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Inspection Summary


Overall summary & rating

Good

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

We inspected Walkden  Medical Centre on the 15 October 2014 as part of our new comprehensive inspection programme. This was the practice’s first inspection by CQC under its new methodology.  The practice was inspected under our previous methodology in September 2013 and was found to be fully compliant.

Our inspection team was led by a CQC Inspector and included a GP specialist advisor, a practice manager specialist advisor and a second CQC Inspector.  We have rated the practice as good.

Comments we received from patients were positive about the care and treatment they had received. Patients told us they are treated with dignity and respect and involved in making decisions about their treatment options.

Our key findings were as follows:

•   The practice was, safe, effective, caring, responsive and well led.

          Patients told us they were treated with dignity and respect and they were involved in care and  treatment decisions.

•             Staff understand their responsibilities to raise concerns, and report incidents.

•             The practice is clean and well maintained.

•             There are a range of qualified staff to meet patients’ needs and keep them safe.

•             Data showed us patient outcomes were at or above average for the locality. People’s needs are assessed and care is planned and delivered in line with current legislation.

•             The practice works with other health and social care providers to achieve the best outcomes for patients

  • The provider should  ensure that all staff receive supervision and an annual appraisal..
  • The provider should  develop ways of gathering patient feedback on their performance.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Inspection areas

Safe

Good

Updated 19 February 2015

The practice is rated as good for safe. The practice had a good track record for maintaining patient safety. Systems

were in place to provide oversight of safety of patients. Learning from incidents took place. Staff took action to safeguard patients.

Effective

Outstanding

Updated 19 February 2015

The practice is rated as good for effective. Data showed patient outcomes were at or above average for the locality. National Institute for Health and Care Excellence (NICE) guidance is referenced and used routinely. People’s needs are assessed and care is planned and delivered in line with current legislation including the promotion of good health. Patients needs were consistently met. Staff have received training and support appropriate to their roles.  Effective multidisciplinary working was evidenced across the whole practice.  There were strong working arrangements with community services that provided a range of targeted and personalised services for patients.

Caring

Good

Updated 19 February 2015

The practice is rated as good for caring. Patients said they were treated with compassion, dignity and respect and they were involved in care and treatment decisions. Accessible information was provided to help patients understand the care available to them. We saw that staff treated patients with kindness and respect at all times.

Responsive

Good

Updated 19 February 2015

The practice is rated as good for responsive. The practice reviewed the needs of their local population and engaged with the CCG to secure service improvements. Patients reported good access to the practice and a named doctor and continuity of care, with urgent appointments usually available the same day. The practice had good facilities and was equipped to treat patients and meet their needs. There was an accessible complaints system with evidence demonstrating that the practice responded to issues raised.

Well-led

Good

Updated 19 February 2015

The practice is rated as good for well-led.  The practice had a clear vision and strategy to deliver this. Staff were clear about the vision, their responsibilities in relation to this and felt supported by management.  The practice had a number of policies and procures to govern activity and governance meeting took place.  There were systems in place to monitor and improve quality and identify risk.  The practice proactively sought feedback from staff and patients and this had been acted upon.  The practice was trying to develop their patient participation group (PPG).  Staff had received inductions, regular performance reviews and attended staff meetings and events.

Checks on specific services

Older people

Good

Updated 19 February 2015

The practice was knowledgeable about the number and health needs of older patients using the service, which was the largest patient population group that the practice dealt with.

The practice actively reviewed the care and treatment needs of older people and ensured each patient had a named GP.

Medication reviews were completed with all patients.  The practice kept up to date registers of patients’ health conditions and carer’s information and used this information to plan services for patients.

Care was tailored to individual needs and circumstances.  

Unplanned admissions and readmissions to hospital for this patient group as was attendance at A&E departments.  Action was subsequently taken to reduce these trends.

People with long term conditions

Good

Updated 19 February 2015

Clinical staff had a good understanding of the care and treatment needs of people with long-term conditions. The practice monitored the needs of this patient group and promoted life style changes and improvements for the benefit of the patient.

Patients told us they attended for annual health care reviews or more frequently when required.

Patient recall systems ensured that patients attended for reviews of conditions, such as diabetes and respiratory issues.

Staff were skilled and regularly updated in specialist areas which helped them ensure best practice guidance was followed.

Care was tailored to individual patient’s needs and circumstances.  The provider aimed to meet patient choice and carer’s needs were considered.

Clinicians made referrals to specialists in an appropriate and timely way.

Families, children and young people

Good

Updated 19 February 2015

The practice provided services to meet the needs of this population group. There were comprehensive child health screening and vaccination programmes.  

Staff were knowledgeable about child protection and one of the registered partners was the lead for safeguarding. The practice monitored any non-attendance of babies and children at vaccination clinics and worked with the health visiting service to follow up any concerns.

All of the staff were very responsive to parents’ concerns and ensured that children were always seen and prioritised.

Practice nurses had in-depth knowledge illnesses that affected young people and adolescents and directed these patients appropriate healthcare resources.

Communication, information sharing and decision making with other agencies, particularly midwives, health visitors and school nurses were well-established. 

Generalist medical care was provided to patients during their pregnancy.

Working age people (including those recently retired and students)

Good

Updated 19 February 2015

The practice provided services to meet the needs of this population group.

The offered early morning surgeries and late evening surgeries each week to meet the needs of this patient group.

Patients who worked told us they appreciated the flexibility around the appointment system and this enabled them to avoid taking time off work to see a GP.

People whose circumstances may make them vulnerable

Good

Updated 19 February 2015

The practice provided services to meet the needs of this population group.

The practice kept a register of patient who had a learning disability and this ensured that this patient group had equal access to care and treatment including annual health care reviews.

The practice offered longer appointment times for patients with a learning disability. This allowed patients to be fully involved in making decisions about their health.

People experiencing poor mental health (including people with dementia)

Good

Updated 19 February 2015

The practice provided services to meet the needs of this population group.

The practice maintained a register of patients who experienced mental health problems. The practice supported patients to attend annual health checks and a medication reviews.

Clinical staff referred patients to counselling and talking therapy services when needed or identified as a need and as part of a treatment plan. 

The practice offered longer appointment times for patients who experienced mental ill or poor mental health. This allowed patients to be fully involved in making decisions about their health.