Plumbridge Medical Centre

This practice is rated as good overall. The practice was previously inspected on 7 November 2018. At that inspection the rating for the practice was requires improvement overall.

We carried out an announced focused inspection at Plumbridge Medical Centre to follow up on breaches of regulations identified during the inspection carried out on 7 November 2018.

This inspection focused on the key questions effective, caring and well-led.

We rated the practice as good overall with the following key question ratings:

Effective – requires improvement

Caring – requires improvement

Well-led – good

Three of the six population groups were rated good. People with long-term conditions, people families, children and young people, and working age people were rated requires improvement.

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

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 and the public.

We rated the practice as requires improvement for providing effective services because:

• The practice was below the minimum child immunisation uptake rate.
• The percentage of women eligible for cervical cancer screening who were screened was below target.

We rated the practice as requires improvement for providing caring services because:

• The practice’s performance in the GP Patient Survey was significantly below the CCG and national average in one of the indicators and trending negative in the remaining three. The practice had failed to address these areas in the internal patient survey.

Additional findings:

• We received 33 comment cards, 31 were wholly positive about their overall experience within the practice, the remaining two mentioned long waiting times at the practice for their GP appointment.
• Processes were in place to support patients who are bereaved and carers.
• The patients we spoke to said they felt treated with respect and dignity and their healthcare professional listened to them during consultations.

We rated the practice as good for providing well-led services because:

• Governance of the practice assured the delivery of high-quality and person-centred care, supported learning and innovation, and promoted an open and fair culture.
• Staff said they felt supported to do their role and that there was an open-door policy.
• Leaders were aware of the challenges within the population and were working towards taking steps to address them, i.e. social prescriber, support of the medicine management team, started to code carers, began tracking referrals.
• Staff were clear about their roles and responsibilities

The areas where the provider should make improvements are:

• Take action to increase the uptake of childhood immunisations and cervical screening.
• Take action to improve the practice’s offering to patients that are carers.
• Take action to appropriately monitor results from the GP patient survey to improve outcomes for patients where necessary.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

This practice is rated as requires improvement overall. The practice was previously inspected on 21 November 2017. At that inspection the rating for the practice was requires improvement overall.

The key questions are rated as:

Are services safe? – good

Are services effective? – requires improvement

Are services caring? – good

Are services responsive? – good

Are services well-led? - requires improvement

We carried out an announced comprehensive inspection at Plumbridge Medical Centre to follow up on breaches of regulations identified during the inspection carried out on 21 November 2017. The inspection was carried out across two days by prior arrangement to accommodate staff leave.

At this inspection we found:

• The practice had some systems to manage risk, but these were not always applied consistently.
• In many areas, the practice was in line with local and national averages for clinical performance. However, in some areas they were not in line with local and national averages. For example, the practice was above the national and local average for their prescribing of hypnotics. In addition, they were below the national and local average in one of the diabetes management indicators.
• We saw evidence that care and treatment had not always been delivered according to evidence-based guidelines.
• When incidents happened, the practice had not always learned from them and improved their processes.
• There was a lack of governance arrangements to ensure that risk was managed and that quality assurance processes were in place to improve patient outcomes.
• The practice had identified 73 patients as carers (3% of the practice list).
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Feedback from patients on the day of the inspection indicated that staff treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was limited focus on continuous learning and improvement at all levels of the organisation.

The areas where the provider must make improvements as they are in breach of regulations are:

• The practice must ensure systems and processes are established and operated effectively to demonstrate good governance.

The areas where the provider should make improvements are:

• Take action to increase the uptake of childhood immunisations and cervical screening.
• Review the information available to patients about how to make a complaint.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice