Adlington Medical Centre

We carried out an announced inspection at Adlington Medical Centre on 28 and 29 July 2022. Overall, the practice is rated as Good.

For each key question we rated the following;

Safe - Good

Effective - Good

Caring - Good

Responsive - Good

Well-led - Good

Following our previous inspection in December 2021, the practice was rated requires improvement overall, was rated inadequate for safe and requires improvement for the effective, responsive and well-led key questions. Improvements had been implemented since then and at this inspection no breaches of regulations were found, therefore the rating moved to good overall.

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

Why we carried out this inspection

This inspection was a comprehensive inspection to follow up on concerns and breaches of regulation identified during the previous inspection.

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 inspection was carried out in a way which enabled us to spend a minimum amount of time on site. This was with consent from the provider and in line with all data protection and information governance requirements.

This included:

• Conducting staff interviews using video conferencing
• 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 evidence from the provider
• A site visit
• Requesting documents and information from the provider.
• The completion of feedback forms by staff.

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 practice had addressed all the issues identified in the previous inspection. They had put in place systems and processes around safety and governance.
• The clinical records reviews we conducted on this inspection showed an improvement and patients on high risk drugs and those with long term conditions received the correct monitoring.
• Recruitment checks were undertaken in line with regulations and appropriate evidence recorded and stored.
• Infection prevention and control audits were in place with appropriate actions taken and evidenced as completed.
• There were cleaning schedules in place and there was oversight of the cleaning contract. Environmental walkarounds were conducted and recorded.
• The incident reporting process was improved to clarify the actions taken to ensure risk was reduced and learning was achieved.
• Clinical supervision and quality monitoring was in place for clinical staff including non-medical prescribers and locum staff.
• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice adjusted how it delivered services to meet the needs of patients during the COVID-19 pandemic. While patient feedback in the national patient survey indicated ongoing dissatisfaction around access, we saw the practice had worked hard to implement measures to improve this, and we saw evidence patients could access care and treatment in a timely way.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

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

• Continue the improvement work leading from the DNACPR audit of records to ensure that where patients lack capacity the patients’ records have evidence of mental capacity assessments and best interest decisions.
• Continue to work on the initiatives to improve patient satisfaction as identified from the NHS patient survey and continue to monitor satisfaction through surveys.
• Continue the improvement initiatives from the outcomes of clinical search audits to ensure monitoring of high risk medicines and long term conditions are managed well.
• Improve processes for security of paper for electronic prescriptions is undertaken correctly.
• Improve that sharps boxes are completed fully upon assembly.

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

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services