Buckshaw Village Surgery

Updated 8 September 2022

Buckshaw Village Surgery is located in Chorley at:

Buckshaw Village Health Centre,

Unity Place,

Buckshaw Village,

Chorley Lancashire PR7 7HZ.

The organisation also has a second registered location at;

Adlington Medical Centre,

22-24 Babylon Lane,

Anderton,

Chorley Lancashire PR6 9NW.

The second location has branch surgeries at:

Croston Medical Centre,

Lostock Village Surgery,

Medicare Unit Surgery,

Eaves Lane Surgery (closed at the time of inspection).

Patients could access services at all locations within the organisation.

The provider organisation is known locally as NM Health Innovations registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services and treatment of disease, disorder or injury and surgical procedures.

These are delivered from all sites except for Eaves Lane Surgery, as this is currently closed to the public and Medicare Unit Surgery, which is open two days a week for limited services, such as baby immunisation clinics.

Buckshaw Village Surgery delivers an ‘Alternative Provider Medical Services’ (APMS) contract to 11,428 patients. The provider delivers services within the NHS Lancashire and South Cumbria Integrated Care Board (ICB). The provider forms its own network of GP practices called a Primary Care Network (PCN).

Information published by Public Health England shows that deprivation within the practice population group is in the second highest decile (eight of 10). The lower the decile, the more deprived the practice population is relative to others. According to the latest available data, the ethnic make-up of Buckshaw Village Surgery is 96.2% white and 1.9% Asian and 1.9% other.

The age distribution of the practice population differs somewhat from the local and national averages. There are fewer older people at 6.5% and more young people in the practice population.

Practice % Local ICB % England %

Older People 6.5% 20.85% 17.7%

Working Age People 64.2% 59.4% 62.3%

Young People 29.3% 19.8% 20.0%

There are more male patients registered at the practice compared to females.

There is a team of seven GPs who provide cover at all sites, three nursing practitioners, seven practice nurses, a physiotherapist, three pharmacists and five pharmacy technicians, two paramedics and a social prescriber. The GPs are supported at the practice by a team of reception and administration staff. The business manager and practice manager are in place to provide managerial oversight.

The practice is open between 8.00am to 8.00pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments. Extended and increased hours are provided locally by the provider, where late evening and weekend appointments are available. Out of hours services are provided through and arrangement with an out of hours provider and NHS 111.

Updated 8 September 2022

We carried out an announced inspection at Buckshaw Village Surgery on 25 and 26 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 on 9 December 2021, the practice was rated requires improvement overall, was rated inadequate for safe and requires improvement for 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 Buckshaw Village Surgery 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 condition 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 interests 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 use of clinical search audits to ensure monitoring of high risk medicines and long term conditions are managed well.

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