• Doctor
  • GP practice

Adlington Medical Centre

Overall: Good read more about inspection ratings

22-24 Babylon Lane, Anderton, Chorley, Lancashire, PR6 9NW (01772) 376600

Provided and run by:
Dr Nimalendran Muttucumaru

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

All Inspections

28 July 2022

During a routine inspection

We carried out an announced inspection at Adlington Medical Centre on 28 and 29 July 2022. Overall, the practice is rated as Good.

For each key question we rated the following;

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection in December 2021, the practice was rated requires improvement overall, was rated inadequate for safe and requires improvement for the effective, responsive and well-led key questions. Improvements had been implemented since then and at this inspection no breaches of regulations were found, therefore the rating moved to good overall.

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

Why we carried out this inspection

This inspection was a comprehensive inspection to follow up on concerns and breaches of regulation identified during the previous inspection.

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 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
  • Requesting documents and information from the provider.
  • The completion of feedback forms by staff.

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 addressed all the issues identified in the previous inspection. They had put in place systems and processes around safety and governance.
  • The clinical records reviews we conducted on this inspection showed an improvement and patients on high risk drugs and those with long term conditions received the correct monitoring.
  • Recruitment checks were undertaken in line with regulations and appropriate evidence recorded and stored.
  • Infection prevention and control audits were in place with appropriate actions taken and evidenced as completed.
  • There were cleaning schedules in place and there was oversight of the cleaning contract. Environmental walkarounds were conducted and recorded.
  • The incident reporting process was improved to clarify the actions taken to ensure risk was reduced and learning was achieved.
  • Clinical supervision and quality monitoring was in place for clinical staff including non-medical prescribers and locum staff.
  • 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 adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. While patient feedback in the national patient survey indicated ongoing dissatisfaction around access, we saw the practice had worked hard to implement measures to improve this, and we saw evidence patients could access care and treatment in a timely way.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

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

  • Continue the improvement work leading from the DNACPR audit of records to ensure that where patients lack capacity the patients’ records have evidence of mental capacity assessments and best interest decisions.
  • Continue to work on the initiatives to improve patient satisfaction as identified from the NHS patient survey and continue to monitor satisfaction through surveys.
  • Continue the improvement initiatives from the outcomes of clinical search audits to ensure monitoring of high risk medicines and long term conditions are managed well.
  • Improve processes for security of paper for electronic prescriptions is undertaken correctly.
  • Improve that sharps boxes are completed fully upon assembly.

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 Hospitals and Interim Chief Inspector of Primary Medical Services

07 December 2021

During a routine inspection

We carried out an announced inspection at Adlington Medical Centre on 3 and 7 December 2021. Overall, the practice is rated as requires improvement.

The ratings for the key questions are as follows:

Safe - Inadequate

Effective – Requires Improvement

Caring - Good

Responsive - Requires Improvement

Well-led – Requires Improvement

Following our previous inspection on 6 December 2016, 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 Adlington Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection;

This inspection was a fully comprehensive inspection due to concerns that were raised to us about this provider.

How we carried out the inspection/review

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 staff interviews using video conferencing and face to face
  • 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 short site visit
  • Interview outside professionals such as care home managers

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 found that:

  • There were a significant number of issues relating to safety including gaps in relation to medicines management. For example, we confirmed all 22 of the patients whose records we reviewed had not had appropriate monitoring for their medicines or conditions.
  • There were concerns with recruitment systems that were in place including where conduct of staff had not been checked from a previous employer, contracts unsigned and DBS checks missing. We found that risk management was not always effective. For example, infection control audits that were in place were not working as intended.
  • Systems to govern staffing were not working effectively and performance assurance systems were not working as intended. We saw that the practice had exceeded targets on childhood immunisations but had not yet reached cervical screening targets, given the pressure the sector had been under.
  • 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 during the COVID-19 pandemic. Patients felt that they could not always access care and treatment in a timely way. The practice had taken action to address this including self-funding a new telephony system; but as this was newly established, they were unable to demonstrate that it had yet been successful.
  • There was a disconnect between practice leaders’ expectations of day to day operations and the reality of these. We saw that oversight was lacking and silo working in and between teams, leading to gaps.

We saw an area of outstanding practice;

  • The provider had set up a Covid-19 Vaccine centre at jubilee House in Preston. They had created a new and separate staff team and had vaccinated 103,000 patients in the last 12 months. NHS Choices feedback for this centre was positive, with 110 comments praising the staff and the systems governing the centre.

We found 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 specified information is available regarding each person employed.

The care quality commission are following its enforcement policy in dealing with the risks identified at this location.

The provider should:

  • Seek to determine if measures established to address low patient satisfaction were successful.

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

06/12/2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at the practice of Adlington Medical Centre on 6 December 2016. Overall the practice is rated as good.

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

  • Staff understood and fulfilled their responsibilities to raise concerns and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
  • Risks to patients were assessed and well managed, including those relating to recruitment checks.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • Data showed patient outcomes were comparable to those locally and nationally.
  • Feedback from patients about their care was strongly positive,
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a result of feedback from patients.
  • Information about services and how to complain was available and easy to understand.
  • Patient’s views were positive when asked how easy it was to make an appointment including availability of same day appointments.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • 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.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice