Cranbrook Medical Centre Also known as Cranbrook Medical Practice

Updated 1 July 2022

Cranbrook Medical Practice is located in Exeter at:

169 Younghayes Rd,

Cranbrook,

Exeter

EX5 7DR

The provider 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.

The practice is open from 8.30am – 6pm Monday to Friday. The nurse practitioner starts at 7am one day a week and a GP holds a late-night surgery until 7pm one day a week.

The practice is also part of a rota with the local Primary Care Network which enables patients access to a GP on a Saturday.

The practice is situated within the Devon Clinical Commissioning Group (CCG) and delivers General Medical Services (GMS) to a patient population of approximately 4,041. This is part of a contract held with NHS England.

The practice is part of a wider network of five GP practices known as the Outer Exeter Primary Care Network (PCN).

Information published by Public Health England shows that deprivation within the practice population group is in the eighth decile (eight of 10). The lower the decile, the more deprived the practice population is relative to others. The practice has a higher than average population of young people and those of working age.

According to the latest available data, the ethnic make-up of the practice area is 57% Asian, 21% White, 15% Black, 4% Mixed, and 3% Other.

There is one GP who provides medical cover at the practice. The practice has a team of three nurses, including a nurse practitioner, a trainee nurse practitioner and a registered prescribing nurse, who provide nurse led clinics for long-term conditions and minor illness.

There was also a phlebotomist / health care assistant. The GP is supported at the practice by a team of reception/administration staff. An interim practice manager and the operations manager are based at the practice to provide managerial oversight.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If the GP needs to see a patient face-to-face then the patient is offered a choice of either an appointment at the medical centre or a home visit when necessary.

Extended access is provided locally by the Primary Care Network, where late evening and weekend appointments are available. Out of hours services are provided by Devon Doctors.

Updated 1 July 2022

We carried out an announced inspection at Cranbrook Medical Practice on 18 May 2022. Overall, the practice is rated as Requires Improvement.

Safe Requires improvement

Effective Good

Caring Good

Responsive Requires improvement

Well-led Requires improvement

Following our previous focused inspection on 7 December 2021, an inspection

focused on the management of access to appointments, the practice was rated as Requires Improvement for the provision or responsive services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Cranbrook Medical Practice on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a comprehensive inspection incorporating remote searches, interviews of staff and a site visit. The inspection looked at all the five key areas Safe, Effective, Caring, Responsive, Well Led.

How we carried out the inspection/review

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Requesting evidence from the provider
• A short site visit

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 this practice as Requires Improvement overall. We rated Safe Responsive and Well-led as Requires Improvement because we found:

• Some staff recruitment records were incomplete or not up to date.
• The practice did not have a clear and effective process for managing risks, issues and performance.
• Clinical governance systems, including oversight of policies and procedures to keep patients and staff safe were not fully effective as they had not been fully developed and embedded.
• The practice did not have a system in place for formally discussing and recording significant events and the learning from them.
• The complaints process, whilst promoting duty of candour, did not provided an effective oversight of the complaints process and outcomes were not shared with the whole team, which would support learning and service improvements.

We rated the practice as Good for Caring and Effective services because:

• The practice provided care in a way that kept patients safe and protected from avoidable harm.
• The practice had provided staff training for receptionists to support care navigation since the previous inspection
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• 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.
• The way the practice was led and managed promoted the delivery of high-quality, person-centred care.

We found breaches of regulations, the provider MUST:

• Ensure care and treatment is provided in a safe way to patients
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The provider should:

• Develop a system to monitor the quality of access to services for patients.
• Review and improve processes to indentify and register carers, including young carers.

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