Background to this inspection
Updated
9 May 2018
Castle Gardens Surgery has one location at Castle Hill Gardens, Torrington, Devon EX38 8EU. We inspected this location on 8 March 2018.
Castle Gardens Surgery is a GP practice providing NHS primary care services for 6,888 patients. The practice population is in the sixth deprivation decile for deprivation. In a score of one to ten the lower the decile the more deprived an area is. There is a practice age distribution of male and female patients equivalent to national average figures. Average life expectancy for the area is similar to national figures with males living to an average age of 80 years and females to 85 years.
The practice has a total of eight GPs who are supported by two qualified nurses, currently recruiting for vacant practice nurse post and two healthcare assistants, comprising of one male and 11 female staff. There is an administrative team consisting of a practice manager, office manager, receptionists, data administration and dispensers.
Opening hours are between 8.30am to 1.15pm and 2pm to 6pm Monday to Friday. The practice provides extended opening hours every Monday from 6.30pm to 7.30pm for patients needing appointments with a GP, nurse or health care assistant. Extended hours appointments are pre-bookable and preferably for patients who find it difficult to come to the practice during normal working hours. Outside of these hours a service is provided by another health care provider by patients dialling the national 111 service.
The practice is able to offer dispensing services to those patients on the practice list who live more than one mile (1.6km) from their nearest pharmacy. The dispensary is open for ordering and collection of medicines from 8am to 12pm and from 2pm to 6pm. Patients are also able to collect medicines from reception between 12pm and 2pm.
Routine appointments are available daily and are bookable up to six weeks in advance. Urgent appointments are made available on the day, provision of sit and wait appointments and telephone consultations also take place.
Patients who use the practice have access to community staff including community matron, district nurses, community psychiatric nurses, health visitors, physiotherapists, mental health staff, counsellors, chiropodist and midwives.
Updated
9 May 2018
Letter from the Chief Inspector of General Practice
This practice is rated as Good overall. (Previous inspection October 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 Castle Gardens Surgery on 8 March 2018. This was a routine inspection part of our inspection programme.
At this inspection we found:
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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.
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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.
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Staff involved and treated patients with compassion, kindness, dignity and respect.
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The staff were knowledgeable about their patients putting reasonable adjustments in place, where necessary, to ensure they did not experience discrimination.For example, the staff continued to work closely with the community learning disability team providing information for patients in appropriate formats, flexible appointments and continuity of staff. Patients with complex needs were able to have appointments in a place and time that suited them.
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Patients found the appointment system easy to use and reported that they were able to access care on the day when they needed it.
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There was a strong focus on continuous learning and improvement at all levels of the organisation.
We saw two areas of outstanding practice:
The delivery and advancement of knowledge and skills at the practice is highly developed and strongly focussed on delivering a responsive service to meet the needs of patients. For example, emergency life support training is delivered more frequently and was role specific.
The practice has been proactive ensuring patient views are heard in the development of Great Torrington becoming a dementia friendly town, providing opportunities for support, companionship and activities for vulnerable people.
The area where the provider should make improvements is:
Continue to monitor newly implemented governance systems to track action taken.
Professor Steve Field (CBE FRCP FFPH FRCGP)
Chief Inspector of General Practice