The Care Quality Commission
  • Doctor
  • GP practice

Launceston Medical Centre

Overall: Good read more about inspection ratings

Landlake Road, Launceston, Cornwall, PL15 9HH (01566) 772131

Provided and run by:
Launceston Medical Centre

All Inspections

1 August 2023

During an inspection looking at part of the service

We carried out an announced focused inspection at Launceston Medical Centre on 1 August 2023. Overall, the practice is rated as good.

Safe - good

Effective - good

Caring - good

Responsive - requires improvement

Well-led - requires improvement

Following our previous inspection on 16 February 2022, the practice was rated requires improvement overall and for the safe and well-led key questions. The caring and responsive were rated as good.

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

Why we carried out this inspection

We carried out this inspection to follow up breaches of regulation from a previous inspection in line with our inspection priorities.

How we carried out the inspection/review

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing and during the inspection.
  • 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.
  • A short site visit.

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:

  • The practice had systems to provide care in a way that kept patients safe and protected them from avoidable harm. However, not all systems had been consistently followed. For example, we saw gaps in the monitoring of some patients prescribed certain medicines.
  • Patients generally 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.
  • The provider had implemented systems to increase access to care and treatment for patients.
  • The way the practice was led and managed promoted the delivery of quality, person-centred care.

The provider should:

  • Improve systems to record full details within the medicine reviews for patients.
  • Consistently follow the processes and systems for monitoring patients who are prescribed certain medicines which require additional monitoring. Continue to embed safeguarding level 3 training for all clinicians.
  • Continue to develop systems and processes to improve the delivery of NHS health checks to those patients who were identified as eligible.
  • Continue to take action to increase the cervical screening provided to patients.
  • Continue to take action to increase the take up of baby and children’s immunisations.
  • Continue to embed systems and processes to improve access for patients to the practice.

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 Health Care

16 February 2022

During an inspection looking at part of the service

We carried out an announced inspection at Launceston Medical Centre on 16 February 2022. Overall, the practice is rated as Requires Improvement.

Safe – Requires Improvement

Effective – Good

Well-led – Requires Improvement

Following our previous inspection on 16 February 2017, 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 Launceston Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a focused inspection. We have inspected and rated Safe, Effective and Well-led domains.

We undertook this inspection at the same time as CQC inspected a range of urgent and emergency care services in Cornwall. To understand the experience of GP Providers and people who use GP services, we asked a range of questions in relation to urgent and emergency care. The responses we received have been used to inform and support system-wide feedback.

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,
  • Requesting evidence from the provider,
  • A short site visit.

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,
  • information from the provider, patients, the public and other organisations.

We have rated this practice as Requires Improvement overall

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm, however we couldn't be assured this was maintained at all times.
  • Patients received effective care and treatment that met their needs.
  • 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.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care, however, not all aspects of the governance were managed appropriately and that caused some shortfalls in the managerial overview. Systems were in place to monitor and review risk, however they were not fully embedded.

We found breach of Regulation 17 HSCA (RA) Regulations 2014 Good governance. The provider must make sure they are following up to date guidance and have processes in place and follow them to assure themselves that:

  • All staff’s mandatory training is up to date,
  • Infection Prevention Control audit is carried out regularly,
  • Emergency medicine is stored safely and securely,
  • All long term conditions have appropriate monitoring,
  • Relevant clinical staff have regular clinical supervision,
  • Patient Group Directions are managed appropriately.

While we found a breach of Regulation 17 HSCA (RA) Regulations 2014 Good governance, we have also found an area of outstanding practice in provider employing full-time clinical psychologist, who is leading a mental health team in the practice and working towards improving access for people with poor mental health by offering up to 25 clinics a week.

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

15 February 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Launceston Medical Centre on 26 May 2016. The overall rating for the practice was good. The full comprehensive report on the Month Year inspection can be found by selecting the ‘all reports’ link for Launceston Medical Centre on our website at www.cqc.org.uk .

This inspection was an announced focused inspection carried out on 15 February 2017 to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations we identified in our previous inspection on 26 May 2016. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is now rated as good in all domains.

Our key findings were as follows:

  • There were effective recruitment procedures ensuring all necessary checks were made prior to a new member of staff commencing employment. This included obtaining

    satisfactory information for locum GPs.

