The Care Quality Commission
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  • GP practice

Royal Crescent Surgery

Overall: Outstanding read more about inspection ratings

25 Crescent Street, Weymouth, Dorset, DT4 7BY (01305) 774466

Provided and run by:
The Royal Crescent and Preston Road Practice

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Royal Crescent Surgery on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Royal Crescent Surgery, you can give feedback on this service.

17 November 2022

During a routine inspection

We carried out an announced focused inspection at Royal Crescent Surgery on 17 November 2022. Overall, the practice is rated as Good. However, their rating of outstanding remains due to the carry over from caring and responsive.

We have rated the domains as:

Safe - Good

Effective - Good

Caring - Not inspected, rating of Outstanding carried forward from previous inspection

Responsive - Not inspected, rating of Outstanding carried forward from previous inspection

Well-led - Good

Following our previous inspection on 4 April 2017 the practice was rated outstanding overall and for the caring and responsive domains because :

  • The practice had developed a range of services to support some of the most vulnerable patients across Weymouth and Portland.
  • The practice had developed a visiting team which consisted of a GP, nurse practitioners and a community matron for patients over 75 years of age.

The practice had developed a service called “Community Angels” . This was a joint venture between the practice and the local church. It provided a volunteer befriending service and transport for patients who were isolated. The surgery employed a co-ordinator to run the service.

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

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
  • A 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 found that:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • 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.
  • 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.

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

  • Continue to improve uptake of cervical screening
  • Review systems to monitor patients on high risk medications (such as warfarin, lithium) prior to prescribing.
  • The provider should monitor training to ensure all staff training is up to date.
  • Continue to embed systems and processes to allow for effective monitoring of risk, for example acting on safety alerts.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services

20 October 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Royal Crescent and Preston Road Practice at the Royal Crescent Surgery on 20 October 2016. Overall the practice is rated as outstanding.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. We received consistently positive feedback from patients including the 73 comment cards we reviewed. 
  • Staff were motivated and inspired to offer kind and compassionate care and would deliver prescriptions when there was an urgent need and drive patients home when they or their carers had been taken unwell at the practice.
  • The practice had worked with people with a learning disability in the development of information about the annual review process and the easy read invite letter included a photograph of the clinician who would be undertaking the review. 
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by the management team. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the duty of candour.  

The area where the provider should make improvement is:

  • The practice should consider how they monitor the quality and outcomes framework exception rates so they are more in line with national averages and patients receive appropriate services.

We saw three areas of outstanding practice:

  • One of the GPs within the practice had been supported to develop a range of services to some of the most vulnerable patients within the Weymouth and Portland area and had secured funding for two community nurses to provide physical and mental health support to the homeless population. Alongside this the GP provided one session per week to the community alcohol detox addictions service supporting 60-70 patients in receipt of substitute prescribing. 
  • The practice had a visiting team providing services for the over seventy five year olds. A GP was supported by nurse practitioners and a community matron in the provision of weekly or fortnightly visits to 18 nursing homes within the catchment area supporting 208 residents . The team also provided home visits to 160 housebound patients.  The practice met regularly to review the impact of this service and conducted nursing home surveys, and analysed data about hospital admission rates and uptake of vaccines. We were told that emergency hospital admission rates from nursing homes had decreased by 30% since 2014 and that requests for same day GP visits from care homes had decreased by 57% between 2014 and 2016. 90% of care home residents and 95% of housebound residents had received a flu vaccine at the time of the inspection.
  • The practice had developed a service called ‘Community Angels’, which was provided from the branch Preston Road Surgery. This was a joint venture between the practice and the local church. It provided a volunteer befriending service, transport for patients to attend hospital appointments and a support scheme to address social isolation. The practice employed a coordinator who managed this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice