Tieve Tara Medical Centre

We carried out an announced comprehensive inspection at Tieve Tara Medical Centre on 5 and 6 July 2023. Overall, the practice is rated as requires improvement.

Safe - requires improvement

Effective - requires improvement

Caring - good

Responsive - good

Well-led - good

Why we carried out this inspection

We carried out this inspection as a new provider Spectrum Community Health C.I.C had registered with CQC to deliver services from Tieve Tara Medical Centre.

How we carried out the inspection

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.
• 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 to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• Undertaking a visit to the practice location.

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:

• Patients’ needs were assessed. However, care and treatment had not always been delivered in line with current standards and evidence-based guidance. For example, we identified concerns in relation to medicines management, the diagnosis of conditions, and monitoring and follow-up of patients with long-term conditions. In addition, the clinical supervision of non-medical prescribers was limited and not formalised.
• Fire evacuation drills had not been undertaken recently.
• The provider had undertaken a project to reduce repeat prescribing of hypnotic medicines, and antibiotic prescribing rates had shown an over reduction over the past 4 years.
• Staffing, both clinical and non-clinical, was a challenge, and at the time of inspection the provider relied on regular locums to deliver GP services. We saw that the provider had measures in place to tackle staffing issues and had recently appointed new non-clinical staff to the practice.
• The provider had a programme of quality improvement activities in place which included clinical audit.
• Child immunisation rates were close to or above national targets.
• Staff, patients and partner organisations were generally positive about their views of the practice.
• Senior provider staff had the skills and competence to effectively manage the service. Governance and performance management processes were in place.

We saw an area of outstanding practice:

• The provider had worked closely with others such as Spectrum Community Health C.I.C’s own charitable arm Spectrum Health and other community groups to improve the health and wellbeing of the local population.

We found one breach of regulations. The provider must:

• Ensure that care and treatment is provided in a safe way to patients.

In addition, the provider should:

• Work to improve cervical screening and breast screening rates.
• Improve the numbers of carers identified by the practice.
• Continue to implement measures to improve capacity via recruitment.

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