The Care Quality Commission
  • Doctor
  • GP practice

Fig Tree Medical Practice

Overall: Good read more about inspection ratings

Farnworth Health Centre 1, Frederick Street, Farnworth, Bolton, Lancashire, BL4 9AH (01204) 795170

Provided and run by:
Fig Tree Medical Practice

All Inspections

During an assessment under our new approach

Fig Tree Medical Practice Centre is a GP practice and delivers services to 4,859 people under a contract held with NHS England. The National General Practice Profiles states that the ethnic make-up of the service area is 80.9% White, 12.2% Asian, 2.1% Mixed, 3.5% Black and 1.3% Other. Information published by the Office for Health Improvement and Disparities shows deprivation within the service population group is in the 1st decile (1 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.


Staff kept facilities clean and maintained equipment appropriately to ensure people were kept safe. They assessed and managed the risk of infection well and took steps to control the risk of it spreading. There were enough staff with the right skills, qualifications and experience.


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 clear vision and strategy, which considered the needs of the people who used their service and the wider community. Staff understood their individual roles and responsibilities. Leaders accounted for the actions, behaviours and performance of staff through clear and effective governance processes.
 

21 September 2017

During an inspection looking at part of the service

Letter from the Chief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Farnworth Health Centre on 20 March 2017. The overall rating for the practice was good however there were improvements required in the key question safe. The full comprehensive report on the 20 March 2017 inspection can be found by selecting the ‘all reports’ link for Farnworth Health Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 21 September 2017 to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspections. This report covers our findings in relation to those requirements and also additional improvements made since our last inspection.

Overall the practice is rated as good and the practice is now rated as good for being ‘safe’.

Our key findings at this inspection were as follows:

  • We reviewed a range of documents which demonstrated they were now meeting the requirements of Regulation 12 Health & Social Care Act 2008 (Regulated Activities) Regulations 2014: Safe Care and Treatment.
  • The practice had ensured that Patient Group Directions were implemented correctly.
  • The practice had ensured that risk assessments to the health and safety of service users were now in place.


Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

20 march 2017

During a routine inspection

Letter from the Chief Inspector of General Practice

We previously carried out an announced comprehensive inspection at Dr Agarwal and Partners on 28 October 2015. The overall rating for the practice was requires improvement. The full comprehensive report on the 28 October 2016 can be found by selecting the ‘all reports’ link for Dr Agarwal and Partners on our website at www.cqc.org.uk.

This inspection was undertaken as a follow up inspection and was an announced comprehensive inspection on 20 March 2017. Overall the practice is now 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 not always assessed as the practice did not have a health and safety risk assessment.
  • Patient Group Directions (PGDs) were not correctly implemented for nurses administering vaccines.
  • 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.
  • 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.
  • 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.

The areas where the provider must make improvement are:

  • The service must assess the risk to the health and safety of service users
  • Medicines must be administered in accordance with prescriber instructions

The areas where the provider should make improvement are:

  • Review the storage of prescriptions left in printers overnight

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

28th October 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Agarwal and Partners on 28 October 2015. Overall the practice is rated as Requires Improvement.

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

  • Understanding about how to raise concerns, and to report incidents and near misses was inconsistent among the staff. Information about safety was recorded, monitored, reviewed and addressed but this was done in an informal way between clinical staff.
  • Staff were able to give examples of incidents and actions taken to make change, but they were unable to evidence that the changes were effective or ongoing.
  • Risks to patients were not always assessed and well managed, specifically in relation to patients’ medical records, emergency medicines, equipment and recruitment and staffing.
  • Clinical audits had been carried out with evidence that audits were driving some improvement but patient outcomes remained lower than average for the locality.
  • Information about services and how to complain was available to patients, but not all complaints were addressed in line with recognised guidance and contractual obligations for GPs in England.
  • The majority of patients said they were treated with compassion, dignity and respect.
  • Patients’ needs were assessed and care was planned and delivered following best practice guidance.
  • Most staff had received appropriate training, relevant to their roles with the exception of clinical staff.
  • Most patients reported that they were able to get an appointment of their choice; urgent appointments were available; and staff were flexible and accommodating.
  • The practice did not have an active patient participation group (PPG) but they had made serious attempts to facilitate this and were now trying to organise a virtual group which they proposed to facilitate through email communication. It was too early to say whether or not this was successful.

The areas where the provider must make improvements are:

  • All members of clinical and non-clinical staff must understand what constitutes an event of significance to be recorded and reported.

  • Safety incidents and complaints must be thoroughly investigated with any actions, learning and outcomes documented and reviewed. People affected must receive reasonable support and a verbal and written apology.

  • All clinical and administration staff must have the appropriate training, understanding and knowledge required to carry out their roles effectively, specifically Safeguarding children and adults, information governance and Mental Capacity Act 2005

  • Potential risks must be assessed and managed appropriately, specifically in relation to medical records, emergency medicines, equipment, recruitment and staffing.

  • Oxygen must be available on the premises in the event of a medical emergency.

In addition the provider should:

  • Encourage medical staff to become computer effective so that they can code patient records appropriately and identify, quantify and understand data in order to benchmark their practice on a regular basis and ensure that outcomes are being achieved.

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Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

15 August 2013

During a routine inspection

We found the practice was clean with ample seating for patients. The practice was situated within a Health centre offering other services including a pharmacy.

We spoke with Six patients on the day. They spoke positively about the practice and commented that they were happy with the care they received.

The practice provided patients with information about the services available through leaflets available throughout the practice.

The practice had electronic and paper patient records in place to record the contact patients had with the service.

We found staff had access to contact details for both child protection and adult safeguarding teams. They were able to describe the appropriate actions to take if they had any safeguarding concerns.

The practice had up to date Infection Prevention Control policies and information available to both staff and patients within the practice.

The practice had a range of policies and procedures in place which supported the safe running of the service.

The practice notice boards provided patents with information about how to raise a concern or complaint.

Patients told us; 'I am happy with my care and know about my asthma and my mum knows too'. 'I am very happy with the appointments process; I am rarely delayed more than a day getting an appointment. The reception staff are good and friendly. There are good nurses and doctors'. 'I just feel the reception staff could inform everyone when the surgeries are running late just to keep you informed and stop people getting annoyed'.