The Roseland Surgeries

Updated 19 March 2018

The Roseland Surgeries is situated in a rural area of Cornwall. The practice is comprised of three sites on the Roseland peninsula.

The main practice is situated in the coastal town of Portscatho, Cornwall. There are also two branches at Tregony and St Mawes. The practice provides a primary medical service to 3,700 patients of a diverse age group. The practice is a teaching practice for medical students and a training practice.

The deprivation decile rating for this area is six (with one being the most deprived and 10 being the least deprived). The 2011 census data showed that majority of the local population identified themselves as being White British.

There is a team of three GP partners, two male and one female. There is one male salaried GP. Some worked part time and some full time. The whole time equivalent was three. The team were supported by a practice manager, two practice nurses, a treatment room nurse and additional administration staff.

Patients using the practice also have access to community nurses, mental health teams and health visitors who are based at the practice. Other health care professionals visit the practice on a regular basis, including a podiatrist and a physiotherapist.

The practice is a dispensing practice and has a dispensary manager and two other dispensing staff.

The practice is open between the NHS contracted opening hours 8am and 6.30pm Monday to Friday. Appointments can be offered anytime within these hours. Extended hours surgeries are offered at twice a month on Saturday mornings 9am to 12 noon.

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

The practice offers a range ofappointment types including book on the day, telephone consultations and advance appointments (eight weeks in advance) as well as online services such as repeat prescriptions.

The practice has a General Medical Services (GMS) contract with NHS England. This report relates to the regulatory activities being carried out at the following three sites, all of which we visited during our inspection;

Gerrans Hill, Portscatho, Kernow TR2 5EE

Hill Head, St Mawes, Kernow TR2 5AL

Well Street, Tregony, Kernow TR2 5RT.

Updated 19 March 2018

This practice is rated as Good overall. (Previous inspection 20 September 2016 – Good)

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? - Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Outstanding

People with long-term conditions – Good

Families, children and young people – Outstanding

Working age people (including those recently retired and students – Good

People whose circumstances may make them vulnerable – Good

People experiencing poor mental health (including people with dementia) - Good

We carried out an announced comprehensive inspection at The Roseland Surgeries on Tuesday 6 February 2018 as part of our planned inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw three areas of outstanding practice:

• The practice had gained SAVVY level two, (a county-wide initiative by the council supporting improved access to GP services for young people) approval. This indicated a focus on the emotional health and well-being of young people. Staff encouraged young people to visit the practice and engage with their GP and reassure them that their appointments were entirely confidential. This scheme supported 14% of the practice population which was approximately 500 patients aged under 18 years.
• In order to reduce social isolation particularly for the population groups of older people and families, children and young people, in this rural area, the practice had worked with its patient participation group (PPG) to set up two community cafes. These were staffed by PPG volunteers including a mental health community nurse. Organised activities included a ping pong group, a young people’s drama group, computer workshops and various arts and crafts. There were also areas for quiet conversation and tea, coffee and refreshment facilities. These community cafes were attended by about 25 to 30 patients a week in the villages of Portscatho and Veryan. The practice had trained the café volunteer staff in manual handling, first aid and food hygiene. Patients provided us with positive feedback about the community cafes.
• The practice supported a volunteer patient transport service which included a 20 seater minibus. Drivers had received appropriate background checks. The PPG had secured a grant from the local council in order to support this service, of key importance in a rural area with challenging roads and infrequent public transport (only two buses a day on the Roseland peninsula). The PPG volunteer transport service ferried patients from their villages to the practice, to the two community cafes and to other essential health care providers such as the hospital which was a 45 minute journey. Approximately 50 patients who had mobility issues or difficulties accessing public transport in this rural area, benefitted from this service. Patients benefitted from reduced isolation from the service and unplanned hospital admissions had reduced.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

Updated 19 March 2018

Updated 19 March 2018

Updated 19 March 2018

Updated 19 March 2018

Updated 19 March 2018

Updated 19 March 2018