The Care Quality Commission
  • Doctor
  • GP practice

Archived: Beacon Primary Care

Overall: Good read more about inspection ratings

Sandy Lane Health Centre, Sandy Lane, Skelmersdale, Lancashire, WN8 8LA (01695) 736000

Provided and run by:
Beacon Primary Care

Important: The provider of this service changed. See new profile

All Inspections

3 December 2019

During an annual regulatory review

We reviewed the information available to us about Beacon Primary Care on 3 December 2019. We did not find evidence of significant changes to the quality of service being provided since the last inspection. As a result, we decided not to inspect the surgery at this time. We will continue to monitor this information about this service throughout the year and may inspect the surgery when we see evidence of potential changes.

25 September to 25 September 2018

During an inspection looking at part of the service

This practice is rated as Good overall. (Previous rating March 2018 – Requires Improvement)

The key questions at this inspection are rated as:

Are services caring? – Good

Are services responsive? – Good

We carried out an announced comprehensive inspection at Beacon Primary Care on 15 March 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. At this inspection we rated the practice as requires improvement overall, with requires improvement ratings for the key questions of caring and responsive due to poor patient feedback about their experiences at the service. The full report from our March 2018 inspection can be found here: https://www.cqc.org.uk/location/ 1-543753416.

We carried out a focussed follow up inspection on 25 September 2018 to establish how the practice had addressed the concerns identified at the March 2018 visit. This visit inspected the caring and responsive key questions only. The practice is now rated good for both the caring and responsive key questions and good overall.

At this inspection we found:

  • The practice had implemented changes to address patient feedback around experience and access.
  • The appointment system had been reviewed and updated to improve its effectiveness.
  • Telephone triage appointment slots had been lengthened from five to seven minutes in order to allow for more effective management of the patients’ presenting problems.
  • Clinical capacity had been increased.
  • The practice had created and recruited to a new non-clinical post to focus on organisational development and communications, with particular focus on patient and public engagement.
  • The practice’s telephone system was being updated to incorporate an additional line specifically for managing prescription requests.
  • A new system had been implemented to facilitate the proactive identification of patients with caring responsibility, as well as to identify patients with hearing or visual impairment or those who were housebound.
  • Following our inspection in March 2018, we recommended the practice should review how it monitored expiry dates of medicines held in the GPs’ bags. At this inspection we saw a new system had been put in place which was operating effectively. All medicines were in date.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

15th March 2018

During a routine inspection

Letter from the Chief Inspector of General Practice

This practice is rated as requires improvement overall. (Previous inspection 26/05/2015 – Outstanding)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Requires Improvement

Are services responsive? – Requires Improvement

Are services well-led? – Good

As part of our inspection process, we also look at the quality of care for specific population groups. The population groups are rated as:

Older People – Requires Improvement

People with long-term conditions –Requires Improvement

Families, children and young people – Requires Improvement

Working age people (including those retired and students) – Requires Improvement

People whose circumstances may make them vulnerable – Requires Improvement

People experiencing poor mental health (including people with dementia) – Requires Improvement

We carried out an announced comprehensive inspection at Beacon Primary Care on 15 January 2018. This inspection was carried out under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

At this inspection we found:

  • There were established and comprehensive systems in place to manage and monitor risks to patients, staff and visitors. This included risks to the building, environment, medicines management, staffing, equipment and a range of emergencies that might affect operation of the practice.

  • The practice routinely reviewed the quality, effectiveness and appropriateness of the care it provided. Care and treatment were delivered according to evidence-based guidelines.We saw that a wide range of clinical audit was carried out.

  • There was a formal system to audit clinical decision making and non-medical prescribing for clinicians working in advanced roles and staff felt well supported.

  • Staff involved and treated patients with compassion, kindness, dignity and respect.

  • Staff understood their role in safeguarding vulnerable patients. They were fully aware they should go to the lead GP for safeguarding for further guidance. The GP held monthly meetings with health visitors, school nurses and practice staff. There was a regularly updated spreadsheet of all patients known to be at risk.

  • The practice reviewed the needs of their local population and had initiated positive service improvements for patients. They implemented suggestions for improvements as a consequence of feedback from the patient participation group.

  • There was evidence that innovation and service improvement was a priority among staff and leaders with evidence of strong team working and commitment to personal and professional development.

  • The National GP patient survey results were generally below the CCG and national averages. It was unclear how the practice had responded to this.

