We carried out an announced comprehensive inspection at Tregenna Group Practice on 10 January 2019 as part of our inspection programme.

At the last inspection in December 2015 we rated the practice as good overall.

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 good overall and good for all population groups.

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.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
• The practice had implemented systems of specific support for patients nearing end of life and this included a direct telephone number to obtain support from the practice cancer champions.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We saw one area of outstanding practice

• The practice delivered person centred support to patients they assessed as vulnerable or needing additional support with ordering their medicines. The identified patients were called each month to discuss their medicine requirements and the appropriate prescriptions were sent to the patient’s preferred pharmacist.

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

• Obtain evidence of conduct in previous employment for new employees as part of the recruitment process.
• Continue to review the practice levels of antimicrobial prescribing.
• Improve practice records including a log of patient safety alerts and actions taken, standardising meeting agendas to include significant event, guidance updates and alerts and implement a clinical audit plan.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Tregenna Group Practice on 10 December 2015. 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.
• Generally risks to patients were assessed and well managed. However, some workplace risk assessments were not available.
• 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.
• The practice was responsive to the different needs of its patient population. For example, they had received recognition for their support of people who were lesbian, gay, bisexual and transgender. One GP was trained to respond and support victims of domestic violence and abuse and in-house counselling services were provided to people with mental health needs
• Information about services and how to complain was available and easy to understand.
• Patients said they did not always find it easy to get through to the practice on the telephone but could get an appointment with a named GP and that there was continuity of care. Urgent appointments were available the same day.
• The practice had facilities and equipment 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 practice was open and transparent and apologised when they got something wrong.

The areas where the provider should make improvement are:

• Ensure staff training is up to date including safeguarding and the Mental Capacity Act 2005.
• Review and update procedures to ensure they are easily accessible and ensure risk assessments for lone worker and manual handling are developed.
• Ensure safety risk assessments and COSHH assessments are undertaken for the storage and use of liquid nitrogen.
• Ensure an asbestos assessment is undertaken and that the refurbishment plan for the premises is recorded.
• Ensure the record of prescription paper and prescription pads received into the building includes the log of identity numbers.
• Ensure the locum GP induction is recorded.
• Ensure a planned programme of clinical and internal audits is established to enable the practice to monitor quality consistently and to make improvements as required quickly.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice