Dr Berni

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

There was an inclusive and positive culture of continuous learning and improvement. The provider had reviewed the arrangements for clinical governance following the findings of our last inspection. This was now clearly set out with dedicated roles and responsibilities. Staff understood their roles and responsibilities and the limitations of these and the lines of accountability. Staff told us they felt well supported in their role and there were clear expectations about the training they were required to undertake. Staff told us they felt confident to speak up and that they would be supported if they did and that matters would be addressed. Systems were in place for monitoring and managing the performance of staff. There were appropriate arrangements for the availability, integrity and confidentiality of data, records and data management systems. Information was used effectively to monitor and improve the quality of care. The service was well managed and leaders demonstrated that they understood the challenges to quality and sustainability and had taken actions necessary to address them. The practice had a stable, core team of GPs with clear lead roles and responsibilities. The provider had worked to a detailed quality improvement/action plan to ensure concerns highlighted during our last inspection had been promptly addressed so as to improve the clinical care and treatment provided and improve outcomes for patients.

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.

There was a shared vision across the leadership and staff team to provide a good quality service that was responsive to the needs of patients. This included an understanding of the challenges and the needs of the patient population. Staff told us in feedback forms that they felt the practice had a clear vision for the future and some staff told us they felt involved in shaping this. Staff demonstrated an understanding of equality, diversity and human rights, and they prioritised good quality and compassionate care. Equality and diversity issues were identified and equality and diversity was actively promoted. Staff told us the culture of the service was positive, open, transparent and supportive.

Regular staff meetings were held and staff were involved in discissions and decisions about the service and service development.

Staff told us they felt supported by the leadership/management team. Staff reported that managers were visible and approachable. Staff told us the culture of the service was open and the manager had an open-door approach. They said their colleagues were supportive and they were confident and comfortable approaching the management team for any reason. Staff told us teamwork was good and without exception, they enjoyed working in the practice. Leaders spoke with us about the improvements that had been undertaken since our previous inspection. Staff told us they had good training opportunities and they attended training sessions regularly.

Leaders were knowledgeable about issues and priorities that could impact the quality of the service and they could access appropriate support and development in their role. The provider monitored and acted upon data about outcomes for patients. They made improvements when required. The provider had responded swiftly to the findings of our last inspection. They had developed and worked to an action plan to address the concerns raised and had achieved their aims in this at the time of this assessment. The provider had appropriate staff recruitment procedures in place. Leaders encouraged professional development.

Staff told us the management team were approachable and supportive and that they were encouraged to raise concerns. As a result there was a culture of speaking up where staff felt they could raise concerns and would be supported, without fear of detriment. Staff knew there was a whistleblowing policy and they told us they would feel confident to speak up if they had any concerns. Staff were confident that if they reported concerns then they would be addressed and appropriate action would be taken.

The provider fostered a positive culture where people felt that they could speak up and that their voice would be heard and acted upon. Staff and leaders acted with openness and transparency. There was a designated person who staff knew they had the freedom to speak up to. There were regular opportunities for team meetings and appraisals where staff were encouraged to make suggestions, raise issues or concerns for their personal and professional development or developments to the service. We saw in the management of complaints that people received a sincere and timely apology and were told about any actions planned to prevent the same thing happening again.

Leaders promoted equality, diversity and inclusion. Staff felt leaders would take action to prevent and address bullying and harassment for any staff, including those with protected characteristics under the Equality Act and those from excluded and marginalised groups.

Staff had completed training in equality, diversity, and inclusion and were aware of supporting people with protected characteristics such as age, gender, religion, or disability. Reasonable adjustments were made to support staff to carry out their roles. Staff with caring responsibilities were actively supported with a flexible approach and changes to schedules to accommodate their needs. The provider actively supported all staff to meet their roles and responsibilities. We saw and heard of no concerns with regards to workforce equality at any level including the recruitment of staff, training and on going support for staff welfare.

Staff told us they had the opportunity to attend meetings and had protected time for non-direct patient duties for example stock control and training. Staff told us they found the meetings beneficial, and it allowed them opportunities to discuss issues.

A clear management structure was in place with designated staff members who acted as leads for clinical and non-clinical areas. Staff roles, responsibilities and lines of accountability were clear. Structures, processes and systems to support good governance and management were clearly set out, understood and effective. We saw how information about risk, performance and outcomes, was monitored and how change was discussed and implemented following feedback from people who used the service, staff and relevant stakeholders. Information was used effectively to monitor and improve the quality of care and treatment provided. The provider was open and transparent and completed a series of actions to ensure issues highlighted during this assessment were promptly addressed. The provider had acted on the findings of our last inspection and the arrangements for clinical governance had been reviewed and changed. A new clinical lead had been identified and new procedures and standard operating procedures linked to clinical governance had been introduced. A regular suite of searches of the clinal record system were being run to identify people's needs and ensure these were being met. For example, to ensure that people on high risk medicines underwent the required checks so that the medicines they were prescribed remained safe to take. There were effective arrangements for identifying, managing, and mitigating risks. A major incident plan was in place. The provider had systems and protocols in place to ensure data and notifications were submitted to external organisations as required. There were clear arrangements in place for the availability, integrity and confidentiality of data, records, and data management systems.

The practice had a small newly formed Patient Participation Group (PPG) who they consulted with. Plans were in place to increase the membership of this group going forward to ensure a wider view from the community was gathered. The practice used NHS Friends and Family test feedback, the national GP patient survey, compliments, and complaints to assess people’s views or experiences of the service and implement change and improvements in response. Overall, feedback from people who used the service was positive.

The provider understood their duty to collaborate and work in partnership with other stakeholders. Staff and leaders told us how they worked in partnership with key organisations to support care provision, service development and joined-up care.

The practice worked closed with the local Primary Care Network (PCN) and the Integrated Care Board (ICB) who spoke positively about the practice and the work they had undertaken since our last inspection.

Staff and leaders engaged with people, communities and partners and used local networks to identify new or innovative ideas that can lead to improvements in outcomes and experience for people who used the service.

There was a focus on continuous learning and improvement across the service. Leaders encouraged staff to speak up with ideas for improvement and innovation.

The provider worked with stakeholders to improve the experience of the patient population as they worked in partnership to improve services for people within the locality. This included being involved in ways of delivering equity of experience and outcomes and providing high quality care and treatment for people. There were processes to ensure that learning was shared when there were incidents and action was taken to improve the service and prevent a reoccurrence. Staff and leaders had made improvements to the service in relation to the clinical care and treatment and governance since our last inspection of the service. Systems for assessing the quality of the service and outcomes for patients had been developed and were being embedded into practice.