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Review carried out on 18 December 2019

During an annual regulatory review

We reviewed the information available to us about Middleway Surgery on 18 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.

Inspection carried out on 22 March 2018

During a routine inspection

This practice is rated as Good overall. (Previous inspection was in March 2015 and was rated as Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

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 – Good

People with long-term conditions – Good

Families, children and young people – Good

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 Middleway Surgery on 22 March 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.
  • 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 with many examples shared of career development.
  • There were high levels of staff satisfaction. Staff were proud of the organisation as a place to work and spoke highly of the culture. This had led to a happy, loyal workforce with low staff turnover. The practice welcomed nursing students, and medical students.

There was one area where the provider should make an improvement

  • The practice should continue to monitor and improve how patients could access care and treatment

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 3 March 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

St Blazey Surgery was inspected on Tuesday 3 March 2015. This was a comprehensive inspection. Overall the practice is rated as good.

St Blazey Surgery provides primary medical services to people living in St Blazey and the surrounding areas. Of the 6,350 patients registered at the service, 99% had described their ethnicity as White British. The practice provides services to a predominantly Cornish population and is situated in a semi-rural location. The practice provided health services under a General Medical Services contract (GMS) from the NHS.

The service had a team of four GP partners. Two were male and two were female. GP partners held managerial and financial responsibility for running the business. There were two nurses and two health care assistants at the practice. In addition there was a practice manager, a deputy manager and additional administrative and reception staff.

Patients who use the practice have access to community staff including district nurses, community psychiatric nurses, health visitors, physiotherapists, mental health staff, counsellors, chiropodist and midwives.

Our key findings were as follows:

We rated this practice as good. Patients reported having good access to appointments at the practice and liked having a named GP which improved their continuity of care. The practice was clean, well-organised, had good facilities and was well equipped to treat patients. There were effective infection control procedures in place.

The practice valued feedback from patients and acted upon this. Feedback from patients about their care and treatment was consistently positive. We observed a patient centred culture. Staff were motivated and inspired to offer kind and compassionate care and worked to overcome obstacles to achieving this. Views of external stakeholders were positive and were aligned with our findings.

The practice was well-led and had a clear leadership structure in place whilst retaining a sense of mutual respect and team work. There were systems in place to monitor and improve quality and identify risk and systems to manage emergencies.

Patients’ needs were assessed and care was planned and delivered in line with current legislation. This included assessment of a patient’s mental capacity to make an informed decision about their care and treatment, and the promotion of good health.

Suitable staff recruitment, pre-employment checks, induction and appraisal processes were in place and had been carried out. Staff had received training appropriate to their roles and further training needs had been identified and planned.

Information received about the practice prior to and during the inspection demonstrated the practice performed comparatively with all other practices within the clinical commissioning group (CCG) area.

Patients told us they felt safe in the hands of the staff and felt confident in clinical decisions made. There were effective safeguarding procedures in place.

Significant events, complaints and incidents were investigated and discussed. Learning from these events was communicated and acted upon.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection carried out on 4 February 2014

During a routine inspection

St Blazey Surgery provides primary medical services for approximately 6,300 patients.

As part of our inspection we spoke with one of the registered managers, practice manager, deputy practice manager, GP�s, nursing staff, a health care assistant, reception and clerical staff and representatives from the Patient Participation Group (PPG).

We spoke with patients at St Blazey Surgery, to obtain their feedback regarding the services they received from the practice. Comments included, �very friendly�, �it�s generally pretty good� and �constantly good, no complaints at all�.

Overall patients were complementary of the staff at the practice and of the clinical care and treatment they received. Patients told us that it was easy to get an appointment, and confirmed they consistently saw the same GP. Other comments included, �If you get through at 8.30am yes. I�ve never not got an appointment�, and �pretty good, not too bad�.

We found, people's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People�s privacy, dignity and independence were respected.

People experienced care, treatment and support which met their needs and protected their rights.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. The provider also had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.