The Care Quality Commission
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  • GP practice

Archived: Elizabeth Street Surgery

Overall: Inadequate read more about inspection ratings

61 Elizabeth Street, Blackpool, Lancashire, FY1 3JG (01253) 628949

Provided and run by:
Elizabeth Street Surgery

Important: The provider of this service changed. See new profile

All Inspections

11 January 2019

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Elizabeth Street Surgery on 24 July 2018 in response to concerns and the practice was rated as inadequate overall (previous rating June 2016 – Good). We imposed conditions on the provision of services for breaches of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Safe care and Treatment) and issued a warning notice for breaches of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Good Governance). The full comprehensive report on the 24 July 2018 inspection can be found by selecting the ‘all reports’ link for Elizabeth Street Surgery on our website at .

This inspection was an unannounced focused inspection carried out on 11 January 2019 to confirm the practice had carried out their plan to meet the legal requirements in relation to the breaches identified within the warning notice.

At this inspection we found:

  • The practice had made improvements to systems and processes to ensure that safety incidents were less likely to happen. We saw when incidents did happen, the practice learned from them and improved their processes.
  • The practice ensured incoming correspondence to the practice was managed effectively. There were sufficient staff in place to ensure this was done in a timely way.
  • Staff had worked to ensure most of the backlog of new patient records had been summarised onto the practice computerised patient record system.
  • Practice policies and procedures had been reviewed and stored on the practice shared drive and staff knew how to access them.
  • Governance systems had been improved although management overview of some areas was lacking. Overview of staff training, immunisation status and clinical staff membership of professional bodies was not in place.
  • Outstanding risk assessments relating to premises and health and safety had been initiated although not completed.
  • Staff appraisals were still overdue although we saw there were plans for appraisals to start in January 2019.
  • We found evidence of improved recruitment processes for new staff and better documentation in staff files.
  • There was an improved meeting structure in place for staff and meetings with other services. Meetings were documented and evidenced shared learning.
  • We saw evidence of quality improvement work. New clinical audit and review processes were in place.

At our previous inspection on 24 July 2018, we rated the practice as inadequate and placed the service into special measures. As per our published inspection methodology, a further full comprehensive inspection visit will be carried out within three months of this inspection to monitor the work the practice has started to produce the required improvements to the service.

Details of our findings and the evidence supporting them are set out in the evidence tables.

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

24 July 2018

During a routine inspection

This practice is rated as inadequate overall. (Previous rating June 2016 – Good)

The key questions are rated as:

Are services safe? – Inadequate

Are services effective? – Requires improvement

Are services caring? – Good

Are services responsive? – Requires improvement

Are services well-led? - Inadequate

We carried out an announced comprehensive inspection at Elizabeth Street Surgery on 24 July 2018 in response to concerns.

At this inspection we found:

  • The practice systems to manage risk so that safety incidents were less likely to happen had not been followed. We saw little evidence to show when incidents had occurred, the practice learned from them and improved its processes. Some incidents had not been acknowledged or documented by the provider.
  • Practice systems and policies to safeguard vulnerable patients were not comprehensive.
  • Information coming into the practice was not managed safely.
  • There was evidence some patient consultation records were not sufficient to ensure patient safe care and treatment.
  • The management of staff training was not comprehensive.
  • Communication with staff, patients and other services was lacking; care plans were not routinely shared for vulnerable patients.
  • There was little evidence of quality improvement work by the practice to drive improvements in service.
  • Staff involved and treated patients with compassion, kindness, dignity and respect.
  • Patients did not always find the appointment system easy to use.
  • Some staff reported they did not feel supported or valued.

We saw one area of outstanding practice:

  • The practice had developed a software application for patients that enabled them to communicate using their phone to access online patient services and communicate the results of self-monitoring tests, for example, blood pressure readings. This had been shared with other practices and was in the process of being developed further to provide wider community use. We saw approximately 25% of practice patients were using this application to communicate with the practice.

The areas where the provider must make improvements as they are in breach of regulations are:

  • Ensure care and treatment is provided in a safe way to patients.
  • Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

The areas where the provider should make improvements are:

  • Continue with the implementation of electronic patient care planning.
  • Maintain an overview of staff training, membership of professional bodies and staff vaccination status including records of staff completion of required safeguarding training.
  • Continue engagement with the practice patient participation group.

I am placing this service in special measures. Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any population group, key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to remove this location or cancel the provider’s registration.

Special measures will give people who use the service the reassurance that the care they get should improve.

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

16 August 2018

During an inspection looking at part of the service

We carried out an announced comprehensive inspection at Elizabeth Street Surgery on 24 July 2018 in response to concerns and the practice was rated as Inadequate overall (previous rating June 2016 – Good). The full comprehensive report on the 24 July 2018 inspection can be found by selecting the ‘all reports’ link for Elizabeth Street Surgery on our website at www.cqc.org.uk. We carried out an unannounced focused visit on 16 August 2018 to ensure the practice had begun to make progress to address the serious concerns identified at our inspection in July and to ensure the regulatory action we proposed was proportionate.

At this inspection we found:

  • The lack of administrative staff in the practice had been addressed to enable the safe management of patient information coming into the practice. All outstanding information not previously seen by a GP or entered onto patient records had been assessed by the GP and dealt with appropriately.
  • The practice had introduced a new protocol for managing communications regarding patient care and treatment and all information had begun to be viewed by the GP.
  • The practice had carried out a peer review of patient consultation records for all clinicians and told us they planned further training.
  • The backlog of new patient records not summarised onto the computer had begun to be addressed.
  • At this visit, staff told us they had attended an awayday and had experienced an improvement in morale and felt more involved in the future of the practice. We saw a new programme of staff meetings had been initiated.

This service was rated Inadequate overall following our inspection on 24 July 2018 and was placed in special measures. This visit does not affect the ratings and the practice remains in special measures.

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

27 May 2016

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Elizabeth Street Surgery on 27 May 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 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.

We saw two areas of outstanding practice:

  • The practice had introduced an internal peer review and referral process. They used GP clinical specialties to good effect to reduce referrals to external services.
  • One of the practice GPs had developed a mobile smartphone application which allowed patients greater online access to the practice and provided communication facilities with the practice and patient health advice.

The areas where the provider should make improvement are:

  • Ensure emergency equipment and medicines can be accessed in a timely manner in the event of an emergency situation.
  • Review and update all practice clinical protocols.
  • Ensure that care plans are freely available to all clinicians and that they are updated as soon as possible following review.


Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

18 December 2013

During a routine inspection

We spoke individually with a registered manager, practice manager and two staff at Elizabeth Street Surgery. We also discussed treatment with two people who were currently using the service. We additionally reviewed policies and procedures, staff files and various audit records.

The service ensured that whilst people were receiving treatment, they were cared for in a supportive and respectful manner. One person told us, "I have no complaints, it’s a great surgery. The staff, the nurses and doctors are all lovely".

The practice worked hard to ensure patients were respected and involved in their treatment. Elizabeth Street also used several different methods to involve people in the running of the service. Along with a variety of quality audits, this meant the practice effectively monitored the quality of its service provision.

We found that Elizabeth Street had in place effective practices in relation to infection control. Staff demonstrated a good understanding of related principals. Furthermore, the service had a variety of recruitment policies and related procedures in place. All staff had undergone a range of checks prior to being employed. This meant that people using the service were protected from unsafe recruitment.