Background to this inspection
Updated
9 August 2019
The Crossroads Surgery is operated by Dr Adrian Paul Rose. The practice is located at 449 Warrington Road, Rainhill, Prescot, Merseyside. L35 4LL. The website address is www.thecrossroadssurgery.nhs.net. The surgery has good transport links.
The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, family planning, surgical procedures and treatment of disease, disorder or injury.
The Crossroads Surgery is situated within the St Helens Clinical Commissioning Group (CCG) and provides services to 2,702 patients under the terms of a general medical services (GMS) contract. This is a contract between general practices and NHS England for delivering services to the local community.
The provider is a single-handed male GP who registered with the CQC in December 2016. The practice has two further GPs (both female), one salaried and one locum. The practice also has a practice nurse and regular locum advanced nurse practitioners (ANP). The clinical team are supported by the practice manager, receptionists and reception staff. The practice is in the process of forming a closer working relationship with another small GP practice.
There are higher than national average number of patients over the age of 75, in common with the characteristics of the St Helen’s CCG area and fewer patients aged under 18 than the local and national average.
The National General Practice Profile states that 96.3% of the practice population is from a white background. Information published by Public Health England, rates the level of deprivation within the practice population group as six on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.
Male life expectancy is 80 years which is in line with the national average. Female life expectancy is 83 years which is also in line with the national average.
Updated
9 August 2019
We carried out an announced comprehensive inspection at The Crossroads Surgery on 12 July 2019.
At this inspection we followed up on breaches of regulations identified at a previous inspection on 24 July 2018.
At that inspection we found that:
- The practice had not always learnt from incidents to improve their processes.
- Formal arrangements to provide GP support to the nursing team in the absence of the provider had not been introduced.
- Systems were not effective in assessing and monitoring the quality and safety of all aspects of the service.
- The safeguarding policy did not provide staff with information required for them to meet their legal obligations.
- Systems for dealing with mental capacity were not sufficiently detailed.
- Processes for promoting confidentiality were not followed.
- The complaints policy was not specific to the service and information about making a complaint was not readily accessible.
- Some policies and procedures were not sufficiently detailed and did not provide staff and patients with enough information about what to do in given circumstances.
- The patients right to complain was not promoted by the service because information about how to complain was not readily available.
At this inspection we found the provider had satisfactorily addressed these areas.
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 and good for all population groups.
We found that:
- The practice provided care in a way that kept patients safe and protected them from avoidable harm.
- 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 organised and delivered services to meet patients’ needs. 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:
- Increase the information about support groups available on the practice website.
- Develop a formal written business plan which relates to implementing and monitoring the services strategy.
- Be explicit about the agencies that need to be contacted in the event of actioning the Business Continuity plan. For example, include when it would be required to complete a Care Quality Commission notification.
- Make the monitoring processes easier to review.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care