This practice is rated as Outstanding overall. (Previous inspection October 2015 – Outstanding)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Outstanding

Are services well-led? - Outstanding

We carried out an announced comprehensive inspection at The Stennack Surgery on

10 October 2018. The inspection was a routine inspection part of our inspection schedule.

At this inspection we found:

• Despite some significant challenges in the last few years the leadership had demonstrated resilience and commitment to their patients and the wider community. They had continued to implement the strategy with the delivery of objectives that were stretching, challenging and innovative.
• The practice had a clear vision which had quality and safety as its top priority. A five year strategy was in place, monitored and regularly reviewed and discussed with all staff and patient representatives.
• Feedback from all 30 patients we spoke with or who provided feedback, who used the service, family members and carers, and stakeholders were continuously positive about the way staff treated them. Staff were said to go the extra mile and were patient focussed in all aspects of care delivery and developments at the practice.
• People’s individual needs and preferences were central to the planning and delivery of flexible tailored services.
• Integrated health and social care was strongly advocated and the practice had driven innovation in the integration of community services in the Penwith locality.
• All patient feedback highlighted improved ease of access to the appointment system after a short period of resource challenges.
• The practice was proactive in addressing lower uptake rates of childhood immunisation, providing flexible clinics and appointments, immunisation champions to engage and educate parents in hard to reach families.
• Patient engagement was a high priority with patient representatives seen as critical partners actively involved in developing services.
• There was a strong focus on continuous learning and improvement at all levels of the organisation. Proactive succession planning was evidenced.
• Leaders had an inspiring shared purpose, strove to deliver and motivated staff to succeed.
• GP partners invested heavily in the practice, purchasing the building. The risk and business management was effective with data showing significant benefits for patients and NHS health budget savings made as a result.

We saw areas of outstanding practice:

There was a strong communitarian approach, with many examples seen demonstrating this: Patients had immediate and easy access to the many types of support available from representatives at the practice community hub including information, exercise and social activities to prevent social isolation and loneliness and improve health.

The practice identified patients living in St Ives all year round to determine who the community is, who needed help, and who the practice needed to connect with to provide support. This facilitated proactive identification of people who could be at or likely to become frail and at risk.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Stennack Surgery, St Ives on 14 October 2015. Overall the practice is rated as outstanding.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• The practice used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice.

• Feedback from patients about their care was consistently and strongly positive.

• The practice was innovative in the way it worked closely with other organisations and with the local community in planning how services were provided to ensure that they will meet patient needs. The voices of young people in the community led to the development of the current young patients drop in clinic.

• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients and from the patient participation group.
• The practice had good facilities and was well equipped to treat patients and meet their needs. Every effort was made to make information accessible, for example following recommendations of the Royal National Institute for the Blind (RNIB).
• Information about how to complain was available and easy to understand.
• The practice had GPs with specialist interest qualifications, which enabled them to provide a home detoxification service for patients with drug and alcohol issues. GPs worked in conjunction with external specialist agencies to ensure that patients had a responsible carer during this period for their safety.
• The practice had robust systems of governance in place, which put quality and safety as its top priority in delivering person centred care and treatment. We saw many examples of this throughout the inspection, this was a common thread seen in the areas of outstanding practice.
• We found a number of examples where the practice was contributing and leading improvement in pathways of care across the wider local health system not only for the practice.

We saw areas of outstanding practice:

• The practice had a strong vision which had quality and effective care and treatment as its top priority. Stennack Surgery has embraced the concept of living well and is facilitating the integration of services to specifically bring care and treatment closer to home for patients. For example, the practice was setting up a branch surgery, with an attached private pharmacy, in Carbis Bay as a result of patient feedback about the needs of the local community there.

• Innovative approaches are used to gather feedback from patients and improving the service. The relationship with the Patient Participation Group (PPG) is effective and collaborative, with members actively involved in delivering services closer to home for patients in the practice. PPG members act as ‘Ambassadors’, seeking out patient feedback and actively helping them access support in their communities.

• The practice takes a truly holistic approach to assessing, planning and delivering care and treatment to people who use services. In particular, vulnerable older patients and those with chronic health conditions were closely monitored by a dedicated specialist nurse who did home visits and provided early interventions to reduce the risk of unplanned hospital admissions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice