Archived: Lever Chambers 2

Updated 30 May 2022

Lever Chambers 2 is located in Bolton at:

Lever Chambers Centre For Health

Ashburner Street

Bolton

BL1 1SQ

The practice has a branch surgery at:

Great Lever Health Centre

Rupert Street

Great Lever

Bolton

BL3 6RN

Both sites were visited during the inspection.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury. These are delivered from both sites.

The practice offers services from both a main practice and a branch surgery. Patients can access services at either surgery.

The practice is situated within the Bolton Clinical Commissioning Group (CCG) and delivers Personal Medical Services (PMS) to a patient population of about 3779. This is part of a contract held with NHS England.

The practice is part of a wider group of 13 GP practices called Bolton Central Primary Care Network (PCN). PCNs work together with community, mental health, social care, pharmacy, hospital and voluntary services in their local area.

Information published by Public Health England shows that deprivation within the practice population group is in the lowest decile (one of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the practice area is 57% Asian, 21% White, 15% Black, 4% Mixed, and 3% Other.

The age distribution of the practice population closely mirrors the local and national averages. There are slightly more male patients registered at the practice compared to females.

There is a team of two GPs, the lead GP plus one long term locum who provide cover at both practices. The GPs are currently supported by three locum GPs, two part time locum nurses who provide nurse led clinics for long-term conditions at the branch location. The clinical team are supported at the practice by a team of 5 reception/administration staff. The practice manager is part time and is based at the branch site.

Due to the enhanced infection prevention and control measures put in place since the pandemic and in line with the national guidance, most GP appointments were telephone consultations. If the GP needs to see a patient face-to-face then the patient is offered a choice of either the main GP location or the branch surgery.

We were told that extended hours access is not offered by the practice. Out of hours services are provided by NHS111.

Updated 30 May 2022

We carried out an announced inspection at Lever Chambers 2 on 7 April 2022. Overall, the practice is rated as inadequate.

Set out the ratings for each key question

Safe - inadequate

Effective - inadequate

Caring – good

Responsive - good

Well-led - inadequate

Why we carried out this inspection

This inspection was a comprehensive inspection which included a site visit. The inspection was carried out following changes to the practice registration in September 2021 whereby they registered this location as an individual provider, previously a partnership.

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:

• Obtaining staff feedback using questionnaires sent electronically, by telephone and face to face interviews where requested.
• 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 both the main site and the 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.
• information from the provider, patients, the public and other organisations.
• Findings from the clinical searches on the patient records system.

We have rated this practice as Inadequate overall

We found that:

• Staff dealt with patients with kindness and respect.
• Patients could access care and treatment in a timely way.

We found four breaches of regulations. The provider must:

• Ensure care and treatment is provided in a safe way to patients
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care
• Ensure sufficient numbers of suitably qualified, competent, skilled and experienced persons are deployed to meet the fundamental standards of care and treatment
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

I am placing this service in special measures. The Care Quality Commission will refer to and follow its enforcement policy in dealing with the risks identified at the inspection.

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