This practice is rated as Requires Improvement overall. (Previous rating under a previous provider: September 2015 – Good)

The key questions at this inspection are rated as:

Are services safe? – Requires Improvement

Are services effective? – Requires Improvement

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires Improvement

We carried out an announced comprehensive inspection at Crewkerne Health Centre on 5 and 6 September 2018 as part of our inspection programme. During this inspection we visited Crewkerne Health Centre and the branch surgery West One Surgery.

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 they provided. They ensured that care and treatment was delivered according to evidence-based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• There was a focus on continuous learning and improvement at all levels of the organisation.
• There were systems in place for reviews of patients and their medicines (polypharmacy – concurrent use of multiple medications by a patient) where they were taking four or more different medicines daily.
• There had been significant delays in the programme of annual reviews of patients with long term conditions, mental health needs and dementia, although improved recently they were still below the expected local and national targets.
• Staff encouraged and supported patients to be involved in monitoring and managing their own health, for example through social prescribing schemes.
• The patient participation group had a positive effect on the practice and the community with working with the practice to provide emergency first aid training for parents or carers of children.
• There were new policies and procedures and a system of governance which needed to have time to be fully implemented and embedded.

The areas where the provider must make improvements are:

• Ensure the necessary information is available regarding staff immunisation status in line with Public Health England(PHE) guidance.
• Ensure they monitor and address the gaps in maintaining meeting the patients’ needs including patients with long term conditions, mental health and dementia.
• The provider must ensure patient records at West One Surgery are adequate maintained so that there is continuity of care.
• Ensure there are safe systems in place for fire safety, checks for safe equipment, safeguarding training and training for persons undertaking health and safety audits and risk assessments, for infection prevention and control and for chemicals used by the practice.
• Ensure medicines are stored safely.
• Ensure there is a system of safe storage and handling of prescription stationery.

The areas where the provider should make improvements are:

• Review and continue to monitor the progress to bring employment information up to date regarding staff transferred to the provider organisation such as training, skills and qualifications.
• Review and continue to monitor regular audits for health and safety.
• Review and continue to monitor patient confidential information is kept securely and in line with General Data Protection Regulation (GDPR) 2018.
• The practice should continue to proactively identify carers.

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.