Slough Walk in Centre - Care Quality Commission

Background to this inspection

Updated 1 June 2017

We undertook an inspection of this centre on 26 April 2017. The centre provides services from Upton Hospital, Albert Street, Slough SL1 2BJ. The service provider is Berkshire Healthcare Foundation Trust.

Slough Walk-in Centre is a purpose built location with good accessibility to all its consultation rooms which are located on the ground floor. The centre serves patients from the surrounding town.

The walk-in service enabled patients to attend and wait to see a nurse following information provided to reception staff. If patients need to see a GP there are slots available for them to access this. The walk-in service treats minor illness and minor injury. It can also refer patients onto other services where they cannot meet patients’ needs, such as A&E.

Patients can also register with the centre as they would with a GP practice and there were approximately 7300 patients registered. The centre’s demographics are very different to the national average in terms of age and ethnicity. The proportion of black and ethnic minority patients is 59% and from other European countries 29%. Local communities have high numbers of people who are new migrants and therefore have limited experience of accessing NHS healthcare.

At the time of the inspection the provider was having difficulty in recruiting new staff due to some uncertainty over commissioning arrangements for the future of the service. There was historically a high turnover of staff at the centre. The manager explained this was due to the difficulties in working at the centre compared to traditional general practice. A lack of consistent staff posed a problem for the provider to meet the ongoing needs of clinical care and governance arrangements. However, action had been taken to ensure consistency in care was provided where possible to patients via amended governance structures.

According to national data there is significant deprivation among sections of the local population. In addition to these challenges the registered population has high prevalence of obesity and a higher mortality rate. The proportion of patients between 25 and 40 is much higher than the national average and the number of over 50s is considerably lower than the national average.

There are three GPs employed at the centre equating to 2.4 whole time equivalent (WTE), two female and one male. There are two long term locums covering a 0.6 WTE post. There is one WTE advanced nurse practitioner, three nurse practitioners, providing one WTE and an emergency care practitioner who provides one WTE. In addition there is one WTE HCA and currently a practice nurse post is out to advertisement, covered by full time locum nurses.

The centre is open between 8am and 8pm seven days a week. This is for walk in patients and for registered patients appointments were available during these times.

Out of hours GP services were available when the centre was closed by phoning 111 and this was advertised on the centre website.

Overall inspection

Good

Updated 1 June 2017

Letter from the Chief Inspector of General Practice

Our previous comprehensive inspection at Slough Walk-in Centre on 9 August 2016 found breaches of regulations and issued a requirement notice for regulation 12 safe care and treatment. We rated the service as requires improvement in providing safe, effective and well-led services and good for providing caring and responsive services. Overall we rated the service requires improvement. Consequently we rated all population groups as requires improvement. The full comprehensive report on the August 2016 inspection can be found by selecting the ‘all reports’ link for Slough Walk-in Centre on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 26 April 2017 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 in August 2016. This report covers our findings in relation to those requirements since our last inspection.

We found the practice had made improvements since our last inspection. Overall the service is rated as good. We have amended the rating for this practice to reflect these changes.

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

During this inspection we found the system of clinical governance covered a comprehensive range of care outcomes and led to improvements.
Learning outcomes were regularly discussed with staff in meetings and significant event outcomes were routinely communicated.
Data from the Quality and Outcomes Framework (QOF) showed significant improvements to clinical care, specifically in diabetes and mental health.
There had been an increase in audit activity’ which had led to specific improvements in patient care.
An improved assessment process for walk-in patients had been implemented to reduce the risk of delays in treating urgent conditions or referring patients onto hospital where necessary.
The number of health checks carried out for patients diagnosed with a learning disability had increased.
Carers support was available and work had been done to try and identify more carers.

Professor Steve Field (CBE FRCP FFPH FRCGP)

Chief Inspector of General Practice