Castle Place Practice

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect.

This is the first inspection for this service since its registration with CQC. This key question has been rated as Good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service staff always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

There were arrangements to promote patients’ privacy. National GP Patient Survey data reflected higher than average positive response in relation to people feeling listened to and being treated with kindness. Staff we spoke with understood Gillick competency and there was a process to ensure young adults had control over their own privacy and the amount of parental involvement in managing their care and support.

GPs had designated patient lists to ensure continuity of care. The service treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

People’s personal, cultural, social, religious and equality characteristics needs were understood and met. People’s communication needs were met to enable them to be fully involved in their care. For example, texts sent via the practice could be translated into other languages.

The service promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff helped patients and their carers to access advocacy and community-based services.

We saw the service provided clear, accessible information on care and treatment options, supported shared decision-making in all consultations, including providing written information and signposted to other services and supported self-management tools.

Meeting minutes reviewed showed that clinicians routinely discussed and documented people’s consent, capacity, and involvement in decisions.

The service liaised with the Urgent Community Response (UCR) Team to support people at risk of hospital admission, promoting care at home where safe and preferred. Additionally, the practice had close links with the Community Nursing team and the Reablement service within Tiverton Hospital, to ensure they were aware of any changes in people’s care needs, to proactively review and avoid unnecessary hospital admissions (where appropriate) and allow people to maintain their independence at home.

The service listened to and understood people’s needs, views and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern or distress.

There was a system for appointment triage that ensured people with immediate needs had access to services. Staff we spoke with knew the process for referral to emergency support, including mental health crisis teams. For those people with complex needs or long-term conditions needing help to make decisions, the practice had close links with the RDUHs Mental Capacity Team, as well as a Mental Capacity Act Champion within the practice.

The service cared about and promoted the wellbeing of their staff and supported and enabled staff to always deliver person-centred care.

Staff told us they were valued by practice management. Leaders had taken steps to recognise and meet the wellbeing needs of staff, which included the necessary resources and facilities for safe working, such as regular breaks and rest areas, employee benefits and staff assistance programmes. Additionally, staff were supported within their individual roles to ensure their workloads were realistically manageable. All staff members had regular individual work review meetings with their team lead, which enabled workload and wellbeing to be monitored; this facilitated early recognition and addressing of any issues.

We were told by staff and managers that each team lead also completes a department improvement plan. These improvement plans and team progress are discussed at the regular individual work reviews.

All staff had access to the RDUH Hub whereby they could access a variety of well-being forums/courses or general information ranging from Mental Health, Sleep Clinics, Menopause Support and Occupational Health Services.

The practice had held 3 closed Practice Learning Events (PLE). We were told these had brought all the staff together for both learning and an opportunity to build relationships across teams. Attendance levels at these events were high, and the staff had provided positive feedback from the events over the past year. The last PLE Agenda focused on staff wellbeing and creating connections across all staff teams, whilst also offering protected time to complete mandatory training.

Castle Place Practice had reviewed staff feedback from RDUH staff surveys and had good overall results. They had reviewed the highest scoring results, which evidenced that staff felt the practice was a nurturing and supportive environment to work in, providing care, encouragement and well-being for all employees.