Linden Medical Group

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• 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

The provider’s senior leadership team worked across all clinical and non-clinical staffing groups to provide a stable, core leadership team. There were clear responsibilities, roles and systems of accountability to support good governance and management. Staff felt supported and explained that leaders were visible and approachable. Leaders demonstrated that they understood the challenges to quality and sustainability and had taken actions necessary to address them. The practice had clear succession plans in place for areas such as planned retirement. The leadership team routinely reviewed the effectiveness and appropriateness of care provided and safety in most areas within the practice using quality improvement activities. There was a clear understanding within the leadership team of the practice performance; actions were taken to improve areas following outcome from quality improvement audits.

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.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff told us there were clear responsibilities, roles and systems of accountability to support good governance and management. They told us they were clear about their roles and responsibilities and who to contact should they need advice or want to discuss any concerns. The practice had an overall organisational chart which detailed practice and provider level governance arrangements. Staff were aware of those with lead roles, such as safeguarding. Staff we spoke with explained a team-based sense of working; for example, the nursing team explained they worked well together. There were areas where staff in some leadership roles felt they would benefit from more autonomy in their role and communication between teams could be strengthened. Staff were aware of the whistleblowing policy and felt comfortable to raise any concerns with the freedom to speak up guardian. Staff felt listened to and explained actions would be taken when concerns were raised. For example, staff explained changes to the rota had been made following feedback. Staff explained various meetings such as daily clinical development meetings, monthly clinical meetings, nurse meetings as well as practice meetings. Leaders carried out staff well-being surveys. Data from the practice September 2024 internal staff survey which the practice leadership team received responses from 12 clinical staff and 34 non-clinical staff showed 89% felt supported by colleagues and managers and 91% felt they received adequate support and guidance in their role. The December 2024 internal staff survey saw an increase from 91% to 97% of staff who felt they received adequate support and guidance in their role.

The practice had a variety of policies and procedures in place to govern the practice. These were accessible for all staff on the practice internal computer system. Staff were clear about their roles and responsibilities. All staff had a job description. There was a Business Continuity plan to provide a first response and a framework under which the practice could be managed and continue to operate under exceptional and adverse circumstances. There were assurance systems which were regularly reviewed and improved. This included those for managing risks for patients and staff such as fire safety and learning from safety alerts and significant events. There were clear action plans in place to ensure most risks identified were mitigated, most actions were completed and monitored to ensure they were sustained. During our on-site inspection where we found actions from the practice infection control audit which did not have a time-frame for completion and had not been addressed; staff in lead roles acted. For example, risk assessments were revisited to mitigate risk associated with carpeted clinical rooms. In addition, at the time of our on-site inspection staff explained they were awaiting quotes to replace carpeted flooring in two consulting rooms at Ise Village practice. Where audits identified broken blinds in waiting room which was flagged in May 2024 as a potential risk and safety issue to children as outlined in the practice Infection Prevention Control (IPC) audit; then flagged again in August 2024; during our on-site visit we gained assurance through discussions with staff regarding actions to mitigate risks. The provider had a comprehensive quality improvement process where staff actively used audits to drive improvement. We saw evidence of several audits undertaken which were repeat cycle audits that showed improvements made following actions taken. There was a process to support and manage staff when their performance was poor or variable.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.