The Weavers Practice

Updated 28 September 2023

The Weavers Practice offers services from both a CQC registered GP surgery in Rishton (High Street, Rishton, BB1 4LA) as well as a branch surgery in Great Harwood Health Centre in Great Harwood (Water Street, Great Harwood, BB6 5QR). Patients can access services at either surgery.

We visited both the main and the branch surgery as part of this inspection.

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. These are delivered from both sites.

The practice is part of the integrated care board (ICB) for Lancashire and South Cumbria and services are delivered under a General Medical Services (GMS) contract to a patient population of about 8850. The provider is also part of the Hyndburn Rural primary care network (PCN) with seven other local GP practices. They have access to the services of a first contact physiotherapist, a mental health practitioner, an Associate Psychological Practitioner (APPS) a Trainee Associate Psychological Practitioner (TAPPS) and a clinical pharmacist. In addition, the GP practice have access to a care home nursing team, an acute home visiting team, and the integrated nursing team.

Information published by Public Health England shows that deprivation within the practice population group is in the third lowest decile (three 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 96.7% White, with 2.4% Asian, and the remainder classed as Other. Public data from 2021 shows the practices younger population aged 18 years and under is slightly smaller at 20.6% when compared with the local population of 21.6%. The over 65s patient population is also slightly higher at 20.4% compared with 18.9% within the local geographical area.

The age distribution of the practice population otherwise closely mirrors the local and national averages and the male to female patient ratio is also similar to national averages.

There is a team of 3 GP partners (2 male and 1 female), and 2 salaried GPs have been recently recruited. The practice has a team of three practice nurses, one nurse practitioner with a community focused role, caring for frail and older patients, and two health care assistants. The clinical team are supported by a practice manager, an assistant practice manager and a team of administrative and reception staff. The practice is a GP training practice and supports two doctors training to be a GP.

The practice is open between 8am to 6.30pm pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments.

Extended access is provided locally by the East Lancashire Alliance CIC GP federation, where evening appointments are available between 6.30pm and 8.30pm, and on Saturday mornings. Out of hours services are provided by East Lancs Medical Services (ELMS) via the NHS 111 service.

Updated 28 September 2023

We carried out an announced follow up inspection at The Weavers Practice on 15 and 17 August 2023. Overall, the practice is rated as Good.

Safe - Good

Effective - Good

Caring – Not inspected. (Rated Good July 2022)

Responsive - Good

Well-led - Good

This inspection was a follow up focused inspection. We had previously inspected the GP service on 14 July 2022. That inspection identified shortfalls in meeting the required standards and the GP practice was rated as requires improvement overall with key questions safe, effective and well led rated as requires improvement with caring and responsive key questions rated as good. We issued 2 requirement notices for breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe care and treatment and regulation 17 Good governance.

The inspection reports for this service can be found by selecting the ‘all reports’ link for The Weavers Medical Practice on our website at www.cqc.org.uk

Why we carried out this inspection.

We carried out this inspection to follow up breaches of regulation from a previous inspection undertaken in July 2022. At this inspection we reviewed 4 key questions: safe, effective, responsive and well led. We found improvements in all the areas previously identified including:

• Systems to ensure medication reviews were undertaken and recorded comprehensively.
• Up to date staffing records including recruitment checks, professional registration, immunisation status, training records and appraisal.
• Up to date training in safeguarding at the appropriate role specific level.
• Regular audits for Infection prevention and control (IPC) supported with spot checks.
• Monitoring of prescribing practice for those working in advanced clinical roles.
• Progress to formalise and record the monitoring of advance clinical practitioners consultation and clinical decision making.
• The establishment of a patient participation programme (PPG) with one meeting held.
• Improved records for the uptake of childhood immunisations.

How we carried out the inspection.

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

This included:

• Conducting face to face staff interviews and using video conferencing.

• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Reviewing evidence from the provider, including the action plan following the inspection in July 2022.
• Reviewing data available in the public domain.
• A site visit.
• Speaking with patients after the inspection 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.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• The practice team recognised the challenges of ensuring patient access to the right clinical care and treatment and was working with the primary care team on a quality improvement initiative to seek ways to improve patient access to timely appropriate care and treatment.

• The way the practice leadership team worked with their staff promoted the delivery of high-quality, person-centre care.
• The nursing staff team had the autonomy and support of the practice to develop strategies and protocols to support patients with end of life care and to understand and better self-care with health conditions such as diabetes .

Whilst we found no breaches of regulations, the provider should:

• Implement the planned system to record the monitoring of patient consultations for those team members working in advanced clinical roles.
• Update the complaints procedure to include a timescale of when complainants can expect a response to their concerns.

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 Health Care