The Care Quality Commission
  • Doctor
  • GP practice

Tower House Practice

Overall: Good read more about inspection ratings

St Paul's Health Centre, High Street, Runcorn, Cheshire, WA7 1AB (01928) 567404

Provided and run by:
Tower House Practice

All Inspections

During an assessment under our new approach

Date of Assessment: 06 July 2026. Tower House Practice is a GP practice and delivers services to approximately 12,643 people under a contract held with NHS England. According to the latest available data, the ethnic make-up of the service area is approximately 96.6% White, 1.0% Asian, 1.3% Mixed, 0.5% Black and 0.6% Other. Information published by the Office for Health Improvement and Disparities shows deprivation within the service population group is in the 3rd decile (3 of 10). The lower the decile, the more deprived the service population is relative to others.

This was a focused assessment. We undertook this assessment due to the length of time since our last assessment. We assessed 10 quality statements from across all 5 key questions. This assessment considered the demographics of the people using the service, the context the service was working within and how this impacted service delivery. Where relevant, further commentary is provided in the quality statements section of this report.

The provider ensured the premises were kept clean and managed the risk of infection. The premises were appropriately maintained overall. However, some improvements were needed to how legionella risks were assessed.

Staffing levels and staff skill mix were monitored to ensure they met the needs of the service. Staff told us they received effective support, supervision and training and they worked together well to care for patients.

Staff supported people to live healthier lives, monitoring their care and treatment to ensure they received positive and consistent outcomes.

Staff treated people with kindness, empathy and compassion, and respected their privacy and dignity.

People could access care, treatment and support when they needed it. Leaders and staff were alert to discrimination and inequality that could disadvantage groups of people who used the service and sought ways to address any barriers.

The service had a vision and strategy, which considered the needs of the people who used the service and the wider community. Staff understood their individual roles and responsibilities.

30 October 2018

During a routine inspection

This practice is rated as Good overall. (Previous rating April 2017 – Good)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Tower House Practice on 30 October 2018. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

  • The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved processes.
  • The practice routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
  • There was a comprehensive system of meetings for staff at all levels. Governance of all areas of service delivery was embedded into practice.
  • There was a clear management structure in place and staff had lead roles in all areas of practice service provision.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients found the appointment system easy to use and reported that they were able to access care when they needed it. The practice took every opportunity to listen to patient views and concerns.
  • There was a strong focus on continuous learning and improvement at all levels of the organisation. The practice participated in the training of new GPs and was a teaching practice for medical students.

We saw an area of outstanding practice:

  • The practice was proactive in taking every opportunity to work with patients, staff and external partners to shape and improve patient services. It had begun work with other local practices to standardise best practice across the local area and led on areas of this work. We saw examples of innovation in services such as the in-practice dermatology service which was to be adopted in the community by the clinical commissioning group. The practice also offered a sponsorship scheme for non-EU workers locally, allowing GPs to remain in the country who would otherwise have left.

The areas where the provider should make improvements are:

  • Improve the protocol for the management of communications coming into the practice and introduce a GP audit of the process.
  • Take steps to record action taken in response to patient safety medicines alerts in individual patient health records.
  • Introduce a formal annual review of significant incidents in the practice.
  • Review registers of those patients excluded from some areas of long-term condition monitoring.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

3 April 2017

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Tower House Practice on the 16 December 2015. The overall rating for the practice was good although the domain for safe required improvement. The full comprehensive report on the inspection can be found by selecting the ‘all reports’ link for Tower House Practice on our website at www.cqc.org.uk.

This inspection was a focused review carried out on 3 April 2017 to confirm that the practice had carried out their plan to improve areas identified in our previous inspection on 16 December 2015. This report covers our findings in relation to those improvements made since our last inspection.

Our key findings were as follows:

  • The practice had addressed the issues identified during the previous inspection.

  • Clinical staff now manage the clinic for patients who require monitoring of anticoagulants (medicines that prevent the blood from clotting.)

  • Mercury spillage kits have been supplied and are accessible to the practice.

  • Staff ensure that treatment room doors are closed when any care and treatment is provided to ensure patient’s privacy is maintained.

Letter from the Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

16 December 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of Tower House Practice on 16 December 2015. 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. However we found instances were a HCA was acting outside the protocol for management and monitoring of warfarin patients which could compromise the safety of patients within this group.

  • The practice used proactive methods to improve patient outcomes, for example, by having community practitioners such as the local Wellbeing Officer and the Social Care in Practice (SCIP) worker at practice meetings. These community workers shared information with clinicians, for example on patients they felt were more vulnerable due to domestic circumstances.

  • 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.
  • The practice did not have a spill kit available to deal with any spillage from a mercury gauge blood pressure monitor in one of the consulting rooms at the practice.
  • 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.
  • Patients said they found it easy to make an appointment with a named GP and that there was continuity of care, with urgent appointments available the same day.
  • 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.

There were areas where the provider must make improvements. The provider must:

  • Ensure that non-clinical staff checking INR testing results do not alter dosing for patients.

  • Ensure a mercury spill kit is available in rooms where blood pressure monitors that use a mercury gauge are used.

There were areas where the provider should make improvements. The provider should:

  • Ensure treatment of patients in the ground floor health care assistants room is carried out with the door closed to ensure patient privacy at all times.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice