This practice is rated as Good overall. (Previous inspection 26 November 2014 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Good

People with long-term conditions – Good

Families, children and young people – Good

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at Church View Medical Centre on 7 March 2018. We carried out this inspection under Section 60 of the Health and Social Care Act2008 as part of our regulatory functions. This inspection was planned as our inspection programme to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

At this inspection we found:

• The practice had 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.

• Staff involved and treated patients with compassion, kindness, dignity and respect.

• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

• Practice staff were responsive and accommodating to patient’s individual needs.

The areas where the provider should make improvements are:

• Review the way training records are kept so that they provide good oversight of the training needs and achievements of staff.

• Review systems for ensuring prescription paper and prescription pads are held securely and tracked in line with national guidance..

• Review governance arrangements to ensure the dispensary activities were in line with practice protocols and standard operating procedures.

• Review security of the dispensary regularly and put actions in place to maintain safety in this area.

• Review the oversight of risk assessments with a planned approach to developing or updating.

• Review the practices oversight of chemicals used at the practice in regard to Control of Substances Hazardous to Health (COSHH) and the management of legionella.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

Church View Medical Centre was inspected on Wednesday 26 November 2014. This was a comprehensive inspection.

There were two GP partners at this practice (one female and one male), with a team of staff in place to provide a service to approximately 2,200 patients in the village of Broadway and the surrounding areas of Horton, Ilminster and Hatch Beauchamp. The practice also had a dispensary. A dispensing practice is where GPs are able to prescribe and dispense medicines directly to patients who live in a rural setting which is a set distance from a pharmacy.

Patients using the practice also have access to community staff including district nurses, community psychiatric nurses, health visitors, physiotherapists, speech therapists, counsellors, podiatrists and midwives.

We rated this practice as good.

Our key findings were as follows:

The practice was well led and responded to patient need and feedback. There was a clear leadership structure and staff felt supported by management. The practice sought feedback from staff and patients, which it acted on. The practice had a patient participation group, who ensured patient feedback was relayed to the practice and that comments were acted upon.

Patients liked having a named GP, which they told us improved their continuity of care. The practice was clean, well-organised, was purpose built with good facilities and was well equipped to treat patients. There were effective infection control procedures in place.

Feedback from patients about their care and treatment was consistently positive. We observed a non-discriminatory, person centred culture. Staff told us they felt motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this. Views of external stakeholders were very positive and aligned with our findings.

Patient’s needs were assessed and care was planned and delivered in line with current legislation. This included assessment of mental capacity and safeguarding concerns to make decisions about care and treatment, and the promotion of good health.

Suitable recruitment, pre-employment checks, induction and appraisal processes were in place and had been carried out thoroughly. There was a culture of further education to benefit patient care and increase the scope of practice for staff.

Documentation received about the practice prior to and during the inspection demonstrated the practice performed comparatively with all other practices within the clinical commissioning group (CCG) area.

Patients felt safe in the hands of the staff and felt confident in clinical decisions made. There were effective safeguarding procedures in place.

Significant events, complaints and incidents were investigated and discussed. Actions were taken in response to such events showing that learning and improvements had taken place.

In relation to areas for improvement, the provider should:

• Training in the workings of the Mental Capacity Act (2005) should be extended to all practice nursing staff.
• The practice would benefit from formalised clinical meetings to ensure learning is evaluated.
• The provider should ensure that procedures in place for handling controlled drugs are always followed.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice