Graham Road Surgery

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 quality statements in the well led key question. Our rating for this key question is now good. Systems and processes that have been implemented since our last inspection have been embedded and are supporting the safe delivery of care. Staff were clear on their individual responsibilities and knew who was accountable for each aspect of the service. Leaders had oversight of the practice to ensure the effective running of the service. The practice encouraged candour, openness and honesty.

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.

Staff were positive about the direction and culture the practice manager and lead clinician had fostered. There was an open-door policy where staff could access and speak openly to leaders. Staff were encouraged to keep their knowledge and skills up to date in line with continued professional development to support the practice. There was a strong emphasis on the safety and well-being of staff.

The practice had a plan to continue to work on quality improvement, supporting the practice with their clear vision and commitment to the patients. The plan included areas that the practice want to focus on such as embedding the recall system for patients with long-term conditions and developing an antibiotic prescribing reduction strategy. Regular meetings and newsletters kept staff up to date with any changes or progress the practice had made.

Staff felt supported by leaders who were visible and approachable. Leaders supported staff in professional and personal matters. Leaders were aware of the challenges of delivering good quality care and were striving for improvements. Leaders 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 necessary to address these challenges and make improvements. Senior leaders were available to staff at all times.

Staff knew what a freedom to speak up guardian (FTSUG) was and how to access them. However, not all staff knew the name of the FTSUG. Staff felt confident to raise any concerns with their managers and leaders.

There were policies and processes in place to support speaking up and these were accessible to all staff online. The name and contact details of the freedom to speak up guardian was included in these.

Staff were able to explain their understanding of equality, diversity and inclusion and had completed training in this area.

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

Staff and leaders were clear on their individual roles and responsibilities. Patient confidentiality and information security was understood and upheld. Staff confirmed learning was shared effectively and used to make improvements. Staff told us learning and development opportunities were identified during annual appraisals and appropriate training was sourced.

There were clear and effective processes for managing risks, issues and performance. There was evidence of systems and processes for learning, continuous improvement and innovation. Systems and processes were established and evidenced by the positive results of our remote clinical searches of patient records. Staff could access all policies and procedures. Regular meetings discussed clinical concerns, reviewed incidents and shared learning.

We received no specific feedback in this area.

Staff worked with stakeholders to build a shared view of challenges and of the needs of the population. Leaders told us the practice did not have an active Patient Participation Group however, this was something they were working towards restarting. Staff views were reflected in the planning and delivery of services.

Mixed feedback from partners indicated some good working relationships. However, some partners felt practice staff did not always listen to the concerns being raised on behalf of patients: ‘Listen to us more and our concerns and knowing how well we know our service users and why we have asked for help’.

The practice understood its patient population and had adapted its service to deliver to the community. For example, there were good working links with local homeless services. The practice had allocated named individuals to work with services in the community to support continuity and partnership working. For example, there was a mental health team who linked in and worked closely with local services to support patients.

Some staff had worked at the practice for a number of years and had developed their skills set while at the practice to enable them to take on new roles and responsibilities. Learning needs were discussed in team meetings and individual needs were identified in annual appraisals.

The practice had developed a ‘score card’ to regularly review and monitor progress on patient safety. This enabled the practice to have a clear up-to-date oversight of patient safety. The ‘score card’ was initially based on the remote clinical searches CQC carries out but the practice saw the merit in the oversight this gave and has added to it. It has been such a success for the practice, it has been shared with other practices who are considering using to track their own improvements.