The Care Quality Commission
  • Doctor
  • GP practice

The Three Spires Medical Practice

Overall: Good read more about inspection ratings

Truro Health Park, Infirmary Hill, Truro, Cornwall, TR1 2JA (01872) 272272

Provided and run by:
The Three Spires Medical Practice

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about The Three Spires Medical Practice 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 The Three Spires Medical Practice, you can give feedback on this service.

14 September 2022

During an inspection looking at part of the service

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

12 September 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out a focussed inspection and on noting elements of notable practice extend the inspection at The Three Spires Medical Centre on 9 August 2017. Overall the practice is rated as Good.

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

  • There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
  • The practice had clearly defined and embedded systems to minimise risks to patient safety.
  • Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
  • Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
  • Eighty nine percent of the patients surveyed said they found it easy to make an appointment with a named GP and added there was continuity of care, with urgent appointments available the same day.
  • Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
  • The practice had good facilities and was well equipped to treat patients and meet their needs. For example, there was a fully equipped operating theatre for vasectomies and skin cancer surgery on site. The practice was clean, tidy and hygienic. We found suitable arrangements were in place that ensured the cleanliness of the practice was maintained to a high standard.
  • There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
  • The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.
  • The leadership, governance and culture of the practice put quality and safety as its top priority in delivering person centered care and treatment. We saw many examples of this throughout the inspection and noted strong leadership was a common thread seen in the areas of outstanding practice.

We saw areas of outstanding practice:

The practice understood its population profile and had used this understanding to meet the needs of its population. GP partners told us that a fundamental aim in developing services at the practice was to provide resilient, proactive and responsive services for patients there and county wide. We saw several examples demonstrating that patients experienced flexibility, choice and continuity of care. For example:

The practice held two no-scalpel vasectomy clinics each week; this includes giving pre and post-operative information. This service was available from two GPs through the choose and book system for all patients throughout the county. In the past twelve months 323 vasectomies had been performed with positive feedback from the patients.

The practice employed a specialist spinal physiotherapist and four physiotherapists and has a purpose built treatment room and shared gymnasium to deliver a physiotherapy service to their patients and county wide. This service was able to provide soft tissue work, and any qualified provider (AQP) service for patients with lower back and neck problems. In the past year over 689 patients were seen. This service received excellent feedback with a 96% satisfaction score of all patients stating they received an excellent service. There was also a muscular interface clinic (MSK) that provided an enhanced service for patients with hip, knee and shoulder problems, and also acupuncture and “back classes to empower the patients to self manage their pain and reduce the amount of pain relieving medicines needed

The practice worked in partnership with the Royal Cornwall Hospital Trust to provide two week wait skin cancer referrals in the practice, the first in the country. Working with two local dermatologists and a GP from the practice the Cornwall skin clinic, as it is known, offers both see and treat clinics for patients at the practice and county wide three times a week and have treated 2161 patients this year.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

18 March 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

Three Spires Medical Practice was inspected on Wednesday 18 March 2015. This was a comprehensive inspection.

Overall the practice is rated as good.

Specifically, we found the practice to be good for providing safe, effective, caring, responsive and well led care. It was also good for providing services for the six population groups.

Our key findings were as follows:

There was a track record and a culture of promptly responding to incidents, near misses and complaints and using these events to learn and change systems so that patient care could be improved.

Staff were aware of their responsibilities in regard to consent, safeguarding and the Mental Capacity Act 2005 (MCA).

The practice was clean and tidy and there were effective infection control procedures in place.

Medicines were managed well at the practice and there were effective systems in place to deal with emergencies.

The GPs and other clinical staff were knowledgeable about how the decisions they made improved clinical outcomes for patients although patients were not always fully included in their care planning.

Data outcomes for patients were equal or above the average locally.

Patients were complimentary about how their medical conditions were managed.

Practice staff were professional and respectful when providing care and treatment.

The practice planned its services to meet the diversity of its patients. There were good facilities available, adjustments were made to meet the needs of the patients and there was an effective appointment system in place which enabled a good access to the service.

The practice had a vision and clear ethos which were understood by staff. There was a leadership structure in place and staff felt supported.

We found areas where the provider SHOULD make improvements. The provider should:

  • Improve privacy for patients at the reception desk to enable patients to share information with reception staff without other patients overhearing.
  • Improve patient involvement in their personalised care plans to demonstrate they had been included in discussions about their care.
  • Ensure patients are aware of the chaperone service available before they go into the consulting room.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice