The Care Quality Commission
  • Doctor
  • GP practice

Netherton Practice

Overall: Good read more about inspection ratings

Netherton Health Centre, Magdalen Square, Bootle, L30 5SP (0151) 247 6098

Provided and run by:
Primary Care 24 (Merseyside) Limited

Important: The provider of this service changed. See old profile

All Inspections

6 July 2023

During a monthly review of our data

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

24 November 2023

During an inspection looking at part of the service

We carried out an announced assessment of Netherton Practice on 24 November 2023. The assessment focused on the responsive key question.

Following our previous inspection on 24 February 2020 the practice was rated good overall and for all key questions. The full reports for previous inspections can be found by selecting the ‘all reports’ link for Netherton Practice on our website at www.cqc.org.uk.

The practice continues to be rated as good overall as this was the rating given at the last comprehensive inspection. However, we have now rated the responsive key question as requires improvement as a result of the findings of this focused assessment.

Safe - Good

Effective - Good

Caring - Good

Responsive – Requires improvement

Well-led - Good

Why we carried out this review

We carried out this assessment as part of our work to understand how practices are working to try to meet demand for access and to better understand the experiences of people who use services and providers.

We recognise the work that GP practices have been engaged in to continue to provide safe, quality care to the people they serve. We know colleagues are doing this while demand for general practice remains exceptionally high, with more appointments being provided than ever. In this challenging context, access to general practice remains a concern for people. Our strategy makes a commitment to deliver regulation driven by people’s needs and experiences of care. These assessments of the responsive key question include looking at what practices are doing innovatively to improve patient access to primary care and sharing this information to drive improvement.

How we carried out the review

This assessment was carried out remotely. It did not include a site visit.

The process included:

  • Conducting an interview with the provider and members of staff using video conferencing.
  • Reviewing patient feedback from a range of sources
  • Requesting evidence from the provider.
  • Reviewing data we hold about the service
  • Seeking information/feedback from relevant stakeholders

Our findings

We based our judgement of the responsive key question on a combination of:

  • what we found when we met with the provider
  • information from our ongoing monitoring of data about services and
  • information from the provider, patients, the public and other organisations.

We found that:

  • The provider organised and delivered services to meet patients’ needs. They worked alongside other agencies to meet the needs of the patients and improve their experiences of care and treatment.
  • Patient feedback was that they could not always access care and treatment in a timely way. Patients were dissatisfied with the arrangements for getting through to the practice by phone and their experience of obtaining an appointment.
  • Complaints were listened to, managed appropriately and used to improve the quality of care.

Whilst we found no breaches of regulations, the provider should:

  • Produce a detailed plan as to how they intend to respond to patient concerns/feedback about access and their experience of making an appointment with an aim to improve patient experience.

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 Health Care

24 January 2020

During a routine inspection

We carried out an announced comprehensive inspection at Netherton Practice on 24 February 2020 as part of our inspection programme.

At this inspection we followed up on breaches of regulations identified at a previous inspection on 11 December 2018.

This inspection looked at the following key questions:

Safe

Effective

Caring

Responsive

Well-led

At the last inspection in December 2018 we rated the practice as requires improvement for providing safe and well-led services because:

  • The systems in place for safeguarding patients were not fully effective.
  • Governance systems were not fully effective in monitoring the service, managing risks and driving improvement.

At this inspection we found that the provider had satisfactorily addressed the above areas.

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 and good for all population groups.

We found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice organised and delivered services to meet patients’ needs. Patients could access care and treatment in a timely way.
  • The way the practice was led and managed promoted the delivery of good quality, person-centre care.

Whilst we found no breaches of regulation, the provider should:

  • Review safeguarding arrangements to include setting up an alert for relevant others for children at risk.
  • Introduce a programme of clinical audit as part of the clinical governance in an aim to improve outcomes for patients.
  • Provide reception staff with sepsis awareness training to support them in dealing with patients presenting with potential sepsis.
  • Review Patient Group Directions (PGDs) to ensure designated people have been authorised to administer the vaccines.
  • Monitor unplanned hospital admissions and readmissions.
  • Continue to monitor and encourage cancer screening uptake for all eligible patients.
  • Look to increase the number of identified carers to ensure these patients are provided with appropriate support.
  • Continue to encourage uptake of patients to form a Patient Participation Group.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care.

11 December 2018

During a routine inspection

This practice is rated as requires improvement overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Requires improvement

We carried out an announced comprehensive inspection at Netherton Practice on 11 December 2018 as part of our inspection programme.

At this inspection we found:

  • The practice had systems to manage risk and to ensure that safety incidents were less likely to happen. However, the learning from incidents was not well communicated across the staff team.
  • The systems in place for safeguarding patients from the risk of abuse were not robust. This was because there was no designated lead for safeguarding in the practice and a safeguarding register had only recently been produced.
  • All clinical sessions were delivered by locum GPs and an agency practice nurse. The provider had taken steps to ensure as much consistency as possible in the use of temporary staff and systems were in place to support the clinical team such as regular meetings. However, members of the clinical team were not always taking these up.
  • There were systems in place to reduce risks to patient safety. A risk register was in place and this was monitored.
  • There were shortages in the staff team and the practice had been taking on a high number of new patients. This was not being managed effectively and if not addressed could lead to the practice being unable to meet patients care and treatment needs in a timely and safe manner.
  • Medicines were not always being managed in line with policies and procedures.
  • Procedures to prevent the spread of infection were in place and regular Infection control and cleanliness audits were carried out.
  • Systems were in place to deal with medical emergencies and staff were trained in basic life support.
  • Clinicians assessed patients’ needs and delivered care in line with current evidence based guidance in those areas we explored.
  • Data showed that outcomes for patients at this practice were comparable to outcomes for patients locally and nationally.
  • Systems to review the effectiveness and appropriateness of the care provided were in place and some of these were being developed further. However, there were no clinical audits being carried out at the practice.
  • Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Staff told us they felt supported in their roles.
  • Patients told us they were treated with dignity and respect and involved in decisions about their care and treatment. Some patients felt there was little consistency in the clinical team. The provider had taken action to reduce the number of clinical staff used.
  • Systems were in place to check on the quality of the service. However, these were not fully effective for this location as we identified shortfalls.

The areas where the provider must make improvements are:

  • Ensure the systems in place for safeguarding patients include a designated safeguarding lead and ensure that safeguarding registers are reviewed on a regular basis.
  • Review the governance systems to ensure these are fully effective in monitoring the service, managing risks and driving improvement.

The areas where the provider should make improvements are:

  • Review staffing levels and staff capacity to ensure this is sufficient to meet demand.
  • Ensure procedures relating to the management of medicines and prescribing are followed appropriately.
  • Ensure that clinical audits are carried out as part of their assessment of clinical effectiveness and to improve outcomes for patients.
  • Identify carers in order to ensure these patients are offered appropriate advice and support
  • Improve system for communication with the staff team.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice