Lawton House Surgery

Updated 20 March 2017

Lawton House Surgery is located in Congleton in East Cheshire. The practice is registered with CQC to provide primary care services. The practice treats patients of all ages and provides a range of medical services. The staff team includes six GP partners, three practice nurses, a practice manager, an assistant practice manager, a reception manager, reception and administrative staff.

The practice is open Monday to Friday from 8am to 6.30pm. Patients can book appointments in person, online or via the telephone. The practice provides telephone consultations, pre bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of medical services. The practice closes one afternoon per month for staff training. When the practice is closed patients access Eastern Cheshire Out of Hours Service.

The practice is part of Eastern Cheshire Clinical Commissioning Group (CCG). It is responsible for providing primary care services to approximately 10146 patients. The practice has a higher than average population of patients 65 years of age and older and a higher than average patient population who are in a nursing home. The practice is situated in an area with low economic deprivation. The practice has a General Medical Services (GMS) contract.

Updated 20 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Lawton House Surgery, formerly known as 'Dr Dutton and Partners' on 4 December 2014. The full comprehensive report on the December 2014 inspection can be found by selecting the ‘all reports’ link for Lawton House Surgery on our website at www.cqc.org.uk.

At our previous inspection on 4 December 2014 we rated the practice as ‘good’ overall but as ‘requires improvement’ for safety as we identified two breaches of regulation. This was because improvements were needed to the recruitment of staff as the recruitment records did not demonstrate that all necessary checks were undertaken to demonstrate staff suitability for their roles. Improvements were also needed to the fire safety systems at the premises because fire safety equipment was not properly maintained and suitable for its purpose.

This inspection was a desk-based review carried out on 10 February 2017 to confirm that the provider had carried out their plan to meet the legal requirements in relation to the breaches. This report covers our findings in relation to that and additional improvements made since our last inspection.

The findings of this inspection were that the provider had taken action to meet the requirements of the last inspection and the service is now rated as good for providing safe services. Our key findings were as follows:

• Patients were protected against the risks associated with unsuitable staffing because the provider had a system in place to ensure that all required pre-employment checks were obtained.

• Patients were protected against the risks associated with unsafe equipment because fire safety equipment was in place and maintained.

We also found that the provider had made a number of improvements where we had identified these. These included;

• Increased accountability in relation to stock control and storage of prescriptions pads.

• A more robust system for checking and recording that emergency medication and equipment are suitable for use.

• A review of the policies and procedures available for staff to ensure they have access to the information they require.

• The provision of a complaints policy and procedure for patients to refer to.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 March 2015

The practice is rated as good for the population group of people with long term conditions. The practice held information about the prevalence of specific long term conditions within its patient population such as diabetes, chronic obstructive pulmonary disease (COPD), cardio vascular disease and hypertension. This information was reflected in the services provided, for example, reviews of conditions and treatment, screening programmes and vaccination programmes. The practice had a system in place to make sure no patient missed their regular reviews for long term conditions and to follow up unplanned hospital admissions in a timely manner. The practice had a high prevalence of patients with diabetes and the registered manager told us about their proactive response to diabetes management. An audit of patients with pre-diabetes had been undertaken that looked at their risk of other conditions such as heart disease. The audit suggested that the practice were treating a very high percentage of these for cardiovascular risks and action had been taken to provide health advice and ensure continued monitoring with a view to reducing the risk of harm to patients in the future. Clinical staff kept up to update in specialist areas which helped them ensure best practice guidance was always being considered. The practice had identified all patients at risk of unplanned hospital admissions and a care plan had been developed to support them.

Updated 19 March 2015

The practice is rated as good for the population group of families, children and young people. Child health surveillance and immunisation clinics were run on a weekly basis. The practice monitored any non-attendance of babies and children at these clinics and worked with the health visiting service to follow up any concerns. Staff were knowledgeable about child protection and a GP took the lead for safeguarding. Staff put alerts onto patients’ electronic records when safeguarding concerns were raised. All young people under 16 were offered an appointment on the day.

Updated 19 March 2015

The practice is rated as good for the care of older people. The practice was knowledgeable about the number and health needs of older patients using the service. They kept up to date registers of patients’ health conditions and information was held to alert staff if a patient was housebound. The practice had a record of carers and used this information to discuss any support needed and to refer carers on to other services if necessary. The practice ensured each person who was over the age of 75 had a named GP. The practice worked with other agencies and health providers to provide support and access specialist help when needed. The practice had identified all patients at risk of unplanned hospital admissions and a care plan had been developed to support them. The practice had a higher than average population of patients 65 years of age and older and a higher than average patient population who were in a nursing home. The practice had responded to this identified need by providing a GP who had two dedicated sessions per week to carry out visits to patients in nursing homes. This provided continuity of care for these patients and meant that reviews of care needs were regularly undertaken and that more immediate patient care needs were met.

Updated 19 March 2015

The practice is rated as good for the population group of working-age people (including those recently retired and students). Patients were able to book appointments in person, on-line or by telephone. The practice was open Monday to Friday from 8.00am until 18.30pm. Patients were able to book on the day for medically urgent appointments, routine appointments could be booked up to 6 weeks in advance, telephone consultations were available and home visits were offered to patients whose condition meant they were unable to visit the practice. Staff told us they would accommodate patients who were working to have early or late appointments wherever possible. Appointments could be booked and repeat prescriptions ordered on line. The practice monitored patient satisfaction with access to the service through patient feedback. Patient feedback indicated patients were satisfied with the range of appointments available.

Updated 19 March 2015

The practice is rated as good for the population group of people experiencing poor mental health (including people with dementia). GPs worked with other services to review care, implement new care pathways and share care with specialist teams. The practice maintained a register of patients who experienced poor mental health. The register supported clinical staff to offer patients an annual appointment for a health check and a medication review. The practice referred adult and child patients to appropriate services such as psychiatry and counselling services when they were needed. The practice liaised with schools when children or young people were absent due to experiencing poor mental health which provided support to both the young person and parent. The practice had information for patients in the waiting areas and online to signpost them to other services available. For example, mental health support groups, Samaritans and bereavement support services.

Updated 19 March 2015

The practice is rated as good for the population group of people whose circumstances may make them vulnerable. The practice was aware of patients in vulnerable circumstances and ensured they had appropriate access to health care to meet their needs. For example, a register was maintained of patients with a learning disability and annual health care reviews were provided to these patients. Longer appointments were offered to patients with learning disabilities to ensure their needs were adequately assessed. Home visits were made to some patients with a physical and/or disability to carry out health care assessments where this was assessed as being in the patients best interests. A clinic to support patients who were withdrawing from illegal substance misuse was held every six weeks. Staff were knowledgeable about safeguarding vulnerable adults. They had access to the practice’s policy and procedures and had received training in this.