The Stennack Surgery

Updated 30 May 2022

The Stennack Surgery is located in St Ives, Cornwall at:

The Old Stennack School

Stennack

St Ives

Cornwall

TR26 1RU

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.

The practice offers services from one location.

There is a minor injury unit at the practice open between 8am – 8pm Monday to Friday (including some Bank holidays except Christmas Day and Boxing Day). This is a walk-in service, where no appointment is needed. This service is able to treat patients with minor injuries, such as lacerations, sports injuries and infections. All other patients experiencing major trauma, head injuries, poisonings or major collapse are directed to the main hospital in Truro.

The practice population is in the sixth deprivation decile for deprivation. In a score of one to ten the lower the decile the more deprived an area is. Some surrounding villages have higher levels of deprivation. There is a practice age distribution of male and female patient’s equivalent to national average figures.

The Stennack Surgery is a semi-rural general practice in St Ives, a popular retirement destination resulting in a higher than average patient population aged over 65. This increases during the summer months due to tourism in the area. On average up to 4000 temporary residents attend the practice annually due to tourism.

The partnership at the practice comprises of six GP partners (five male and one female), supported by three salaried GPs (two male and one female), and GP retainer who is female. The team are supported by a practice manager and finance/development manager, 10 nurses, including a nurse manager, five practice nurses and three nurse practitioners, and post inspection a new trainee nurse practitioner; alongside four healthcare assistants, one recruited since the inspection.

The Stennack Surgery is an approved training practice providing vocational placements for GP registrars. Two GP partners are approved to provide all three years of training for GPs. One GP partner is an academic tutor for the Deanery and a trainer for second year post qualification doctors. There is a practice nurse mentor and teaching placements are provided for medical students and student nurses.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If the GP needs to see a patient face-to-face then the patient is offered an appointment at the surgery.

Out of hours services are provided via the NHS 111 service.

Updated 30 May 2022

We undertook this inspection at the same time as CQC inspected a range of urgent and emergency care services in Cornwall. To understand the experience of GP Providers and people who use GP services, we asked a range of questions in relation to urgent and emergency care. The responses we received have been used to inform and support system wide feedback.

We carried out an announced inspection at The Stennack Surgery between 28 February to 4 March 2022. Overall, the practice is rated as Outstanding.

The ratings for each key question

Safe - Good

Effective -Good

Caring - Good

Responsive - Outstanding

Well-led - Outstanding

Following our previous inspection on 10 October 2018, the practice was rated Outstanding overall and for the responsive and well led key questions; the three key questions of safe, effective and caring were rated as good.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Stennack Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection focused comprehensive.

Key questions covered were:

Safe- Good

Effective- Good

Well-led- Outstanding

Ratings for the Caring and Responsive key questions were carried forward from the previous inspection.

How we carried out the inspection

Throughout the pandemic 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, we have conducted our inspections differently.

This inspection was carried out in a way which enabled us to spend a minimum amount of 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 clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Requesting evidence from the provider
• A short site visit

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 have rated this practice as Outstanding overall

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, which took account of their social and health needs.
• A strengthened recall system for patient health reviews had been developed and was due to be implemented fully in April 2022. This had involved a review of all patient records.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. Patients could access care and treatment in a timely way.
• The practice had continued to ensure that patients received appropriate care and treatment, which included medicine reviews, referrals to secondary services, and support with mental health.
• The practice had used information from their practice population demographics to improve the service provided. In particular, for patients who had multiple contacts for care and treatment. The practice used this data to adjust services so that patients were seen by the most appropriate clinician and received continuity of care.
• The practice had noted that there had been an increase of over 39% in appointments offered for the period of July 2021 to the time of the inspection; and had recruited extra staff and improved the range of appointments to meet patient need. Improvements had also been made to the home visiting service.
• Staff had continued to received training for their role and were supported to access role specific training.
• Governance systems were embedded and effective and enabled accurate information on performance to be maintained.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.
• The practice had successfully changed their computer and telephone system and continued with refurbishing the building during the COVID-19 pandemic.
• Staff who worked at the practice were consistently positive about teamwork; being involved in decision making; and being supported to carry out their roles.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.

Whilst we found no breaches of regulations, the provider should:

• Continue to promote uptake of cervical screening.

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