Oakham Medical Practice Inspection report Care Quality Commission,
Date of inspection visit: 29 November 2022 Date of publication: 11/01/2023
Date of inspection visit: 29 November 2022 Date of publication: 11/01/2023
Oakham Medical Practice
Cold Overton Road
Oakham
LE15 6NT
Tel: 01572722621
The Care Quality Commission report describes their judgement of the quality of care at this Oakham medical practice. It is based on a combination of what they found when they inspected, information from their ongoing monitoring of data about services and information given to them from the provider, patients, the public and other organisations.
Ratings
Overall rating for this location Good –––
Are services safe? Requires Improvement –––
Are services effective? Good –––
Are services caring? Good –––
Are services responsive to people’s needs? Good –––
Are services well-led? Good –––
They carried out an announced inspection at Oakham Medical Practice on 29 November 2022. Overall, the practice is rated as Good.
At their previous inspection in April 2022, the practice was rated as inadequate overall and inadequate for the key questions of effective and well-led. The key questions of safe and responsive were rated as requires improvement, whilst caring was awarded a good rating. The service was placed into special measures.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for Oakham Medical Practice on their website at www.cqc.org.uk
This inspection in November 2022 was a comprehensive inspection including a site visit to review progress with the action plan the provider had sent the CQC following the last inspection, and to reassess their special measures status.
Following this inspection the practice is now rated as good overall and for all the key questions with the exception of safe, which remains rated as requires improvement.
How CQC carried out the inspection
Throughout the pandemic the Care Quality Commission (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, they have conducted inspections differently.
This inspection was carried out in a way which enabled CQC to spend less time on site. This was with consent from the provider and in line with all data protection and information governance requirements.
This included:
• Conducting staff interviews using video conferencing.
• Completing remote clinical searches on the practice’s patient records system and discussing findings with the provider.
• Requesting evidence from the provider to be submitted electronically.
• A shorter site visit.
CQC findings
CQC based their judgement of the quality of care at this service on a combination of:
• what they found when they inspected
• information from their ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.
They have rated this practice as Good overall
CQC findings
CQC based their judgement of the quality of care at this service on a combination of:
• what they found when they inspected
• information from their ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.
CQC have rated this practice as Good overall
CQC found that:
Overall summary
The practice did not always ensure care and treatment was provided in a safe way to patients.
They found some concerns relating to medicines management and safety alerts.
• 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.
• Patients could mostly access care and treatment in a timely way, although further work was required to work with patients to promote new ways of working.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
CQC found the following example of outstanding practice:
• The practice had designed and implemented a suite of auto consultation templates. The focus was initially to ensure any high risk medicines were fully reviewed within recommended timescales by following a step by step automated process. This was being developed for use on a wider scale, for example, to be used as a guide to assess patients presenting with a potential emergency presentation such as sepsis.
CQC found the following breach of regulations.
The provider must:
• Ensure care and treatment is provided in a safe way to patients.
In addition, the provider should:
• Continue to review and take any action needed in relation to access in terms of patient experience and satisfaction in collaboration with others such as their patient participation group, and with external agencies.
• Complete the collation of evidence that staff have documented evidence of appropriate immunisations in line with national guidance.
• Utilise staff involvement in the development of change and the formation of future service objectives.
• Widen the scope of DNACPR documentation to look at all parameters and not solely a clinician’s signature.
• Always record the reason to explain any deviation from the expected vaccine fridge temperature range on manual temperature logs.
Dr Sean O’Kelly took Oakham Medical Practice out of special measures.
This recognises the significant improvements that have been made to the quality of care provided by this Oakham Medical Practice.
Details of the CQC findings and the evidence supporting their 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
CQC inspection team
CQC inspection team was led by a CQC lead inspector who spoke with staff using video conferencing facilities and undertook a site visit on 15 November 2022 with a second CQC inspector and a nurse specialist advisor.
The inspection team also included a GP specialist advisor who spoke with staff using video conferencing facilities, and completed clinical searches and records reviews on 23 November 2022 without visiting the location
Background to Oakham Medical Practice
Oakham Medical Centre is located in Rutland at:
Cold Overton Road
Oakham
Rutland
LE15 6NT
01572 722621
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.
The practice offers services from both a main practice and in the neighbouring Rutland Memorial Hospital where the practice are commissioned to deliver a minor injuries same day service. Patients can access services at either of these sites, although they need to fulfil the necessary criteria to be seen by the same-day team working at the hospital.
Oakham Medical Practice is situated within the NHS Leicester, Leicestershire and Rutland Integrated Care Board (LLRICB) and delivers General Medical Services (GMS) to a patient population of approximately 15,147.
This is part of a contract held with NHS England. An Integrated Care Board (ICB) is a statutory organisation bringing the NHS together locally to improve population health and establish shared strategic priorities within the NHS.
The practice is part of a wider network of GP practices and is part of Rutland Health Primary Care Network (PCN) with 3 other locally based GP practices.
Information published by Public Health England shows that deprivation within the practice population group is in the 10th lowest decile (10 of 10).
The lower the decile, the more deprived the practice population is relative to others, and
therefore Oakham Medical Practice is in the least deprived decile.
According to the latest available data, the ethnic make-up of the practice area is 97.4% white, 1.1% Asian, and 1.5% other non-white ethnic groups.
The age distribution of the practice population shows higher percentages of older patients compared to national averages, but in alignment with their PCN.
There are also lower percentages of patients aged 20-50 registered at the practice compared with national figures.
There is a high prevalence of long-term conditions amongst registered
patients.
There is a team of 5 GP partners and 4 salaried GPs working at the practice.
The GPs are supported by 2 advanced nurse practitioners, 7 practice nurses, 4 health care assistants, 1 phlebotomist and 2 pharmacists.
The clinical team is supported by a team of approximately 20 reception/administration staff.
Two practice managers provide managerial oversight.
The practice is an approved training practice and provides training to GP Registrars as part of their ongoing training and education.
There were 5 GP registrars working at the practice at the time of our inspection.
The practice is open between 8am to 6.30pm Monday to Friday.
The practice offers a range of appointment types including book on the day, telephone and online consultations, and advance appointments.
Patients can obtain additional appointments in the evening and weekends via a local enhanced access service.
This is provided onsite on Wednesdays 6.30pm-8.00pm and remotely on Fridays 6.30pm-8.00pm.
Out of hours services are provided by DHU Healthcare when the practice is closed.
Requirement notices
Action CQC have told the provider to take
These are the legal requirements that were not being met.
The provider must send CQC a report that says what action they are going to take to meet these requirements.
Diagnostic and screening procedures
Family planning services
Maternity and midwifery services
Surgical procedures
Treatment of disease, disorder or injury
Regulation 12 HSCA (RA) Regulations 2014 Safe care and
treatment
• Medicines management in relation to patients with
asthma required greater oversight and ongoing review
to ensure patient safety and optimal care.
• Medicines safety alerts were not being effectively acted
upon; this included historic alerts.
