We carried out an announced comprehensive inspection at Gateacre Medical Centre on 8 February 2019 as part of our inspection programme.

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 have rated this practice as good overall but requires improvement for providing safe services and good for all population groups.

We rated the practice as Requires Improvement for providing safe services because:

• Medicines management required improvement. For example, the practice had some medicines for use in medical emergencies but not all that is currently recommended. There was no risk assessment to outline how the practice would manage certain medical emergencies such as diabetic patients with very low sugar levels or patients with epilepsy, without the medicines currently recommended. Improvements were also required around the management of blank prescriptions, prescribing rates and authorisation documentation for vaccines.
• There was no system to ensure clinicians’ own equipment was calibrated.

We rated the practice as good for providing effective, caring, responsive and a well led service because:

• 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 organised and delivered services to meet patients’ 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.
• The practice was working towards the formation of a Primary Care Network (PCN) involving a group of other small GP practices in the area. The practice manager took an active role in planning how the practices could best support each other to tailor services to the community needs.

There was an example of outstanding practice:

• The practice manager had innovative ideas to help manage the administration of the practice and had shared their knowledge with the local PCN and local Clinical Commissioning Group (CCG) to improve patient outcomes. For example, they were currently involved with the local PCN to help improve outcomes for patients with learning disabilities and had previously developed a tool to identify the care processes for patients experiencing poor mental health. The tool had been fully shared with the Mental Health team and CCG Leads and has now been implemented in every Liverpool GP Practice.

However, the provider must:

• Ensure care and treatment is provided in a safe way to patients.

The provider should:

• Update safeguarding policies in line with national guidance.
• Monitor the ongoing immunisation status for all staff.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Gateacre Medical Centre on 19 November 2015.

Overall the practice is rated good.

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

• There were systems in place to mitigate safety risks including analysing significant events and safeguarding.

• There were facilities for the disabled, however access would be difficult. There were translation facilities available but no hearing loop.

• Information about services and how to complain was available. The practice sought patient views about improvements that could be made to the service, including having a patient participation group (PPG) and acted on feedback.

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

There was an example of outstanding practice:-

The practice manager had designed tools to improve systems to manage diabetes care and mental health reviews to ensure patients’ needs were assessed. In addition, the practice manager had designed a system to allow more information about care needs of the elderly population to be available for the GP called me ‘forget me not’. This involved birthday cards with health questionnaires being sent to patients so that information returned could be monitored and actioned where necessary by the GP. These processes had been adopted by other practices in the local area.

However, there were improvements the provider should consider:-

• Carry out a risk assessment for the provision of emergency care when clinicians were not on site.

• Formulate a business plan, strategy and values for the practice.

• Consider arrangements for the nursing team to attend meetings to improve on knowledge of systems within the practice and ensure clinical consistency.

• Improve the approach to clinical audit to demonstrate quality improvement for patient outcomes.

• Formally record the monitoring of the cleanliness of the premises.

• Carry out a formal disability access risk assessment.

• Complete the electrical safety inspection for the premises.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice