The Care Quality Commission
  • Doctor
  • GP practice

Newquay Health Centre

Overall: Good read more about inspection ratings

The Health Centre, St Thomas Road, Newquay, Cornwall, TR7 1RU (01637) 850002

Provided and run by:
Newquay Health Centre

All Inspections

25 November 2022

During an inspection looking at part of the service

We carried out an announced focused inspection at Newquay Health Centre on 25 November 2022. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring – Not inspected, rating of Good carried forward from previous inspection.

Responsive – Inspected but not rated, rating of Good carried forward from previous inspection.

Well-led - Good

Following our previous inspection on 7 December 2021, the practice was rated Requires Improvement overall and for the key questions of Safe and Well-led. Key questions Effective, Caring and Responsive were rated Good.

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

Why we carried out this inspection

This inspection was a focused follow-up inspection to review:

  • Safe, Effective, Responsive and Well-led domains
  • Breaches of regulations and recommendations identified from the previous inspection

How we carried out the inspection

Throughout the pandemic, CQC has continued to regulate and respond to risk. However, taking into account 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 included:

  • Conducting staff interviews using video conferencing facilities.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A short 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 found:

  • Improvements had been made across the practice’s governance and assurance systems since our last inspection.
  • There were clear and effective processes for managing health and safety including infection prevention and control (IPC).
  • The practice had implemented improved systems to ensure the security and tracking of blank prescriptions, in line with national guidelines.
  • The practice provided care that supported the appropriate and safe use of medicines, this included regular monitoring arrangements for patients prescribed high-risk medicines.
  • Patients received effective care and treatment that met their needs. The practice’s auditing of care and treatment was now embedded providing assurance of this.
  • There was a structured and coordinated approach to the management of patients with long term conditions.
  • Patients could access care and treatment in a timely way.
  • Incidents and complaints were investigated and managed openly and transparently when something went wrong, in line with the duty of candour.
  • 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:

  • Take action to correctly apply the protocol for patient results handling, in line with practice policy timescales.
  • Implement a formal process outlining the scope of practice and supervision arrangements for non-medical prescribers.
  • Improve the uptake of cervical cancer screening and childhood immunisation to eligible patients.
  • Support staff awareness for the cancer detection protocol and pathways in place for the new detection of cases in patients.

09 December 2021

During an inspection looking at part of the service

We carried out an announced inspection at Newquay Health Centre on 7 and 9 December 2021. Overall, the practice is rated as Requires Improvement.

Safe - Requires Improvement

Effective - Good

Caring - Good

Responsive - Good

Well-led – Requires Improvement

Following our previous inspection on 1 December 2017 the practice was rated Good overall and Good for all key questions.

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

Why we carried out this inspection

This inspection was a focused inspection incorporating remote searches, interviews of staff and a site visit.

  • The ratings for Caring and Responsive were carried forward from the previous inspection.

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
  • A short site visit
  • Conducting an interview with a Patient Participation Group member
  • A pre-site visit staff questionnaire

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 Requires Improvement overall. We rated Safe and Well Led as Requires Improvement because we found:

  • Some staff recruitment records were incomplete or not up to date.
  • There was no evidence of Infection Prevention and Control audits having been completed since 2019.
  • The practice did not have clear and effective processes for managing risks, issues and performance.
  • The practice did not have a reliable system in place to ensure the security and tracking of blank prescriptions and this was not in line with national guidance.
  • Recent actions implemented by the senior leadership team provided assurance of the provider’s oversight of risks and awareness of key issues requiring improvement. However, due to the team being newly re-organised, they needed time to demonstrate a clear understanding of accountabilities and that new processes were embedded with lasting improvements.
  • Clinical governance systems, including oversight of medicines management specifically blank prescription stationary, adherence to recruitment and induction procedures and health and safety risk assessments were not fully effective due to the fact they needed further time to fully embed.
  • Staffing at Newquay Health Centre was potentially vulnerable due to the impact of staff shortages, unexpected absences and recruitment challenges.
  • People did not always receive a timely apology when something went wrong and were not consistently told about any actions taken to improve processes to prevent the same happening again.

We have rated the practice as Good for providing Effective services because:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • 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 way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We found breaches of regulations, the provider must:

  • Ensure care and treatment is provided in a safe way to patients
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
  • Ensure specified information is available regarding each person employed

The area where the provider should make improvements is:

  • Implement regular infection prevention and control (IPC) audits to ensure measures are effective and embedded.

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

1 December 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection September 2015 –Outstanding)

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 the Newquay Health Centre on 1 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.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.
  • The practice were linked to the local community orchard scheme for “green prescribing” and refer those with anxiety/depression for 12 week course in horticulture.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

23 September 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Newquay Medical Centre on Wednesday 23 September 2015. Overall the practice is rated as outstanding.

Our key findings across all the areas we inspected were as follows:

  • There was a safe track record and staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed. Learning from these events was effectively shared with other stakeholders and commissioners.
  • Risks to patients were assessed and well managed. Medicines were well managed and the practice had clean and tidy facilities. There was sufficient equipment to treat patients and meet their needs and systems to maintain and monitor the safety of this equipment.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Information for frail patients was shared with other providers appropriately.
  • Patients appreciated the care they received and said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. The service welcomes complaints and responded promptly to feedback.
  • Patients said they found it easy to make an appointment with a GP and that there was continuity of care, with urgent appointments available the same day.
  • There were clear recruitment processes in place. Staff had received training appropriate to their roles and any further training needs had been identified and planned
  • The practice was well organised and there was a clear leadership structure. The practice proactively sought feedback from staff, which it acted on.

We identified areas of outstanding practice:

  • The practice had responded to the needs of the community and were effective in sharing the learning from this. The practice were part of the ‘Living Well’ scheme in Cornwall. The scheme was adopted by Kernow Clinical Commissioning Group (CCG) following the GPs involvement and success of a pathfinder project that started in Newquay three years ago and subsequently spread across the county. This patient centred way of working created a partnership between primary care, community health services, social care and the voluntary organisation to support an individual to achieve their goals. The scheme had triggered other projects such as directing patients with anxiety and depression to a community orchard gardening course and to a scheme called food works where selected patients could access a six week healthy eating programme run by a well known restaurant in the town. The CCG report stated that the Newquay living well scheme had reported a 23% increase in positive impact on patients and reduced hospital admissions for patients with long term conditions by 40% and had seen a 5% reduction in cost and demand for adult social care. The scheme is being monitored by and has been praised by the Minister of State for Social Care and Support.
  • The practice had responded to the needs of patients and introduced learning cafés. These themed events were for patients and carers to meet primary care staff, volunteer and charity groups and health care professionals. Patients were given information on self-management, healthy living and information on where to access patient support. The last café on dementia had been well attended.
  • The GPs provided a primary medical service presence each weekday afternoon to the local community hospital. This service had reduced the average hospital stay from 28 days to 18 days by providing continuity of care for patients and improving communication with hospital staff.
  • The practice had been part of developing a new project monitoring epilepsy patients for risk factors and early intervention to reduce risk of SUDEP (sudden death in epilepsy). The pilot had led to 17% of these patients receiving several interventions in the previous year that would not have happened without the tool. The GP had co written an article which had been published in the British Journal of General Practice and nominated for a HSJ award. The GPs were welcoming the use of the template and the practice were currently monitoring emergency department attendance, patient experience and clinician experience.

However, there were also areas of practice where the provider needs to make improvements.

Importantly the provider should:

  • Consider formalising the business plan and strategy.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice