We carried out an announced comprehensive inspection at Milnrow Village Practice on 24 January 2019 as part of our inspection programme.

The practice was previously inspected on 3 February 2016. The inspection was a comprehensive inspection under the Health and Social Care Act 2008. At that inspection the practice was rated good overall.

At this inspection in January 2019 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 outstanding overall with caring and responsive rated as outstanding and rated outstanding for all population groups.

We rated this practice as outstanding for providing caring and responsive services because:

• Feedback from patients was consistently positive and was higher than local and national averages.
• There were innovative approaches to providing education to patients and the wider community.
• People were truly respected and valued as individuals and empowered as partners in their care

We rated this practice for good for providing safe, effective and well led services because:

• The practice had recently undertaken training and all staff were Dementia Friends.
• 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 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 strongly supported staff in their career development.
• The practice, with other practices in the Clinical Commissioning Group and the wider NHS, had receptionists who were trained as care navigators who signposted patients to the right person at the right time across a variety of health services.

We saw areas of outstanding practice including:

• The practice held regular patient education events. Recent events held were bowel screening, breast and cervical screening for patients with a learning disability, mens health, veterans together and basic life support. We saw evidence where these events had led to, a definite and possible cancers detected, improved screening rates and improvements in the quality of lives of some patients.
• All patients over the age of 16 were contacted and asked if they had served in the military. As a result, 170 patients were now on the practice military veterans register. The practice then organised a Veterans in the Community event. Information including a website and a newsletter was prepared and offered to all the veterans. Training, support and counselling was also offered. Some patients had carried on meeting with some of the other veterans reducing the isolation that some of them felt.
• The practice had provided extensive Cardiopulmonary resuscitation (CPR) training for patients and in the local area. Working with the North West Ambulance Service (NWAS), training started in 2015 and since then approximately 800 people have been trained, the youngest being 12 years old. Heartbeat donated 15 “Annie” dummies to carry out the training. One of the PPG members was funded and trained to deliver CPR training which the practice has opened up to the Milnrow community and businesses. This training led to one patient saving a life as they had the confidence to use the defibrillator. Both patients had since spoken about their experience at CPR sessions and talked about the benefits of the sessions. The practice now has the ability to run the sessions without relying on the availability of NWAS.

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

• Carry out a formal fire drill

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

Dr Rosie Benneyworth BS BM BMedSci MRCGP

Chief Inspector of Primary Medical Services and Integrated Care

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Milnrow Village Practice on 3 February 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 the skills, knowledge and experience to deliver effective care and treatment.

• Feedback from patients about their care was consistently and strongly positive.
• 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.
• Patients said they found it easy to make an appointment with a named GP and that 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 worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet patients’ needs.

One area of outstanding practice was that the practice held regular events for all patients such as a recent bowel screening event and regular cardiopulmonary resuscitation (CPR) training sessions.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice