Pilch Lane Surgery

Updated 17 February 2017

Dr Suare's Practice is based in a residential area within Huyton close to local amenities. There are 4830 patients on the practice list. The practice was in an area identified as having high levels of

deprivation. The practice has two partners (one male and one female GP) and three male salaried GPs working at the practice. They also have one practice nurse, reception and administration staff, a business manager and a data quality and performance manager. The practice had employed a practice manager since their last inspection.

The practice is open Monday to Friday from 7.30am to 6.30pm. Outside of this time the practice uses UC 24 Urgent Care. Knowsley Primary Care Trust is responsible for the commissioning of this service. Patients can book appointments in person, on-line or by telephone. Patients can access a range of appointments with the GPs and nurse.

The practice has a Primary Medical Services (PMS) contract. In addition the practice carry's out a variety of enhanced services such as shingles vaccinations and avoiding unplanned admissions to hospital.

Updated 17 February 2017

We carried out an announced comprehensive inspection at Dr Suares on the 10th November 2015. Overall the practice is rated as good.

Our key findings were as follows:

• Clinical staff regularly reviewed significant events although there was no formal system to share learning amongst the whole staff team to identify and learn from events.

• The practice had a safeguard lead and staff were aware of how to report patients considered at risk. The practice staff advised they would introduce fire safety checks. However there were gaps in staff training where some staff had not received safeguard training for vulnerable adults.

• Some aspects of managing safety needed further review as the practice did not have a formal fire risk assessment although they did have various fire safety checks in place for managing risks. The practice had an oxygen cylinder but we found that it was not securely stored to the wall and had no signage for the room it was stored in. The practice staff advised they would introduce fire safety checks and ensure the oxygen cylinder would be secured to the wall with clear sign posting of were its located.

• Staff files were mainly organised and had appropriate checks in place apart from one staff file. This file lacked any evidence of safe recruitment checks such as: references; medical review; interview notes and no evidence of a DBS check. Following our visit the practice have advised that necessary recruitment checks will be in place for all staff.

• The practice was clean and tidy.

• The clinical staff proactively sought to educate patients to improve their lifestyles by regularly inviting patients for health assessments.

• Patients spoke highly about the practice and the whole staff team. They said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• The practice has a Patient Participation Group (PPG) who regularly met with the practice staff. They made suggestions throughout the year to help improve the service provided by the practice.

• Information about the services provided and how to complain was available at the practice. Complaint records had detailed information to show how they had been investigated.

• Staff had delegated duties assigned to them. Staff felt supported by the GPs and the external business team supporting them since the practice manager had left the practice. The practice staff advised that a new full time practice manager would be appointed. Staff felt well trained however training records had gaps and were in need of being updated to reflect the training staff had carried out.

There were areas of practice where the provider must make improvements.

• Take action to ensure its recruitment policy, procedures and arrangements are improved to ensure necessary employment checks are in place for all staff and the required information in respect of workers is held. Health and Social Care Act 2008 Fit and Proper Person Employed. (Regulated Activities) 2014 Regulations 19 1)2)4)5).

There were areas of practice where the provider should make improvements.

Action the provider should take to improve:­­­

• To ensure all serious incidents of risk and complaints are shared with all staff to help improve shared learning within the practice and to help staff understanding of any lessons learnt.
• To ensure safeguard training is available and provided for all staff in regard to vulnerable adults and children and ensure staff are updated in the level of training
• To provide an updated fire risk assessment that ensures clear arrangements are in place for managing all aspects of fire safety within the practice.
• To review training records to ensure that all staff have evidence of updated training relevant to their role.
• To review all policies and procedures to ensure they are up to date with necessary guidance for staff.

Letter from the Chief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 January 2016

The practice is rated as good for the care 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 and screening programmes. The practice contacted these patients to attend regular reviews to check that their health and medication needs were being met. The practice had adopted a holistic approach to patient care rather than making separate appointments for each medical condition.

Updated 7 January 2016

The practice is rated as good for the care of families, children and young people. Immunisation rates were comparable with local CCG benchmarking for standard childhood immunisations. The practice monitored any non-attendance of babies and children at vaccination clinics and reported any concerns they had identified. The staff we spoke with had appropriate knowledge about child protection and they had access to policies and procedures for safeguarding. One GP with level 3 training took the lead for safeguarding. Staff put alerts onto patient’s electronic records when safeguarding concerns were raised. Urgent access appointments were available for children.

Updated 7 January 2016

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. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. They kept up to date registers of patients’ health conditions and used this information to plan reviews of health care and to offer services such as vaccinations for flu. The practice staff met with the community matron and multi-disciplinary professionals on a regular basis to provide support and access specialist help when needed. The practice carried out home visits to a high number of care homes and to patients who were house bound.

Updated 7 January 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).  The needs of this group had been identified and the practice had adjusted the services it offered to ensure it was accessible, flexible and offered continuity of care. The practice offered electronic prescribing and an online appointment services which provided flexibility to working patients and those in full time education. The practice offered drop in clinics for services such as flu vaccinations and early morning appointments from 7.30am Monday to Friday. Health checks were offered to patients who were over 40 years of age to promote patient well-being and prevent any health concerns.

Updated 7 January 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice maintained a register of patients with mental health problems in order to regularly review their needs and carry out health checks.  The practice staff liaised with other healthcare professionals to help engage these patients to ensure they attended reviews. Staff were knowledgeable in regard to consent and supporting patients in obtaining consent however they had not received updated training in consent and the Mental Capacity Act 2005. The practice were able to refer patients to the ‘Mental Health Assessment Team’ in accordance with each person’s individual circumstances.

Updated 7 January 2016

The practice is rated as good for the care 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 24 patients with a learning disability and annual health care reviews were provided to these patients. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.  However they had not all received up to date safeguarding training.