Archived: Mount Gould Local Care Centre

Updated 15 February 2017

Sentinel Healthcare South West Community interest Company (CiC) is owned byshareholders of General Practitioners and Practice Managers in Plymouth. Sentinel Healthcare provide services for patients and medical professionals in Plymouth, South East Cornwall, South Hams and West Devon from Mount Gould Local Health Centre and other locations in the area.

Sentinel Healthcare is an NHS funded organisation covering Plymouth, South East Cornwall, South Hams and West Devon offering assessment and treatment services for patients, as well as training and development opportunities for health professionals.

Sentinel's main location is registered as Mount Gould Local Care Centre. The other locations are managed through service level agreements with location providers.

Sentinel Healthcare has a standard NHS contract. This is a contracting route available to enable primary care organisations (PCO) to commission or provide primary medical services within their area.

Sentinel Healthcare are registered with CQC to provide regulated activities such as, diagnostics and screening, treatment of disease, disorder or injury and surgical procedures. Sentinel Healthcare provides services in locations that are close to the patient population reducing the need to visit large acute hospitals in the locality.

Sentinel Healthcare operates from up to 14 clinical centres which are rented from location providers. These include community hospitals, GP practices, Derriford hospital and community centres. The organisation also rents other locations for health education purposes. These include libraries, football clubs, village halls and hotel conference facilities.

The organisation is led by a strategic director and operations director who coordinate a team of up to 20 administration staff and 30 clinical staff. These include GPs with special interest (GPwSI), extended scope practitioners (physiotherapists), podiatrists, occupational therapists, hospital consultants, osteopaths, nurses, practice nurses and health care assistants.

There is a headquarters at 6 Research Way, Plymouth, PL6 8BU where many of the administration tasks are coordinated from. The registered location address is Mount Gould Local Care Centre, Mount Gould Road, Plymouth, PL4 7QD. During our inspection we visited both these locations.

Updated 15 February 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Mount Gould Local Care Centre (also known as Sentinel Healthcare South West (Community Interest Company)) on Thursday 24 November 2016. For the purposes of this report Mount Gould Care Centre will be referred to as Sentinel Healthcare or the provider.

Overall Mount Gould Care centre (Sentinel Healthcare) 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.
• Clinical risks to patients were assessed and well managed. Environmental and organisational risk assessments were being developed to ensure they identified and mitigated risk.

• Governance processes were monitored on an annual cycle.Environmental health and safety and infection control processes were checked as services were used and monitored on an annual rolling programme.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• Sentinel Healthcare used patient feedback, clinical audit, service reviews and significant incident report monitoring to monitor outcomes for patients. A Sentinel Healthcare quality account was provided each year which stated how the organisation would meet clinical effectiveness, patient satisfaction, promotion of self-care and how to manage complaints and significant events.

• Sentinel Healthcare were working with Devon, Cornwall and Somerset Clinical Education Provider Network to provide an additional facility to ensure a consistent approach to safeguarding in the South West.

• Sentinel Healthcare provided diabetic education to newly diagnosed insulin diabetic patients. This was provided by a multidisciplinary team of dieticians and nurses and in various locations to suit patient’s needs.
• Sentinel Healthcare were communicating with external businesses and stakeholders to understand how they could help support better lifestyle options and reduced dependence on the NHS.
• 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. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients were complimentary about the service, staff and access to treatment.

• Appointments were 20 minutes or longer if needed which benefitted patients with complex issues.

• There was a clear leadership structure and staff felt supported by management.
• Sentinel Healthcare 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.

• Sentinel Healthcare had performed a review of care homes in Plymouth, West Devon and the South Hams to understand the diagnosis rates of residents with undiagnosed dementia. The results have been presented at a Parliamentary and CCG level and were currently shaping some of the way services will be commissioned in the future. Sentinel Healthcare had also worked with the Plymouth Dementia Action Alliance. As a result Sentinel Healthcare had been awarded a Dementia Action Alliance – Friendly City award – in recognition of their efforts.

The areas where the provider should make improvement are:

Continue to develop governance processes to more clearly identify, record and manage risks at all centres where clinical care and treatment is provided. For example further development of:

• Systems to monitor medicines management, equipment safety, control of infection, and environmental health and safety in buildings not within control of the provider.

• Systems to more formally record and report issues within the centres used.

Fully maintain induction records to demonstrate staff have received suitable support , appraisal and induction.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice