Castle Health Centre

Updated 18 October 2022

Castle Health Centre is in Scarborough at 3-4 York Place, Scarborough, YO11 2NP. The practice list size is approximately 4,500 with most patients being white British. 61% of patients are aged 40 years or below with 21% of these being 18 years or under.

The provider is Intrahealth. They are registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services, treatment of disease, disorder or injury and surgical procedures.

The practice is situated within Humber Coast and Vale Health Integrated Care System. The practice is part of a wider network of GP practices known as Scarborough Core Primary Care Network (PCN) which is made up with three other practices.

The practice scores one on the deprivation measurement scale; the deprivation scale goes from one to ten, with one being the most deprived. People living in more deprived areas tend to have greater need for health services.

There is a team of salaried staff including three GPs (one being the lead), (two male and one female), one advanced nurse practitioner, three practice nurses, one specialist homeless nurse, one health care assistant, one ‘bank’ advanced nurse practitioner and one ‘bank’ health care assistant/phlebotomist. Bank staff refers to workers who can be contacted by an employer when the need arises. All these staff are female. There are two care co-ordinators. There is a practice manager and one office manager supported by a range of administration/reception staff.

The practice is open between 8am and 8pm seven days a week, excluding Bank Holidays. Out of hours services are provided by NHS 111.

Updated 18 October 2022

We carried out an announced focused inspection at Castle Health Centre on 12th to 16th September 2022. Overall, the practice is rated as good.

The ratings for each key question are:

Safe - Good

Effective - Good

Caring – Not rated

Responsive – Not rated

Well-led - Good

Following our previous inspection on 28th June 2017, the practice was rated good overall and for all key questions.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Castle Health Centre on our website at www.cqc.org.uk

Why we carried out this inspection

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

How we carried out the inspection/review

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing and obtaining feedback from staff using electronic questionnaires.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records.
• Requesting evidence from the provider.
• A short site visit.

Our findings

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 found that:

• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• There were adequate systems to assess, monitor and manage risks to patient safety with embedded systems in place to keep people safe and safeguarded from abuse.
• Patients received effective care and treatment that met their needs. The practice routinely reviewed the effectiveness and appropriateness of the care it provided. The practice actively managed and encouraged patient engagement with the practice and with other services, taking a holistic approach to their health and well-being. Regular multi-disciplinary working was evident.
• 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. There were high levels of satisfaction across all staff. Staff were proud of the organisation as a place to work and spoke highly of the culture.
• There was evidence of systems and processes for learning, continuous improvement and innovation.

Whilst we found no breaches of regulations, the provider should:

• Improve the system for gathering and maintaining a record of staff vaccinations.
• Take action to introduce sepsis training for practice staff.
• Take action to address the small number of issues identified from our clinical searches.

We found one area of outstanding practice:

• We received letters of commendation from North Yorkshire Clinical Commissioning Group (CCG)/Integrated Care Board (ICB) for the work the staff at Castle Health Centre had provided, stepping up at short notice to provide primary medical services to a group of Afghan nationals arriving in the area as part of the Afghan relocation scheme (ARAP) for families evacuated under the Operation Pitting programme in August 2021. The CCG/ICB said they were impressed by the commitment and professionalism shown in ensuring a very high-quality clinical service in very difficult circumstances. Castle Health Centre continue to provide a service for this group equating to over 200 patients. Other letters of praise were also received and described staff at the practice as developing a constructive working relationship with other agencies including North Yorkshire County Council and the Refugee Council (integration provider). Castle Health Centre had previously registered all the Syrian refugee families in Scarborough.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services