Kirkoswald Surgery

Updated 29 August 2019

Kirkoswald Surgery is registered with the Care Quality Commission to provide primary care services.

The practice provides services to around 2,500 patients from one location at The Surgery, Kirkoswald, Penrith, Cumbria, CA10 1DQ. The practice is based in converted premises in the centre of Kirkoswald. The building is on one level and has recently been extended. There is parking, a disabled WC and access is step-free.

The practice has a single-handed GP (female) and a salaried GP (female). The practice employs a practice manager, two practice nurses, a healthcare assistant, a lead dispenser and three staff who carry out receptionist, administration and dispensing duties. The practice provides services based on a General Medical Services (GMS) contact.

The practice is open from 8am to 6.30pm on Monday to Friday. On alternate Tuesdays and Wednesdays the practice opens at 7.30 am. When the practice is closed patients are directed to the NHS 111 service. This information is available on the practice noticeboard, telephone message and the practice website.

The practice is part of NHS North Cumbria clinical commissioning group (CCG). Information from Public Health England placed the area in which the practice is located in the 8th least deprived decile. There is a slightly higher than local and national average number of patients over 65, but this practice is below local averages for patients aged over 75. There is a higher than local average number of patients aged between five and 18. The practice is situated in a rural location with limited public transport. The service for patients requiring urgent medical care out of hours is provided by the NHS 111 service and Cumbria Health on Call Limited (CHOC).

Updated 29 August 2019

We carried out an announced comprehensive inspection at Kirkoswald Surgery on 12 July 2019 as part of our inspection programme.

We based our judgement of the quality of care at this service is 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 outstanding overall as the practice was operating at a high level across all areas and had continued to develop well following their transition to a new provider.

We rated the practice as outstanding for providing caring services because:

• Feedback from people who used the service, those who were close to them, and stakeholders was continually positive about the ways staff treated people.
• Staff recognised and respected the totality of people’s needs. The practice could show how they always took people’s personal, cultural, social and religious needs into account.

We rated the practice as outstanding for providing responsive services because:

• Services were tailored to meet the needs of individual patients. They were delivered in a flexible way that ensured choice and continuity of care.

We rated the practice as outstanding for providing well-led services because:

• The culture of the practice and the way it was led and managed drove the delivery and improvement of high-quality, person-centred care. All staff told us they felt they had an equal share in the running of the practice and felt able to put forward ideas for improvements which were taken on board and had been shown to have a benefit for patients.

We also rated the practice as good for providing safe and effective services because:

• 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.

We saw several areas of outstanding practice including:

• The practice was rated as outstanding for providing caring services when inspected under the previous provider in November 2015. Since then, patient feedback has continued to improve and the practice was consistently ranked among the top practices in the local area for feedback relating to care. We were given many examples of outstanding care by patients we spoke to and those who left comment cards;
• By involving all staff members in the running of the practice and being open to new ideas, the leadership drove continuous improvements which had led to a number of positive outcomes for patients. For example, the practice nurse carried out home visits, which had led to many improvements in patient care. This included increased numbers of patients who had an advanced care plans in place and an increase in the proportion of palliative care patients who died in their preferred place of death.
• The practice had worked hard on increasing the uptake for reviews. They gave the receptionists at the practice protected time to call patients who hadn’t attended for their reviews in the past and appointed a healthcare assistant to carry out other duties in order to free up more time for the practice nurse to carry out patient reviews. The practice more than doubled their number of NHS health checks in the first year and had continued to improve since.

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

Updated 29 August 2019

Updated 29 August 2019

Updated 29 August 2019

Updated 29 August 2019

Updated 29 August 2019

Updated 29 August 2019