Highlands Surgery

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

People were respected and valued as individuals and this was demonstrated by the feedback we received from the PPG which was very active and had in excess of 200 active members.

We found that people were supported as partners in their care by a service described by people, other agencies and staff as professional, caring, exceptional and second to none. Staff consistently treated people with kindness, empathy, and compassion, while ensuring their privacy and dignity were always upheld. People’s wishes and choices were fully understood, and every effort was made to honour these, enabling them to live as independently and fully as possible.

The culture of the whole team and every member of staff without exception was strongly patient centred and demonstrated how they valued their work, their colleagues, their leaders and their environment which empowered them to provide a high quality and caring service to people. Feedback consistently described the service and its staff as exceptionally kind, considerate, and empathetic.

At our last inspection, we rated this key question as Good. At this assessment, the rating has remained as Good.

This service scored 90 (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 was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

We saw that over a 24-month period, the practice Friends and Family Test data, consistently reflected high levels of patient satisfaction. This feedback was shared with staff each month during their time to learn (TTL), reinforcing good practice. Importantly, the practice also placed strong emphasis on reviewing and addressing the small number of negative comments received. Each of these was carefully reviewed, discussed, and used as an opportunity for learning and improvement, reflecting the practice’s commitment to continuous quality enhancement.

People who had completed CQC Give Feedback on Care forms consistently praised staff for being thoughtful and kind. People commented that this kindness and respectful attitude was maintained at all times. People who identified themselves as carers specifically mentioned that they benefited from longer consultations so they could talk about their needs and receive vaccines and age-related health checks in a single appointment.

People who had completed CQC Give Feedback on Care forms also gave exceptionally positive feedback about the staff. Comments included phrases such as efficient, friendly, kind, extremely inclusive, and helpful, and reliable evidencing the compassionate culture at the heart of the service.

Patient feedback also included examples of the practice calling and offering support at time of difficult diagnosis, bereavement, and other sensitive situations.

A key theme in staff feedback was the caring nature of leaders relating to patients and staff. We saw evidence of tailored working arrangements in place for staff facing temporary personal difficulties, flexible working patterns, positive re-enforcement, career progression opportunities, recognition, staff functions and celebrations and encouragement for training and career progression.

The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

All practice staff, without exception, demonstrated that patient care was person-centred. The service treated people as individuals and ensured their care, support and treatment met their needs and preferences. People’s individual needs and equality characteristics were understood, and services were adapted accordingly. This was evident from the partnerships that had been established and the positive feedback received by CQC from those partner organisations.

All patients on the Dementia Register and the learning disability register had received an annual review, providing an opportunity to establish or update care plans. Extended appointments helped ensure individual needs were met. The Social Prescriber was directly employed by the practice and they had a vast knowledge of local services and excellent working relationships with them. This meant that they were able to signpost and refer people in their time of need without any delay.

The practice was accredited as Veteran Friendly and they had recently recruited a Veteran to the team and had proactively identified patients had served in the armed forces who was then able to make contact with this group of people to raise awareness of local and national support services.

Carers were identified and supported, with appointment flexibility to accommodate their caring responsibilities. The Social Prescriber worked in the practice and provided valuable non-clinical support. This led to positive outcomes for patients with complex needs, including those experiencing homelessness, poverty relationship breakdown, bereavement etc. Adjustments were made for patients with hearing impairments such as alerts for lip-reading requirements, to support inclusive communication.

Patients on the Learning Disability Register received extended annual reviews and tailored appointment times. All reviews were undertaken by a GP of the patient/relative’s choice and all were 30 minutes long. Appointments were provided at an appropriate time to suit the patient. All patients on the register had attended and received a review at the time of our site visit,

The practice also maintained excellent working relationships with the palliative care team and the integrated nursing team to deliver coordinated end-of-life care.

The service was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

It was demonstrated during the site visit and overall that the service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. There was a system for appointment triage that ensured people with immediate needs had access to services. A duty doctor was available each day to support nonclinical staff in care navigation.

Staff could offer a range of alternatives to patients to meet their immediate needs including emergency support, and access to mental health crisis teams. People’s needs were usually managed on the day of contact with the service. The remaining were either signposted or offered an appointment in the future to meet their needs rather than having to call back. People were directed to the most appropriate person or service to meet their needs and ensure continuity of care where required.

