Channel View Medical Practice

Updated 1 November 2019

Channel View Medical Practice is located within the NHS South Devon & Torbay CCG authority and seaside town of Teignmouth. It provides general medical services to approximately 8,700 patients.

Information published by Public Health England rates the level of deprivation within the practice population group as seventh on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

• The practice has a large proportion of elderly patients aged 65 years and over (47%). This is higher than the local average of 37% and national averages which is 27%.

The practice is led by five GP partners, four female and one male. The GPs are supported by a salaried GP and retained GP (a package of support resources aimed at GPs who may be considering leaving the profession, to help them remain in clinical practice providing between one and four sessions per week). The GPs provide a general medical service and is registered with the CQC for the following regulated activities: diagnostic and screening procedures, family planning, maternity and midwifery services, surgical procedures and treatment of disease, disorder or injury.

The GP partners are supported by a practice manager, operations manager, nurse practitioner, community nurse practitioner, mental health nurse, three practice nurses, four healthcare practitioners and additional reception and administration staff.

Channel View is the main practice. Clinical staff work across two additional branch sites located in the town of Chudleigh and village of Bishopsteignton. Patients can access appointments at any of the three sites:

Channel View Medical Practice

3 Courtenay Place
Teignmouth
Devon
TQ14 8AY

Chudleigh Health Centre

Market Way
Chudleigh
Newton Abbot
Devon
TQ13 0JT

Bishopsteignton Surgery

Fore Street
Bishopsteignton
Teignmouth
Devon
TQ14 9QP

Updated 1 November 2019

We carried out an inspection of this service following our annual review of the information available to us including information provided by the practice. Our review indicated that there may have been a change to the quality of care provided since the last inspection. Following our review of the information available to us, including information provided by the practice, we focused our inspection on the following key questions: Effective and Well led.

Because of the assurance received from our review of information we carried forward the ratings for the following key questions: Safe, Caring and Responsive.

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 provided care in a way that kept patients safe and protected them from avoidable harm.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care. The practice ethos was to provide an accessible and approachable patient-orientated service.
• The practice organised and delivered services to meet patients’ needs.
• The way the practice was led was inclusive, supportive and promoted the delivery of high-quality, person-centre care.
• Feedback from patients who used the service was positive about accessing appointments, the treatment received, and the way staff cared for patients.
• The practice valued and welcomed feedback from patients, staff and the PPG (Patient Participation Group) and had included consultation about a future merger with another practice in the town.
• Staff told us they felt supported by the leadership team.
• There was a strong focus on working with external stakeholders and other GP practices in the locality.

We saw one area of outstanding practice:

The prevalence of vulnerable (dementia and older people) in the practice population was three times higher than the national average. The practice had responded to this through the employment of specialist staff to ensure patients’ needs were met and frailty identified. For example:

• A mental health nurse who completed reviews at the practice and in patient’s homes for those patients experiencing mental health issues and dementia.
• The recent employment of a community nurse practitioner who visited frail, housebound patients and was in the process of identifying patients over the age of 80 who may be vulnerable.

The areas where the provider should make improvement are:

• Introduce systems to ensure all staff are aware of the signs of sepsis and the deteriorating patient.
• Ensure governance processes and records maintained at the practice reflect decision making processes, mitigation of risks and monitoring quality.

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

Updated 14 April 2016

The practice is rated as good for the care of patients with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Quality outcome framework (QOF) data for 2014-15 showed that the percentage of patients with asthma who had received a review in the last 12 months was 96.5% which was higher than the national average of 87%.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 14 April 2016

The practice is rated as good for the care of families, children and young patients.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young patients who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• Patients told us that children and young patients were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.

• The practice had achieved a cervical screening rate of 80% which was in line with the national average of 81%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 14 April 2016

The practice is rated as good for the care of older patients.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

Updated 14 April 2016

The practice is rated as good for the care of working-age patients (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

• The practice smoking cessation statistics showed that of 35 patients registered as smokers who had been offered support, 13 had successfully stopped smoking.

• The practice was in the process of introducing systems to identify military veterans and ensure their priority access to secondary care in line with the national Armed Forces Covenant.

Updated 14 April 2016

The practice is rated as outstanding for the care of patients experiencing poor mental health (including patients with dementia).

• The prevalence of dementia in the practice population was three times higher than the national average. The practice had responded to this demand through the employment of a specialist mental health nurse on a part time basis. This member of staff also worked part time at the local mental health NHS Trust, which ensured that their skills were kept up to date. The mental health nurse carried out reviews at the practice and in patient’s homes for those patients experiencing mental health issues and patients with dementia. These were comprehensive written reviews which were in line with best practice and helped inform how GPs supported their patients.

• The percentage of patients with a diagnosed mental health condition who had received a review was 84% which was higher than the national average of 82%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 14 April 2016

The practice is rated as good for the care of patients whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless patients, travellers and those with a learning disability.

• The practice offered longer appointments for patients with a learning disability. Letters sent to patients with learning disabilities informing them of the time and date of their annual health reviews included a photograph of the visiting nurse.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.