Sudbury and Alperton 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

We assessed all the quality statements for this key question. Our rating for this key question is good. We found that the leaders were visible and the staff team worked well together to provide and improve the service. The provider worked with external partners to meet the needs of people including those with complex needs. There were generally effective governance systems in place. The provider could demonstrate improvements in relation to most of the issues we raised at the previous inspection. However, a consistent theme of staff feedback was that opportunities to develop did not always seem to be fairly allocated and this was creating tensions within the team.

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.

Leaders and staff told us that the team generally worked well together with the shared aim of providing a high quality and accessible service. Several staff gave improved access as an example of the positive impact of the team’s collective action.

The practice leaders had identified short and longer-term priorities. For example, they had identified space restrictions in their premises as a barrier to service development and had plans, albeit at an early stage, to address this.

The practice leaders were visible. All the staff we interviewed described the partners positively. They told us they were approachable and responded quickly to queries. There had been a recent unplanned change to the internal management structure. The leaders had subsequently put new line management arrangements in place which were still bedding-in at the time of the inspection.

Different members of the team had been clearly identified to lead on various aspects of the service. The practice manager was scheduling individual appraisals with staff members which they told us would include consideration of staff development and inclusion.

Staff informed us they would feel able to raise any concerns about the service (for example, about safety) without fear of retribution and there were opportunities to do so, for example, at team meetings.

Information about speaking up was available to staff in relevant policy documents and included in the induction process. Staff had access to an independent Freedom to Speak Up Guardian so they could talk to somebody outside the practice team if necessary.

Both leaders and staff told us that the practice benefited from having a diverse team that reflected the local community. However, a theme of staff feedback was that the allocation of tasks and learning opportunities was not always openly addressed which created tensions and perceptions of unfairness within the team.

The practice had a policy on workforce equality, diversity and inclusion and included consideration of equality in relevant policies, for example staff recruitment. Staff were required to complete training on equality and diversity. The practice was physically accessible. The practice had systems to support staff to develop their experience, skills and confidence, for example with training and discussion around supporting carers. However, there were some concerns within the team that such support was not always applied consistently.

Staff were clear about their roles and responsibilities. They told us there were clear policies and processes and any updates and changes were shared and discussed with the team.

The practice had governance arrangements in place. Policies and risk assessments were regularly reviewed. There were systems in place to monitor clinical and business performance and to respond to any changes. The practice had a major incident plan in place. However, there was scope to formalise clinical oversight and supervision, for example by documenting key discussion points.

A representative of the patient participation group reported that the provider engaged positively with the group, for example, sharing patient feedback.

The lead GP and practice manager described positive relationships with local partner organisations and services.

Partners did not raise any specific concerns about partnerships and community working.

The provider had sought and obtained feedback from people about the service and used this feedback to make improvements. The practice had an active patient participation group. The practice had mechanisms to involve health and social services professionals from partner organisations in the planning and delivery of care, for example when people had complex conditions.

The leaders were able to describe improvements since the previous inspection. They had taken a structured approach to identify and address issues and to meet priorities and goals. However, we noted that one of the risks raised at the previous inspection in relation to infection prevention and control had not yet been addressed.

There were systems in place to learn from incidents, updates, and staff and patient feedback. The practice carried out clinical audit and other quality improvement activity and was making increasing and effective use of available resources, such as the clinical pharmacist who carried out prescribing audits and discussed the results with the clinical team.