Four Acre Health 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 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 question as requires improvement. At this assessment, the rating has changed to good.

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 and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The practice promoted a positive and compassionate culture that supported trust and understanding between staff and patients using the service. Learning and development were supported. All staff we spoke to felt positive about working at the practice and feedback from staff questionnaires was consistently positive. Staff described good teamwork and a service that was clear on its function to work in the interests of patients and provide the best patient experience they could.

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. Leaders demonstrated the importance of staff wellbeing to support them in maintaining good outcomes for patients. The provider was knowledgeable about issues and priorities for the quality of services and staff told us managers were visible and there was a compassionate management team. Leaders worked with patients, staff, and partner organisations to gather feedback on their leadership and communication. Responses, from patients, staff and partners both to the practice and directly to CQC, were positive. Leaders invested in learning and development for all staff and developed tools to assist staff to achieve best practice. There were strong support and wellbeing arrangements in place for staff when impacted by personal issues.

The service fostered a positive culture where people felt they could speak up and their voice would be heard. Leaders encouraged staff to raise concerns and promoted the value of doing so. We received 24 completed CQC staff feedback forms and spoke with staff during assessment. All staff who commented felt well supported and confident to raise concerns. Staff had clear safe routes to raise concerns, there was a whistleblowing policy and staff had been provided with access to a freedom to speak up guardian to better promote transparency, trust and psychological safety within the workplace.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by supporting equality and diversity for people who worked for them. Staff felt empowered and confident to raise concerns and ideas. Reasonable adjustments were made to support staff to conduct their roles. Staff with caring responsibilities were supported with a flexible approach and changes to schedules to accommodate their needs. Staff had completed training in equality, diversity, and inclusion and were aware of supporting people with protected characteristics such as age, gender, religion, or disability. The practice had an equality, diversity, and inclusion policy.

The provider had established governance processes appropriate to the service. They used these to manage and deliver good quality, sustainable care, treatment and support. Staff acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate. Patient confidentiality and information security were well understood and consistently upheld. Staff we spoke with were clear on their individual roles and responsibilities and they could access policies and procedures. Opportunities for learning and development were identified during annual appraisals and appropriate training was provided.

The service understood their duty to collaborate and work in partnership, so services worked seamlessly for people. The practice demonstrated a commitment to work within their community and worked collaboratively and in partnership with relevant external stakeholders, commissioners and partner agencies across St Helens south PCN to provide and develop services. The practice had an active patient participation group (PPG). Members of the PPG told us the practice consulted with them and sought their views on the service provided. They commented that the practice was well run and the team were excellent. Feedback from one partner organisation described the practice staff as polite, pleasant and responsive. One member of staff was described as demonstrating excellent engagement with patients, staff, and relatives and being attentive and demonstrating patience throughout interactions.

The service focused on continuous learning, innovation and improvement across the organisation. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. Leaders and staff were proactive in sharing ideas and using good practice to improve care. They regularly listened to feedback from patients and the community, using it to shape and assess new ways of working. Examples included home visits to encourage take up of vaccinations and immunisations, the introduction of care navigators to better direct patients to the most appropriate appointment to meet their needs and a call back option to reduce call wait times. The practice received recognition as a finalist at the Practice Manager Association awards 2024 for innovation in general practice.

The service worked within a multi-disciplinary team to provide the right support for patients. The service actively participated in regular meetings where people’s care, and treatment needs were discussed to improve their outcomes. There was a focus on continuous learning and improvement within the service.