Cam & Uley Family Practice Also known as The Orchard 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

The practice had a clear vision and strategy to deliver high quality care and promoted good outcomes for people. At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same. Staff were clear on their individual responsibilities and knew who was accountable for each aspect of the service. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Leaders had oversight to ensure the effective running of the service and were capable, compassionate, and inclusive. The practice encouraged the duty of candour, openness, and honesty. Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable and supportive, helping staff develop in their roles. The practice continued to embed new systems and processes, to improve their governance and oversight.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Leaders at the practice had a detailed vision and values for the practice. Some staff told us they felt engaged by leaders at the practice. They told us they were listened to and had contributed to the development of the practice. However, some staff expressed that they did not always feel included or that their ideas and concerns were acknowledged during the implementation of changes. Additionally, some staff noted that communication between leaders, staff and other staff groups could be improved. Concerns were also raised about confidentiality, with some staff feeling uncomfortable sharing sensitive information with certain leaders. Staff were encouraged to maintain and enhance their knowledge and skills through ongoing professional development. Leaders highlighted a strong focus on staff safety and well-being. Regular meetings were held to keep staff informed about any changes or progress within the practice.

Staff told us leaders were visible, approachable and genuinely cared about them. Leaders were aware of the challenges of delivering good quality care and were striving for improvements. Leaders understood the challenges to quality and sustainability and demonstrated the skills and knowledge required to influence others and understand their role in leadership. Leaders included staff in their planning for the future. The practice had identified the actions needed to address challenges and make improvements.

Staff knew what a freedom to speak up guardian was (FTSUG) and knew who the FTSUG was. The practice had an external contact from the Gloucester Local Medical Committee (GLMC) who had the role of FTSUG and served as a point of contact for any member of staff to raise concerns about colleagues, the practice or leadership. There were policies and processes to support speaking up and these were accessible to all staff.

The practice actively promoted equality and diversity. Staff had access to an equality, diversity, and inclusion policy and had completed relevant training. Newly recruited staff completed a monitoring form, so the practice was aware of the diversity of their workforce.

The practice had clear responsibilities, roles, systems of accountability and good governance. Leaders and managers supported staff, and staff we spoke with were clear on their individual roles and responsibilities. They acted on information about risk, performance and outcomes, and shared this securely with others when appropriate. Effective processes were followed for managing risks, issues, and performance. There was evidence of systems and processes for learning, continuous improvement, and innovation. Staff were encouraged to attend meetings where updates and new information was shared. Actions from meetings was recorded and accessible to all staff. Staff took patient confidentiality and information security seriously. Staff had access to all policies and procedures. However, we identified some gaps in clinical audits that had been conducted. The practice did not consistently maintain full oversight to ensure that actions were completed. Additionally, audits were sometimes undated or lacked information about the individual who conducted them. However, once these issues were identified, the practice responded promptly and began implementing improved systems to strengthen oversight in this area. Our clinical searches identified some areas of patient risk that had not been previously recognised by the practice. Although new systems and processes had been introduced to address these issues, they were still in the early stages of implementation. We observed evidence that some of these systems were already in use. For instance, a monthly clinical safety report had been established to monitor potential risks. This new process was introduced in April this year and was still being embedded into routine practice.

Staff recognised there had been changes within the management team and structures. We received many positive comments regarding the support provided by leaders. Staff worked with stakeholders to build a shared view of challenges and of the needs of the population. Leaders told us they engaged with services they referred to regularly for feedback on the quality of referrals. Staff and external partners' views and concerns were encouraged, heard and acted on to shape the service and culture.

The practice focused on continuous improvement across the service. A quality improvement plan was in place to support positive changes aimed at enhancing patient health and wellbeing. A key focus of this plan was the implementation of a new appointment triage system. The practice worked within a multi-disciplinary team to ensure individuals received appropriate and tailored support. Staff regularly participated in meetings to review and discuss people’ care and treatment needs, with the goal of improving outcomes. There was a clear emphasis on ongoing learning and development. The practice reviewed both internal and external incidents and complaints, using the insights gained to drive improvements. Lessons learned were shared across the team to support this process. Leaders ensured staff received training to uphold high standards of care. The practice continued to embed new systems and processes, including those related to recruitment and staff appraisals.