evidenced an established process for monitoring clinical care, which was effective.

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 collaborate for improvement.

The service worked with other local services to improve accessibility for working people by offering extended access appointments outside normal working hours and sessions for fitting and removal of contraceptive devices on Saturdays.

The service worked in partnership with a local charitable community support service to provide seamless care for people. Their representative commented they had a good working relationship and the staff were always supportive and responsive to them.

The service met regularly with district nurses and complex care team to optimise people’s care.

The service worked closely with the PPG. The practice manager regularly attended the quarterly PPG meetings. The service shared news and ideas on issues identified. The PPG members felt valued by the service and they had two-way communication. They gave examples on improvements made based on their feedback such as an update of the service’s website. The PPG helped the service to collect people’s feedback at a vaccination clinic session. The service analysed the responses and addressed people’s concerns which was published on their service’s website and social media.

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. They actively contribute to safe and effective practice.

The service conducted various prescribing and clinical audits to drive improvement in people’s outcome.

Staff were encouraged to develop their skill set to enable them to take on new roles, responsibilities and further their career. For example, the service supported a member of staff to train up as a nursing associate and another member to take a course on leadership.

The service was a training practice for doctors training to become GPs. To enable the service to be a training practice they must meet specific criteria including having adequate facilities and a supportive learning environment. The service also provided placement opportunities for medical students, practice nurses and student nursing associates.

The service used learning from significant events and complaints to continually improve the service they provide. All staff were encouraged to put forward and test out new ways of working. For example, a daily short team catch-up was implemented in the administrative team to check on workloads and express concerns upon staff feedback.