Background to this inspection
Updated
2 September 2021
Crewkerne Medical Centre is located in Crewkerne at:
Crewkerne Health Centre
Middle Path
Crewkerne
TA18 8BX
The practice has a branch surgery, West One Surgery, at:
West Street
Crewkerne
TA18 8AY
We did not visit the branch site during this inspection. At the time of our inspection there was a reduced service provided from West One Surgery as this site was being used as a ‘hot’ site during the COVID-19 pandemic. A ‘hot’ site is where patients who are suspected of or who have COVID-19 are seen, with the premises and facilities altered to provide isolation rooms for patients who potentially had COVID19.
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. These are delivered from both sites.
The practice is situated within the Somerset Clinical Commissioning Group (CCG) and delivers services as part of a contract held with NHS England to a patient population of about 13,000.
The practice is part of a Primary Care Network which is a wider group of GP practices.
Information published by Public Health England shows that deprivation within the practice population group is in the seventh decile (seven of 10). The lower the decile, the more deprived the practice population is relative to others.
According to the latest available data, the ethnic make-up of the practice area is 98.8% White, 0.6% Asian and 0.8% Mixed.
There is a team of 3.96 whole time equivalent GPs who provide cover at both sites. The practice has a team of 3.19 whole time equivalent nurses, who provide nurse led clinic’s for long-term conditions at the main and branch location. The GPs are supported at the practice by a team of reception and administration staff. The practice manager and assistant practice manager are based at the main location 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 the main GP location or the branch surgery.
Out of Hours (OOH) patients can access the local OOH GP services via the NHS 111 service.
Updated
2 September 2021
Why we carried out this inspection
At our inspection in September 2019 we rated the service as requires improvement overall. The key questions for safe, effective and well led were rated as requires improvement; the key questions for caring and responsive were rated as good. We issued requirement notices for regulation 12 (safe) and regulation 17 (good governance) of the Health and Social Care Act 2014.
We carried out an announced inspection at Crewkerne Health Centre on 19 July 2021. At this inspection we found the provider had taken action to address the issues raised at the previous inspection including in the areas where there were breaches to regulations. The provider is now compliant with regulations. At this inspection we have rated the practices as good.
Safe - Good
Effective - Good
Caring - Good
Responsive - Good
Well-led - Good
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Crewkerne Health Centre on our website at www.cqc.org.uk
How we carried out the inspection
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
- Reviewing documentation, policies and procedures
- A 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 Good overall and Good for all population groups.
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- The clinical needs of patients were monitored by clinicians in a timely way and appropriate care and treatment was provided.
- Staff were trained and competent to carry out their roles. Infection control procedures ensured safety and reduced the risk of cross infection.
- A programme of refurbishment was in progress and included the replacement of carpets within clinical areas; changing ceiling window blinds so they were easier to use; and clean and decoration of some areas.
- Governance arrangements were formalised to ensure non-medical prescribers were competent and PGDs complied with national guidelines.
- Comprehensive checks and records were undertaken to ensure the safety of emergency equipment and medicines.
- 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 practice monitored and reviewed the telephone systems and provided data to support this monitoring. However, during our inspection we saw there had been a number of calls abandoned and patients waiting for their call to be answered.
- The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
Whilst we found no breaches of regulations, the provider should:
- Continue to monitor the telephone access for patients and take appropriate action so that patients do not abandon their call and are answered in a timely way.
- Continue to follow the identified actions to improve the environment so that infection control and prevention is promoted in all areas.
- Continue to take action to meet the national targets for cervical screening.
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