Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bolton Community Practice CIC on 17 October 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• 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.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice had two members of staff who were fully trained dementia friends and had further training sessions booked for all other members of staff.
• The practice had introduced a dementia friendly coloured chair in the waiting area and dementia friendly coloured signs throughout the surgery.

We saw areas of outstanding practice:

• The practice cared for patients on Bolton’s Violent Patient (Safehaven) Scheme. These patients had a GP key worker and were risk assessed on arrival on to the scheme. The patients had a dedicated telephone line and were provided with a range of appointments at quieter times across the week with named GPs, a security guard was also present in the building to support the service. The practice worked closely with the patients, their carers and the prison, probation, drug and alcohol services and mental health services to meet the needs of these patients. Patients were able to register on the regular list when they were removed from the scheme. The practice held a quarterly meeting to review any risks, share appropriate information and review patients care planning.
• The practice worked closely with a local charity, Urban Outreach, and the local foodbank to offer support for their vulnerable adults struggling with difficult lives, including homelessness. One member of staff had been trained and was able to issue food bank vouchers.
• The practice held weekly coffee mornings for vulnerable patients that were lonely and socially isolated.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Bolton Community Practice CIC managed five GP practices across Bolton. This inspection was undertaken at the Navigation Park, Waters Meeting Road, practice, also known locally as Astley Dale branch.

We noted staff spoke with patients and dealt with telephone calls in a friendly but professional manner. Confidentiality was maintained.

There was a well established and effective patient advisory group (PAG). Patients were actively involved in the development of the practice and it's services.

We sampled four patients care files which were maintained electronically. We saw when patients had registered with the practice, they attended for an initial health review. We found that medical histories and consultations were well documented.

We found staff had an appropriate understanding of safeguarding.

We found care was provided in an environment which was clean and well organised. The practice was based in a modern purpose built health centre. Cleaning was undertaken by an external company for the whole centre.

A comprehensive range of policies, procedures and guidance in place for staff to access. This supported the safe management of the service. Systems had been implemented to effectively identify, assess and manage risks related to the service.

Patients we spoke with were positive about the practice. We were told: "The staff here are great, I have no complaints" and "Sometimes it's hard to get an appointment, but the staff are always very nice".