Archived: Pensilva - The Health Centre

Letter from the Chief Inspector of General Practice

Pensilva Health Centre was inspected on Tuesday 17 March 2015. This was a comprehensive inspection. Overall the practice is rated as good.

The practice provides general medical services to people living in Pensilva and the surrounding areas. The practice provides services to a predominantly Cornish population and is situated in a rural location.

At the time of our inspection there were approximately 4,700 patients registered at the service with a team of three GP partners. There were also two salaried GPs. In total the practice had five GPs. Three were male and two were female. GP partners held managerial and financial responsibility for running the business. There were two nurses and one health care assistant at the practice. One of these nurses was an assistant practitioner. In addition there was a practice 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:

Pensilva placed an emphasis being a caring practice in the face of increasing demands for its services. The patient population had risen by 100 a year for the past three years. This was one of the highest rates in Kernow.

The practice was engaged with local population and GPs and staff knew their patients personally. There was a very active Friends of the Health Centre group. There was also a good Patient Participation Group (PPG) with a walking group, carers group, and bereavement group.

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 well with all other practices within the clinical commissioning group (Kernow CCG) area.

Significant events had been recorded, discussed and acted upon in a systematic way. Shared learning had taken place.

We found examples of outstanding practice at Pensilva Health Centre. For example;

The practice had a level of commitment to safeguarding which went beyond its contractual obligations. Written evidence about individual incidents confirmed this. GPs at the practice liaised regularly with other health and social care professionals to ensure high standards of safeguarding were in place. All patients told us they felt safe in the hands of the staff and confident in clinical decisions made. There were effective safeguarding procedures in place. There was a highly trained lead GP for safeguarding.

The practice was rated the best in Kernow for diagnostic rates of dementia. The practice had achieved 84% of the expected rate of their practice population in dementia diagnosis.

There were also areas which the practice needed to improve. For example;

There was some uncertainty among the nursing team as to responsibility for lead nursing roles. One of the new nurses had not received a three monthly probation review which was due. The practice should ensure that the nursing team received appropriate management support.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice