Background to this inspection
Updated
17 December 2020
Castlefields Surgery provides a range of primary medical services, from its location at The Mannock Medical Centre, Irthlingborough Road, Wellingborough, Northamptonshire, NN8 1LT. Its services are commissioned by NHS Northamptonshire Clinical Commissioning Group (CCG).
The practice operates from the ground floor of a purpose built modern two-storey building, with disabled access throughout. The building also accommodates a pharmacy, another GP practice and other healthcare services that were not inspected as part of this inspection. There is a large car park outside the practice, with disabled parking available.
The practice holds a General Medical Services contract (GMS), this is a nationally agreed contract with NHS England.
The practice serves a population of approximately 3,900 patients with a slightly lower than national average population of patients aged over 65 years. The practice population is 72% white British and 12% Asian. The remaining 16% is an accumulation of other ethnic backgrounds.
Information published by Public Health England rates the level of deprivation within the practice population group as four on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.
The clinical team consists of a lead GP. There are also three regular locum GP’s. The practice also employs two practice nurses and one health care assistant. The team is supported by a practice manager and a team of non-clinical, administrative staff. Members of the community midwife team operate regular clinics from the practice.
Castlefields Surgery is open from 8am to 6.30pm Monday to Friday with extended opening until 8.30pm on alternate Thursdays. The practice is closed once a month for staff training for half a day. When the practice is closed, out of hours services can be accessed via the NHS 111 service.
Information about this is available in the practice and on the practice website.
The practice is registered with the Care Quality Commission under Dr Bazurulla Khan, Castlefields Surgery, Mannock Medical Centre, Irthlingborough Road, Wellingborough NN8 1LT and provides the Regulated Activities of:
- Surgical procedures
- Maternity and midwifery services,
- Treatment of disease, disorder or injury and
- Diagnostic and screening procedures.
The practice offers extended access for evening and weekend appointments via the East Northants Hub. Appointments are booked via the practice. The extended hours access appointments are provided by GPs, Practice Nurses, Paediatric Nurses and other clinicians both inside and outside of core General Practice opening hours in East Northants.
Opening times are:
• 8am to 6.30pm Monday to Friday (with extended hours on alternate Thursdays until 8.30pm via the hub)
• 8am to 12 midday Saturdays (via the hub)
• 8am to 12 midday Bank Holidays (via the hub)
Updated
17 December 2020
We carried out an announced comprehensive inspection at Castlefields Surgery on 16 November 2020 as the practice had previously been rated inadequate and was put in special measures in January 2020.
We were mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the Covid-19 pandemic when considering what type of inspection was necessary and proportionate. This is why there was a delay in reinspecting this service.
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 found the practice had made improvements across several areas of non-compliance identified at our previous inspection. The practice had made the improvements during a global pandemic. However, at this inspection, some areas of concern still existed and we have rated the practice as Requires Improvement overall and Requires Improvement for patients with long term conditions and working age population because some patients had not received their blood monitoring and blood pressure monitoring in a timely manner. The number of patients who had received their cervical screening remains well below the local and national averages. Although the practice had taken some action to address this, we have not yet seen the impact of this.
Key findings included:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- Staff dealt with patients with kindness and respect and involved them in decisions about their care.
- The practice had identified 2% of patients who were also carers and had updated its carers’ register accordingly.
- The practice’s Patient Participation Group were positive about their relationship with the practice. They felt supported, appreciated and valued.
- The practice now had a comprehensive system in place to learn from significant events and complaints.
- The practice was now up to date with summarisation of patient notes and extra staff had been specifically trained to help with this.
- The practice had completed a number of audits over the last 12 months to improve outcomes for patients including a minor surgery audit.
The areas where the provider must make improvements are:
- Ensure care and treatment is provided in a safe way to patients.
In addition, the provider should:
- Continue to improve its recall process for patients with long term conditions and those patients identified as from vulnerable groups.
- Continue to improve its cervical screening uptake rates.
- Review historic MHRA alerts to ensure that any actions needing to be taken are completed.
I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service. The improvements the practice made were enough to remove from special measures but due to improvement still needed in medicine monitoring this warranted a requires improvement rating.
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