We carried out an announced comprehensive inspection at Mayfield Medical Centre on 8 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.

We have rated this practice as requires improvement for safe and good overall and good for all population groups.

We found that:

• Patients were at risk of harm because systems and processes were not in place to keep them safe. For example, up to date risk assessments and actions identified to address concerns with fire safety and health and safety had not been taken.
• 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 organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We saw several areas of outstanding practice including:

• The practice had been involved in initiatives to maintain GP services in the Torbay area through supporting local practices by providing staff cover and consulting room space.

• The practice was instrumental in the formation of and providing the administrative and nursing staff support for the new care home visiting service in Paignton and Torbay. This took place during October 2018 and involved 1000 visits. This resulted in reducing pressure on the accident and emergency departments and delivering care closer to home. In February 2019 this service will be provided by other practices in Torquay.

The areas where the provider should make improvements are:

• Continue to monitor the patients survey to further improve access to the service.
• Ensure all staff have completed safeguarding training.
• Increase the uptake of cervical smear testing.

The areas where the provider must make improvements are:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure all clinical staff have the correct level of safeguarding training.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced inspection at Mayfield Medical Centre on Wednesday 24 June 2015. The practice is rated as good. It was good for providing safe, effective, caring, responsive and well led services. It was good for providing services for all the population groups, older people, families, children and young people, people with long term conditions, people in vulnerable circumstances, people experiencing poor mental health and people who are working age or recently retired.

Our key findings were as follows:

• Outcomes for patients were positive, consistent and met expectations. Patients told they could get an appointment with their own GP or a GP of their choice, which provided continuity of care. They confirmed they were seen or spoken with on the same day if they had an urgent need. GPs kept individual lists so all patients had a named GP.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.

• Reliable systems were in place to maintain safety throughout the practice. There was a health and safety manager in a dedicated health and safety role.

• There was good IT support to enable staff to manage patient records well.

• Treatment rooms and public areas were clean and there were systems in place to ensure hygienic conditions and equipment.

• The practice implemented suggestions for improvements and made changes to the way it

delivered services as a consequence of feedback from patients and from the Patient Participation Group (PPG).

• The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand.

We found one area where the practice needs to make improvements. Importantly, the provider should:

Improve patients’ privacy and maintain their dignity during examinations, investigations and treatments in rooms without screens or curtains.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We communicated with sixteen patients who were "extremely happy", and "satisfied" with the service they received. Patients told us they had been involved in the decisions made about their care. One patient said “During a visit to the surgery for an examination or consultation, the doctors have always shown a personal interest in my condition, and listen carefully to what I have to say, before prescribing a course of medication or treatment.” Patients with children were also very pleased with the care their family received.

Patients we spoke with told us they found it easy to make an appointment. One patient said “I usually find it fairly easy to contact my surgery by phone. After weekends and holidays there is sometimes a slight delay, which is to be expected.”

Patients felt confident and safe in the care of the doctor and nurse. Staff were clear about what action they would take if they saw or suspected any poor practice or abuse. Staff had been given information on the safeguarding of adults and had received training.

Patients told us that they always felt "in safe hands." There were appropriate arrangements in place to ensure staff kept their knowledge and skills up to date. Staff spoke about the supportive environment and about having access to adequate training.

There were effective systems in place to monitor the quality of the service provided and patients felt able to give feedback about the service they received.