Clare House

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 have rated the practice as Good for providing responsive services because: Leaders and managers had oversight of systems and processes to promote effective and safe service provision. There was a focus on continuous learning and development. Feedback from staff and patients was used to improve the service. Staff who worked at the practice considered they were well supported, received appropriate training and development; and able to contribute to the running of the practice.

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 commented that the culture is very friendly and staff were supportive of each other. There was good teamwork with a positive atmosphere.

The mission statement and strategy was displayed on the practice premises. The aim was to provide outstanding personalise healthcare and improve the lives of patients. This had been reviewed as part of the merger process to make sure it was still relevant. Staff were aware of the vision and values of the practice.

There was a clear staffing structure and staff were aware of their own roles and responsibilities. Staff had access to line managers and other leaders, and said they were able to seek advice and guidance when needed. Daily huddles enabled effective information sharing, such as updates on patients seen during out of hours who needed to be followed up by the practice. However, some staff considered further improvements could be made in communicating changes. Staff said they were able to attend meetings where areas such as end of life care, safeguarding and significant events were discussed. They said they also had other meetings for specific staff roles where peer support was promoted and encouraged by leaders. Staff said that leader encouraged them to raise concerns or suggest improvements to help improve the service. However, 7 out of 33 staff who provided feedback considered that their view were not always listened to and acted upon.

Leaders shared results of a staff survey, carried out in September 2023 which showed that they had introduced 2 additional forms of communication for staff, in response to staff comments about consistent communication. These communications were a staff newsletter with a focus on introducing new staff, staff events, wellbeing opportunities outside of the practice and patient feedback. The other communication was a practice manager update providing information on changes to policies and procedures, updates on community teams and to assist staff in understanding how the practice operates. Staff appraisals had a focus on training and development, alongside wellbeing for staff. Managers and leader had received specific training to enable them to fulfil their roles.

Staff who responded to our questionnaire said they were aware and able to share concerns; but not all were aware of who the Freedom to Speak Up Guardian was and how to contact them.

The whistleblowing policy set out the process for speaking up and included the details of external organisations, to contact if staff felt the need to do this.

A staff wellbeing survey carried out in July 2023 showed that staff considered there was good teamwork and staff felt they made a positive difference for patients. Concerns were raised about effective communication and workload. Step had been taken to address these concerns. Staff we spoke with said their workload was more manageable and they now had dedicated time for administration tasks and training. Work was continuing on restructuring teams to provide resilience when there were absences and to improve monitoring of service provision.

All staff were required to complete training on equality and diversity and the employee handbook set out expectations on staff behaviours at work. These included ethical conduct and information on equal opportunities within the practice. There was also information on reasonable adjustments and types of discrimination.

Leaders said that the management structure was reviewed to ensure all staff were aware of their line manager and had access to regular one to one support. A business continuity plan provided guidance and information for staff to follow in the event of systematic failures. This included action to take in emergency situations such as electrical power failure, environmental issues, inclement weather, and sickness. Digital services were used securely and effectively within the service.

Governance meetings were held regularly and the practice used a risk register and action plan to monitor service provision. Areas covered included workflow management, such as the summarising of documents and dealing with correspondence from other services. Staff wellbeing and training was also discussed. A range of audits were completed to monitor care and treatment delivered, these included prescribing audits, long term condition management, patient access and capacity. Leaders also had oversight of recruitment, staff sickness and staff turnover and used this information for workforce planning. Policies and procedures were routinely reviewed every 2 years, or more frequently when needed. We found these underpinned how the practice operated. For example, failsafe processes when making referrals to ensure action had been taken; and management of pathology requests and results and identifying who was responsible for carrying this work and who should provide cover in case of staff absence.

We received approximately 250 give feedback on care response from people who used the service since July 2023. Positive comments included that they were kept informed of referrals made to secondary care.

The practice had recently merged with another practice and prior to the merger people who used the service and staff were kept informed of the progress of the merger and had opportunities to ask questions about how they would be affected. Patient surveys were undertaken to gauge understanding of the process and provide an opportunity to raise any concerns. The practice received over 1300 responses to this survey and collated common themes and set out the actions they were taking to address these.

The practice worked with district nurses, care homes and secondary care with the aim of providing a joined up service for people. Learning was also shared across the primary care network, for example results of audits on use of inhalers by asthmatic patients.

Policies and procedures used by the practice contained information on actions staff should take to make sure information was shared effectively. For example, when safeguarding concerns were identified.

The practice was a training practice for GP registrars and there were clear structures in place to support them in their learning. This included regular clinical supervision sessions and time allocated on the day to discuss patient care. Salaried GPs were able to develop their skills and received training on carrying out minor surgical procedures. Information from complaints and significant events was used to improve practice. The practice had links with the local university and a GP was involved with the clinical commissioning group.

Staff were supported to undertake additional qualifications relevant to their role. The practice ran a free A Taste of Medicine (ATOM) programme for local students to gain exposure and insight into a potential career in medicine. This provided opportunities and promoted equity for students from different backgrounds to access such information and experience.