Four Acre Health Centre

Updated 13 February 2023

Four Acre Health Centre is located in St Helens at: Burnage Avenue, Clock Face, St Helens, Merseyside, WA9 4QB.

The provider is registered with CQC to deliver the Regulated Activities; diagnostic and screening procedures, maternity and midwifery services, family planning treatment of disease, disorder or injury and surgical procedures.

The provider offered some private appointments which were not reviewed as part of this inspection.

The practice is situated within the Chesire and Merseyside Integrated Care System (ICS) and delivers General Medical Services (GMS) to a patient population of about 8,100. This is part of a contract held with NHS England.

The practice is part of St Helens South Primary Care Network, a wider network of GP practices.

Information published by Office for Health Improvement and Disparities shows that deprivation within the practice population group is in the second lowest decile (two of 10). The lower the decile, the more deprived the practice population is relative to others. A lower level of deprivation can indicate challenges in providing health care. The supply of healthcare services tends to be lower in more deprived areas due to a number of factors but has an increased demand. The population tends to have poorer health status among individuals with a greater need for health services. For example, there may be higher levels of long-term conditions such as those affecting the cardiovascular system and respiratory system.

This practice has higher than local and national average prevalence of hypertension, asthma, chronic obstructive pulomary disease, depression, obesity and diabetes.

According to the latest available data, the ethnic make-up of the practice area is 98.5% white, 1.5% Asian, Black, Mixed, and Other.

The age distribution of the practice population closely mirrors the local and national averages. There are more working age patients registered at the practice.

There is a lead GP and 3 whole time equivalent salaried GPs. The practice has 3.5 whole time equivalent Advanced Nurse Practitioners, a clinical pharmacist, a practice nurse, a GP Assistant, 9 reception/admin staff, a part time counsellor and deputy practice manager. At the time of the inspection the practice manager post was vacant.

The practice is open between 8 am to 6 pm Monday to Friday. The practice offers a range of appointment types including book on the day, telephone consultations and advance appointments. The practice is also a registered training practice for medical students.

Extended access and out of hours is provided St Helens Rota, where late evening and weekend appointments are available.

Updated 13 February 2023

We carried out an announced comprehensive inspection at Four Acre Health Centre on 16, 21 November and 9 December 2022. Overall, the practice is rated as requires improvement.

Safe - good

Effective – good

Caring - good

Responsive - requires improvement

Well-led - requires improvement

Following our previous inspection on 7, 8, 9 and 16 March 2022 the practice was rated inadequate overall and for key questions safe and well-led. Effective and responsive were rated as requires improvement and caring was rated as good.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Four Acre Health Centre on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection to follow up concerns identified from our last inspection.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting staff interviews using video conferencing.
• Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A short site visit.

Our findings

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 found that:

• 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.
• Patients reported difficulty accessing the practice by telephone and reported less satisfaction making an appointment.
• The way the practice was led and managed promoted the delivery of high-quality, person-centre care. Further work was required to embed the governance and oversight of risk into every day practice.

We found one breach of regulations. The provider must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

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

• Take action to improve feedback from patients.
• Continue to improve the uptake of cervical cancer screening and childhood immunisations.

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

I am taking this service out of special measures. This recognises the significant improvements that have been made to the quality of care provided by this service.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services