Letter from the Chief Inspector of General Practice

We carried out an announced focused inspection at Stillmoor House Medical Practice on 5 January 2016. This was to review the actions taken by the provider as a result of our issuing two legal requirements.

Overall the practice has been rated as GOOD following our findings.

Our key findings across all the areas we inspected were as follows:

• The provider had protected patients against the risks associated with unsafe use and management of medicines by means of making the appropriate arrangements for the safe keeping of medicines. This included the servicing of refrigerators used to store medicines, calibration of thermometers and use of additional digital thermometers to record internal temperatures for continued monitoring.

• Effective systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients and others had been implemented. These included the involvement of relevant staff in the discussion and learning from significant event analysis. Records showed subsequent actions were taken and how or with whom any learning was shared.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We inspected Stillmoor House Medical Practice on 3 February 2015. This was a comprehensive inspection. 

Overall the practice is rated as good. Specifically we found the practice to be good for providing effective, responsive, caring and well led services, but improvements are required for providing safe services.  It was good for providing care for all the population groups: older people; people with long term conditions; families, children and young people; people experiencing poor mental health, people in vulnerable circumstances; working age people and those recently retired. 

There are seven GP partners, who work the equivalent of five full time GPs. The practice provides primary medical services to around 10,500 patients who live in Bodmin and the surrounding villages in Cornwall. The practice provides services to a diverse population age group and is based in the town centre. The practice has a dispensary attached.

Our key findings were as follows:

• Patients felt they were treated with dignity and respect and in a professional manner that showed kindness and care towards them.
• Some patients reported difficulties in seeing the practitioner of their choice. During this visit staff were seen helping patients to access GPs, and explaining the appointment system.
• Good systems were in place to maintain a clean and hygienic service.
• GPs and nurses kept up to date with professional guidance on treatment of disease and management of long term conditions.
• The practice operated a college based service in the town offering lunchtime appointments to pupils aged 13-19 years at the college. These appointments were with either a GP or practice nurse and offered counselling, contraception, lifestyle advice, as well as routine medical care. Patients did not have to be registered with the practice to use this service. The drop in clinic was provided by this practice two days per week, and by another practice in the town on another two days.
• The local community team had instigated a ‘Single Point of Access’ for all referrals by patients with mental health problems including access to urgent care on the day, using e-mail to the duty community psychiatric nurse team for assessment. The practice found this was a useful system for obtaining good outcomes for patients.

There were areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Monitor the significant events that are reported, as well as any complaints received, ensure that appropriate staff are included in the discussion and that any learning and subsequent action to be taken in response is recorded and shared with the team.
• Ensure that fridges used to store medicines are reliable and the medicines are stored at correct temperatures at all times.

In addition the provider should:

• Review the policy and procedures for updating patients' medicine records after discharge from hospital, and for repeat prescribing.
• Maintain a record of checks made when employing locum staff, and maintain on-going records of GP validations, nurse registration and staff training.
• Introduce a system for identifying informal carers, assessing their needs and signposting them to support.
• Introduce a system to ensure that staff have read and understood policies and procedures.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

We visited Stillmoor House Medical Practice. We spoke with 10 patients who were visiting the surgery. All of the patients told us they were very happy with the service they received. Comments included, “they’re good doctors”, “they make you feel welcome and that you are not wasting their time” and “they are good”.

When we asked patients about whether it was easy to get an appointment, comments were variable; some patients told us that it was, whilst others told us that it was not. We were told by some patients that if they wanted to see their own GP they may have to wait two or three weeks for an appointment.

As part of our inspection, we spoke with the registered manager, the practice manager, the deputy practice manager, reception team, GP's, pharmaceutical dispensing staff, nursing staff and a representative from the patient participation group (PPG).

We found, people's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People experienced care, treatment and support that met their needs and protected their rights.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. The provider also had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

We reviewed the information available to us about Stillmoor House Medical Practice on 14 May 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.