Carnon Downs Surgery

Updated 29 April 2016

The Carnon Down Surgery was inspected on 19 January 2016. This was a comprehensive inspection.

The practice is situated in the village of Carnon Down approximately 4 miles from Truro in Cornwall. The practice provides a general medical service to 5,200 patients. 34.7% of the patients were aged 65 years or over. 

There is a team of three GPs partners, two male and one female and two salaried GPs. Some worked part time and some full time. Partners hold managerial and financial responsibility for running the business. The team is supported by a practice manager,

four practice nurses, an assistant practitioner, a healthcare assistant  and additional administration staff.

The practice also has a dispensary with a dispensary manager and three dispensers. The dispensary is open Monday to Friday between 8:30am and 6:15pm and 8:30am to 11:15am on Saturday morning.

Patients using the practice also had access to the community matron who is based at the practice. Other health care professionals visit the practice on a regular basis.

The practice is open between 8:30am and 6:30pm Monday to Friday. Appointments are available from 8:30am every morning to 6pm daily. Extended hours appointments are offered on a Saturday morning for pre bookable appointments between 8:30am and 11:15am. The practice offered a range of appointment types including book on the day, telephone consultations and advance appointments.

Outside of these times patients are directed to contact the out of hour’s service by using the NHS 111 number.

The practice has a General Medical Services (GMS) contract with NHS England.

The practice provided regulated activities from The Surgery, Carnon Downs, Truro, Cornwall. We visited this location during our inspection. The practice did not have any branch sites.

Updated 29 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Carnon Downs Surgery on 19 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.
• 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 an area of outstanding practice

• The staff held fund raising activities, such as parachute jumps, and cycle rides from Paris to Cornwall to raise funds for local charities and the memory café in the village which patients attended

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 29 April 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.

• Nationally reported data from the Quality and Outcomes Framework showed that outcomes for patients were good for patients with long term conditions. For example, 90.1% of patients diagnosed with chronic obstructive pulmonary disease (COPD) had received an annual health check review within the past 12 months.

• Longer appointments and home visits were available when needed.

• All these patients had a named GP and a structured annual review into check their health and medicines needs were being met.

• For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

• Weekly meetings were held to review any outstanding issues such as missed appointments, new complications, or drug alterations.

Updated 29 April 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.

• 71.43% of patients diagnosed with asthma had received an annual health check review within the past 12 months.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. 

• The practice promoted SAVVY Kernow, a local scheme which encourages young people to become savvy and seek help and advice about their health, wellbeing or everyday life.

• The percentage of women aged 25-64 whose notes record that a cervical screening test had been performed in the preceding 5 years was 85.86% which was comparable to the national average of 81.83%

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 29 April 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.

• Longer appointment times were available to enable older patients with multiple ailments to be discussed in one visit.

• The practice did not have any residential or care homes in their catchment area, so they focused on keeping patients at home for as long as possible, if the patient made that choice.

• Nationally reported data showed that outcomes for patients were good for conditions commonly found in older patients.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The staff held fund raising activities, such as parachute jumps, and cycle rides from Paris to Cornwall to raise funds for local charities and the memory café in the village which patients attended

Updated 29 April 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 29 April 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which is higher than the national average 84.01%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those with dementia.

• The practice actively supported the local memory café located in the village hall by participating in charity events to help raise funds. A member of the reception team had been instrumental in the setting up of this service.

• The practice carried out advance care planning for patients with dementia.

• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.

• There was a counselling service available to patients and a self-referral service for those patients experiencing or being diagnosed with  anxiety and depression.

• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 29 April 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people and those with a learning disability.

• Of 27 patients registered at the practice with a learning disability, all had received a health check in liaison with the local learning disability team.

• The practice offered longer appointments for patients diagnosed with a learning disability.

• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.

• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.