Crawcrook Medical Centre

We carried out an announced comprehensive at Crawcrook Medical Centre on 17 and 31 August 2023. Overall, the practice is rated as requires improvement.

Safe – good.

Effective – good.

Caring - good

Responsive - requires improvement

Well-led - requires improvement

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

Why we carried out this inspection

This inspection was a comprehensive inspection, we have carried out this inspection because the practice has reregistered with us as a new provider of GP services for this location. We also received information of concern regarding this provider.

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.
• We issued questionnaires to staff.
• 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 site visit.
• Reviewing information received to CQC from patients regarding their experience of being a patient at the practice.
• Sending an email to members of the practice patient participation group for feedback

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.
• We saw a large amount of work had been carried out by the new provider of services since they acquired the contract in September 2022. This included addressing access issues at the practice. However, although most patients reported they could access care and treatment in a timely way, we had concerns that some patients could not get through on the telephone or obtain appointments. We received several complaints and staff had concerns regarding this.
• There was effective leadership at the practice. However, from our staff questionnaires we identified that some staff were unhappy, some reported being stressed and anxious working at the practice, and that communication was poor and staff morale low.

We saw one area of outstanding practice which was;

• The practice sought to increase the number of identified carers at the practice. They carried out a clinical audit, carried out actions such as, education of staff and patients, developing and distributing educational materials, staff training, checking and analysing progress. The practice website contained information for carers. The practice for the last 9 months had worked with a local community centre which a focused-on health and wellbeing. The practice and charity worked together to set up a group providing social prescribing support for carers. All of the carers on the register received an invitation to the group. Attendees were offered refreshments, an opportunity to talk with link workers, the practice received positive feedback from patients saying it was good that someone else understood how it was to be a carer. This resulted in an increase from 5.9% to 7% of the practice population who were registered as carers.

Whilst we found no breaches of regulations, the provider should:

• Continue to assess access to the practice for patients.
• Continue to address staff concerns regarding culture at the practice.
• Review the quality of medicines reviews.

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