The Three Spires Medical Practice

Updated 8 November 2022

The Tree Spires Medical Practice is in Truro, Cornwall at:

Truro Health Park

Infirmary Hill

Truro

Cornwall

TR1 2JA

The Three Spires Medical Practice provides NHS GP services to adults and children. The practice offers services from one main practice.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, family planning, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.

The Three Spires Medical Practice is a purpose-built building with consultation rooms, treatment rooms and a minor operation theatre, over two floors and a further floor used for administration of the service. The practice has approximately 17,500 registered patients.

The practice provides a wide scope of services which includes general practice and clinics available to practice patients and some services available to the wider community. The practice employs a specialist spinal physiotherapist, four physiotherapists and has a purpose-built treatment room and shared gymnasium. This physiotherapy service is available to the practice patients and patients within the county who are not registered with the practice. The practice works in partnership with the local hospital to provide skin cancer referrals clinics. The service works with three local dermatology consultants and a GP from the practice as part of the Cornwall Skin Clinic. The clinic provides see and treat clinics for patients at the practice and hospital referrals. .

The practice team includes 14 GP Partners and four salaried GPs. The nurse team of seven staff and the health care assistant team of 10 staff have recently had an increase in number to meet workload demand. Clinical staff are supported by a team of 11 whole time equivalent reception and administration staff. Patients also have access to four paramedics, mental health team, health visitors and other health care professionals who visit the practice regularly. The practice also has a full-time senior clinical pharmacist and clinical pharmacist, three pharmacy technicians and a pre-registration pharmacy technician.

The service is a teaching practice for registrars training to become GP’s and medical students training to become doctors and is active in research and clinical trials.

The practice is part of a wider network of GP practices, the Truro Primary Care Network (PCN) which is made up of two GP practices. PCNs provide proactive, coordinated care to their patients, in different ways to match different people’s needs, with a strong focus on prevention and personalised care.

Information published by Public Health England shows that deprivation within the practice population group is in the middle area of the decile (six of 10). The lower the decile, the more deprived the practice population is relative to others.

The practice population’s ethnic profile is predominantly White British. According to the latest available data, the ethnic make-up of the practice area is 96% white and 1.7 % Asian.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, GP appointments were telephone consultations and face-to-face appointments.

Patients can book appointments in person, by telephone or using the online services. Opening hours are from 7 am to 6:30 pm. Extended hours are offered from 7.30 am to 7.30 pm to meet patient demand. Outside of these times patients are directed to contact the NHS 111 service. Details are also given on the practice website of other useful telephone numbers and addresses where patients can seek assistance when the practice is closed.

Updated 8 November 2022

We carried out an announced inspection at The Three Spires Surgery on 6, 7 and 14 September 2022. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Well-led - Good

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Three Spires Medical Practice on our website at www.cqc.org.uk

Why we carried out this inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, considering the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing facilities.
• Speaking with staff during the visit to the practice.
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A staff questionnaire.
• A site visit.

Our findings

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

We found that:

• The practice had clear systems, practices and processes to keep people safe and safeguarded from abuse. Staff had the information they needed to deliver safe care and treatment and the practice learned and made improvements when things went wrong.
• There were adequate systems to assess, monitor and manage risks to patient safety and appropriate standards of cleanliness and hygiene were met.
• The practice had systems for the appropriate and safe use of medicines. Ongoing monitoring was being maintained with actions taken to follow up late reviews.
• Patients’ needs were assessed, and care and treatment were delivered in line with current legislation, standards and evidence-based guidance supported by clear pathways and tools. The practice had a comprehensive programme of quality improvement activity and routinely reviewed the effectiveness and appropriateness of the care provided.
• The practice was able to demonstrate that staff had the skills, knowledge and experience to carry out their roles. Staff worked together and with other organisations to deliver effective care and treatment.
• The practice obtained consent to care and treatment in line with legislation and guidance and was consistent and proactive in helping patients to live healthier lives.
• There was a high level of compassionate, inclusive and effective leadership at all levels. The practice had a clear vision and strategy to provide high-quality sustainable care and had an inclusive culture which valued staff and drove the development of the practice. The practice demonstrated a continued and sustained level of development of the service.
• There were clear responsibilities, roles and systems of accountability to support good governance. All staff understood their role and involvement in managing governance. Management had clear and effective processes for managing risks, issues and performance.
• The practice involved the public, staff and external partners to sustain high-quality and sustainable care. There was a strong focus on learning, development and collaboration for individual and service development.

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

• Continue to increase the uptake of cervical screening for eligible patients.
• Ensure that all oxygen cylinders are secured for safety.
• Ensure that all long term conditions and high risk medicines reviews continue to be monitored and addressed to meet any backlog.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Primary Medical Services and Integrated Care