Archived: Holly Bank Surgery

Updated 4 April 2018

Holly Bank Surgery is located in Fingerpost Park Health Centre, St Helens, Merseyside. The practice was providing a service to approximately 3,900 patients at the time of our inspection.

The practice is part of St Helens Clinical Commissioning Group (CCG) and is situated in an area with lower than average levels of deprivation when compared to other practices nationally. The practice has a higher than average elderly population with 34% of the population aged over 65 years of age. The percentage of the patient population who have a long standing health condition is higher than the national average at 62% (national average 53%).

The practice is run by one male GP. There is one practice nurse, a practice manager and a team of reception/administration staff. The surgery is open from 8am to 6.30pm Monday to Friday. When the surgery is closed patients are directed to the GP out of hours service provided by St Helens Rota.

Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services.

The practice has a General Medical Services (GMS) contract. The practice provides a range of enhanced services, for example: childhood vaccination and immunisations and checks for patients who have a learning disability.

Updated 4 April 2018

We carried out an announced comprehensive inspection at Holly Bank Surgery on 13 June 2017. The full comprehensive report on the June 2017 inspection can be found by selecting the ‘all reports’ link for Holly Bank Surgery on our website at www.cqc.org.uk.

At our previous inspection in June 2017 we rated the practice as ‘good’ overall but as ‘requires improvement’ for the key question of safety. This was because improvements were needed to demonstrate staff suitability for their roles and responsibilities. We made this judgment because we found there were gaps in employee records included identity checks and Disclosure and Barring service checks. We issued a requirement notice as this was a breach of regulation.

This announced inspection visit was carried out on 6 March 2018 to check that the provider had carried out their plan to meet the legal requirements in relation to the breach. This report covers our findings in relation to that and additional improvements made since our last inspection.

The findings of this inspection were that the provider had taken action to meet the requirement notice issued as all required checks and associated records had been obtained and were held on staff personnel records.

The key question of safety is now rated as good. Overall the practice continues to be rated as good.

Our key findings were as follows:

• All required information and employment checks were available for each person employed.

The provider had also made a number of improvements to the service in response to recommendations we made at our last inspection. These included:

• A review of the level of clinical staffing had been carried out and this had been increased.

• The system in place for identifying and acting upon significant events had been improved to ensure all events were captured appropriately.

• Information provided to patients about the complaints process had been reviewed and updated.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 21 July 2017

The practice is rated as good for the care of people with long-term conditions.

• The practice held information about the prevalence of specific long term conditions within its patient population. This included conditions such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. The information was used to target service provision, for example to ensure patients who required immunisations received these.

• Patients with several long term conditions were offered a single, longer appointment to avoid multiple visits to the surgery.

• Data from 2015 to 2016 showed that the practice was performing in comparison with other practices nationally for the care and treatment of people with chronic health conditions.

• Patients were provided with advice and guidance about prevention and management of their health and were signposted to support services.

Updated 21 July 2017

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and those who were at risk, for example, children and young people who had a high number of A&E attendances.

• There was a designated lead for child protection.

• Staff we spoke with had appropriate knowledge about child protection and they had ready access to safeguarding policies and procedures.

• Child health surveillance clinics were provided for 6-8 week olds.

• Immunisation rates were higher than national average for all standard childhood immunisations.

• Babies and young children were offered an appointment as a priority and appointments were available outside of school hours.

• The premises were suitable for children and babies and baby changing facilities were available.

• The percentage of women aged 25-64 whose notes recorded that a cervical screening test had been performed in the preceding five years was comparable to the national average.

Updated 21 July 2017

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care and treatment to meet the needs of the older people in its population.

• The practice kept up to date registers of patients with a range of health conditions (including conditions common in older people) and used this information to plan reviews of health care and to offer services such as vaccinations for flu.

• Nationally reported data showed that outcomes for patients for conditions commonly found in older people were similar to outcomes for patients locally and nationally.

• Regular GP visits were provided to a local nursing home to assess and review patients’ needs and to prevent unplanned hospital admissions.

• Home visits and urgent appointments were provided for patients with enhanced needs.

Updated 21 July 2017

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The practice was open from 8am to 6.30 pm Monday to Friday. Telephone consultations could be provided if requested by patients.

• A system of ‘on the day’ appointments was in place. This could present more difficulty for working patients. The provider told us they always tried to be flexible to accommodate working patients and patients could book appointments in advance on line.

• The practice provided a full range of health promotion and screening that reflected the needs of this age group.

• The practice was proactive in offering online services including requests appointments and for repeat prescriptions. Electronic prescribing was also provided.

Updated 21 July 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice held a register of patients experiencing poor mental health and these patients were offered an annual review of their physical and mental health.

• Data about how people with mental health needs were supported showed that outcomes for patients using this practice were comparable to local and national averages.

• Patients were referred to appropriate services such as psychiatry and counselling services.

• A system was in place to follow up patients who had attended accident and emergency and this included where people had been experiencing poor mental health.

• A system was in place to prompt patients for medicines reviews at intervals suitable to the medication they were prescribed.

• Patients experiencing poor mental health were informed about how to access various support groups and voluntary organisations.

• Staff had been provided with training in dementia awareness to support them in supporting patients with dementia care needs.

Updated 21 July 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances in order to provide the services patients required. For example, a register of people who had a learning disability was maintained to ensure patients were provided with an annual health check and to ensure longer appointments were provided for patients who required these.

• Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.

• The practice provided appropriate access and facilities for people who were disabled.

• Information and advice was available about how patients could access a range of support groups and voluntary organisations.