Tieve Tara Medical Centre

Updated 27 July 2023

Tieve Tara Medical Centre is located in Castleford at:

Park Dale

Castleford

West Yorkshire

WF10 2QP

We visited the surgery as part of this inspection activity.

The provider Spectrum Community Health C.I.C is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures. Spectrum Community Health C.I.C took over the running of the practice in 2021.

The Ouseburn Practice operates under the Tieve Tara Medical Centre registration. This delivers a Special Allocations Scheme service to around 35 patients who reside in the North East of England (a Special Allocations Scheme practice delivers GP services to patients who had been removed from their previous GP’s patient list). This service is primarily delivered remotely via telephone consultations, with face to face consultations being undertaken at a GP practice in Seaham, County Durham and at Queen Elizabeth Hospital in Gateshead. We did not visit this service during the inspection.

The building is accessible for those with a disability and has been adapted further. For example, the reception desk had been lowered for wheelchair users and a hearing loop had been installed for those with a hearing impairment. There is parking available nearby for patients and an independent pharmacy is adjacent to the practice.

The practice is situated within the NHS West Yorkshire Integrated Care Board and delivers Personal Medical Services (PMS) to a patient population of 5,480.

The practice is part of a wider network of GP practices Wakefield North Primary Care Network (PCNs are groups of practices working together to focus local patient care).

According to the latest available data, the ethnic make-up of the practice patient population is 98.2% White, 0.6% Asian, 0.6% Black and 0.6% Mixed..

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the lowest decile (1 of 10). The lower the decile, the more deprived the practice population is relative to others.

Tieve Tara Medical Centre has a larger proportion of younger patients aged 0-19 years, and a lower proportion of patients aged 65 years and over compared to local and national averages.

Tieve Tara Medical Centre appointments and support include:

• Pre-bookable appointments for certain conditions and reviews.
• Telephone and face to face appointments.
• Telephone triage and advice.
• On the day/urgent appointments.
• Home visits.
• Support to registered patients who live in 8 residential care settings.

Tieve Tara Medical Centre is open between 8am and 6.30pm Monday to Friday, although a limited number of nurse and healthcare assistant appointments were available from 7.30am to 8am Monday to Friday. In addition, the practice can make appointments for patients to access primary care services via a local extended hours service. Out of hours care is provided by Local Care Direct Limited.

Tieve Tara Medical Centre is managed by a head of primary care, and clinical services are delivered by a team of regular locum GPs, 1 advanced nurse practitioner, 1 clinical pharmacist, 1 lead nurse, 1 practice nurse, 1 nurse associate, and 1 healthcare assistant. The clinical team is supported by a practice manager and a team of receptionists and administration staff. At the time of inspection recruitment is going for some additional staff roles. In addition, the practice receives and/or hosts additional staff from their PCN including pharmacists and pharmacy technicians and care coordinators.

The Ouseburn Practice Special Allocations Scheme operates 8am to 6pm Monday to Friday, and offers both telephone consultations and face to face appointments. The Ouseburn Practice is delivered by 1 salaried GP and 1 bank GP, 1 lead nurse, and 1 healthcare assistant/administration support worker.

Updated 27 July 2023

We carried out an announced comprehensive inspection at Tieve Tara Medical Centre on 5 and 6 July 2023. Overall, the practice is rated as requires improvement.

Safe - requires improvement

Effective - requires improvement

Caring - good

Responsive - good

Well-led - good

Why we carried out this inspection

We carried out this inspection as a new provider Spectrum Community Health C.I.C had registered with CQC to deliver services from Tieve Tara Medical Centre.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• Undertaking a visit to the practice location.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We found that:

• Patients’ needs were assessed. However, care and treatment had not always been delivered in line with current standards and evidence-based guidance. For example, we identified concerns in relation to medicines management, the diagnosis of conditions, and monitoring and follow-up of patients with long-term conditions. In addition, the clinical supervision of non-medical prescribers was limited and not formalised.
• Fire evacuation drills had not been undertaken recently.
• The provider had undertaken a project to reduce repeat prescribing of hypnotic medicines, and antibiotic prescribing rates had shown an over reduction over the past 4 years.
• Staffing, both clinical and non-clinical, was a challenge, and at the time of inspection the provider relied on regular locums to deliver GP services. We saw that the provider had measures in place to tackle staffing issues and had recently appointed new non-clinical staff to the practice.
• The provider had a programme of quality improvement activities in place which included clinical audit.
• Child immunisation rates were close to or above national targets.
• Staff, patients and partner organisations were generally positive about their views of the practice.
• Senior provider staff had the skills and competence to effectively manage the service. Governance and performance management processes were in place.

We saw an area of outstanding practice:

• The provider had worked closely with others such as Spectrum Community Health C.I.C’s own charitable arm Spectrum Health and other community groups to improve the health and wellbeing of the local population.

We found one breach of regulations. The provider must:

• Ensure that care and treatment is provided in a safe way to patients.

In addition, the provider should:

• Work to improve cervical screening and breast screening rates.
• Improve the numbers of carers identified by the practice.
• Continue to implement measures to improve capacity via recruitment.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services