The Care Quality Commission
  • Doctor
  • GP practice

Library House Surgery

Overall: Good read more about inspection ratings

Avondale Road, Chorley, Lancashire, PR7 2AD (01257) 514030

Provided and run by:
Library House Surgery

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Library House Surgery on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about Library House Surgery, you can give feedback on this service.

02 December 2022

During a routine inspection

We carried out an announced inspection at Library House Surgery on 2 December 2022. Overall, the practice is rated as Good.

We inspected;

Safe -Good

Effective -Good

Caring – Good (not inspected, rating of good carried forward from previous inspection).

Responsive – Good (not inspected, rating of good carried forward from previous inspection).

Well-led -Good

Following our previous inspection on 21 January 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 Library House Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities.

We inspected against the three key questions of safe, effective and well-led. We also looked at access to services within the responsive key question but did not rate this. The ratings from the previous inspection on 21 January 2016 were carried over for the key questions of caring and responsive.

How we carried out the inspection/review

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

  • Conducting staff interviews using video conferencing facilities as well as face to face
  • Requesting written feedback from staff and patients
  • 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

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 found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • Patients received effective care and treatment that met their needs.
  • 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:

  • Improve documentation and recording around Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) orders. In particular when mental capacity and best interest decisions are involved. A review process should also be considered.
  • Continue implementing the recovery plan in relation to medicines that require monitoring.
  • Formalise supervision and oversight of non-medical practitioners in advanced roles.
  • Continue with plans to introduce a clinical nurse manager to provide supervision and oversight of the nursing team. Continue with the appraisal catch up programme.
  • Continue with the housekeeping being undertaking around recruitment files and records.
  • Aim to improve uptake of cervical screening.

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

21 January 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection on 21 January 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.
  • 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.
  • 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.
  • The provider was aware of and complied with the requirements of the Duty of Candour.

Areas of outstanding practice:

  • The care was delivered from a family perspective with a dynamic team.
  • The practice was working with other local practices and the community nursing team to actively support and mange people living in care and nursing homes to avoid unplanned admissions into hospital.
  • The practice was working seven days a week to ensure continuity of care for its patients.
  • There was a good supportive environment for staff with a positive atmosphere.
  • Deep vein thrombosis (DVT) clinics conducted at the practice for all referred patients (including patients registered with other practices). This service provided local clinics within a quick timescale and reduced the number of admissions into the local hospital.
  • Good use of a locum induction pack that contained a comprehensive list of information and checks that were performed before any locum was used.
  • Each GP and senior member of staff had defined clinical responsibilities in different areas such as safeguarding, elderly care and information governance.

The areas where the provider should make improvements are:

  • Audit the prescription paper and pads to ensure the stock is accounted for.
  • Consider the seating in the reception area for people with mobility issues.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice