The Care Quality Commission
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Archived: Castle Place Practice

Overall: Good read more about inspection ratings

Kennedy Way, Tiverton, Devon, EX16 6NP (01884) 252333

Provided and run by:
Castle Place Practice

All Inspections

21 August 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

This announced focused inspection was carried out on 21 August 2017 to confirm that the practice had made improvements to meet the recommended actions in our previous comprehensive inspection on 14 January 2016. In January 2016 the overall rating for the practice was Good. The full comprehensive report for the January 2016 inspection can be found by selecting the ‘all reports’ link for Castle Place Practice on our website at www.cqc.org.uk.

Overall the practice is rated as Good

Our key findings were as follows:

  • Systems had been set up to schedule audits and monitor these to provide assurance of embedded shared learning and improvement so that patients experience high quality care and treatment. Examples seen included audits looking at appropriate appointments and effective management of prescriptions.

  • The practice had clearly defined and embedded systems to obtain patient consent in a consistent way. Governance had been strengthened and monitoring results demonstrated consent was consistently obtained and followed national guidelines.

  • Succession planning and implementation of GP recruitment and retention was effective, within the context of the national shortage of GPs.

  • Implementation of a nationally recognised on line training source for all staff providing assurance of adherence and internal rewards in recognition of completion of modules.

  • Wider engagement across the health and social care sector within Tiverton and surrounding areas to utilise resources effectively and improve patient experience.For example, the practice led a working group with all the community pharmacists and GPs in the area to agree a consistent approach across Tiverton.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

14 January 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Castle Place Practice on 14 January 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • 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.
  • The practice achieved higher than local and national averages of patient satisfaction. Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand.
  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

We saw two areas of outstanding practice:

  • The practice takes a proactive approach to understanding and meeting the needs of patients with complex learning disabilities, promoting equality and diversity.We saw several examples demonstrating a responsive and person centred approach, which had had improved the health of the people.

  • The delivery and advancement of knowledge and skills at the practice is highly developed and strongly focussed on delivering a responsive service to meet the needs of patients. For example, emergency life support training is delivered more frequently, was role specific and focussed. The nurses have advanced skills and are able to provide services closer to home at the practice, such as venesection ( for patients with a blood disorder, which is a procedure normally carried out at the acute hospital in Exeter some 25 miles away.

The areas where the provider should make improvement are:

  • The schedule of audits should be reviewed and monitored to provide assurance of embedded shared learning and improvement so that patients experience high quality care and treatment.

  • The practice should review the way consent is obtained from patients to ensure that a consistent approach is always followed and meets current guidelines.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

21 January 2014

During a routine inspection

During our visit to the surgery we spoke with three patients, six GPs, the practice manager, IT manager, six practice nurses, a health care assistant, two administrators, a receptionist and the two members of the PPG (Patient Participation Group).

Patients expressed satisfaction with the service they had received. One patient said "Castle Place is a pro-active and professional practice where the staff go beyond the call of duty to make one feel looked after promptly and courteously' and 'We are treated so well here'. They told us they had a good service when they telephoned for an appointment and were given a slot at a convenient time. One patient said 'We know if there is a wait then the GP is spending quality time with someone and we would get the same service'. They said that the receptionists were polite and helpful. They told us they could see a doctor of their preference and if they saw another doctor they could be sure of being well looked after.

Patients were referred to other healthcare services when required. The provider maintained detailed consultation notes in order to ensure patients received appropriate care and treatment that met their needs in a timely way.

People's privacy, dignity and independence were respected. People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. People who used the service told us that the GP explained treatment options and they felt involved and able to make informed choices. Records reflected this. One patient said "The staff ensure that we are able to make informed choices and they don't mind if you question anyone's judgement'.

Staff were clear about what action they would take if they saw or suspected any bad practice or abuse. Staff had been given information and received formal training in this area.

There were effective systems in place to monitor the quality of the service provided and patients felt able to give feedback about the service they received which was listened to and acted upon. Patients said 'I can't think of any complaints, staff couldn't be more attentive'.