Lostock Hall Medical Centre

Updated 9 May 2022

Lostock Hall Medical Centre is situated in the Lostock Hall area of Preston. It is sited in a three-storey, recently refurbished Victorian building at Dardsley House, Brownedge Rd, Lostock Hall, Preston PR5 5AD. The practice provides level access for patients to the building and has disabled facilities available. There is on-site car parking for patients and good access to public transport.

The provider is registered with CQC to deliver the regulated activities; diagnostic and screening procedures, maternity and midwifery services, family planning, surgical procedures and treatment of disease, disorder or injury.

The GP provider is female and is assisted by a clinical team consisting of two female locum GPs, an advanced nurse practitioner, a practice nurse and two healthcare assistants. A practice manager, and a team of administrative and reception staff support the practice.

The practice is part of the Greater Preston Clinical Commissioning Group (CCG) and services are provided under a General Medical Services Contract (GMS). The provider is also part of the Ribble Medical Group primary care network (PCN) with six other local practices. They have access to the services of a social prescriber and a clinical pharmacist through their membership of the PCN.

The practice provides services to approximately 5300 patients. According to the latest available data, the ethnic make-up of the practice area is 96.6% White with 1.6% Asian and the remainder classified as other.

There are the slightly fewer patients registered at the practice aged 18 years and under, with 17.9% when compared with local 20.8% and national 20.2% averages. Similarly, there are more patients aged 65 years and over is slightly higher at 17.9% when compared with local 15.9% and national 17.4% averages.

Information published by Public Health England rates the level of deprivation within the practice population group as seven on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. The practice proportion of patients experiencing a long-standing health condition is, 54.1%, slightly higher than the local and national averages at 52% and 51.1% respectively.

The practice tried to offer patient a choice in the type of appointments and this included face to face appointments.

The practice is open Monday to Friday from 8am until 6.30pm with extended opening hours until 8pm on Tuesday evenings. The practice also opens two Saturday morning per month. Three extended access appointments are available each week at the local Out of Hours service. When the practice is closed, patients are able to access out of hours services by telephoning NHS111.

Updated 9 May 2022

We carried out an announced inspection at Lostock Hall Medical Centre on 6 April 2022. Overall, the practice is rated as good. We inspected

Safe -Good

Effective -Good

Caring – Good (rating awarded at the inspection 5 December 2019).

Responsive – Good (rating awarded at the inspection 5 December 2019)

Well-led -Good

Following our previous inspection on 1 September 2021, the practice was rated Requires Improvement overall and for key questions safe and well led. The key question effective was rated good. We issued the practice with requirement notices for regulation 12(1) Safe care and treatment and regulation 17(1) Good governance. The key questions caring and responsive were rated as good at the practice’s inspection in December 2019.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Lostock Hall Medical Centre on our website at www.cqc.org.uk

Why we carried out this inspection

This inspection was a focused follow-up inspection to follow up on areas identified at our last inspection which included two breaches of regulations.

We found that the issues identified at inspection in September 2021 had been addressed. These included:

• Staff recruitment records were comprehensive and included satisfactory evidence of conduct from previous employment and included identify checks.
• Systems to monitor clinical decision making for those working in advanced clinical roles were in place and this complemented the informal systems in place.
• A system of monitoring and oversight of incoming patient clinical information that was work flowed was in place.
• Systems to monitor the quality of patient medication reviews and review ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) agreements were in place.
• A system of continuous quality improvement was established.
• Since our last inspection the practice had ensured the oxygen cylinder was stored securely, records and monitoring of staff training including locum GPs were in place and complaint letters included reference to the health ombudsman.

We undertook this inspection at the same time as CQC inspected a range of urgent and emergency care services in Lancashire and South Cumbria. To understand the experience of GP Providers and people who use GP services, we asked a range of questions in relation to urgent and emergency care. The responses we received have been used to inform and support system wide feedback.

How we carried out the inspection

Throughout the pandemic CQC has continued to regulate and respond to risk. However, taking into account the circumstances arising as a result of the pandemic, and in order to reduce risk, we have conducted our inspections differently.

This included :

• Conducting staff interviews using video conferencing and face to face
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider
• Reviewing patient records to identify issues and clarify actions taken by the provider
• Requesting and reviewing evidence from the provider
• A site visit

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as Good overall

We found that:

• The way the practice was led and managed promoted the delivery of high-quality, person-centred care.
• The practice provided care in a way that kept patients safe and protected them from avoidable harm.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• Patients received effective care and treatment that met their needs in a timely way.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic and continued to follow government guidance to mitigate the risk of this virus.

We saw two areas of outstanding practice including:

• The lead GP promoted a collaborative approach working with the Community Frailty team and the local hospital trust to raise awareness of the two frailty pathways for care and treatment for patients assessed as frail. A presentation to explain the different pathways was being delivered by the GP to the local primary care team.
• The lead GP had undertaken additional training and was a GP with an extended role in Menopause Care. The GP was proactive with her patients, and the local community raising the profile of menopause in the newspapers and on local BBC radio.

Whilst we found no breaches of regulations, the provider should:

• Adapt the medicine monitoring log sheet to include oxygen masks and tubing and the expiry dates for medicines and equipment.

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

Dr Rosie Benneyworth BM BS BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care