Background to this inspection
Updated
13 April 2020
Twin Oaks Medical Centre is located in the village of Bransgore, near Christchurch, Dorset. The practice is on the border of the counties of Hampshire and Dorset and is part of the West Hampshire Clinical Commissioning Group (CCG). The practice operated from purpose-built premises which are owned by the GP partners. The practice building has four consulting rooms and a treatment room. There is space for allied clinical services, such as a midwife and health visitor, to use the consulting rooms. Other health care professionals operate
from the premises and share waiting room facilities.
Twin Oaks Medical Centre has a branch surgery called Park View situated in Burley, about four miles away. This branch surgery also has a dispensary authorised to dispense to patients in the Burley area. We did not inspect the Park View branch surgery.
The practice website advertised surgery opening times and how to access urgent care from an alternative primary care provider.
The practice provides a range of primary medical services to approximately 4,700 patients. The list size had increased from approximately 4,200 patients in 2015. There are three GP partners and two salaried GPs. In addition, there is a healthcare assistant, a dispenser and staff employed jointly with other practices, including a pharmacist. A newly appointed practice nurse was about to start employment at the practice at the time of the inspection. Further support is provided by the practice manager and administrative and reception staff.
Twin Oaks Medical Centre has a General Medical Services (GMS) contract. The GMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.
The patient population serviced by Twin Oaks Medical Centre is one of the least deprived in the country, however within this, there are contrasting pockets of high deprivation.
Updated
13 April 2020
We carried out an announced focused inspection at Twin Oaks Medical Centre on 24 February 2020 as part of our inspection programme. The previous comprehensive inspection, published in March 2015, rated the service as good overall, with some areas of outstanding practice. We rated safe as requires improvement due to a breach of Regulation 12 of the Health and Social Care Act 2018 (Regulated Activities) Regulations, in relation to cleanliness and infection control. Subsequently, we rated the key questions safe as good on 26 July 2016. This resulted in the service carrying an overall rating of good and a rating of good for the five key questions.
We decided to undertake an inspection of this service following our annual review of the information available to us. This inspection looked at the following three key questions: is the service effective, responsive and well-led?
We based our judgement of the quality of care at this service is 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.
We rated the practice as good for providing effective services because:
- Patients received a high standard of care, with regular reviews, based on good practice guidelines. This resulted in good outcomes for patients of all ages and with different needs.
- There was a holistic approach to assessing, planning and delivering care and treatment. The service worked collaboratively with health, social care and educational professionals to support individuals with specific needs.
- Staff consistently supported patients to live healthier lives, including identifying those who needed extra support. The practice had developed innovative ways to improve engagement.
- Staff had additional skills and special interests to support the needs of local patients.
We rated the practice as outstanding for providing responsive services because:
- Services were tailored to meet the needs of families children and young people and vulnerable patients within the local community. They were delivered in a flexible way that ensured choice and continuity of care.
- There were innovative approaches to providing integrated person-centred care.
- The practice had identified areas where there were gaps in provision locally and had taken steps to address them. Such as tailoring services for patients living in a community for travellers and for those with a learning disability.
- The practice had reviewed and changed their appointment system to ensure patients could access services and appointments in a timely way. Patients reported positive access compared to other practices in the area and nationally.
We rated the practice as good for providing well-led services because:
- The leadership and culture of the practice promoted the delivery of high-quality, person-centred care.
We carried over the rating of good for providing safe and caring services from our previous inspections.
We rated the population groups of families, children and young people and vulnerable people as outstanding because:
- The practice had implemented an effective protocol to encourage those eligible to attend for cervical screening. This including those with a learning disability.
- The practice liaised with local schools to support vulnerable families and their children in the community.
- The GPs worked closely with the care navigator and social prescriber to support individuals with their physical and mental health care.
- For the traveller community, the practice provided healthcare services that met their specific needs and encouraged engagement with health and social care services.
The areas where the provider should make improvements are:
- Establish a procedure to secure access to archived files.
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