Castletown 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

This is the first inspection for this service since its registration with CQC. This key question has been rated as Good.

This service scored 79 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. When they took over the practice, they recognised it was a failing practice with a significant background of governance and quality failures and high staff turnover. They told us that they wanted to build access for patients at the right time, and drive inefficiencies out of the system. They wanted to give care to their patients which you would give to your own family. They wanted to be unconventional and openminded in their approach to changing the practice for the better. They wanted to build trust with patients and staff by following through on commitments, to communicate directly and treat every interaction with kindness.

The practice planned to grow and increase the patient population; they planned to advertise once they had established themselves and improved the practice. There was underutilised space at the practice which they had plans for.

Staff had been included in the development of the practice. There was an open-door policy, and they had received some good feedback from staff regarding the recent changes. They told us their staff morale had improved.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders demonstrated they had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Once the provider had taken over the practice in October 2024 they shared with us their action plan, unprompted, and continually kept us updated with their plans for improvement for the practice.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

The practice had established Freedom to Speak up arrangements with other practices in the primary care network. Staff were aware of how to raise concerns, and we saw examples where staff had used the arrangements in place to positive effect.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who work for them.

Policies and procedures to promote diversity and equality were in place. We saw senior leaders had addressed concerns related to discrimination. Adjustments had been made to ensure all staff were valued, for example we saw adjustments to support disabled staff were in place.

The service had established clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews. The provider had established governance processes that were appropriate for their service. Staff could access all required policies and procedures.

Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. We saw minutes of these meetings. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff. The service produced a monthly clinical governance report of the meetings held. The report included feedback on, for example, safeguarding, safety alerts, infection prevention control and mandatory training. Listed were dates of the previous other meetings, such as practice meeting and palliative care meeting.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborate for improvement.

The provider worked with other practices within their primary care network to offer extended access, and flu and covid vaccination programmes. Staff had made adjustments to improve coordination of their service with community healthcare services, including through recently established weekly meetings centred on the care of those at higher risk of hospital admission.

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. They were encouraging creative ways of delivering equality of experience, outcome and quality of life for people. The were proactively seeking out and embedding new ways of providing care and treatment.

The provider had shared with us their action plan for improvement, very quickly after they took over the practice. They continually kept us up to date with progress. They identified what issues needed improvement, acted upon this whilst gathering the views of patients and staff. This included improving access to the telephone lines and appointments. Reducing the burden of work on GPs, giving them more time for clinical care. They had introduced a clinical support tool to manage patient care more efficiently.

The practice had ongoing work to improve medicines optimisation. This included call and recall of patients, management of antibiotic prescribing, plans were in place to improve clinical coding and to introduce an IT solution to help with the management of medicines.

Staff told us they had been given protected time for learning and development. Some staff told us they had the opportunity to attend development programmes.

The practice had improved the practice environment and had further plans to offer more services. This included joint injections and fitting of intrauterine devices (IUD)