Rolle Medical Partnership

Updated 28 October 2022

At this inspection, we visited the main location and did not visit the branch surgery.

Rolle Medical Partnership is located in Exmouth at:

Exmouth Health Centre
Claremont Grove
Exmouth
EX8 2JF

Tel: 01395 226530

The practice has a branch surgery located at:

Treetops Surgery

Prince of Wales Drive

Exmouth

Devon

EX8 4SW

Tel: 01395 336530

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures. These are delivered from the location at Rolle Medical Partnership.

The practice is situated within the NHS Devon Integrated Care System (ICS) and delivers General Medical Services (GMS) to a population of 12,378 people. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices in the Woodbury, Exmouth and Budleigh Primary Care Network.

Information published by Public Health England shows that deprivation within the practice population group is in the eighth lowest decile (eighth of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 98.4% White, 0.7% Asian and 0.7% Mixed.

The age distribution of the practice population closely mirrors the local and national averages.

There is a team of 12 GPs, of which six are GP partners. The GPs are supported at the practice by a team of nurses comprising of three nurse practitioners, four practice nurses, four practice nurse assistants and two phlebotomists. The patient services staff provide support and are overseen by the practice manager. The practice manager is based at the medical centre and provides managerial oversight. Rolle Medical Partnership is a training practice and at the time of the inspection was providing placements for three doctors training to be GPs.

The practice is open between 8am to 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments. Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If the GP needs to see a patient face-to-face then the patient is offered an appointment.

The practice has opted out of providing out-of-hours services to their own patients. Patients can access a local out-of-hours GP services via NHS 111.

Updated 28 October 2022

We carried out an announced inspection at Rolle Medical Partnership on 17 August 2022. Overall, the practice is rated as Good.

Set out the ratings for each key question

Safe - Good

Effective - Good

Well-led – Good

At the last inspection in 2016, we rated the practice overall outstanding and for the domains of caring, responsive and well led.

At this inspection on 17 August 2022, the ratings for Caring and Responsive key question were carried forward from the previous inspection. Both are rated Outstanding. However, we found that those areas previously regarded as outstanding practice in Well-led were now embedded throughout the majority of GP practices nationally. While the provider had maintained this good practise, the threshold to achieve an Outstanding rating had not been reached. The practice is therefore now rated Good for providing Well-led services.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Rolle Medical Partnership on our website at www.cqc.org.uk

Why we carried out this inspection

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

This inspection was a focused inspection carried out this inspection in line with our inspection priorities. We focussed on the key questions of safe, effective and well led.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• 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.
• information from the provider, patients, the public and other organisations.

We have rated this practice as Outstanding overall, based on carrying forward the ratings from two domains – Caring and Responsive

We found that:

• Patient feedback was strongly positive about the kind and attentative care staff provided to them.
• The practice was able to demonstrate they had continued to learn and innovate through the COVID-19 pandemic. There was a commitment to engage with other providers and educational institutions to highlight and share best practice.
• The practice provided care in a way which kept patients safe and protected them from avoidable harm.
• Delayed patient reviews, resulting from the COVID-19 pandemic, were being addressed and prioritised. 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.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. There was recognition and evidence of actions taken to increase patient awareness of ongoing changes to the way the service was now delivered. Patients could access care and treatment closer to home in a timely way, when there was assessed clinical need.The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We identified areas of outstanding practice:

• There were a number of refugees registered at the practice (Afghan and Ukrainian). When Afghan refugees arrived in September 2021, the practice set up an out reach clinic at a local hotel where they were residing, to build relationships and ensure they understood how to access services. A GP was the locality area lead and increasing their knowledge about paediatric refugee health via training.

• The practice led the development of a primary care network (PCN) single point of access, for children and young people, to access mental health and emotional well-being support quickly and easily.

The areas where the provider should make improvements are:

• Implement regular infection prevention and control (IPC) audits to ensure measures, including hand hygiene, are effective and embedded.
• Improve emergency equipment check procedures, specifically to provide additional assurance of continuous no tamper safeguards for the emergency grab bag.
• Improve the authorisation procedure for Patient Group Directions (PGDs) to ensure approval is authorised after signatures are obtained for clinical staff undertaking vaccination and immunisation of patients.
• Take action to secure non-patient areas, where clinical equipment and medicines are stored.

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 Hospitals and Interim Chief Inspector of Primary Medical Services