Members of the team had been provided with training on care navigation and in basic life support including the signs and symptoms of sepsis. Staff carried out reviews and monitoring for people and altered their medicines when necessary to meet their changing needs. Leaders had reviewed staffing to ensure there were more than enough clinicians to meet the needs of people.

Staff went to great lengths to make sure that people’s needs, views, and wishes were considered a priority in deciding a treatment plan.

There was a duty doctor on site every day who was dedicated to triage, processing the clinical workflow inbox and being available to support staff. They were not in clinic on their duty day, and this meant that all communication into the practice was processed on the same day, triage queries were dealt with in real time, and staff told us that they had their requests answered very quickly. This system worked very well and meant that people were receiving test results in a timely manner, referrals were made without delay, and staff received the support they needed to answer clinical and safeguarding queries. During our assessment, we saw that the global inbox for the practice was clear at close of business each day. Duty clinicians told us that this way of working was positive for patients and staff feedback confirmed this.

The service was exceptional in how they listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

It was demonstrated during the site visit and overall that the service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress. There was a system for appointment triage that ensured people with immediate needs had access to services. A duty doctor was available each day to support nonclinical staff in care navigation.

Staff could offer a range of alternatives to patients to meet their immediate needs including emergency support, and access to mental health crisis teams. People’s needs were usually managed on the day of contact with the service. The remaining were either signposted or offered an appointment in the future to meet their needs rather than having to call back. People were directed to the most appropriate person or service to meet their needs and ensure continuity of care where required.

Members of the team had been provided with training on care navigation and in basic life support including the signs and symptoms of sepsis. Staff carried out reviews and monitoring for people and altered their medicines when necessary to meet their changing needs. Leaders had reviewed staffing to ensure there were more than enough clinicians to meet the needs of people.

Staff went to great lengths to make sure that people’s needs, views, and wishes were considered a priority in deciding a treatment plan.

There was a duty doctor on site every day who was dedicated to triage, processing the clinical workflow inbox and being available to support staff. They were not in clinic on their duty day, and this meant that all communication into the practice was processed on the same day, triage queries were dealt with in real time, and staff told us that they had their requests answered very quickly. This system worked very well and meant that people were receiving test results in a timely manner, referrals were made without delay, and staff received the support they needed to answer clinical and safeguarding queries. During our assessment, we saw that the global inbox for the practice was clear at close of business each day. Duty clinicians told us that this way of working was positive for patients and staff feedback confirmed this.

The service always cared about and promoted the wellbeing of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care. Staff told us, without exception, that they were valued by leaders. Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as regular breaks and rest areas.

Staff reported being supported if they were struggling at work. We saw team building days were established and well-attended within the practice.

Staff reported they were listened to, and their ideas were respected and taken seriously. It was also reported that staff were given praise and credit when they contributed to improvements. Staff were able to provide anonymous feedback via a QR code displayed in the staff areas of the practice. We saw evidence that prior to the assessment, staff had used this method to communicate their feelings about their uniforms and as a result, leaders undertook a wider consultation exercise and new uniform options were being discussed with staff.

We saw evidence that at time to learn (TTL) sessions, leaders had engaged external providers to deliver presentations relating to staff well-being, including counselling services. We saw that encouragement and praise was given to staff during those sessions and staff reported without exception how this was reflected throughout their working environment.

Staff at the practice had been supported to establish a staff forum and at the time of the site visit, this was in place, with members and terms of reference in place. Staff feedback we received indicated that they felt it was an excellent idea and would ensure all staff had the opportunity to contribute ideas, including those who were less comfortable with raising suggestions at the bigger practice meeting.

Leaders were proactive in sourcing training opportunities that met the needs and interests of individual staff. We saw evidence of many examples of staff undertaking current or recent training and saw how this had enabled them to change / combine roles or to progress in their career and improve service delivery as a result.

We saw that time was laid aside to ensure staff had the information and resources they required to enable them for the good of their patients. We saw how leaders made staff feel valued, relaxed and included as part of a whole team that worked together to provide an excellent service to their patient community. Leaders demonstrated the systems they had in place to support staff and staff reported without exception how their views and feedback were listened to, carefully considered and used to drive change.