Fowler de Pledge

Updated 24 June 2019

• The provider of this service is CountryHealth Ltd.

• CountryHealth is located at Cornwallis Chambers, 23 Great Colman Street, Ipswich, Suffolk, IP4 2AN.
• The website address is: https://www.countryhealth.co.uk/
• CountryHealth Ltd is an independent provider of GP services, which specialises in thyroid health. They offer a range of specialist diagnostic services and treatments, which include complementary therapies, with a focus on functional medicine. They offer health screening for individuals and companies.
• The clinic provides a service to children and adults and holds a list of registered patients. They offer services to patients who reside in Suffolk and the surrounding areas but also to patients who live in other areas of England who require their services. Appointments are offered on a mainly pre-bookable basis. Telephone consultations are also available.
• The practice is open between 9am and 12 noon and from 1pm to 4pm on Mondays, Tuesdays, Wednesdays and Thursdays. It is open from 9am to 12 noon on Fridays. Patients who need emergency medical assistance out of corporate operating hours are requested to seek assistance from alternative services such as the NHS 111 telephone practice or accident and emergency. This is detailed on the practice website and its practice guide.

Before visiting, we reviewed a range of information we hold about the service and asked them to send us some pre- inspection information which we reviewed.

During our visit we:

• Spoke with a range of staff from the service including the GP lead, healthcare assistant and patient coordinator.
• Reviewed a sample of treatment records.
• Reviewed comment cards where clients had shared their views and experiences of the service.
• Looked at information the service used to deliver care and treatment plans.

To get to the heart of clients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 24 June 2019

This service is rated as Good overall. (Previous inspection July 2018- met the requirements).

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

We carried out an announced comprehensive inspection at CountryHealth Ltd on 28 May 2019. This inspection was to rate the service.

CountryHealth Ltd is an independent provider of GP services, which specialises in thyroid health. They offer a range of specialist diagnostic services and treatments, which include complementary therapies, with a focus on functional medicine. They offer health screening for individuals and companies.

This practice is registered with Care Quality Commission (CQC) under the Health and Social Care Act 2008 in respect of some, but not all, of the practices it provides. There are some exemptions from regulation by CQC which relate to particular types of services and these are set out in Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At CountryHealth Ltd, some services, such as health checks are provided to clients under arrangements made by a local council government department. These types of arrangements are exempt by law from CQC regulation. At CountryHealth Ltd, health schemes (that do not involve treatment requiring admission to hospital) organised through an employer, where these are for the benefit of the employee only are exempt from regulation. Therefore, at CountryHealth Ltd, we were only able to inspect the services which are not arranged for patients by a government department. The practice refers patients to affiliated practitioners, for example a Life and Mindfullness Coach, a counsellor, a reflexologist and a QiGong teacher. (QiGong is a holistic system of coordinated body posture and movement, breathing, and meditation). We did not inspect the affiliated practitioners as they are out of the scope of CQC regulation.

The practice is registered with the CQC under the Health and Social Care Act 2008 to provide the following regulated activities:

• Diagnostic and screening procedures
• Treatment of disease, disorder or injury.

The GP is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the practice. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run. The GP is also the nominated individual. (A nominated individual is a person who is registered with the Care Quality Commission to supervise the management of the regulated activities and for ensuring the quality of the practices provided).

As part of our inspection we asked for CQC comment cards to be completed by clients prior to our inspection visit. We received two comment cards, and spoke to one patient, all were wholly positive about the service. The cards reflected the kind and caring nature of staff, how informative staff were, the pleasant environment and the positive effects of the treatment received. Other forms of feedback, including patient surveys and social media feedback was consistently positive.

Our key findings were:

• We saw there was leadership within the service and the team worked together in a cohesive, supported, and open manner.
• There was an effective system in place for reporting and recording significant events.
• Information about services and how to complain was available and easy to understand.
• The provider was aware of and complied with the requirements of the Duty of Candour.
• Risks to patients were assessed and monitored.
• The service held a range of policies and procedures which were in place to govern activity; staff were able to access these policies easily and staff had signed each one.
• To ensure and monitor the quality of the service, the service completed audits which showed the effectiveness of the service.
• 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.
• All patients said they were treated with compassion, dignity, and respect and they were involved in their care and decisions about their treatment.
• The service had good facilities and was well equipped to treat patients and meet their needs.
• The service proactively sought feedback from staff and patients, which it acted on. Regular surveys were undertaken, and reports collated from the findings and action taken where required.

The areas where the provider should make improvements are:

• Embed the system for the documenting of actions relating to patient safety alerts.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care