The Care Quality Commission
  • Doctor
  • GP practice

Archived: Dr Andrew Garrod

Overall: Requires improvement read more about inspection ratings

The Medical Centre, Churchfield, Camelford, Cornwall, PL32 9YT (01840) 213893

Provided and run by:
Dr Andrew Garrod

All Inspections

2 November 2022 - remote inspection

During an inspection looking at part of the service

We carried out an announced focused inspection at Dr Andrew Garrod practice on 2 November 2022 to follow up on warning notices issued to the provider following our inspection in June 2022. The warning notice was regarding a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – safe care and treatment.

This inspection was not rated therefore, ratings following our last inspection in June 2022 remain:

Safe - Requires Improvement

Effective - Requires Improvement

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 29 June 2022, the practice was rated Requires Improvement overall for the Safe, Effective and Well-led key questions. For key questions of Caring and Responsive, the practice was rated as Good.

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

Why we carried out this inspection

This inspection was a focused follow-up inspection to confirm that the practice had met the legal requirements in relation to the warning notice served after our previous inspection in June 2022.

How we carried out the inspection/review

This inspection was carried out remotely and included:

  • Conducting staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.

Our findings

We based our judgement of the quality of care at this service on a combination of:

  • What we found when we inspected through carrying out remote searches of the patient clinical records, review of documents submitted by the provider and interviews with staff.
  • Information from the provider, including an action plan detailing their progress to meeting the requirements of the warning notice.

We have not rated this inspection.

We found that:

  • The practice had made improvements to the areas highlighted in our warning notice.
  • The practice provided care, by undertaking appropriate monitoring of patients on high-risk medicines in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs for the management of long-term conditions.

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

29 June 2022

During an inspection looking at part of the service

We carried out an announced inspection at Dr Andrew Garrod – Camelford Medical Centre on 29 June 2022. Overall, the practice is rated as Requires Improvement.

Set out the ratings for each key question

Safe - Requires Improvement

Effective - Requires Improvement

Well-led - Requires Improvement

Following our previous inspection on 19 January 2018, the practice was rated Good overall and for all key questions.

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

Why we carried out this inspection

This inspection was a focused inspection to follow up on:

  • Key questions inspected
  • The ratings for Caring and Responsive were carried forward from the precious inspection. Both are rated Good.

How we carried out the inspection/review

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
  • Talking with patients on the telephone

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 have rated this practice as Requires Improvement

We found that:

  • The practice had not consistently provided care in a way that kept patients safe and protected them from avoidable harm. Clinical record searches highlighted a number of patients potentially at risk due to a lack of monitoring or missed diagnosis.
  • Controlled drugs had not been disposed of correctly.
  • Environmental risk assessments identified risks which had not been addressed.
  • Patients medical information was not consistently accessible to clinicians and not all paper medical records had been stored securely.
  • Patient’s needs were not consistently assessed.
  • The practice had not reached the national targets for cervical screening and baby immunisations.
  • Staff were proactive in helping patients to live healthier lives.
  • The practice worked well together and with external providers to receive person centred care.
  • Patient’s needs were not consistently assessed.
  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
  • There was visible, approachable and inclusive leadership within the practice. The provider had not formally developed visions, values and a strategy to provide sustainable care.
  • There was an open culture within the practice.
  • The overall governance arrangements had not ensured systems and process were followed consistently.
  • Not all processes for managing risks, issues and performance were formalised.
  • The practice complied with digital and information security standards.
  • Patient and staff views were welcomed and when necessary acted upon.

We found two breaches of regulations. The provider must:

  • Ensure care and treatment is provided in a safe way to patients.
  • Embed effective systems and processes to ensure good governance and assurance in accordance with the fundamental standards of care.

The provider should:

  • Review the system for the provision of health checks for patients to consistently meet patient need.
  • Review the system regarding the use of interpretation and translation services to promote patient confidentiality.
  • Continue to promote screening and immunisations for patients to meet national targets
  • Continue to review and promote staff safety and wellbeing.
  • Review the environmental risk assessments and develop to include all risks and formulate action plans to reflect the action taken to reduce the risks.

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

18 December 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (The practice was previously inspected in September 2015– At that time it was overall rated as 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 the Churchfield Practice on 18 December 2017 as part of our inspection programme.

At this inspection we found:

  • 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 it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation.
  • There were routine and urgent appointments easily available and patients were able to access care when they needed it.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

24 September 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Health Centre, Dr Garrod on 24 September 2015. Overall the practice is rated as good.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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 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.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it easy to make an appointment with their GP 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 management. 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.

However there were areas of practice where the provider should make improvements:

  • The practice should form a patient participation group to seek feedback from patients.

We saw one area of outstanding practice:

The practice recognised the needs of their population and had links with the local food bank. They provided food vouchers to patients in need and held food boxes to give out provisions when necessary.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

During a check to make sure that the improvements required had been made

We carried out a follow-up review of The Medical Centre after our inspection on 14 June 2013 when we identified areas where the provider was not fully compliant.

The Commission had received an action plan from the provider, which detailed how they intended to address the areas of concern.

We did not visit the service or speak with people who used the service on this occasion.

We found, people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

The provider had a system to assess and monitor the quality of service that people received.

14 June 2013

During a routine inspection

For this inspection we visited The Medical Centre and the branch location of St Breward. We spoke with patients who were visiting both surgeries. We also spoke with a number of patients over the telephone in order to ask for their view about the services they had received.

Patients were happy with the services received from the provider and surgery staff. Comments included 'It is really easy to get an appointment. All of the staff are very accommodating, nothing is too much trouble'. Another patient said 'The GP has been my lifeline. He was prompt to diagnose my condition and the treatment prescribed has brought my illness under control'.

Measures were in place to manage infection control. The surgery buildings were generally well maintained.

People were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Staff had the skills to meet the needs of the patients and their performance was monitored.

There were some systems in place to monitor the quality of the service provided and patients felt able to give feedback about the service they had received. However, at the time of our inspection a record of the audit of medicines was not in place.