Archived: Garston and West Speke Health Centre

Updated 26 November 2015

We previously undertook a focused inspection in February 2015 in response to concerns we received. We issued two Requirement Notices as a result of our findings and requested an action plan. Requirement Notices were issued in relation to: governance (Regulation 17) and failing to notify us of a police incident (Regulation 18 (CQC Registration Regulations 2009).

Garston and West Speke Health Centre is situated in a deprived area of Merseyside. The service operates from two sites; one in Garston, 32 Church Road Liverpool L19 2LW and one in Blackstock Hall Road, Speke, Liverpool L24 3TY. There were 4751 patients on the practice list at the time of our inspection.

The practice has four permanent GPs. There is a nurse practitioner, a practice nurse and a healthcare assistant. Members of clinical staff are supported by the practice manager, reception and administration staff.

The practice is open 8am to 6.30pm every weekday. Patients requiring a GP outside of normal working hours are advised to contact the GP out of hours service provided by 111 services.

The practice has an alternative primary medical services contract (APMS) contract and had enhanced services contracts for example, childhood vaccinations.

Updated 26 November 2015

Letter from the Chief Inspector of General Practice

This is the report from our announced comprehensive inspection of Garston and West Speke Health Centre. The service operates from two sites; one in Garston, 32 Church Road Liverpool L19 2LW and one in Blackstock Hall Road, Speke, Liverpool L24 3TY. We inspected both sites on the 22 October 2015. Where information in the report refers to the practice, this refers to both sites unless otherwise specified.

We previously undertook a focused inspection at the Garston site only in February 2015 in response to an issue of concern. We issued two Requirement Notices as a result of our findings and requested an action plan.

Overall the practice is rated good.

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

• The provider had met the Requirement Notices and made improvements in quality assurance processes.
• A Local Medical Director had been recently appointed to oversee the clinical governance of the practice and was proactively encouraging the use of clinical audits to ensure patients received treatment in line with best practice standards.

• The practice had good facilities including disabled access and translation services and three of the GPs spoke other languages.

• There were systems in place to mitigate safety risks including analysing significant events and safeguarding.
• The practice was clean and tidy.
• The practice used a pharmacy advisor to ensure the practice was prescribing in line with current guidelines.

• Information about services and how to complain was available. The practice sought patient views about improvements that could be made to the service, including having a patient participation group (PPG) and acted on feedback.

• Staff worked well together as a team and all felt supported to carry out their roles.

However the provider should consider improving the service by:-

• Reconsider the risk assessment for the need for a defibrillator at the branch surgery.

• Review the storage of emergency drugs at the branch practice to allow easy access.

• Have a systematic approach to whether the practice implements best practice guidance and record the rationale if the guidance is not followed.

• Revisit the register of patients with learning disabilities to ensure that all care plans are updated.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 26 November 2015

The practice is rated good for providing services for people with long term conditions. These patients had a six monthly or annual review with either the GP and/or the nurse to check their health and medication. The practice had registers in place for several long term conditions including diabetes and asthma. The practice had adopted a holistic approach to patient care rather than making separate appointments for each medical condition. The practice offered appointments with the practice nurse for up to 45 minutes to ensure patients with multiple needs were seen.

Updated 26 November 2015

The practice is rated good for providing services for families, children and young people. There were systems in place 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 A&E attendances. The practice regularly liaised with health visitors. Immunisation rates were high for all standard childhood immunisations. The practice had developed an ‘Access for Children’ policy to ensure that all children under five could be seen on the same day if required.

Updated 26 November 2015

The practice is rated good for providing services for older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and offered home visits and nursing home visits. The practice participated in meetings with other healthcare professionals to discuss any concerns. There was a named GP for patients over the age of 75 years The practice offered several services to this population group such as telecare systems for personal alarms, telehealth services to monitor a variety of conditions and medication reviews with a pharmacist and consultant geriatrician.

Updated 26 November 2015

The practice is rated good for providing services for working age people. The needs of this population group had been identified and the practice had adjusted the services it offered to ensure these were accessible. For example, the practice offered online appointment bookings. The practice also offered telephone consultations to reduce time off work.

Updated 26 November 2015

The practice is rated good for providing services for patients experiencing poor mental health. Patients experiencing poor mental health received an invitation for an annual physical health check. Those few that did not attend had alerts placed on their records so they could be reviewed opportunistically. Mental Capacity Act training was available to all staff and SSP Health Ltd had also disseminated information regarding Deprivation of Liberty Safeguards to all its practices.

Updated 26 November 2015

The practice is rated good for providing services for people whose circumstances make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability but this needed to be updated. Longer appointments were available for people with a learning disability. Staff had received safeguarding training.