Stratton Medical Centre

Updated 19 August 2019

We inspected Stratton Medical Centre on 18 June 2019. The practice is situated at: Hospital Road, Stratton, Bude, Cornwall EX23 9BP. The practice is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury.

The provider is a partnership of GPs and the strategic business partner registered as Ruby Country Medical Group, which is a multisite provider delivering services to nearly 30,000 patients in total from three registered locations: Stratton Medical Centre, Holsworthy Doctors and Hatherleigh Medical Centre and are in Cornwall and Devon.

Stratton Medical Centre is situated within the Kernow Clinical Commissioning Group (CCG) and provides services to 10,567 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community. Patients are referred to secondary services within Cornwall and North Devon.

There are seven partners, six GPs and the strategic business manager (two male and five female) who are registered with the CQC as Ruby Country Medical Group. A team of salaried GPs are either based at one of the three sites or rotate across the group locations. There is a large multisite nursing team comprising of nurse practitioners, practice nurses, phlebotomists and health care assistants. There is a home visiting team comprising of nurse practitioners and paramedics who review patients who are unable to attend the practice due to frailty or ill health. The practice networks with another GP practices in Bude and across the North Devon border.

There are higher than average number of patients over 65 at 45.2% compared with the national average of 16%. The National General Practice Profile states that 98.7% of the practice population is from a white background with 1.3% of the population originating from Asian, black, mixed or other non-white ethnic groups. Information published by Public Health England, rates the level of deprivation within the practice population group as six, on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is 80 years compared to the national average of 79 years. Female life expectancy is 84 years compared to the national average of 83 years.

There are limited transport links due to its remote rural coastal location. Patients registered at Stratton Medical Centre, near Bude are also able to use services at the larger site of Holsworthy Doctors which provide increased access appointments during the evenings and at weekends. Information about opening times is displayed at the practice and on its website.

The practice sees an influx of temporary patients each year, peaking during the Summer months. Stratton Medical Centre is co-located on a site shared with Stratton Hospital which has a minor injuries unit and in-patient beds.

Ruby Country Medical Group is an approved training and teaching provider with close links to universities. It provides placements every year for medical students, GP registrars and F2 doctors. Students and registrars are able to work across all three sites run by the medical group, including Stratton Medical Centre.

Updated 19 August 2019

We carried out an announced comprehensive inspection at Stratton Medical Centre on 18 June 2019 as part of our inspection programme. This was the first inspection of the practice since the new provider Ruby Country Medical Group had taken over the contract to deliver primary medical services there.

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 had a clear vision which had quality and safety as its top priority. A five-year strategy was in place, monitored and regularly reviewed and discussed with all staff and patient representatives.
• There was extensive public engagement prior to and after Ruby Country Medical Group had taken over the contract to provide GP services.
• Concerns raised at these meetings were acted on and explanations provided about the rationale for some changes in service delivery, for example the discontinuation of a phlebotomy service off site with increased appointment access at the medical centre to promote patient safety.
• Patient satisfaction was high about the care and attention they received from staff.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• All patient feedback highlighted improved ease of access to the appointment system after a short period of resource challenges in 2018.
• 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.
• Improvements to the premises included complete decoration and refurbishment, in particular of clinical rooms.
• The practice had reviewed and organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way with near patient testing available on site or at two other locations run by Ruby Country Medical Group.
• The way the practice was well led and managed promoted the delivery of high-quality, person-centre care.
• There was a teaching culture, which was supportive and encouraged staff development and competencies to extend services for patients in North Cornwall and Devon.

Whilst we found no breaches of regulations, the provider should:

• Ensure nurses achieve the appropriate competencies and levels of training in safeguarding children or child protection as per intercollegiate guidance in January 2019.

• Review systems to ensure accurate information is held to facilitate overall governance of staff training.

Updated 19 August 2019

Updated 19 August 2019

Updated 19 August 2019

Updated 19 August 2019

Updated 19 August 2019

Updated 19 August 2019