13 September 2023
During a routine inspection
We carried out an announced comprehensive inspection at Burnham & Berrow Medical Centre on 13 September 2023. Overall, the practice is rated as good.
Safe - good
Effective - good
Caring - good
Responsive - good
Well-led - good
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Burnham & Berrow Medical Centre on our website at www.cqc.org.uk
Why we carried out this inspection
We carried out this 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.
- 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 provided care in a way that kept patients safe and protected them from avoidable harm.
- Patients 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.
- 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.
While we found no breaches of regulation, the areas where the provider should make improvements are:
- Continue to embed medicines management improvements to improve patient outcomes.
- Continue to embed reporting processes for significant events.
- Continue to review and update practice policies to reflect current roles and responsibilities.
- Take steps to formally assess health and safety at both practice locations.
- Take steps to include appropriate oversight of clinical complaints and identify improvements.
- Continue to monitor and improve patient access.
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