We carried out an announced comprehensive inspection at Seaton and Colyton Medical Practice on 26 February 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 good overall, and good for all population groups.

We found that:

• The practice had responded positively and taken action on feedback received from the previous CQC inspection. This included improved awareness and health information available for younger people and regular infection prevention control audits.

• The practice had clear 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.

• Improvements since our previous inspection included health navigation and E-Consult.

• The practice offered extended access appointments which included early mornings and evenings, together with weekend appointments in conjunction with 13 practices which comprised East Devon Health federation.

We found examples of outstanding practice;

• The practice was among the first nationally to become an official “Parkrun practice”. This involved the active promotion to patients of attending the weekly Park run. GPs invited patients to join them. Less mobile patients were invited to a walking group, ‘ Walk for Health’ which had been set up by one of the GPs. The aim was to support and encourage those patients that would benefit from regular exercise and prevent social isolation.

• The practice had introduced an “Eating With Dignity” scheme, a multi-disciplinary approach to nutrition for patients. This scheme had been adopted by local care homes and the wider community.

• A GP at the practice had been pivotal in facilitating the formation of the home nursing service which was now independent of the practice (but was located within the practice)that looked after patients who needed palliative care. They offered 24-hour care and provided support for people with terminal illness and for people wishing to die in their own homes.

We found areas where the practice should make improvements;

• The practice should review their arrangements for communication with patient’s who had hearing difficulties.

• Increase the uptake of cervical screening.

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

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Seaton and Colyton Medical Practice on 4 November 2015. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the Duty of Candour.

We saw several areas of outstanding practice:

• The practice had introduced services to promote positive outcomes for patients and provide information to allow patients to make changes to their lifestyle. For example, patients were invited to a walking group, ‘ Walk for Health’ which had been set up by one of the GPs. The aim was to support and encourage those patients that would benefit from regular exercise and prevent social isolation.

• Another initiative developed by a GP at the practice in 2011 was an ‘Eating with Dignity’ scheme. The idea was to combine the practice ethos of patient dignity with the fundamental human desire for quality tasty food. The vision was to provide this for all people, regardless of their stage of life but especially when they were ill or vulnerable. After initially exploring the current NICE guidance for food replacement safety they formed a multidisciplinary team which included practicing NHS doctors (hospital), speech and language therapists, dieticians, palliative care and dementia care specialists. Together they had devised healthy, nutritious and tasty meals and meal replacements for people to enjoy. There was a website for people to look at as well as leaflets available in the practice. This scheme had been embraced by local care homes and the wider community.

• One GP had a special interest in the care of patients with drug and alcohol addiction. These patients were reviewed every two weeks with their GP to support and maintain good health and keep their care under frequent review.

• Since the closure of the beds in Axminster Hospital, the GPs had been responsible for Axminster patients at Seaton Hospital.These patients were typically elderly and frail, and frequently requiring palliative care.In order to ensure continuity of care the practice had arrangements in place with Axminster surgery to appropriately share clinical records so that the patient received the best treatment whilst in hospital and to ensure a smooth discharge on returning home. Consent was gained from the patient before information was shared and care was provided.

In addition the provider should

• Improve awareness and health information available for younger people.

• Ensure the actions identified in the infection control audit of October 2014 are recorded as complete and continue with an updated audit.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice