Modality Mid Sussex

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 Inadequate. This was because the provider could not demonstrate that comprehensive and effective systems were in place and regularly reviewed to identify and manage risk. At this assessment, we found the provider had made improvements. The rating for this key question is now Good.

However, leaders still leaders lacked oversight of some systems and processes and the provider was in breach of legal regulation 17 in relation to good governance.The breach of regulation does not affect the rating for this key question or the overall rating.

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 practice 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 had a business development plan and strategy based on resilience and improving the health of the local population. There was a good understanding of the challenges they faced which included improving access and the need to improve communication with patients and take their feedback on board.

The practice 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.

Staff told us leaders in the practice were approachable and responded to any concerns raised. We saw the leadership team worked with the primary care network and were engaged in the development of services within the local area.

The practice fostered a positive culture where people felt they could speak up and their voice would be heard. The practice had established Freedom to Speak up arrangements with another practice within the Modality Partnership. Staff were aware of how to raise concerns and felt able to do so.

The practice valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

Policies and procedures to promote diversity and equality were in place. Adjustments had been made to ensure all staff were valued, for example we saw adjustments to support disabled staff were in place.

The practice 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. However, for some systems and processes there was still a lack of oversight, specifically for medicines reviews, recruitment checks and clinical supervision.

For example, practice processes had not been fully implemented to ensure medication reviews contained necessary information. The practice conducted monthly audits of medicine reviews; however, this had not ensured clinicians were compliant with the practice’s standard operating procedure. The practice’s recruitment and induction processes were not fully implemented and did not always follow national guidance. Their recruitment policy did not ensure gaps in employment history were explored and signed job descriptions were not always completed in line with their induction policy. Arrangements for demonstrating the competency of allied health professionals were insufficient. The clinical supervision policy lacked detail about the frequency and structure.

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. Since our last inspection the provider had strengthened management arrangements to ensure consistency across each site. Staff could access all required policies and procedures. Managers held regular practice 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.

The practice understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The practice was working with their primary care network, integrated care board and local communities to develop neighbourhood plans that reflected a shared vision for improving the local area. It was working with local healthcare organisations to develop a frailty service. It held regular muti-disciplinary, multi-agency meetings to discuss the care needs of those at higher risk of hospital admission.

The practice 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.

The practice had a quality improvement plan in place to help drive improvements in services. This focussed on the appointment system and improving access. Staff were encouraged to put forward and test out new ways of working, and we saw examples of this. We saw examples of innovation which included the introduction of a palliative care outreach service. The practice had implemented innovative technological solutions to improve efficiency which included automated note taking and test result filing systems.