The Care Quality Commission
  • Doctor
  • GP practice

Dalston Medical Group

Overall: Good read more about inspection ratings

The Surgery, Townhead Road, Dalston, Carlisle, Cumbria, CA5 7PZ (01228) 710451

Provided and run by:
Dalston Medical Group

All Inspections

During an assessment under our new approach

Dalston Medical Group is a GP practice which incorporates a practice dispensary and delivers services to approximately 5,208 people under a contract held with NHS England. According to the latest available data, the ethnic make-up of the practice area is approximately 98% White, 0.8% Asian, 0.7% Mixed, 0.2% Black and 0.3% Other. Information published by the Office for Health Improvement and Disparities shows deprivation within the practice population group is in the 8 decile (8 of 10). The lower the decile, the more deprived the practice population is relative to others.

This was a focused assessment. We undertook this assessment due to the length of time since our last assessment. We assessed 10 quality statements from across all 5 key questions. This assessment considered the demographics of the people using the practice, the context the practice was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.

Staff kept facilities clean and maintained equipment appropriately to ensure people were kept safe. They assessed and managed the risk of infection and took steps to control the risk of it spreading. There were enough staff with the right skills, qualifications and experience.

Staff supported people to live healthier lives, monitoring their care and treatment to ensure they received positive and consistent outcomes.

Staff treated people with kindness, empathy and compassion, and respected their privacy and dignity.

People could access care, treatment and support when they needed it. Leaders and staff were alert to discrimination and inequality that could disadvantage groups of people who used the practice and sought ways to address any barriers.

The practice had a clear vision and strategy, which considered the needs of the people who used their practice and the wider community. Staff understood their individual roles and responsibilities. Governance arrangements were generally effective, although some areas of oversight required strengthening, including the content, frequency and attendance of meetings.

22 May 18

During a routine inspection

This practice is rated as Good overall. Previous inspection May 2015 - 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

We carried out an announced comprehensive inspection at Dalston Medical Group on 22 May 2018 as part of our inspection programme.

At this inspection we found:

  • The practice had systems to keep patients safe and safeguarded from abuse.
  • 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 they provided. They ensured that care and treatment was delivered according to evidence- based guidelines.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • The practice organised and delivered services to meet patients’ needs. They took account of patient needs and preferences.
  • Patients were able to access care and treatment from the practice within an acceptable timescale for their needs.
  • There was a focus on continuous learning and improvement at all levels of the organisation. The practice proactively used performance information to drive improvement.

However, there are areas where the provider should make improvements:

  • The provider should be more proactive in their identification and support of carers
  • They should consider having a documented business plan
  • They should improve current processes so that learning and trends and themes arising from significant events and incidents are shared with all staff at regular minuted meetings as a standard agenda item
  • They should continue in their efforts to establish a patient participation group (PPG)

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

7 May 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Dalston Medical Centre on 7 May 2015

Overall, we rated the practice as good. Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well led services.

Our key findings were as follows:

  • We had inspected the practice previously during May 2014. We identified a number of areas of concern. During this inspection we found significant improvements had been made; all of the areas we identified as concerns had been addressed and changes to practice made where necessary;
  • Feedback from patients was positive; they told us staff treated them with respect and kindness;
  • Patients reported good access to the practice, with urgent appointments available the same day;
  • Most of the patients we spoke with told us they felt they had sufficient time during their appointment, although some said they felt rushed at times;
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance;
  • Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, reviewed and addressed;
  • A detailed review of patient access had been carried out and as a result the GPs had revised their working days, additional appointments had been made available each day and emergency appointments with all GPs were set aside each day;
  • There was a clear leadership structure and staff felt supported by the management team. The practice actively sought feedback from patients;
  • The practice was clean and hygienic, and good infection control arrangements were in place.

However, there was an area of practice where the provider needs to make improvements.

The provider should:

  • Take steps to implement effective arrangements for monitoring staff’s Hepatitis B immunisation status.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

9 September 2014

During an inspection of this service

9 September 2014

During a routine inspection

This was a follow up inspection of the practice. Dalston Medical Group provided services from The Surgery. The Surgery provided a weekday service for over 5000 patients in the Carlisle area. The Surgery open Monday to Friday from 08:30 to 18:30 and had 07:30 appointments but the days this was available varied each week. The service 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 the Surgery.

The patients we spoke with were extremely complimentary about the care and treatment being provided. Patients reported that all the staff treated them with dignity and respect.

They found the doctors and nurses had a good understanding of their needs.

We found that action was needed to improve the provider’s involvement of patients in the development of the service.

We found that staff required appropriate training. Clinical governance processes needed to cover checking competency of clinicians. Recruitment procedures needed to be strengthened.

The arrangements for maintaining the building to a safe standard needed to be in place. The service was not cleaned to an appropriate standard.

Governance and risk management measures were not in place and many quality assurance systems needed to be developed. We found that the provider was not meeting eight of the regulations.

We told the provider they must make a number of improvements. At this inspection in September 2014 we checked whether the practice had taken action to address the enforcement actions. We found that the practice had taken action to ensure they improved the processes for monitoring the service, the records and access to training. 

6 May 2014

During a routine inspection

Dalston Medical Group provided services from The Surgery. The Surgery provided a weekday service for over 5000 patients in the Carlisle area. The Surgery open Monday to Friday from 08:30 to 18:30 and had recently introduced appointments at 07:30 but the days this was available varied each week. The service 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 the Surgery.

The patients we spoke with and who completed our comment cards were extremely complimentary about the care and treatment being provided. Patients reported that all the staff treated them with dignity and respect. They found the doctors and nurses had a good understanding of their needs.

We found that action was needed to improve the provider’s involvement of patients in the development of the service.

We found that staff required appropriate training. Clinical governance processes needed to cover checking competency of clinicians. Recruitment procedures needed to be strengthened.

The arrangements for maintaining the building to a safe standard needed to be in place. The service was not cleaned to an appropriate standard.

Governance and risk management measures were not in place and many quality assurance systems needed to be developed. We found that the provider was not meeting eight of the regulations.

We told the provider they must make a number of improvements.