Archived: Tawstock Medical Centre

We carried out an announced comprehensive inspection at Tawstock Medical Centre on 27 February 2020 as part of our inspection programme and following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a change (either deterioration or improvement) to the quality of care provided since the last inspection in October 2015.

When we last inspected Tawstock Medical Centre in October 2015 it had been rated as Good overall; Good for providing safe, effective, caring, responsive and well-led services and Good for all the population groups.

This inspection focused on the following key questions:

• Are services safe?
• Are services effective?
• Are services caring?
• Are services responsive?
• Are services well led?

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 Tawstock Medical Centre as Requires Improvement for providing effective services and Requires Improvement for the two population groups which includes people with long term conditions and People experiencing poor mental health (including people with dementia) because:

• Quality Outcome Framework (QoF) clinical indicators were below local and national averages for long-term conditions and People experiencing poor mental health (including people with dementia) and exception reporting was above local and national averages with no clear clinical reason for this.
• The practice participated in national priorities and initiatives to improve the population’s health. However, there were variation in the uptake of national screening programmes. The practice demonstrated awareness of this and were taking some action to improve the uptake of cervical screening.

We have rated Tawstock Medical Centre as Good overall; Good for providing safe, caring, responsive and well led services and Good for all population groups other than the two population groups which includes people with long term conditions and People experiencing poor mental health (including people with dementia) because:

• At this inspection, we found all the areas of concern from the last inspection had been addressed and improved.
• We found the practice had successfully coped with a significant change and re-organisation of the management team.
• Patients’ needs were assessed, and care and treatment was delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools.
• The practice had a comprehensive programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided.
• Staff had the skills, knowledge and experience to deliver effective care, support and treatment.
• Staff worked together and with other organisations to deliver effective care and treatment.
• There was compassionate, inclusive and effective leadership at all levels. This included working with and supporting the practice Patient Participation group (PPG).
• The practice had a clear vision and set of values that prioritised quality and sustainability.
• The practice had a culture that drove high quality sustainable care.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.
• There were processes for managing risks, issues and performance.
• We provided the practice with Care Quality Commission feedback cards prior to the inspection and we received 22 completed cards. Patients were extremely positive about the practice staff, their experiences, and the care and treatment they received.

Although we did not find any beaches of regulation at this inspection, we did see some areas where the provider should make improvements. These are:

• Continue monitoring the uptake of cervical screening in line with national guidance.
• Continue monitoring exception reporting and associated performance data to support patients with long term conditions and those experiencing poor mental health (including people with dementia).
• Consider reviewing the emergency medicines that are held and that would be used in the event of drug overdoses or completing a risk assessment which would sufficiently mitigate the risk and explain why the practice did not stock it.
• Implement systems to ensure that training and infection control audits are up to date.
• Continue implementing the changes identified within the practice recovery plan.

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