Background to this inspection
Updated
26 February 2020
Windermere and Bowness Medical Practice is situated in the Windermere Health Centre, Goodly Dale, Windermere, Cumbria, LA23 2EG. The Health Centre is in purpose-built premises; all patient services are on the ground floor. There is a car park beside the practice and step-free access.
The practice has been registered to be operated by the current provider since August 2015 and provides NHS primary care services. The service is commissioned by NHS Morecambe Bay clinical commissioning group (CCG) to provide services to approximately 5,761 patients under the terms of a personal medical services (PMS) contract.
The service is one of 14 registered services managed and operated by One Medicare Ltd (the provider). These include urgent care centres, GP practices and walk-in services. The provider’s head office and operations centre is based near Otley in West Yorkshire.
GP sessions are provided at the practice by one part-time female salaried GP, one part-time male sessional GP and regular locum GPs. The salaried GP is planning to retire, and at the time of our inspection, the practice was advertising for a replacement salaried GP and a further advanced care practitioner. There was also one other full-time salaried GP employed to start work on the Monday following our inspection. There are two advanced nurse practitioners, one of whom is the practice clinical lead, one nurse practitioner, a musculoskeletal (MSK) practitioner, paramedic, three practice nurses, one of whom is a non-medical prescriber and two health care assistants. The clinical team is supported by a practice co-ordinator, a reception supervisor and a team of staff who undertake reception and administration duties. The practice is further supported by a team of clinical and administration staff employed by the provider.
Information published by Public Health England rates the level of deprivation within the practice population group as nine on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.
Average male life expectancy at the practice is 83 years, which is higher than the national average of 79. Average female life expectancy at the practice is 88 years, which is higher than the national average of 83 years. There are fewer patients aged under 18 years and over 65 years than the local and national averages, and almost 250 more male patients than female.
The practice is registered with CQC to provide the regulated activities diagnostic and screening procedures, treatment of disease disorder and injury, maternity and midwifery services, family planning services and surgical procedures.
The service has been inspected by the Care Quality Commission previously. You can find all the previous reports by accessing our website and clicking on the ‘all reports’ tab for Windermere and Bowness Medical Practice.
Updated
26 February 2020
We carried out an announced focused inspection at Windermere and Bowness Medical Practice on 17 January 2020. We had previously inspected the practice in November 2018 where the practice overall rating was good, with the key question of effective rated as requires improvement.
We issued the practice with a requirement notice for a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Staffing) following the previous inspection. The full comprehensive report following the inspection in November 2018 can be found on our website here: https://www.cqc.org.uk
We also carried out a scheduled annual review of the information available to us including information provided by the practice before this inspection. Our review indicated that there may have been a significant change to the quality of care provided since the last inspection.
We carried out our most recent inspection in order to ensure the practice had implemented appropriate improvements following our inspection in November 2018 and as a result of our subsequent annual review.
This inspection focused on the following key questions: well-led, effective and responsive.
Because of the assurance received from our review of information we carried forward the ratings for the following key questions: safe and caring.
This inspection identified improvements in the effectiveness of the service and that good ratings for other key questions had been sustained.
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 good overall and good for all population groups.
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.
- Areas of clinical staff support, training, professional development, supervision and appraisal had been addressed and comprehensive procedures put in place.
- The practice organised and delivered services to meet patients’ needs. 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.
We saw the following outstanding practice:
- The practice musculoskeletal (MSK) clinician had recognised the need to support patients who had had a fall and lost confidence in mobilising. They developed a monthly “Bounce Back” clinic to offer care and support for all local patients. The service had recently been nominated for a primary care innovation award.
Whilst we found no breaches of regulations, the provider should:
- Improve the practice clinical audit programme to ensure two-cycle audits are carried out.
- Improve records of all clinical staff training.
- Implement a formal policy and procedure for the management of communications coming into the practice including a GP audit of items removed, not seen by a clinician.
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