The Care Quality Commission
  • Doctor
  • Urgent care service or mobile doctor

Skelmersdale Walk in Centre

Overall: Good read more about inspection ratings

The Concourse Shopping Centre, 116-118 South Way, Skelmersdale, Lancashire, WN8 6LJ

Provided and run by:
HCRG Care Services Ltd

All Inspections

11 Mar 2020

During a routine inspection

This service is rated as Good overall. (Previously rated as requires improvement 20 November 2018).

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at Skelmersdale walk-in centre on 20 November 2018. Following our inspection, we rated the practice requires improvement overall and also for the Safe, Effective and Well-led key questions. At our inspection in November 2018, we identified concerns in relation to the identification and monitoring of risks. We also found that staff training was not to the appropriate level in relation to life support and the treatment of children.

Following the inspection in November 2018, we issued a requirement notice for breaches of Regulation 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Good governance and Staffing).

The above inspection report can be found by selecting the ‘all reports’ link for Skelmersdale walk-in centre on our website at

We carried out this announced comprehensive inspection at Skelmersdale walk-in centre on 11 March 2020. This inspection was conducted as part of our inspection programme and to check that improvements had been made following the previous inspection. Our inspection included a visit to the service’s site at the Concourse Shopping Centre, Southway, Skelmersdale.

The head of urgent care is the registered manager of the service. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

As part of our inspection, 34 people provided feedback about the service via CQC comments cards who told us about their experiences using the service. Thirty of them were very positive about the service, one was negative and three were mixed. Patients described the service as excellent and praised the staff for their caring and understanding attitude. They told us they found the service very convenient and the clinicians very caring and professional. A minority of patients said the waiting time to be seen was excessive.

Our key findings were :

  • The service had introduced and maintained comprehensive systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes. There was a blame free culture.
  • The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence-based guidelines.
  • There was a strong focus on quality improvement. Audit was regular, structured and informed by service outcomes.
  • Patients were able to access care and treatment from the service within an appropriate timescale for their needs. Patient feedback on the service was almost wholly positive, with a minority of patients finding waiting times excessive.
  • Staff involved and treated people with compassion, kindness, dignity and respect.
  • Staff at all levels were enthusiastic and demonstrated high levels of knowledge and professionalism. Staff training was viewed as a priority.
  • There was a common focus on improving the quality and sustainability of care.

We saw the following outstanding practice:

  • The service conducted a variety of real-time scenario tests for emergency medical situations which might arise. These were observed, debriefed and any learning identified, and adjustments made to improve future responses. The most recent one related to the identification and processes for dealing with a patient suspected of having contracted the Coronavirus.
  • The provider had recognised that some local patients with limited means needed to travel to the local accident and emergency department, when facilities at the walk-in centre were not appropriate for their needs. As a result, a decision was made to provide a free taxi service for those patients assessed as needing that assistance.

Dr Rosie Benneyworth BM BS BMedSci MRCGPChief Inspector of Primary Medical Services and Integrated Care

20 November 2018

During a routine inspection

Skelmersdale Walk in Centre is operated by Virgin Care Services Limited. The service has approximately 2000 patient contacts per month. Approximately one fifth of patient contacts were children.

The service provides a walk-in and wait service for minor illnesses and minor injuries. We inspected urgent care services.

We inspected this service using our comprehensive inspection methodology. We carried out the announced part of the inspection on 20 November 2018.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

Services we rate

Skelmersdale Walk in Centre had not previously been inspected. We rated it as Requires improvement overall.

We found areas of practice that require improvement in relation to urgent care services:

  • The service did not always have someone on site who was competent to assess and treat children.

  • We had concerns in relation to the level of life support training provided for staff.

  • We found the service did not routinely audit practice against national guidelines and evidence-based practice.

  • The service did not ensure processes were put in place to measure and monitor patient outcomes.

  • The service did not ensure patient pathways complied with best practice guidance to ensure patient treatment was up to date.

  • The service did not maintain an accurate and complete list of risks relating to the health and safety of service users.

However,

  • Staff treated patients with compassion and respect.

  • The service promoted a culture of openness and improvement. Staff were enthusiastic about delivering a high quality service focused on patient centred care.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements to help the service improve. We also issued the provider with a requirement notice that affected the Sklemersdale Walk in Centre. Details are at the end of the report.

Ellen Armistead

Deputy Chief Inspector of Hospitals (North)