The Quantock Medical Centre

Letter from the Chief Inspector of General Practice

The Quantock Medical Centre is a rural practice providing primary care services to patients resident in Nether Stowey, Somerset. The practice has a patient population of approximately 3,100.

We undertook a comprehensive announced inspection on 18 November 2014. Our inspection team was led by a Care Quality Commission (CQC) Lead Inspector, a CQC pharmacy inspector , a nurse specialist advisor and GP specialist advisor.

Overall the practice is rated as good. This is because we found the practice to be good for providing an effective, caring, responsive and well led service. However the practice was rated as requiring improvement for the safe domain.

Our key findings were as follows:

• Patients were able to get an appointment when they needed it.
• Staff were caring and treated patients with kindness and respect.
• Staff explained and involved patients in treatment decisions.
• Patients were cared for in an environment which was clean and reflected good infection control practices.
• Patients were protected from the risks of unsafe medicine management procedures.
• The practice had the appropriate equipment, medicines and procedures to manage foreseeable patient emergencies.
• The practice met nationally recognised quality standards for improving patient care and maintaining quality.
• Patients were treated by suitably qualified staff.
• GPs and nursing staff followed national guidance in the care and treatment provided.
• We found the practice was managed by the practice manager who took responsibility for the non clinical decisions and performance monitoring. However we found the clinical governance systems were not systematic and did not fully demonstrate that the service was robust in monitoring the safety of patient care.

The Quantock Medical Centre demonstrated outstanding practice in several areas

• The practice had a patient centred ethos where medical team saw patients registered with them which gave continuity of care. We were told that GPs gave patients direct contact details to use when in crisis even if this was outside of normal practice hours.

• The practice also reached out to the local community and held health education events in the community hall which benefited the whole community, such as training to use an automated electronic defibrillator for patients who have experienced a cardiac arrest.

• The practice also employed a counsellor and worked with a self employed foot care specialist and self employed fitness and nutrition coach who support and provide services for rural patients who are unable to access services in Bridgwater.

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

The provider must:

• Have established processes in place to assess and monitor the quality of service and includes effective clinical governance processes such as clinical audit and significant events, to assure the safety of patient care.

The provider should:

• Review the checking system for dispensed medicines

We have judged the service to be in breach of the regulation for assessing and monitoring the quality of the service.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice