Woolton House Medical Centre

Updated 5 December 2018

Woolton House Medical Centre is registered with the Care Quality Commission to provide primary care services. It provides GP services for approximately 9342 patients living in Woolton area of Liverpool. The practice is situated in a grade two listed building; it has two floors with lift access for patients. The practice has six GP partners, four female and two males. They also have a number of salaried GPs and they take GP trainees. The practice has a practice manager, office manager, administration staff and practice nursing team. Woolton House Medical Centre holds a General Medical Services (GMS) contract with NHS England.

The practice is part of Liverpool Clinical Commissioning Group (CCG) and is situated in an area of low deprivation. Unemployment is significantly lower than the city rate (4.7% compared to 7.2%) and 7.1% of the population are long term sick or disabled. The practice has a high population of older people with 30% being over 60 years and 17% being over 70 years.

The practice is open Monday – Friday 8am to 6.30pm and until 8pm on Tuesday evenings with the phone lines opening for appointments starting at 8am. Patients can book appointments in person, via the telephone or online. The practice provides telephone consultations, pre-bookable consultations, urgent consultations and home visits. The practice treats patients of all ages and provides a range of primary medical services.

The practice does not provide out of hours services. When the surgery is closed patients are directed to the local out of hour’s service provider (Unplanned Care 24), local NHS walk in centres and NHS 111 for help.

The practice provides family planning, surgical procedures, maternity and midwifery services, treatment of disease, disorder or injury and diagnostic and screening procedures as their regulated activities.

Updated 5 December 2018

Letter from the Chief Inspector of General Practice

This practice is rated as Good overall. (Previous inspection October 2014 – Good)

The key questions are rated as:

Are services safe? – Requires Improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Woolton House Medical Centre 9 May 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:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.

• The practice had systems to safeguard children and vulnerable adults from abuse. However, we could not verify the level of safeguarding training for clinical staff and the children’s safeguarding policy had not been updated.

• The practice had arrangements to ensure that facilities and equipment were safe and in good working order. However, a planned preventative maintenance program was not in place.

• The practice routinely reviewed the effectiveness and appropriateness of the care provided. It ensured that care and treatment was delivered according to evidence- based guidelines.

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

• Patients found the open access appointment system easy to use and reported that they were able to access care when they needed it.

• 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.

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

• The provider was aware of the requirements of the duty of candour. Examples we reviewed showed the practice complied with these requirements.

• The practice had an active Patient Participation Group (PPG) who worked closely with staff to monitor and develop services.

• There was a strong focus on continuous learning and improvement at all levels of the organisation.

• Review the storage of medical records for patients to ensure they are protected against the risk of accidental loss, including corruption, damage or destruction.

We saw areas of outstanding practice:

• The practice continued to proactively identify patients aged over 75 years who were socially isolated and lonely. Patients were then referred to a local social event, supported by the practice and the local charity set up by the lead GP named Woolton Community Life.

The areas where the provider must make improvements are:

• Ensure patients are protected from abuse and improper treatment

The areas where the provider should make improvements are:

• Review the maintenance plans and arrangements at the practice and undertake repairs where building work has deteriorated. Systems should be put into place to ensure that all checks, such as an electrical wiring, are monitored to ensure they do not go out of date.

• Review the access restrictions for disabled patients at the entrance to the practice.

• Review the systems in place for ensuring all

• Review the training for staff with responsibility for specimen handling and storage.

• Review the arrangements in place for Health Care Assistants (HCA) staff who are delivering vaccination programmes, to ensure that they operate with a written patient specific directions (PSD) at all times.

• Review the system in place for monitoring and reviewing policies and procedures.

• Review the information held for all patient complaints to ensure a full and accurate audit trail of events is maintained.

• Review the arrangements for the storage of past medical records for patients.

• Review and develop a staff training matrix so that the practice can demonstrate how they are assured of all staff competence.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 December 2015

The practice is rated as good for the care of people with long-term conditions. Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 17 December 2015

The practice is rated as good for the care of 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. Immunisation rates were relatively high for all standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives, health visitors and school nurses.

Updated 17 December 2015

The practice is rated as outstanding for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care.

The practice proactively identified patients aged over 75 years who were socially isolated and lonely. The practice acknowledged that loneliness could have a negative impact on the patients’ health and well-being and they set up a data base to identify those patients at risk. Those patients who were thought to be suffering from loneliness were referred to the practice health trainer for on-going support and contact. The practice developed with the trainer a monthly ‘afternoon tea party’ as a social event. This initially took place in the practice but because of its success, it now takes place in the local village hall. We heard that for some patients this was the only social contact they had across each month. The practice showed that over the previous 10 months over 135 patients had attended these events. Within this figure 50% of patients had been visited first in their own homes by the health trainer to encourage and support them in their own home initially.

To further support isolated and lonely patients the lead GP also set up a local charity with support from local churches and community groups. The organisation named Woolton Community Life, developed a community directory booklet which included all activities in and around the village for people to get involved with. The aim was to bring people together to reduce social isolation and patient we spoke with during the inspection who were aware of this spoke highly of the lead GPs support for this.

Updated 17 December 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 17 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia. The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia.

Updated 17 December 2015

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 and had carried out annual health checks for people with a learning disability. They offered longer appointments for people with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff 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.