Farrow Medical Centre

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

Overall, we found that the practice was well-led. At the inspection in April 2023, we found that the practice had not established effective systems and processes to ensure good governance, including the management of significant events and safety alerts, and assuring the competency of non-medical prescribers. In this assessment we found that significant improvements had been made in these areas. Staff feedback about leaders was positive and they told us that they felt supported in their roles. We identified some areas for improvement, including submitting notifiable incidents to external organisations without delay, and improving policy control to ensure regular documented reviews and update of information.

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 feedback regarding the culture of the practice was positive. Staff told us they had not been involved in the planning of the practice’s vision and values but understood what they were and their role in achieving them.

The practice mission statement was displayed on the practice website. The practice had a clear vision and set of values which included a focus on the well-being of their patients, supporting staff, and contributing positively to the local community. There was a business plan in place which had been recently updated and this highlighted challenges, strategies for risk mitigation, and future plans for the practice.

Staff told us that managers were visible and approachable and that they felt supported by them. Leaders were knowledgeable about issues and priorities for the quality of services and what work was needed for these. They felt they had a stable partnership in place after the recent assignment of a senior salaried GP as a Partner.

The practice had recently recruited an operations manager to support leadership and achievement of strategic initiatives and was supporting them to undertake a leadership development programme. Leaders had a plan in place to mitigate any risks and to improve performance. The practice had recently started to conduct staff surveys in order to try and enhance staff satisfaction and retention.

Staff we spoke with and received feedback from told us they knew how to raise concerns and felt comfortable to do so. They were aware of the practice’s freedom to speak up guardian.

Staff had access to policies on being open and on freedom to speak up. Concerns could be raised openly and confidentially or anonymously to support any staff members raising concerns. We saw examples of candour being applied by staff where mistakes had been made.

Staff reported a positive and fair culture at the practice, with adequate support and regard for staff wellbeing. We heard examples of how staff feedback had been used to improve processes, for example a change in protocol for how clinical samples are received into the practice.

There were systems and processes in place to support the safety and well-being of staff. This included policies on bullying and harassment, and zero-tolerance. There was also a reasonable adjustments policy for staff which detailed the process for staff to follow if they needed to request adjustments for their roles. A staff survey had been carried out recently which showed many positive comments from staff including good management and training support. Areas for improvement included communication processes and recall systems for monitoring patients with long-term conditions.

Staff we spoke with were clear about their role, responsibilities, and how they interact with other staff. They told us they had access to policies and procedures to support them within their role and attended regular meetings where discussions about the practice, such as complaints and significant events were discussed. Leaders told us about the ways in which they monitored and mitigated risks. They were aware of the practice’s low performance in childhood immunisation and cervical screening uptake and were working on ways to improve this, for example through discussions with their integrated care board to look at what neighbouring practices were doing, and the use of a family worker who promoted services within nurseries and external events. The practice had also put in an application to provide an enhanced access clinic on site which would include cervical screening services, and they anticipated that this would improve the uptake rate. Furthermore, the practice had signed up to a ‘nudge study’ to try and improve the way in which patients are invited for screening.

There was a meeting structure in place and minutes available to staff who could not attend. Policies were in place and accessible to staff. Several policies had been reviewed ahead of this assessment and there was not always a clear audit trail to document policy creation and review dates. A small number of policies contained out of date information, for example the infection prevention and control (IPC) policy had not been updated to reflect the current IPC lead for the practice. In addition, at the time of the assessment we found that some information on the practice website was not up to date, for example current staff members. There was a business continuity plan and this detailed arrangements in place with a nearby practice in the event of certain incidents. The practice had processes in place to submit data and notifications to external organisations however this was not always done immediately. For example, notifications of reportable unexpected deaths were not always immediately reported to the Care Quality Commission until internal investigations had been completed. Staff used data to monitor and improve performance. For example, GPs regularly reviewed data showing their accident and emergency attendance figures, and cancer outcomes data. There was a Caldicott Guardian in place and robust arrangements for the availability, integrity and confidentiality of data. Workflows for communication and pathology results were up to date at the time of our assessment. Managers met with staff regularly to complete appraisals and performance reviews.

We reviewed the responses to the NHS Friends and Family Test (FFT) for April, May and June 2024 and saw that each month over 80% of respondents rated their experience of the service as good or very good.

Staff gave examples of engagement and collaborative working with other services. Leaders told us about the ways in which they supported communities, for example through collections for a local foodbank, and participation in the Bradford Genes and Health research study, and that they were keen to carry out more engagement work within the community.

We spoke with the NHS West Yorkshire Integrated Care Board ahead of this assessment. From the feedback we received from them there was no indication of concern in this area.

The practice worked and shared information with stakeholders to build a shared view of challenges and of the needs of the population. The practice took part in projects and initiatives to strengthen partnerships and support communities. For example, we saw that they were involved in a project that was working to eliminate Hepatitis C cases within Bradford. We saw that that the practice worked collaboratively with the proactive care team (PACT) and reviewed data to monitor the impact of PACT on patient attendance at the practice.

Staff told us they were provided with adequate training for their roles and some staff gave examples of how they were encouraged and supported with professional development. As an accredited training practice, leaders told us they were committed to supporting the development of their trainees.

There was evidence of a learning culture within the practice. The practice undertook clinical audits to monitor performance and drive improvement. Staff also took part in quality improvement projects, including a project to improve care for their asthma patients. This was in response to identifying specific challenges in caring for their patient population and involved adapting care to meet these patient’s needs, for example by creating asthma plans in different languages and using videos for those who struggle with written advice. The practice had responded positively to address the concerns raised in our previous comprehensive inspection in April 2023, including making improvements to their recruitment processes and complaints management system, and carrying out regular safety alert audits.