The Care Quality Commission
  • Doctor
  • GP practice

Mullion Health Centre

Overall: Outstanding read more about inspection ratings

The Health Centre, Mullion, Helston, Cornwall, TR12 7DQ (01326) 240212

Provided and run by:
Mullion Health Centre

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Mullion Health Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Mullion Health Centre, you can give feedback on this service.

21 December 2019

During an annual regulatory review

We reviewed the information available to us about Mullion Health Centre on 21 December 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.

23 April 2018 to 24 April 2018

During a routine inspection

This practice is rated as Outstanding overall. (The previous inspection was in February 2015 where we rated the practice as good overall)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Outstanding

Are services responsive? – Outstanding

Are services well-led? - Good

We carried out an announced comprehensive at Mullion Health Centre on Monday 23 and Tuesday 24 April 2018 as part of our 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.
  • Medicines were managed well at the practice and prescribing rates and patterns were kept under review to ensure safety and cost effectiveness.
  • Improvements within the dispensaries had taken place since the last inspection and were being monitored to further reduce any potential risks to patients and improve the quality of the service provided.
  • 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 gave strongly positive feedback about the care and treatment they received. Results from the July 2017 national GP patient survey, friends and family test results and independent survey results were all strongly positive. For example, in the national survey, the practice had performed better than Clinical Commissioning Group (CCG) and national averages for all 23 questions. 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. Staff said the practice was a good place to work and added that the leadership team were supportive and encouraged career development and learning to help improve patient safety.
  • There was evidence of systems and processes for learning, continuous improvement and innovation. The practice had taken part in many local pilots to test new methodology.

We saw areas of outstanding practice:

Feedback from multiple sources - patients who use the service, those who are close to them and stakeholders - was continually and strongly positive about the way staff treat people, the service received and access to services. People commented staff “go the extra mile” and the care they receive exceeded their expectations.

The practice had recognised the geographical locations and isolation of the practice branches, the needs of the local population and associated restrictions for some patients accessing healthcare. The GPs and staff had reviewed this and offered additional support and services to reduce the need for long journeys, improved access to services. For example:

  • Offering Saturday morning appointments with an aim to reduce unplanned hospital admissions and optimise care in the community,
  • Providing same day interventions such as oxygen concentrators and antibiotics to elderly patients in need who would otherwise require admission to hospital
  • providing a wide-range of soft-tissue and joint injections to its own patients, and to neighbouring practice patients to reduce secondary care burden and improve patient access.
  • Providing a doppler service for patients with peripheral vascular disease (leg ulcers).

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

18 February 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

Mullion Health Centre was inspected on Wednesday 18 February 2015. This was a comprehensive inspection.

The practice provided primary medical services to approximately 7,750 patients. The practice consisted of four sites. Mullion Health centre and Constantine were the main sites, with two smaller branches which opened part time during the week. We visited Mullion and Constantine for this inspection. The branch surgeries were located in the villages of Ruan Minor and Lizard. Ruan Minor, Constantine and Lizard were dispensing practices and provided a service to approximately half of the whole practice population. A dispensing practice is where GPs are able to prescribe and dispense medicines directly to patients who live in a rural setting which is a set distance from a pharmacy.

There was a team of five male GP partners and two female GP partners. Partners hold managerial and financial responsibility for running the business. Some of the GPs work part time. The team were supported by a nurse practitioner, four registered nurses, and four health care assistants. There were a team of six dispensing staff who cover three dispensing practices. The practice also employed a practice manager, additional administrative staff and team of cleaning staff. The GPs, nursing staff and dispensary staff worked across all of the sites. The practice had opted out of providing out-of-hours services to their own patients and refers them to another out of hour’s service.

Patients using the practice also had access to community staff including district nurses, community psychiatric nurses, health visitors, physiotherapists, speech therapists, counsellors, podiatrists and midwives.

We rated the practice as good.

Specifically, we found the practice to be outstanding for providing responsive services.

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

  • There were systems in place to address incidents, deal with complaints and protect adults, children and other vulnerable people who use the service.
  • Significant events were recorded and shared with multi professional agencies.
  • There was a proven track record and a culture of promptly responding to incidents and near misses and using these events to learn and change systems.
  • The dispensary and medicines were generally managed well at the practice and responded well to incidents that occurred with medicines management.
  • There were systems in place to support the GPs and other clinical staff to improve clinical outcomes for patients.
  • Data outcomes for patients registered with this practice were equal to or above average for the locality.
  • Patient care and treatment was considered in line with best practice national guidelines and staff were proactive in promoting good health.
  • There were sufficiently skilled and trained staff working at the practice.
  • Staff knew the practice patients well, are able to identify people in crisis and are professional and respectful when providing care and treatment.
  • The practice planned its services to meet the diversity of its patients and had worked over and above contractual obligations. There was an effective appointment system in place which enabled a good access to the service.
  • The practice had a vision and informal set of values which were understood by staff. There was a clear leadership structure in place and effective governance systems in place.

We saw areas of outstanding practice including:

The practice were responsive in the care they provided to patients.

  • The practice had increased the flexibility of access to appointments and could demonstrate the impact of this by reduced use of the out of hours service and very positive patient survey results. The practice worked with three other practices to provide Saturday and Sunday morning clinics specifically to see patients identified as being vulnerable. This prevented some patients being admitted to hospital and improved continuity of care for the patients.
  • The GPs worked with the emergency services and first responders by attendeding emergency call-outs to patients in the area. This was done because the nearest ambulance often took 20 minutes to attend to patients. The practice were able to give examples of successful resuscitation.
  • An additional service was provided by staff at the practice for patients with indwelling intravenous lines used for prolonged treatments, for example, chemotherapy. Patients were normally required to go to hospital for management of this intravenous line, which is a 50 mile round trip. However, staff at the practice had completed extended training to enable patients to receive care locally, at the practice.
  • One of the branches at the practice had a very active carers support and Friends of Constantine group. The group offered services to carers of patients with long term conditions. The group offered services such as Christmas meals, theatre trips, pamper days for carers, a support group and educational sessions. One GP had responded to a need in the community to offer patients a local specialised dermatology service to remove suspected skin cancers. The GP had completed extensive training and audited this service for patient satisfaction, complications and effectiveness. This service had reduced the dermatology referral rate to the local hospital and had reduced the distance patients had to travel for this service.

Other areas of outstanding practice included:

The practice had been EEFO approved. EEFO is a word that has been designed by young people, owned by young people. EEFO works with other community services to make sure they are young people friendly. Once a service has been EEFO approved it means that service has met certain quality standards in, for example, confidentiality and consent, easy to access services, welcoming environment and staff trained on issues young people face. Part of this scheme is the use of a green card. This is a local collaboration between the practice and the local secondary school whereby a young person can request a green card from the school office allowing them to access medical services without the need to be asked lots of questions by teaching staff. The young person is then seen without the requirement to be given an appointment.

There were areas of practice where the provider should make improvements.

 

Action the provider SHOULD take to improve:

  • Introduce systems that ensure vaccines are always stored at a safe temperature. .
  • All clinical staff should receive training in the Mental Capacity Act (2005) The MCA is a legal framework which supports patients who need assistance to make choices and important decisions about their care and treatment

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice