18 December 2023
During a routine inspection
We carried out unannounced inspections at The Surgery Chorley and the branch site at Leyland Surgery on 18 December 2023. Overall, the practice is rated as Requires Improvement.
Safe – Requires Improvement
Effective - Good
Caring – Good (carried forward from previous inspection)
Responsive - Requires Improvement
Well-led - Good
The previous inspection was undertaken on 22 October 2022, when the practice was rated good in all key questions and good overall.
The full reports for previous inspections can be found by selecting the ‘all reports’ link for The Surgery Chorley on our website at www.cqc.org.uk
Why we carried out this inspection
This inspection was carried out in response to concerns raised to CQC about issues including culture, staffing, workflow and access. We undertook an unannounced inspection and looked at the key questions; Safe, Effective, Responsive and Well-led.
How we carried out the inspection
This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.
This included:
- Conducting staff interviews.
- Requesting written feedback from staff and patients.
- 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.
- Inspection visits to both sites.
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 Requires Improvement because;
- Systems to ensure medications remained safe to use were not always effective; we identified expired medications and equipment.
- Emergency medications and equipment were not organised in a way to enable staff to access the items quickly in the event of a medical emergency.
- At the time of inspection the practice had not adhered to their policy to keep prescription paper safely secured. There was a risk that such paper may have been misappropriated.
- Maintaining staffing levels was a challenge.
- Patients could not always access care and treatment easily and in a timely way.
- Feedback from patients from a range of sources indicated that patients were dis-satisfied with access to the practice by telephone and found it challenging to secure an appointment.
- The National GP patient survey painted a deteriorating picture.
We found one breach of regulation. The provider must:
- Ensure care and treatment is provided in a safe way to patients
In addition, the provider should:
- Improve staffing levels within the practice.
- Implement initiatives to improve the workplace culture and staff retention;
- Promote knowledge of freedom to speak up options.
- Implement responses to improve patient surveys and feedback;
- Take action to improve access to appointments;
- Take action to improve access by telephone;
- Consider the security implication of unsecured clinical rooms at both sites.
- Take action to improve screening and immunisation uptake.
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 Healthcare