The Care Quality Commission
  • Doctor
  • GP practice

Archived: The Elms Surgery

Overall: Requires improvement read more about inspection ratings

16 Derby Street, Ormskirk, Lancashire, L39 2BY (01695) 588710

Provided and run by:
Dr Anbakan Krishnamurthy

Important: The provider of this service changed. See new profile
Important: This service was previously registered at a different address - see old profile

All Inspections

12 Feb 2019

During a routine inspection

We carried out an announced comprehensive inspection at The Elms Surgery on 12 February 2019 as part of our inspection programme.

At the last inspection completed in February 2016 we rated the practice as good overall.

Our judgement of the quality of care at this service is based 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.

The practice is rated as requires improvement overall.

We rated the practice as good for providing caring and responsive services.

We rated the practice as requires improvement for providing safe, effective and well-led services because:

  • People who used the service were generally protected from avoidable harm and abuse, however legal requirements in relation to recruitment of staff were sometimes not met.
  • The practice did not have safe and effective systems and processes to manage medicines and equipment.
  • Patient consent was not recorded appropriately.
  • There was a lack of audit and quality monitoring of systems.
  • Some staff felt unsupported and some clinical staff had not received an appraisal.

This means that:

  • Patient safety was not always assured, management of medicines and equipment were not always safe.
  • Patients generally had good outcomes because they received effective care and treatment that met their needs.
  • Patients were supported, treated with dignity and respect and were involved as partners in their care.
  • Patients’ needs were met by the way in which services were organised and delivered.
  • The leadership, governance and culture of the practice did not always promote the delivery of high quality person-centred care and staff were not always supported.

There were areas where the provider must make improvements:

  • 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 recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed

There were areas where the provider should make improvements:

  • Review internal building security and confidentiality arrangements at the reception desk.
  • Update the practice safety alerts records with any results of action taken.

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

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

11 February 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Elms Surgery, Ormskirk on 11 February 2016. Overall the practice is rated as good.

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

  • There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
  • Risks to patients were assessed and well managed.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.

  • Feedback from patients about their care was consistently and strongly positive. Patients described the GP practice as excellent; staff were described as caring and professional.

  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • The practice had a virtual patient participation group. We were told the practice acted on feedback and took action when comments and suggestions were made
  • Information about services and how to complain was available and easy to understand.
  • The practice had good facilities and was well equipped to treat patients and meet their needs.
  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they met patients’ 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.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

We saw an area of outstanding practice:

  • The practice had well established links with a local university, providing clinics on a weekly basis which in addition to access to a GP, included the provision for counselling and sexual health services. This was in response to reduced access across the local area.

The areas where the provider should make improvements are:

  • Ensure a more systematic approach to clinical audits with two cycle audits to demonstrate effective improvement in care and treatments.

  • Ensure that the patients specific directives for prescribing of vaccinations are signed off for individual patients by a GP.

  • Ensure that annual infection control audits of the practice are undertaken in order to identify and manage infection control and prevention risks.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice