The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Stephen Carr Also known as Bank Street Surgery

Overall: Good read more about inspection ratings

9-13 Bank Street, Keswick, Cumbria, CA12 5JY (017687) 72438

Provided and run by:
Dr Stephen Carr

Important: The provider of this service changed. See old profile

All Inspections

8 February 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Stephen Carr on 5 November 2015. The overall rating for the practice was good, although the practice was rated as requires improvement for safety. The full comprehensive report on the November 2015 inspection can be found by selecting the ‘all reports’ link for Dr Stephen Carr on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 8 February 2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection on 5 November 2015. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

The practice is now rated as good for safe services, and overall the practice is rated as good.

Our key findings were as follows:

  • The practice had taken action to address the concerns raised at the CQC inspection in November 2015. They had put measures in place to ensure they were compliant with regulations.
  • Appropriate checks were now carried out on new staff employed by the practice, including locum GPs.
  • The process for monitoring the storage and use of controlled drugs at the practice was now regularly followed.
  • A system for tracking prescription pads and paper through the practice was now in use.
  • At the November 2015 inspection we told the practice they should review governance arrangements to ensure the practice policies and procedures were up to date and reflected current guidance. We found that the practice were now doing this.

The practice showed us evidence of other improvements they had made since the inspection in November 2015. This included reflecting on positive significant events, using text messages for health promotion campaigns (such as smoking cessation), and implementing alerts on the practice computer system to help staff monitor and review the needs of patients with dementia.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

5 November 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Stephen Carr on 5 November 2015. Overall the practice is rated as good.

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

  • There was an open and transparent approach to reporting significant events.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had 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.
  • Information about services and how to complain was available in the waiting area and was easy to understand.
  • Patients said they found it easy to make an appointment with a named GP and that 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. The building had some limitations and the practice was aware of these and wished to improve the premises but had not yet been able to secure funding to do so.
  • The practice had proactively sought feedback from patients and had an active patient participation group.
  • Staff felt supported by management. The practice proactively sought feedback from staff and patients, which they acted on.

We saw one area of outstanding practice:

  • Data from the National GP Patient Survey published in July 2015 showed that patients rated the practice highly for their experience of making an appointment and for how easy it was to get through the surgery by phone. For example, 99.3% patients said they could get through easily to the surgery by phone (CCG average 80.3%, national average 73.3%).

The area where the provider must make improvements:

  • Ensure recruitment arrangements include all necessary employment checks for all staff, including locum staff when used.

The areas where the provider should make improvements:

  • Review governance arrangements to ensure the practice policies and procedures are up to date and reflect current guidance and their own policy.
  • Monitor the new process of checking the stocks of controlled drugs held by the practice. This is in order to demonstrate these improvements become embedded into practise in the long term
  • Review the practice’s arrangements for the storage and distribution of prescriptions in line with recognised guidance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

22 January 2014

During an inspection looking at part of the service

We carried out this inspection to see if the provider had acted on the concerns we identified, regarding this outcome, when we visiting in July 2013.

At this inspection we reviewed the training records of all staff and discussed this with the interim practice manager. We saw, from staff training certificates, that every member of staff had completed safeguarding of children and vulnerable adults training. We found that the GP was the dedicated lead in safeguarding for the practice. Review of his training showed that he had received level III training. All clinical staff had received level I training or above. All staff, which included the cleaner, had received basic training in this subject.

We discussed the requirement of security checks on staff with the interim practice manager. They told us that a risk assessment had been performed on all staff to identify if a check was required. We saw that all staff had received a check at the level suitable for their role.

30 May 2013

During a routine inspection

All of the patients we spoke with confirmed that they felt confident that the doctor understood their condition. One patient told us, 'I come when I need to. I never have a problem with the staff.' On review of the appointment system we saw that there were appointments available in the coming days. All of the patients we spoke with said they had never experienced any problems when trying to book an appointment. One patient told us; 'It is always very easy to get an appointment when you need one and I never feel rushed when the GP is seeing me.'

We were told that the practice did have a patient reference group which had been allowed to lapse. A patient reference group (PRG) is a group of patients established to give the practice feedback on the range and quality of services provided and to suggest where improvements can be made. We saw that overall the practice was achieving QOF targets however staff were aware that areas of achievement could be improved. There were systems in place to effectively monitor and record performance against the quality and outcomes framework. Appropriate risk assessments were undertaken regarding the safety and suitability of the premises. We found the practice to be clean and tidy. There was evidence that adult safeguarding training for all staff was up to date however we found that child protection training had not been completed. The practice manager confirmed that training would need to be sourced and delivered as a matter of urgency.