Crompton View Surgery Also known as Dr Walmsley and partners

Updated 11 September 2017

Walmsley – Crompton Health Centre is also known as Crompton View Surgery. Following the inspection the practice formally changed their name with the Care Quality Commission. It is located in purpose built premises on a main road approximately two and a half miles from Bolton town centre. The practice moved to the building, which is owned by a private landlord, in December 2007.

The practice is situated on the ground and first floor of the building. Patient areas are on the first floor only, and there is a passenger lift available. All consultation rooms are fully accessible. There is a large car park at the rear of the building.

There are three GP partners (two male and one female) and one GP registrar (a trainee GP, female). There are also two practice nurses and a health practitioner. There is a practice manager and reception and administrative staff.

The practice is open between 8am and 6.30pm on Mondays, Tuesdays, Wednesdays and Fridays. On Thursdays the practice is open between 8am and 8pm. There is some flexibility with surgery times, but normal surgery times are 8.30am until 11.30pm every morning, then 3pm until 6pm Mondays, Tuesdays, Wednesdays and Fridays and 3pm until 7.45pm on Thursdays. Weekend appointments are available via the Bolton GP Federation Hub. This means patients can access pre-bookable appointments at a nearby practice where GPs have access to their electronic patient records.

At the time of our inspection there were 5193 patients registered with the practice. The practice is a member of NHS Bolton Clinical Commissioning Group (CCG). The practice delivers commissioned services under a General Medical Services (GMS) contract. The proportion of patients registered in the 65 to 69 age group is slightly higher than the national average. Male patients have a life expectancy of 78 years (national average 79 years) and the figure is 81 years for females (national average 83 years). The practice area is in the third most deprived decile on the deprivation scale.

There is an out of hours service available provided by a registered provider, Bury and District Doctors on Call (BARDOC), reached via NHS 111.

Updated 11 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Walmsley – Crompton Health Centre on 8 July 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Walmsley – Crompton Health Centre on our website at www.cqc.org.uk.

We carried out a further announced comprehensive inspection at Walmsley – Crompton Health Centre on 14 July 2017. This inspection was to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulation that we identified in our previous inspection on 8 July 2016. This report covers our findings in relation to those requirements. We found the improvements had been made and the practice is now rated as good in all domains.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and a system in place for reporting and recording significant events.
• The practice had clearly defined and embedded systems to minimise risks to patient safety.
• Staff were aware of current evidence based guidance. Staff had been trained to provide them with the skills and knowledge to deliver effective care and treatment.
• Results from the national GP patient survey showed patients were treated with compassion, dignity and respect and were involved in their care and decisions about their treatment.
• Information about services and how to complain was available. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients we spoke with 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 the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

The areas where the provider should make improvement are:

• The provider should have assurance that the defibrillator for the building is available and ready for use.

• The provider should set up a programme of audits.

• The practice should arrange for staff to start the on-line training package that they have signed up to.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 11 September 2017

The practice is rated as good for the care of people with long-term conditions.

• Performance for diabetes related indicators was 100%. This was higher than the CCG average of 88% and the national average of 90%. Clinical exception reporting rates were usually below the CCG and national average.

• The practice followed up on patients with long-term conditions discharged from hospital and ensured that their care plans were updated to reflect any additional needs.

• There were emergency processes for patients with long-term conditions who experienced a sudden deterioration in health.

• All these patients had a named GP and there was a system to recall patients for a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 11 September 2017

The practice is rated as good for the care of families, children and young people.

• From the sample of documented examples we reviewed we found there were systems to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of accident and emergency (A&E) attendances.

• Immunisation rates were relatively high for all standard childhood immunisations.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• The practice worked with midwives, health visitors and school nurses to support this population group.

• The practice had emergency processes for acutely ill children and young people and for acute pregnancy complications.

Updated 11 September 2017

The practice is rated as good for the care of older people.

• Staff were able to recognise the signs of abuse in older patients and knew how to escalate any concerns.

• The practice offered proactive, personalised care to meet the needs of the older patients in its population.

• The practice was responsive to the needs of older patients, and offered home visits and urgent appointments for those with enhanced needs.

• The practice identified at an early stage older patients who may need palliative care as they were approaching the end of life.

• The practice followed up on older patients discharged from hospital and ensured that their care plans were updated to reflect any extra needs.

• Older patients were provided with health promotional advice and support to help them to maintain their health and independence for as long as possible.

Updated 11 September 2017

The practice is rated as good for the care of working age people (including those recently retired and students).

• The needs of this population group had been identified and the practice had adjusted the services it offered to ensure they were accessible, flexible and offered continuity of care, for example, extended opening hours. Weekend appointments were available at a nearby practice.

• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflected the needs for this age group.

Updated 11 September 2017

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• The practice carried out advanced care planning for patients living with dementia.

• The practice specifically considered the physical health needs of patients with poor mental health and dementia.

• The practice had a system for monitoring repeat prescribing for patients receiving medicines for mental health needs.

• Performance for mental health related indicators was 100%. This was higher than the CCG average of 92% and the national average of 93%.

• The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• Patients at risk of dementia were identified and offered an assessment.

• The practice had information available for patients experiencing poor mental health about how they could access various support groups and voluntary organisations.

• Staff interviewed had a good understanding of how to support patients with mental health needs and dementia.

Updated 11 September 2017

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including those with a learning disability.

• End of life care was delivered in a coordinated way which took into account the needs of those whose circumstances may make them vulnerable.

• The practice offered longer appointments for patients with a learning disability.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients.

• The practice had information available for vulnerable patients about how to access various support groups and voluntary organisations.

• Staff interviewed knew how to recognise signs of abuse in children, young people and adults whose circumstances may make them vulnerable. They 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.