  • Training was managed effectively to promote patient safety and any risks that could affect the quality of care were reduced. In particular, Mental Capacity Act 2005 and safeguarding training was completed for all clinical staff and chaperone training had been provided for staff undertaking this role.

We looked at other areas highlighted by us for improvement and saw positive changes:

  • There was a whole team approach to learning from significant events, which ensure all staff were involved in analysing such events to create a team based learning environment.

  • Systems for establishing and monitoring what training staff were required to complete according to their roles and responsibilities had been reviewed and made clear.

  • Systems for capturing any verbal complaints made by patients had been implemented, analysis of these were being used for shared learning to improve the patient experience at the practice.

  • Information displayed about out of hours services had been updated making it clearer for patients with the contact numbers and times to call this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

26 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Launceston Medical Centre on 26 May 2016. Overall the practice is rated as good.

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.
  • The practice had systems, processes and practices in place to keep patients safe and safeguarded from abuse. However, we found some gaps in these systems. This included some training updates had not been provided for staff. Recruitment practices did not meet the legal requirements regarding the checks that must be undertaken to ensure patients are cared for by suitable staff.
  • Risks to patients were assessed and well managed. For example, there were safety systems in place for proactive management of vulnerable older people ensuring they were frequently reviewed and their needs met.
  • 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.
  • All 40 patients giving feedback at the inspection confirmed 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. 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 management. The practice proactively sought feedback from staff and patients, which it acted on. For example, the appointment system had been completely reviewed as a result of patient feedback and provided more flexibility because of the range of staff available for them to see.
  • The provider was aware of and complied with the requirements of the duty of candour.

We saw one area of outstanding practice:

The practice had reviewed the skill mix across the team against the increasing needs of an older population in the area. An emergency paramedic, with a practitioner training was part of the team. Their role and responsibilities included responding to the needs of vulnerable older people and patients with long term conditions by making home visits to them for assessment and treatment within their scope of practice. This had reduced the number of emergency admissions for patients through proactive assessment and treatment and released GP time so that they were able to focus on patients with complex and urgent needs.

The areas where the provider must make improvement are:

  • Ensure recruitment arrangements include all necessary employment checks for all staff. For example, references, checks of professional registers; Disclosure and Barring Service (DBS) checks or risk assessments for all staff providing a chaperone service for patients; and obtaining and retain evidence of insurance indemnity for all clinical staff, including locum GPs.

  • Ensure that training is managed effectively so that patient safety is promoted and any risks that could affect the quality of care are reduced. In particular Mental Capacity Act 2005, safeguarding for all clinical staff and chaperone training for staff undertaking this role.

The areas where the provider should make improvement are:

  • Ensure that the learning from significant events involves the whole team and becomes embedded in everyday practice. Review the approach to analysing such events to create a team based learning environment.

  • Review systems for establishing and monitoring what training staff are required to complete according to their roles and responsibilities.

  • Review systems for capturing any verbal complaints made by patients, and analyse and use these for shared learning to improve the patient experience at the practice.

  • Review information displayed about out of hours services to make it clearer for patients with the contact numbers and times to call this service.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

26 September 2013

During a routine inspection

We spoke with nine patients who were attending the practice on the day of our inspection. Their comments included "give them a big tick"; "Dr 'X' has been very good with my condition, [they] really have been very good and I could not wish for any better"; "my doctor is lovely. [The doctor] is always very kind and does a good job. We have a chat and decide what to do"; and, "I see the nurses an awful lot and they are so kind to me they really are. They always look pleased to see me".

People told us they felt involved in their care and treatment, and they were treated with respect and dignity by all the staff at the practice.

Staff knew the local safeguarding procedures. The policies for safeguarding children and vulnerable adults were reviewed regularly to ensure they were up to date. Staff regularly attended multi-agency safeguarding meetings. This meant people could be kept safe because information was shared and safeguarding plans were put in place.

There were appropriate arrangements in place which ensured that staff kept their knowledge and skills up to date. Staff told us about the supportive environment and confirmed that they had access to adequate training.

The practice was organised and well led. There were effective systems in place to monitor the quality of the service provided and patients were able to give feedback about the service.