Okehampton Medical Centre

This practice is rated as Good overall. (Previous rating December 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Okehampton Medical Centre on 13 November 2018. This was a routine inspection as part of the inspection schedule.

At this inspection we found:

• Okehampton Medical Centre had experienced a significant increase of 15% in the number of patients registered with the practice. The leadership team were proactive in addressing risks, responding to the community needs and had been successful in taking over the minor injury service keeping it in the town of OKEHAMPTON.
• 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 did not always have reliable systems for appropriate and safe handling of medicines, although evidence received since the inspection confirmed these matters had been addressed.
• 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.
• Patient feedback was actively encouraged. Feedback about the telephone and appointment system was acted upon and improvements made increasing access and availability of staff.
• Engagement with patients and community was driving development of services at the practice.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.
• The practice is a member of the National Institute for Healthcare Research Clinical Research Network South West Peninsula and is actively involved in clinical research to improve patient care.
• Leaders had an inspiring shared purpose and strive to deliver high quality services and motivate staff to succeed. There was long-term investment in staff, increasing their skills, qualifications and well-being. Staff had access to health and well-being sessions at lunchtime to increase resilience. They were loyal, proud to work at the practice and there was a low staff turnover. Leaders were successful in recruiting newly qualified GPs, some of whom had trained at the practice. In 2018, this support and motivation was recognised when the employer had won an apprentice training provider award.

The practice focussed on the early identification of risks and illness for the farming community being aware of the high risk of suicide linked to occupational conditions in farming. Thirty-nine patients were identified as farmers, of which 19 were eligible for NHS health checks and had been recalled for a health check. The practice was continuing to carry out regular searches to identify patients in the farming community. Displays in waiting rooms and the patient participation group were helping to increase engagement with this at-risk group.

The area where the provider must make improvements as they are in breach of a regulation is:

Ensure there is proper and safe management of medicines. Governance arrangements for the management of medicines must be kept under review to ensure implemented changes are maintained and safety improved.

The areas where the provider should make improvements are:

Keep policies and procedures for medicines management and dispensary services under review to ensure current best practice guidance is followed to reduce risks.

Keep exception reporting under review to increase uptake of reviews for any patients with long term conditions.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.