This practice is rated as Outstanding overall. (Previous rating July 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Outstanding

Are services responsive? – Good

Are services well-led? - Outstanding

We carried out an announced comprehensive inspection at Caldbeck Surgery on 19 October 2018 as part of our inspection programme.

At this inspection we found:

• 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 strong collaboration and support across all staff and a common focus on improving quality of care and people’s experiences.

We also saw some areas of outstanding practice:

• There was a clear proactive approach to seeking out and embedding new ways of providing care and treatment. The leadership at the practice put staff at the top of their hierarchy, and this culture had driven and improved the delivery of high-quality person-centred care. Improvements included a reduction in certain prescriptions, an increase in the number of patients seeing the same clinician when they visited the practice, and the introduction of a virtual diabetes clinic which had coincided with improvements in outcomes for diabetic patients.
• Staff and patients gave multiple examples of times when the practice had shown determiniation and creativity to overcome obstacles to delivering care. This had led to the practice receiving extremely positive feedback from patients. In the National GP Patient Survey in 2018 the practice scored above local and national averages for all questions and were consistently in the top three practices locally for their scores regarding care and treatment.

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

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We carried out an announced inspection of this practice on 6 November 2014. Breaches of legal requirements were found. After the comprehensive inspection the practice wrote to us to say what they would to do to meet the following legal requirement set out in the Health and Social Care Act (HSCA) 2008:

• Regulation 13 HSCA 2008 (Regulated Activities) Regulations 2010 Management of medicines (which corresponds to Regulation 12 (f) and (g) of the HSCA 2008 (Regulated Activities) Regulations 2014).

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Caldbeck Surgery on our website at www.cqc.org.uk.

Our key findings were as follows:

• The practice had addressed all of the issues identified during the previous inspection.
• Revised arrangements were in place to ensure prescriptions were checked and signed by a GP before medicines were dispensed.
• Any changes to medication records were checked and approved by a GP.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out a comprehensive inspection of Caldbeck Surgery on 6 November 2014.

We rated the practice overall as good.

Our key findings were as follows:

• The practice covered a large geographical and rural area; services had been designed to meet the needs of the local population.
• Feedback from patients was very positive; they told us staff treated them with respect and kindness.
• Staff reported feeling supported and able to voice any concerns or make suggestions for improvement.

We saw some areas of outstanding practice including:

• All staff were aware of and sympathetic to, the particular difficulties faced by the local, rural, population. The practice had taken action to help address some of those issues.
• There was an allocated doctor each morning who solely carried out home visits. Prescriptions were delivered to patients twice a week. In addition, the practice worked with a local community charity to transport patients to and from the practice.
• Clinicians were active within the GP community and had a long and successful history of training new GPs.

There was also an area of practice where the provider needs to make improvements. 

Importantly, the provider must:

• Ensure that prescriptions are checked and signed by GPs before medicines are dispensed and issued to patients.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Caldbeck Surgery is a rural dispensing practice, located in the village of Caldbeck in the Lake District National Park, Cumbria.

We carried out an announced inspection on 6 May 2014.

During the inspection we spoke with patients and staff. We also reviewed completed comments cards. Feedback from patients was very positive. They told us they were happy with the practice and the premises. We saw the results of a patient survey which showed patients were consistently pleased with the service they received.

The leadership team was very visible and staff found them approachable. There were excellent governance and clinical leadership measures in place.