The Care Quality Commission
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  • GP practice

Archived: Prestbury Park Medical

Overall: Good read more about inspection ratings

The Surgery, Crescent Bakery, St Georges Place, Cheltenham, Gloucestershire, GL50 3PN (01242) 226336

Provided and run by:
Prestbury Park Medical

Important: This service is now registered at a different address - see new profile

All Inspections

29 September 2021

During an inspection looking at part of the service

We previously carried out an announced comprehensive inspection at Prestbury Park Medical in February 2020 as part of our inspection programme. We rated the practice as Good overall. We rated the practice Good for providing safe, caring, and well-led services and requires improvement for providing an effective service. You can read the full report by selecting the ‘all reports’ link for Prestbury Park Medical on our website (www.cqc.org.uk).

We were mindful of the impact of the Covid-19 Pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the Covid-19 Pandemic when considering what type of inspection was necessary and proportionate, this was therefore a desk-based review. On 29 September 2021, we carried out a desk-based review to confirm that the practice had carried out improvement plans to their service in response to the requires improvement rating for the effective key question.

We found that the practice had put measures in place for ongoing improvement. The practice is now rated Good overall, good for providing effective services and good and good for all population groups.

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 have rated effective as Good because:

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
  • Quality improvement and monitoring had taken place to reduce exception reporting in line with local and national data, improve the uptake of child immunisations, and implement actions to improve uptake for the cervical screening programme to meet the national target of 80%.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

12/02/2020

During an inspection looking at part of the service

Following our annual regulatory review of the information available to us, we inspected this service on 12 February 2020. The service was last inspected in December 2016. It was rated as good for providing safe, effective, caring, responsive and well led services.

The current inspection looked at the following key questions; was the service providing effective and well led services for the registered patient population. We decided not to inspect whether the practice was providing safe, caring or responsive services as there was no information from the annual regulatory review which indicated this was necessary.

The ratings from our previous inspection for safe, caring and responsive services have been carried through to contribute to the overall rating for the practice

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 have rated this practice as good overall and good for safe, responsive, caring and well-led services because:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.
  • Governance systems were effective and regularly reviewed.
  • The practice was engaged in local initiatives and worked alongside partners in the local healthcare system.

We have rated this practice as requires improvement for effective services because:

  • Quality and Outcomes Framework exception reporting in some areas, including long-term conditions and mental health, was above local and national averages. The practice did not evidence any initiatives to engage with their population to see why patients were not attending. There were no plans to try to improve the attendance rates.

  • The percentage of women taking up the offer of a cervical screening test was 70.3% against and a target of 80%.

We have rated this practice as good overall and good for all population groups except:

  • The population groups people with long-term conditions and people experiencing poor mental health (including people with dementia). We rated these as requires improvement because the practice’s high QOF exception reporting meant the practice could not be assured that people with long-term and mental health conditions were receiving timely reviews to check their health and medicines needs were being met.

  • We rated the population group working age people (including those recently retired and students) as requires improvement because of the low take up of cervical screening by women in the practice population.

The areas where the practice should make improvements are:

  • Continue to monitor Quality and Outcomes Framework (QOF) exception reporting and continue to implement appropriate measures to reduce this in line with local and national data.
  • Continue to monitor and seek to improve the take up of child immunisations.
  • Implement actions to improve uptake for the cervical screening programme to meet the national target of 80%.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

1 December 2016

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

During our comprehensive inspection of Crescent Bakery in June 2016 we found breaches of legal requirements relating to the overview of safety systems and processes; management, monitoring and improving outcomes for people and governance arrangements. These resulted in the practice being rated as requires improvement for the provision of safe, effective and well led services. Specifically we found the practice:

  • Did not take appropriate actions when vaccine fridges were operating outside of the required range.

  • Had not ensured all staffhad the required pre-employment checks.

  • Had nationally reported outcomes for patients with long term conditions that were below average. Patients with these conditions may not have been receiving the reviews of their treatment to ensure their care was maintained.

  • Did not ensure all staff have had an appraisal.

  • Did not have a continuous programme of audits to ensure quality improvements.

The practice sent us an action plan setting out the changes they were making to address the issues that led to our concerns.

We carried out a focused inspection on 1 December 2016 to ensure these changes had been implemented and that the service was now meeting the regulations. The ratings for the practice have been updated to reflect our findings. We found the practice had made improvements in the safe and effective provision of services since our last inspection on 1 June 2016 and they were meeting the requirements of the regulations previously breached.

Specifically the practice had:

  • Introduced stricter controls in monitoring vaccine fridges and had updated relevant staff on the correct procedures for checking and resetting of vaccine fridge thermometers.

  • Completed Disclosure and Barring Service (DBS) check for staff who required these. (DBS checks identify whether a person has a criminal record or is on an official list of people barred from working in roles where they may have contact with children or adults who may be vulnerable).

  • Improved their systems to complete reviews of the care of patients with long term conditions. Data for the first eight months of the recording period in 2016/17 showed improved outcomes for these patients.

  • Ensured all staff have had an appraisal.

  • Introduced a programme of audits and undertaken re-audits to ensure quality improvement.

Additionally,

  • All staff have undertaken Safeguarding adults training.

  • Actions had been taken to improve patient’s satisfaction on consultation with GPs and nurses.

We have updated the ratings for this practice to reflect these changes. The practice is now rated good for the provision of safe, effective and well led services.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

1 June 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Crescent Bakery on 1 June 2016. Overall the practice is rated as requires improvement.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Although risks to patients who used services were assessed, the systems and processes to address these risks were not implemented well enough to ensure patients were kept safe.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. However, GP patient survey result on consultations with GPs and nurses were lower than the clinical commissioning group and national averages.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider must make improvement are:

  • Ensure appropriate actions are taken when vaccines fridges are operating outside of the required range.

  • Ensure all staff have had the required pre-employment checks.

  • Ensure the number of reviews for patients with long term conditions is increased and the outcomes of the reviews are appropriately and accurately recorded in the patient’s medical records.

  • Ensure all staff have had an appraisal.

  • Ensure a continuous programme of audits is maintained to ensure quality improvements.

The areas where the provider should make improvement are:

  • Ensure all staff have received safeguarding adults training.

  • Ensure actions are taken to improve patient’s satisfaction on consultation with GPs and nurses.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice