The Care Quality Commission
  • Doctor
  • GP practice

Archived: Walkden Gateway

Overall: Requires improvement read more about inspection ratings

2 Smith street,Walkden, Manchester, M28 3EZ (0161) 211 7175

Provided and run by:
Lever Chambers 2

All Inspections

26/11/2019

During an inspection looking at part of the service

We carried out a focused inspection at Walkden Gateway on 26 November 2019. The announced inspection was following our annual regulatory review with the practice which had identified changes in the practice and triggered this inspection. We inspected the key question areas of effective and well led. During the inspection we identified concerns which led us to inspect the key question of safe. We utilised information from our previous inspection findings for the key question areas of caring and responsive. 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 practice as requires improvement for providing safe services because:

  • The practice did not have clear systems and processes to keep patients safe.
  • A staff member had acted as a chaperone without training, risk assessment or DBS in place.
  • Patient safety and medicine alerts were not regularly being reviewed and acted on.
  • Not all staff members were aware of the location of the defibrillator and the emergency medicines were not being physically checked.
  • Recruitment checks for a locum GP had not been carried out in accordance with regulations.

We rated the practice as requires improvement for providing effective services because:

  • There was limited monitoring of the outcomes of care and treatment.
  • The practice was unable to demonstrate that staff had completed training relevant to their role.
  • A member of staff had not had an appraisal since 2017.

We rated the practice as inadequate for providing well-led services because:

  • Leaders could not show that they had the capacity and skills to deliver high quality, sustainable care.
  • While the practice had a clear vision, that vision was not supported by a credible strategy.
  • The overall governance arrangements were ineffective.
  • The practice did not have clear and effective processes for managing risks, issues and performance.
  • We saw little evidence of systems and processes for learning, continuous improvement and innovation.

These areas affected all population groups so we rated all population groups as requires improvement.

The areas where the provider must make improvements are:

  • Ensure that care and treatment is provided in a safe way.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

(Please see the specific details on action required at the end of this report).

The areas where the provider should make improvements are:

  • Review the storage location of clinical samples.

9 May 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

This was a focused inspection of Walkden Gateway in one area within the key question safe. The evidence was reviewed at Walkden Gateway.

At this inspection we found the practice had made all required improvements. Overall, the practice is rated as good.

The practice was previously inspected on 10 May 2016. The inspection was a comprehensive inspection under the Health and Social Care Act 2008. At that inspection, the practice was rated good overall but required improvement for providing safe services.

Our key findings at this most recent inspection were as follows:

  • At the inspection on 9 May 2017 we spoke with staff members and reviewed a range of documents that demonstrated all of the required improvements had been made.
  • The practice had employed an extra staff member to work in reception and the practice had also increased the number of hours the nurse worked.
  • The practice now had up to date policies in place that were regularly reviewed.
  • The practice had a health and safety risk assessment in place and six monthly health and safety checks were performed.
  • We saw evidence that patient group directions (PGDs) were correctly signed.
  • The practice now had a prescription log in place to keep track of all prescriptions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

10 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Walkden Gateway on 10 May 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.
  • Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
  • Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
  • Some patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
  • Some patients told us that they were unable to discuss more than one issue during an appointment.
  • 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 provider was aware of and complied with the requirements of the duty of candour.
  • The practice had a number of policies and procedures to govern activity, but some were overdue a review.
  • There was not enough staff to keep patients safe, specifically relating to the number of nursing and non-clinical staff.

The areas where the provider must make improvement are:

  • Ensure there are enough administration and nursing staff working within the practice to meet the demands of the patients.

  • Ensure there is an effective system for monitoring the usage of pre-printed prescriptions and prescription pads.

The areas where the provider should make improvement are:

  • Ensure the practice has performed a Legionella and a health and safety risk assessment.

  • Review the practice policies and ensure they are up to date.

  • Ensure PCs are kept locked when left unattended.

  • Review the location of storing blood samples to be sent off for testing.

  • Review all patient group directions and ensure they are all correctly signed and valid.

  • Review the practice policy of only one issue to be discussed per appointment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice