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Review carried out on 10 August 2019

During an annual regulatory review

We reviewed the information available to us about Castlehead Medical Centre on 10 August 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

Inspection carried out on 15 December 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection November 2014 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Castlehead Medical Practice on 15 December 2017 as part of our inspection programme.

At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

  • Staff involved and 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.

  • The practice worked closely with other healthcare professionals in the area to offer a range of services to patients, such as a falls clinic and a minor injuries clinic.

  • There was a strong focus on continuous learning and improvement at all levels of the organisation.

  • On the day of inspection we saw some staff at the practice had not completed some annual mandatory training in the past 12 months. Some staff had also not received training at a level appropriate to their role. However, we were sent evidence by the practice to show that this had been rectified shortly after the inspection.

The areas where the provider should make improvements are:

  • Continue to carry out annual fire drills at regular intervals

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 11 November 2014

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out a planned comprehensive inspection of Castlehead Medical Centre on 11 November 2014.

Overall, we rated the practice as good. Our key findings were as follows:

  • The practice covered a large geographical and rural area; services had been designed to meet the needs of the local population.
  • We saw that the practice had made improvements which addressed the concerns we raised, at our inspection in May 2014, about the management of medicines.
  • Feedback from patients was positive; they told us staff treated them with respect and kindness.
  • Staff reported feeling supported and able to voice any concerns or make suggestions for improvement.
  • The practice manager regularly monitored the cleanliness of the premises. Actions highlighted in infection control audits were addressed.
  • The practice learned from incidents and took action to prevent a recurrence.

We saw the following areas of outstanding practice:

  • The practice supported their GPs in their emergency work with the Great North Air Ambulance Service, the local mountain rescue team and the paramedic pathfinder initiative run by the North West Ambulance Service, to provide care to their own patients, patients of other practices in the area and visitors.
  • The practice was able to meet patients’ needs in their own home environment or close to home, such as using effective referral processes to treat them at the local cottage hospital wherever possible, which reduced admissions to major hospitals some distance away.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 2 May 2014

During a routine inspection

Castlehead Medical Centre was situated in the centre of Keswick and provided medical care to people in and around the Keswick area. The practice operated a weekday service for 6335patients. It provided extended services so opened at 8.30am four days a week and closed at 6.30pm. At least once a week the centreremained open until8pm. The practice was responsible for providing primary care, which included access to GPs, minor surgery, family planning as well as ante and post natal care. Cumbria Health on Call (CHOC) provided an out of hours service for patients who used Castlehead Medical Centre.

The practice was able to dispense medication to those patients on the practice list who lived more than 1.6 km from the nearest pharmacy. Castlehead Medical Centre is a teaching practice and undertook continuing education and training of medical registrars and medical students from the University of Newcastle-Upon-Tyne.

The patients we spoke with and who completed the CQC comment cards were very complimentary about the care provided by the clinical staff; the overall friendliness and behaviour of all staff. Patients reported that they felt that all the staff treated people in a sensitive and dignified manner. Care and support was given to patients by a caring team of staff who were responsive to patient’s needs.

We found that patients who used the service were mostly kept safe and protected from avoidable harm. However, we identified a concern regarding the checking and supply of some medicines.

The GPs regularly met with the local clinical commissioning group (CCG) to discuss service performance and improvement issues. There was generally a very good relationship between the provider and the CCG. The provider was fully engaged in the local health economy and was proactive in responding to peoples’ needs.

The building was well-maintained and clean. Clinical decisions followed best practice guidelines. There were good governance and risk management measures in place.

Inspection carried out on 1 May 2014

During Reference: R6 not found