Watling Medical Practice

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

Leaders and staff had a shared vision and culture based on listening, learning and trust but this could not be demonstrated because meetings were taking place in isolation. There was no documented formal meeting with a formal agenda where all staff could discuss and share good practice or concerns about what happened at the practice on a daily basis. Staff understood their roles and responsibilities and there was a culture of continuous improvement but we found that policies and procedures did not corroborate with daily practice. Although risk assessments were undertaken, we found risks that were not identified. However, we found that leaders were visible, knowledgeable and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Managers worked with the local community to deliver the best possible care and were receptive to new ideas.

We found breaches of regulation in relation to Regulation 17 Good Governance. We have asked the provider for an action plan in response to the concerns found at this assessment.

This service scored 61 (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. All staff had contributed to the development of the practice vision and strategy, which was kept under review. The practice was aware of the projected increase in the local population and was working with partner agencies to address future challenges.

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

Staff we spoke with did not always feel they could speak up and that their voice would be heard. There was a Freedom to Speak up Guardian but this was a member of the leadership team within the practice and staff were not aware of arrangements where they could speak up to other practices in the primary care network. Staff did know how to raise concerns, but the policies and procedures around this did not align to everyday practice. There was no meeting structure in place that allowed for all staff at the practice to share, communicate, feedback and learn together.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked 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 staff hours were changed and appointment times were lengthened when requested.

The service did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate. We found that staff were supported by leaders and staff and those we spoke with were clear on their individual roles and responsibilities and received regular appraisal and supervision. Although staff could access policies and procedures, they did not always contain the correct information. Risk assessments were in place but were not individualised to suit scenarios. There was no meeting structure in place that enabled all staff to communicate, engage, feedback and learn from things that happened in everyday practice.

The service 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 provider worked with other practices within their primary care network to offer extended access, and flu and covid vaccination programmes.

The service had a quality improvement programme and undertook regular audit activity. However, they did not always focus on continuous learning, and improvement across the whole team. For example although the practice undertook significant event analysis and discussions around the events, feedback from staff was that communication was limited to the people involved and there was a “need to know” culture rather than a whole practice approach to sharing and learning. There was no formal process in place to audit and review all deaths that occurred.