We saw five areas of outstanding practice :-

  • The practice had completed a wide ranging programme of clinical audits over the last 12 months which had resulted in improved patient outcomes. For example there were 17 care homes in the locality and all were provided with regular telephone advice and support. Weekly ward rounds were undertaken in seven of the homes which covered 161 of 198 patients registered in care homes. The practice pharmacist also visited these homes regularly to review patients’ medications, especially after discharge from hospital. Practice staff had developed an enhanced health framework for patients in care homes including access to telemedicine advice. Audit activity demonstrated that all of these initiatives had reduced the high demand for individual visits.

  • The practice had introduced ‘Patient Friends’ who were reception staff who were available throughout the day to review and discuss any problems from the patient’s perspective and use their knowledge of the practice to find a way of resolving issues quickly.

  • The practice had taken part in the Routine Enquiry into Adverse Childhood experience (REACH) feasibility project which had been carried out to investigate long term physical and mental health problems in a primary care setting. As a result staff had been trained to identify and offer support where appropriate.

  • The practice had developed a Well Pathway for patients with dementia covering prevention, diagnosis, living with and supporting people and dying well, with hypertext links to local and national support organisations.

  • The practice was a member of the North West Alliance Primary Care Home which aimed to improve services in communities and offer patients opportunities to maximise their health. They worked together with partner organisations in the voluntary, social care and faith sectors.

The areas where the provider should make improvements are:

  • All GPs should monitor the expiry dates of medicines kept in their medical bags.

  • Continue to identify and support patients who are also carers

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

26/05/2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Beacon Primary Care Group on 26 May 2015. The Group has three locations and we visited two of these locations during our inspection Overall the practice is rated as outstanding.

Specifically, we found the practice to be outstanding for providing, effective and responsive and well led services. We have rated the practice as good for providing safe, caring services to patients.

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

  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
  • The practice was actively involved in local and national initiatives to enhance the care offered to patients. They were proactive in trialling new ways of working to ensure they continued to meet the needs of the patients registered with the practice.
  • Risks to patients were assessed and well managed.
  • Patients’ needs were assessed and care was planned and delivered after considering best practice guidance.
  • Staff had received training appropriate to their roles and any further training needs had been identified and planned.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
  • The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients
  • The practice had a clear vision that had improvement of service quality and safety as its top priority. High standards were promoted and there was good evidence of team working.

We saw several areas of outstanding practice including:

  • The practice had introduced ‘Patient Friends’ who were reception staff who were available throughout the day to review and discuss any problems from the patient’s perspective and use their knowledge of the practice to find a way of resolving issues quickly.
  • The practice offered training to patients in the use of the automated electronic defibrillator.
  • The practice staff had undergone training with the local Personality Disorder Team to allow them to effectively deal with patients who suffered with personality disorder conditions who were registered with the practice.
  • The practice was working with the local nursing and residential homes to carry out training to integrate the care home staff into effective, up to date care delivery for patients registered with the practice.
  • The practice had designed a Personalised Care Plan for older patients which demonstrated a holistic and not just incentivised approach to avoiding unplanned admission to hospital, which included a frailty assessment tool that reflected national good practice and included a detailed personal medical history including advanced care planning details. This had been shared with the CCG and other practices in the local area.
  • The practice took an active lead in all Mental Capacity Act decisions for their patients including patients requiring a Deprivation of Liberty Order. They could demonstrate the involvement of Independent Mental Capacity Advocates for their patients.
  • The practice used the skills of an Advanced Nurse Practitioner (ANP) to carry out minor surgical procedures within the practice in line with their registration and NICE guidance. The outcomes from patients accessing this service were closely monitored by the practice.
  • The practice actively used SKYPE when staff could not attend meetings due to workload at other practices.
  • On-line services include appointment booking and ordering repeat prescriptions and access to full medical records. At the time of the inspection records showed 1167 patients from the 11650 registered patients actively accessed their records on a regular basis.

However, there were also areas of practice where the provider needs to make improvements;

The provider should;

  • Ensure environmental and fire risk assessments are updated and documented at all branches.
  • Ensure daily checks on all areas of the practice and emergency equipment are appropriately documented to reflect completion of the checks.
  • Ensure there is an auditable system for reviewing and monitoring the recording of serial numbers on all blank electronic and hand written prescriptions pads held in storage and once allocated to GPs. Ensure safe storage of all prescription pads across all sites.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice