The Care Quality Commission
  • Doctor
  • GP practice

SPCT Practices

Overall: Good read more about inspection ratings

4 Longshaw Drive, Worsley, Manchester, M28 0BB (0161) 983 0560

Provided and run by:
Salford Primary Care Together CIC

Important: This service was previously registered at a different address - see old profile

All Inspections

15 August 2023

During a routine inspection

We carried out an announced comprehensive inspection at Salford Primary Care Together (SPCT) on 15 August 2023. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection on 11 March 2022 the practice was rated requires improvement for the key questions safe, effective and well led. This amounted to an overall rating of requires improvement. They were found good for the key questions safe and responsive.

Since the previous inspection key members of the leadership team have left the organisation. In January 2023 the previous Chief Clinical Officer was appointed as the Chief Accountable Officer and is now the sole executive in SPCT. Upon appointment they reviewed the quality of care and identified immediate need for support. They worked with the Local Medical Council (LMC) and Integrated Care Board (ICB) and introduced a mutual aid recovery process with help from another practice in Salford. Mutual aid is an organisational model where voluntary, collaborative exchanges of resources and services for common benefit take place amongst community members to overcome social, economic, and political barriers to meeting common needs. A 360 degree review was undertaken and all areas for improvement were identified and worked on. There has been continuous audit and monitoring and continuous learning and improvement so much so that at this inspection we found several areas of outstanding practice.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for SPCT on our website at www.cqc.org.uk

Why we carried out this inspection.

We carried out this inspection to follow up breaches of regulation from a previous inspection. All five key questions were inspected. We reviewed all areas identified as requiring improvement at the last inspection.

How we carried out the inspection.

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Reviewing patient records to identify issues and clarify actions taken by the provider.
  • Requesting evidence from the provider.
  • A shorter 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.

At this inspection 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 and this was continually monitored.
  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.
  • The practice adjusted how it delivered services to meet the needs of patients and ensure that they could access care and treatment in ways that suited them best.
  • There was a wide range of services, clinical and non-clinical that recognised that a patient’s emotional and social needs were as important as their physical needs.
  • In the latest survey, over two-thirds of patients raised concerns regarding difficulties contacting the practice by telephone and regarding the appointment booking process. In response to patient feedback regarding poor access the practice has introduced a simpler way to make and obtain appointments with most appointments face to face unless otherwise requested.
  • Information about the services available, how to access them and how to make a complaint was available and easy to understand in easy read format and different languages.
  • A new hub based approach had been implemented to ensure consistency across all sites and achieve better care navigation for patients. The care navigation system ensured patients were placed with the most suitable health care professional.
  • The way the practice was led and managed promoted the delivery of high quality, person centred care. They provided high quality care and treatment and inspired staff to use innovative ways to improve services for patients.
  • Leaders and all the GPs worked closed together. There was no hierarchy and there was a collaboration of equal proportions. As a community interest company every staff member has a salary which meant they were incentivised to work because of the values they believed in and the teams they worked in and not because of profit. This drove care and treatment to be very much patient centred and provided a safe and supportive environment to work within.

We saw some areas of outstanding practice:

  • The practice had implemented a same day urgent care service (SDUC) with one clinician based at each site offering additional face to face capacity for urgent access. This enabled other clinicians to concentrate on mainstream patients, maintain continuity of care and provide access to specific patients when requested.
  • There was direct access for SAS patients via a designated telephone number. SAS patients are those who have been excluded from their mainstream GP list. The service provided by SPCT ensured that patients who had been removed from a GP practice could still access primary care medical services in a secure environment.
  • The practice had recruited a GP with a special interest and qualifications in complaint management. There was a plan in place with recommendations to implement ‘How do we learn’. These recommendations had been discussed and the practice liaised with NHS Standards and the Parliamentary and Health Service Ombudsman (PHSO) to enable best practice.
  • The practice ran an inclusion service that particularly focused on vulnerable groups including sex workers, people on probation, asylum seekers, refugees and the Traveller community. Barriers to access were removed with appointments at all four sites, including a drop in at a local charity with no need for identification documents. There was a mobile phone number for the inclusion service that allowed patients to text or WhatsApp when they had no credit but could hop on to free Wi-Fi at eateries in the area for example MacDonalds. WhatsApp access also helped patients that struggled with literacy who could record voice notes and have voice notes sent back to them telling them about appointments.

The practice should:

  • Record vaccination status for all clinical and non-clinical staff as per guidelines.
  • Continue and embed improvement plan for uptake of child immunisations.
  • Continue and embed improvement plan for uptake of cytology screening.
  • Continue to improve patient satisfaction.

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

8 March 2022

During a routine inspection

We carried out an announced inspection at SPCT Practices on 8 March 2022. Overall, the practice is rated as requires improvement.

The ratings for each key question are:

Safe – Requires improvement

Effective – Requires improvement

Caring - Good

Responsive - Good

Well-led – Requires Improvement

Why we carried out this inspection

This inspection was a comprehensive inspection of all five key questions as part of our routine inspection programme.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

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 some staff interviews using video conferencing
  • 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 site visit to the main location and one branch site.

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 requires improvement overall.

We rated the provider as requires improvement for providing safe services. Concerns included:

  • Actions from the fire risk assessment were not monitored or completed.
  • When appointing infection control leads for the sites, the infection control policy was not followed.
  • There was no documented approach to the management of test results, and this was not always managed in a timely manner.
  • There was no appropriate clinical oversight of test results, including when reviewed by non-clinical staff
  • There was not an effective system for recording and acting on safety alerts.

We rated the provider as requires improvement for providing effective services. Concerns included:

  • We found patients with potentially missed diagnoses.
  • There was no evidence that patients who had experienced acute exacerbation of asthma had been followed up appropriately.
  • There was no system in place for monitoring thyroxine treatment.
  • There was no programme of targeted quality improvement.
  • There was no formal supervision of non-medical prescribers.

We rated the provider as good for providing caring services.

  • Staff dealt with patients with kindness and respect and involved them in decisions about their care.

We rated the provider as good for providing responsive services.

  • The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic.
  • It was not clear that patients could access care and treatment in a timely way.

We rated the provider as requires improvement for providing well led services. Concerns included:

  • Incorrect information was on the website.
  • Executive clinical leadership was not visible at all sites.
  • It was not clear how the practice monitored progress against delivery of the strategy.
  • Governance structures and systems were not always in place or regularly reviewed.
  • Staff were not always clear about their roles and responsibilities and that of others.
  • There were not always comprehensive assurance systems.
  • There were not always effective arrangements for identifying, managing and mitigating risks.
  • There was little evidence of a system to share learning with staff.

We found one breach of regulations. The provider must:

  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • The practice should continue to make improvements to their telephone system to improve survey scores around getting through to someone on the phone.
  • The practice should make improvements to their cervical screening rates.
  • The practice should make improvements to their child immunisation rates.

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