Worden Medical Centre

Updated 18 September 2017

Worden Medical Centre is situated in West Paddock in the Leyland area of Preston at PR25 1HR serving a mainly urban population. The building is a purpose-built health centre which has been extended. It consists of two floors and all patient facilities are located on the ground floor. The practice provides level access for patients to the building with disabled facilities available.

There is ample parking provided for patients in the practice car park and the practice is close to public transport.

The practice is part of the Chorley with South Ribble Clinical Commissioning Group (CCG) and services are provided under a General Medical Services Contract (GMS) with NHS England.

There are four male and two female GP partners and one male salaried GP assisted by an advanced nurse practitioner, a nurse practitioner, a community specialist practitioner, three practice nurses and one healthcare assistant. A practice manager, nurse manager, assistant manager and 17 additional administrative and reception staff also support the practice along with a medicines co-ordinator who is employed by the practice and funded by the CCG. The practice is a teaching practice for medical students and also conducts research.

The practice is open from Monday to Friday from 8am to 6.30pm (doors close at 6pm) and extended hours are offered on Saturday from 9am to 11.30am and on Sunday from 8.30am to 11.30am. Appointments are offered from 8.10am to 11.30am and from 2pm to 5.40pm on weekdays and from 9am to 11.20am on Saturdays and from 8.30am to 11.10am on Sundays. When the practice is closed, patients are able to access out of hours services offered locally by the provider GoToDoc Ltd. by telephoning 111.

The practice provides services to 12,517 patients. The practice population is generally comparable to the local and national averages with lower numbers of patients aged between 20 and 35 years of age (17%) than the national average of 21%.

Information published by Public Health England rates the level of deprivation within the practice population group as six on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest. Male life expectancy is the same as the national average, 79 years, and slightly lower for females at 82 years compared to the national average of 83 years.

The practice has a lower proportion of patients experiencing a long-standing health condition than average practices (52% compared to the national average of 54%). The proportion of patients who are in paid work or full time education is lower (55%) than the local and national average of 62% and the proportion of patients with an employment status of unemployed is 4% which is higher than the local average of 3% and lower than the national average of 5%.

Updated 18 September 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Worden Medical Practice on 21 November 2016. The overall rating for the practice was requires improvement with the key questions of safe and well-led rated as requires improvement. The full comprehensive report on the November 2016 inspection can be found on our website at

http://www.cqc.org.uk/location/1-544128956

This inspection was an announced focused inspection carried out on 23 August 2017. This was to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches in regulations that we identified in our previous inspection on 21 November 2016. This report covers our findings in relation to those requirements.

Overall the practice is now rated as good.

Our key findings were as follows:

• At our inspection in November 2016 we found that although the practice had protocols and procedures to safeguard patients from abuse, these were not sufficient to keep patients safe. At this inspection we saw that comprehensive, effective safeguarding procedures had been introduced. These procedures had been agreed with the local safeguarding team.
• Our previous inspection in November 2016 identified that not all staff who were acting as chaperones had been trained or risk assessed for the role. At this inspection, we saw that only staff who had been trained and risk assessed to work as chaperones were acting in this capacity.
• At our previous inspection we saw that there had been no infection prevention and control (IPC) audit carried out for the practice and we recommended that the IPC lead receive training for the role. We saw at this inspection that a comprehensive IPC audit had been carried out and an action plan had been documented which was being addressed. Other spot-check audits were also ongoing. We saw that the IPC lead was booked to attend training to further support the role.
• In November 2016, we found that patient vaccines and samples were sometimes being stored in the same fridge in reception and that the temperature of this fridge was not always monitored daily. At this inspection, we saw that this was no longer the case; temperatures were checked and recorded every working day and staff told us how they separated vaccines and patient samples in different fridges.
• At our last inspection, we found that the oxygen cylinder that was with the emergency medicines and equipment was out of date. At this inspection, we saw evidence of a log of checks on the oxygen cylinders in the practice that included a record of the expiry dates for both the oxygen cylinders and the adult and children’s masks for use with the oxygen.
• In November 2016, we found that there was a lack of risk assessment for assessing, monitoring and mitigating risks relating to the health and safety of service users and staff. At this inspection, the practice showed us comprehensive risk assessments for the premises which identified actions which had been addressed or were planned for completion.
• Our previous inspection identified that blank prescriptions were left in printers in the practice when non-practice staff were using the rooms. We found at this inspection that a new procedure had been introduced to lock these prescriptions away securely when practice staff finished their work.
• In November 2016 we saw that not all practice clinical audits were well-documented and there was evidence of discrepancies in reported results. We recommended that audit documentation was improved for all audits. We were shown two completed audits carried out since our last inspection that were well-documented.
• During our inspection in November 2016, we recommended a review of the Patient Specific Direction (PSD) for staff administering vitamin B12 so that all information was accurately recorded. We found at this inspection that the practice had produced a new pathway for this PSD and amended the template on the computerised patient record to ensure that all information was accurately documented and the correct protocol followed.
• In November 2016, we recommended that the practice review procedures for identifying patients who were also carers. At this inspection, we saw that this process had improved. A member of reception staff was acting as a carers champion, there was a new policy and carers registration form in place, clinical staff had been reminded of the criteria for recognising a patient as a carer and the number of carers identified had increased from 0.8% of the practice list to 0.9%. This work was ongoing.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 September 2017

The provider had resolved the concerns for providing safe and well-led services identified at our inspection on 21 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. The specific findings relating to this population group can be found at http://www.cqc.org.uk/location/1-544128956

Updated 18 September 2017

The provider had resolved the concerns for providing safe and well-led services identified at our inspection on 21 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. The specific findings relating to this population group can be found at http://www.cqc.org.uk/location/1-544128956

Updated 18 September 2017

The provider had resolved the concerns for providing safe and well-led services identified at our inspection on 21 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. The specific findings relating to this population group can be found at http://www.cqc.org.uk/location/1-544128956

Updated 18 September 2017

The provider had resolved the concerns for providing safe and well-led services identified at our inspection on 21 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. The specific findings relating to this population group can be found at http://www.cqc.org.uk/location/1-544128956

Updated 18 September 2017

The provider had resolved the concerns for providing safe and well-led services identified at our inspection on 21 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. The specific findings relating to this population group can be found at http://www.cqc.org.uk/location/1-544128956

Updated 18 September 2017

The provider had resolved the concerns for providing safe and well-led services identified at our inspection on 21 November 2016 which applied to everyone using this practice, including this population group. The population group ratings have been updated to reflect this. The specific findings relating to this population group can be found at http://www.cqc.org.uk/location/1-544128956