Archived: Cudmore House

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Cudmore House (Cornwall Health Ltd) on 24 and 25 January 2017. Overall the service 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 an effective system in place for recording, reporting and learning from significant events.
• Risks to patients were assessed and well managed.
• Patients’ care needs were assessed and delivered in a timely way according to need. The service met the National Quality Requirements.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• There was a system in place which enabled staff access to patient records, and the out of hours staff provided other services; for example, the local GP and hospital, with information following contact with patients as was appropriate.
• The service managed patients’ care and treatment in a timely way.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• The service worked proactively with other organisations and providers to develop services that supported alternatives to hospital admission where appropriate and improved the patient experience.
• The service had good facilities and was well equipped to treat patients and meet their needs. The vehicles used for home visits were clean and well equipped.
• There was a clear leadership structure and staff felt supported by management. The service proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.
• Prescription security was highly developed and ensured all prescriptions were accounted for in each location.
• Medicines storage in vehicles had been developed to support security, integrity of packaging and maintaining medicines effectiveness in fluctuating temperatures.
• A children’s review service was being developed following local provider research showing more effective patient treatment could be provided by the out of hours service.

We saw one area of outstanding service:

The urgent care car (UCC) was an innovation to meet the needs of patients in a county without an out of hours district nursing service. The UCC car was staffed by an experienced driver and an urgent care practitioner (UCP) who supported a range of patients who met specific criteria (blocked catheters, deaths, urinary tract infections and end of life care). This enabled other clinicians to focus on the more complex, unwell patients. In a two month period the UCC had responded to 61 urgent non-complex cases, and enabled the service to meet its national quality requirements such as response times in 99% of its cases.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice