This practice is rated as Good overall. (Previous rating September 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 at Taunton Road Medical Centre on 9 January 2019 as part of our inspection programme.
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.
At this inspection we found:
- 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 routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
- The practice had a good programme of ensuring that childhood immunisations were taken up.
- Feedback from other health professionals and services demonstrated that the practice worked well with them and provided support in the interest of the best outcomes for patients. Patients could access assessment and treatment locally instead to the need to travel to other locations.
- Staff involved and treated patients with compassion, kindness, dignity and respect.
- Patients found the appointment system variable to use but reported that they were able to access care when they needed it.
- The practice provided a specialist allocation scheme, formally known as the violent patient scheme to provide medical care to patients who have been referred to the scheme by other local services who were unable to meet their needs.
- There was a strong focus on continuous learning and improvement at all levels of the organisation.
- Mutually support team of staff working well together with the aim of the best outcomes for patients.
- Staff given the opportunity for professional development.
- Medicines management system did not provide assurance that they were secure or that the oversight of high risk medicines was effective.
We saw areas of outstanding practice:
- The practice worked well with the secondary care cardiology team with shared clinics and pro-active treatment for patients. The cardiologist told us the practice’s post heart attack medication follow up and up-titration of medication as per the NICE guidelines had dramatically improved in the past 12 months. They now stood out compared to other practices in the area for their exemplary patient follow up with regards to the up-titration of their medication following a heart attack. This meant that by implementing the research patient’s long-term outcomes were improved. Information from the cardiologist also identified that 20 potential tests with 55 potential appointments at the local hospital were avoided.
- Shared clinics with the secondary care paediatrician had reduced the need for patients to be seen in a hospital environment by 80%.
The areas where the provider must make improvements are:
Reg 12 Ensure care and treatment is provided in a safe way to patients
- The provider MUST continue with developing aspects of safe with an oversight of staff’s immunisation status, processes for safe medicines management, and aspects of infection control audit.
- The provider MUST continue with monitoring the oversight of patients on high risk long term medications.
The areas where the provider should make improvements are:
- The practice should continue to monitor that the changes implemented for safeguarding adults, recruitment, and disclosure and barring check risk assessments are sustained.
- The provider should continue to monitor cervical smear screening to meet Public Health England screening rates.
- The practice should continue to proactively identify carers.
Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice
Please refer to the report and the evidence tables for further information.