Library House Surgery

Updated 6 January 2023

Library House Surgery is located in in Chorley at:

Avondale Road

Chorley

PR7 2AD

The provider is 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.

The practice is situated within the NHS Lancashire and South Cumbria Integrated Care Board (ICB) and delivers General Medical Services (GMS) to a patient population of about 17,127. This is part of a contract held with NHS England.

The practice is part of a wider network of GP practices called the Chorley Central Primary Care Network (PCN) with five other local practices.

Information published by Public Health England shows that deprivation within the practice population group is in the fifth decile (five 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 the practice area is 96% White, 2% Asian and 2% other/mixed.

The age distribution of the practice population is 20% of patients are aged under 20, 69.4% are aged 20-64 and 10.6% are aged over 65 years. This is similar to the PCN and England average figures. There are more female patients registered at the practice compared to males.

There is a team of 9 GPs, 2 nurses, 3 advanced care practitioners, one nurse associate, two health care assistants and a phlebotomist. They are supported at the practice by a team of reception and administration staff and an operational practice manager and two assistant practice managers to provide managerial oversight and a team of administrative and reception staff support the practice.

The practice is open between 08.00am to 6.30pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended and increased access is provided through arrangements with neighbouring primary care networks and GP practices. Late evening appointments are available from 6.30pm to 8.00pm every Monday to Friday and weekend appointments are available every Saturday between 09.00am and 17.00pm Out of hours services are accessed by contacting NHS 111 and through an arrangement with an out of hours provider.

Updated 6 January 2023

We carried out an announced inspection at Library House Surgery on 2 December 2022. Overall, the practice is rated as Good.

We inspected;

Safe -Good

Effective -Good

Caring – Good (not inspected, rating of good carried forward from previous inspection).

Responsive – Good (not inspected, rating of good carried forward from previous inspection).

Well-led -Good

Following our previous inspection on 21 January 2016, the practice was rated good overall and for all key questions.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Library House Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection in line with our inspection priorities.

We inspected against the three key questions of safe, effective and well-led. We also looked at access to services within the responsive key question but did not rate this. The ratings from the previous inspection on 21 January 2016 were carried over for the key questions of caring and responsive.

How we carried out the inspection/review

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing facilities as well as face to face
• Requesting written feedback from staff and patients
• 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

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 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.
• 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:

• Improve documentation and recording around Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) orders. In particular when mental capacity and best interest decisions are involved. A review process should also be considered.
• Continue implementing the recovery plan in relation to medicines that require monitoring.
• Formalise supervision and oversight of non-medical practitioners in advanced roles.
• Continue with plans to introduce a clinical nurse manager to provide supervision and oversight of the nursing team. Continue with the appraisal catch up programme.
• Continue with the housekeeping being undertaking around recruitment files and records.
• Aim to improve uptake of cervical screening.

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